33 Happy Moments Write 33 Happy Moments! Background of “33 Happy Moments” Chin Shengt'an's...
-
Upload
moris-summers -
Category
Documents
-
view
232 -
download
1
Transcript of 33 Happy Moments Write 33 Happy Moments! Background of “33 Happy Moments” Chin Shengt'an's...
33 Happy Moments
•Write 33 Happy Moments!
•Background of “33 Happy Moments” Chin Shengt'an's Thirty Three Happy Moments (17th century), "moments when the spirit is inextricably tied up with the senses." (Supposedly written while Chin was stuck in a temple for 10 days due to rain.)
Referred to in Lin Yutang’s The importance of living (1937) in which Lin describes happiness as “sensuous” – meaning coming from the senses. And that we recognize that we must enjoy/honor the senses throughout our lives (30,000 mornings).
Relate this to Kathe’s talk
Unipolar - Bipolar Chronic - Acute Agitated – Slow Neurotic – Psychotic
Unipolar - Bipolar Chronic - Acute Agitated – Slow Neurotic – Psychotic
The continuums of Mood Disorders
Depression symptoms
Diagnostic Exercise
What are the symptoms and diagnosis?
a. Case studies on the video clips
1. VHS -- Program 8 (Mood Disorders)
2. Faces DVD
Depression symptoms
• Cognitive • Poor concentration, indecisiveness, poor self-esteem, hopelessness, suicidal thoughts, delusions, memory problems
• Physiological and Behavioral
• Sleep or appetite disturbances, psychomotor problems, fatigue,
• Emotional • Sadness,anhedonia (loss of interest or pleasure in usual activities), irritability
Major Depression
Dysthymic Disorder
5 or more symptoms including sadness or loss of interest or pleasure
3 or more symptoms including depressed mood
At least 2 weeks in duration
At least 2 years in duration
Nu
mb
er
of
sym
pto
ms
Du
rati
on
Severity and diagnosis
DysthymiaDysthymia
MajorDepression
MajorDepression
DysthymiaDysthymia
Clinical Description Clinical Description
Melancholic– Occurs within Major Depressive Episode – Near-complete absence of the capacity for pleasure– Strong biological component (e.g., psychomotor
retardation; early morning awakening; significant anorexia)
Melancholic– Occurs within Major Depressive Episode – Near-complete absence of the capacity for pleasure– Strong biological component (e.g., psychomotor
retardation; early morning awakening; significant anorexia)
Feature Specifiers in Mood Disorders
– Onset within four weeks following birth– Spontaneous crying long after the usual duration
of “baby blues” (3-7 days postpartum)– Lability of mood -- can be of a psychotic nature– Suicidal ideation
– Onset within four weeks following birth– Spontaneous crying long after the usual duration
of “baby blues” (3-7 days postpartum)– Lability of mood -- can be of a psychotic nature– Suicidal ideation
Postpartum Onset
– SAD– Episodes during certain seasons (usually winter)– Typically characterized by anergy, hypersomnia,
overeating, weight gain, and a craving for carbos
– SAD– Episodes during certain seasons (usually winter)– Typically characterized by anergy, hypersomnia,
overeating, weight gain, and a craving for carbos
Seasonal Pattern
Major Features Major Features Experience Both
– Manic Episodes
– Major Depressive Episodes
Roller Coaster of Mood
Experience Both– Manic Episodes
– Major Depressive Episodes
Roller Coaster of Mood
Mania and Hypomania Mania and Hypomania
Elevated Mood Decreased need for sleep
Elevated Mood Decreased need for sleep
Grandiosity Grandiosity
Increased Activity Increased Activity
More talkative More talkative
Causes of Mood Disorders
Biological
Psychological
Socio-cultural
• Genetic contribution (heritable vulnerability in mood disorders). Example: Bipolar
Biological Factors in Mood Disorders
0
10
20
30
40
50
60
70
MZ twins DZ twins Sibs, parents,children
Biologicalparents of BP
adoptees
Second-degreerelatives
Generalpopulation
• Neurotransmitters
•Monoamines – Dopamine, Norepinephrine, Serotonin
• Evidence
•Reserpine (hypotensive agent) breakdown of monoamine storage in
vesicles depression
•Antidepressants work on increasing MAs
•MAO Inhibitors
•SSRIs
•Decreased CSF levels of 5-HIAA in patients with severe depression
(and in completed suicides, post-mortem analysis)
Biological Factors in Mood Disorders
• Endocrine Factors
•Stress and its neurochemical impacts
•Chronic glucocorticoid exposure monoamine depletion &
hippocampal cell atrophy (memory dysfunction)
Biological Factors in Mood Disorders
• Brain factors
•Activity in the multi-nodal depression “circuit” (i.e.,
connections between and among the PFC, nucleus
accumbens, overactive anterior cingulate cortex [Cg25])
Biological Factors in Mood Disorders
Deep Brain Stimulation for Treatment-Resistant DepressionHelen S. Mayberg, Andres M. Lozano, Valerie Voon, Heather E.
McNeely, David Seminowicz, Clement Hamani, Jason M. Schwalb, and Sidney H. Kennedy
Neuron, Vol 45, 651-660, 03 March 2005
• Brain factors
• Effort-driven Rewards Center
• Nucleus accumbens-striatum-PFC (emotion-movement-
thinking)
• Lifestyle-depression link (hypothesis regarding increasing
depression with decreasing effort / use of our hands)
Biological Factors (in concert with behavioral factors) in Mood Disorders
www.kellylambert.com
Stressful Life Events Learned Helplessness Rumination Attributional Style / Negative
cognitions
Stressful Life Events Learned Helplessness Rumination Attributional Style / Negative
cognitions
Internal (“I blew it”) Stable (“I’ll blow it again”) Global (“”I blow it in tons of situations”)
Internal (“I blew it”) Stable (“I’ll blow it again”) Global (“”I blow it in tons of situations”)
CD Article (neighborhood characteristics)
CD Article (neighborhood characteristics)
Social-cultural support
• Men get depression DVD clips (treatment section)
Treatments for Mood Disorders
• Medication (prescribed and herbal)
• Electroconvulsive therapy (ECT)
• Repetitive transcranial magnetic stimulation
• Vagus nerve stimulation
• DBS
• Light therapy
• Exercise
Biological Treatments for Mood Disorders
See “Manufacturing Depression”
Medications Medications Tricyclic Antidepressants MAOI’s SSRI’s Herbal (e.g., St. John’s Wort) Lithium Anti-convulsants
Tricyclic Antidepressants MAOI’s SSRI’s Herbal (e.g., St. John’s Wort) Lithium Anti-convulsants
Psychological Treatments for Depression
• Behavioral Therapy– Increase positive reinforcers and decrease aversive events by teaching the
person new skills for managing interpersonal situations and the environment
• Cognitive-Behavioral Therapy– Challenge distorted thinking and help the person learn more adaptive ways
of thinking and new behavioral skills
• Interpersonal
• Existential
• Psychodynamic Therapy– Help the person gain insight to unconscious factors to facilitate change in
self-concept and behaviors
Cycle of Psychological TreatmentsThe risk of suicide and life interference can be reduced by shortening
the duration of MDEs with effective acute-phase treatments, including pharmacotherapy, interpersonal psychotherapy, and cognitive–behavioral therapy . We define acute-phase treatments as those applied during an MDE with the goal of reducing depressive symptoms and producing initial remission. Responders to some acute-phase treatments (e.g., CT) may receive some protection from relapse–recurrence , but prevalent relapse–recurrence after successful antidepressant treatments has long been recognized as a serious limitation of these interventions Consequently, continuation-phase treatments (e.g., pharmacotherapy, interpersonal psychotherapy, CT) may be applied to sustain remission of an MDE and reduce the probability of relapse–recurrence. Continuation-phase treatments can match the “modality” used in the acute phase or differ in modality compared with the acute-phase treatment (e.g., acute-phase pharmacotherapy followed by C-CT
Vittengl et al., JCCP, Vol 75(3), Jun 2007. pp. 475-488.