ABNORMAL PYSCHOLOGY ABD 7043 MDM.

NURHAFIZAH BINTI MOHD SUKOR

Presented by: Sharulizam bin Amat ( 3130190 ) Mohd Khairi bin Mohd Shaari ( 3130177 ) Mohamad Zahroni bin Dalgiri ( 3130202 )

MOOD DISORDER: OVERVIEW

Understanding the key concepts & terms In Mood Disorders Types of Depressive Disorders & Bipolar Disorders Symptoms Prevalence Causes Treatments

DEPRESSION

#1 reason people seek mental health services Leading cause of disability worldwide by the year 2020
Source : Firdaus Mukhtar, Tian P. S. Oei .(2011). A Review On The Prevalence Of Depression In Malaysia. Current Psychiatry Reviews, 7, 1-5.

DEPRESSION

Depression is the most common mental illness reported in Malaysia. It is by far the most important and the most treatable condition, and is projected to affect approximately 2.3 million people in Malaysia, at some point in their lives. Yet, depression remains under detected and undertreated in Malaysia.
Source :
Firdaus Mukhtar, Tian P. S. Oei .(2011). A Review On The Prevalence Of Depression In Malaysia. Current Psychiatry Reviews, 7, 1-5.

DEPRESSION

Stressful events at work and in relationships can precede depression.

Early loss of a parent due to death or separation increases later vulnerability to depression. People with more stressors (family members death, job loss, physical assault, marital crisis) have a higher risk for depression.

Often subsides on its own, but 80 percent of those with depression experience another episode within a year.

DEFINITION OF MOOD DISORDERS

Psychological disorders characterized by emotional extremes Two fundamental experiences contribute to mood disorders : depression and mania. Depression: a devastating low with extreme lack of energy, interest, confidence and enjoyment of life Mania:a frantic high with extreme overconfidence and energy, often leading to reckless behaviour

TWO MOOD DISORDERS WELL DISCUSS

Depressive Disorder Bipolar disorder: alternating periods of depression and mania

CLASSIFICATION OF DEPRESSIVE DISORDERS

Depressive Disorders (also called unipolar disorders because no mania is exhibited): Major depressive disorders Dysthymic disorder Depressive disorders not otherwise specified

DEPRESSIVE DISORDER

Major Depressive Disorder: A disorder in which a group of symptoms, such as depressed mood, loss of interest, sleep disturbances, feelings of worthlessness, and inability to concentrate, are present for at least two weeks.

SYMPTOMS OF DEPRESSION

Sad mood, most of the day, nearly every day Loss of interest and pleasure in usual activities

SYMPTOMS OF DEPRESSION

Difficulties sleeping: insomnia or sleeping a great deal Poor appetite and weight loss, or increased appetite and weight gain Loss of energy, great fatigue

TO BE DIAGNOSED AS DEPRESSED

A person must have:

Sad, depressed mood OR loss of pleasure AND four other symptoms

For at least two weeks in a row

OTHER CONDITIONS

People with depression may also have

Anxiety Panic attacks Substance abuse Sexual dysfunction Personality disorders

Important theme: people often, though not always, suffer from more than one disorder at a time.

CONT

DEPRESSIVE DISORDER

Dysthymic Disorder: Characterized by chronic and relatively continual depressed mood that does not meet the criteria for major depression. Pessimism, guilt, loss of interest, poor appetite or overeating, low self-esteem, chronic fatigue, social withdrawal, concentration difficulties.

PREVALANCE OF DEPRESSION

Lifetime prevalence rate of 11 - 17% in US Twice as common in women as in men Occurs most frequently in young adults

BIPOLAR DISORDER

Formerly called manic depression Alternating periods of depression and mania Mania can occur on its own too.

CLASSIFICATION OF BIPOLAR DISORDER

Bipolar Disorders: Characterized by one or more manic or hypomanic episodes and usually by one or more depressive episodes. Bipolar disorder I Bipolar disorder II Cyclothymic disorder

SYMPTOMS OF MANIA

Increase in activity

At work, socially, or sexually

Unusual talkativeness, rapid speech Impression that thoughts are racing Irritable mood Less than the usual amount of sleep needed

SYMPTOMS OF MANIA Inflated self-esteem

Belief that one has special talents, powers, and abilities

Distractibility Excessive involvement in pleasurable but risky activities, such as spending money, excessive alcohol/drug use, reckless driving, and risky sex

BIPOLAR DISORDERS

Bipolar I Disorders: Single manic episodes, most recent episode hypomanic, most recent episode manic, most recent episode mixed, most recent episode depressed, and most recent episode unspecified. Bipolar II Disorders: Recurrent major depressive episodes with hypomanic episode. Manic episodes without depressive episodes are extremely rare.

BIPOLAR DISORDERS

Cyclothymic Disorder (Cyclothymia): Chronic and relatively continual mood disorder with hypomanic episodes and depressed moods that do not meet criteria for major depressive episode. Symptoms present for more than 2 years, never symptom free for more than 2 months

FAMOUS PEOPLE WITH BIPOLAR

BIPOLAR DISORDES

Lets Watch A Movie Clips About Bipolar Disorders

CONT

CONT

PREVALANCE OF BIPOLAR DISORDER

Lifetime prevalence of about 1% Average onset in the twenties Occurs equally often in men and women

OTHER MOOD DISORDERS

Mood Disorder Due to General Medical Condition: Characterized by depressed mood and/or elevated or irritable mood as a direct result of a general medical condition. Substance-Induced Mood Disorder: Prominent and persistent disturbance of mood attributable to use of a substance or cessation of substance use.

SYMPTOM FEATURES AND SPECIFIERS

Specifiers: Patterns of additional features that sometimes accompany mood disorders

SYMPTOM FEATURES AND SPECIFIERS Course specifiers: Rapid Cycling: Episodes occurred 4 or more times during the previous 12 months. Seasonal Pattern: Moods are accentuated during certain times. Seasonal Affective Disorder (SAD): Serious depression fluctuates according to the season. Postpartum Onset: Occurs within 4 weeks of childbirth.

EXPLAINING CAUSES OF MOOD DISORDER

Psychoanalytic perspective Biological perspective Social-cognitive perspective Interpersonal perspective

PSYCHOANALYTIC PERSPECTIVE

When a child loses a loved one

Grief Separation Withdrawal of affection

the child incorporates the lost person into the self, in a fruitless attempt to undo the loss.

PSYCHOANALYTIC PERSPECTIVE

We all harbor unconscious negativity toward people we love. So the person then becomes the object of his/her own hate and anger. Depression is anger turned against the self. Little support for this theory

BIOLOGICAL PESPECTIVE

Genetic influences The depressed brain

GENETIC INFLUENCES

Mood disorders run in families Risk of depression doubles if a parent or sibling is depressed Adopted people with a mood disorder have biological relatives with mood disorders, alcohol problems, or suicide.

THE DEPRESSED BRAIN

Norepinehprine increases arousal and boosts mood

Scarce during depression and overabundant in mania

THE DEPRESSED BRAIN

Serotonin is also scarce during depression Drugs that relieve depression increase levels of serotonin

THE DEPRESSED BRAIN LOOKS DIFFERENT & FUNCTIONS DIFFERENTLY

Abnormalities in the frontal lobe 7% smaller in severely depressed patients Lower levels of electrical activity in the left frontal cortex

THE DEPRESSED BRAIN LOOKS DIFFERENT & FUNCTIONS DIFFERENTLY

SOCIAL-COGNITIVE PERSPECTIVE

How we think affects how we feel and behave. Negative moods feed negative thoughts. Rumination: persistent brooding, constantly rehashing problem inefficiently and without insight

SOCIAL-COGNITIVE PERSPECTIVE

Attribution style Helplessness/Hopelessness

ATTRIBUTION STYLE

Attribution: the reason we give for why an event occurred

Failing a test Getting a promotion Receiving a compliment Having a fight

ATTRIBUTION STYLE

We can say causes of an event were Internal or external Stable or unstable Global or specific

ATTRIBUTION STYLE

People with depression tend to make internal, stable, and global attributions about negative events.

HELPLESSNESS/ HOPELESSNESS

An individuals feelings of helplessness and lack of control over lifes events lead to depression.
No matter what I do, I just cant succeed, so I might as well give up. Can interact with attribution style.

HELPLESSNESS/ HOPELESSNESS
Bad event Attributed to Internal Stable Global factors

Sense of Helplessness: No response I can make to alter the Situation, nothing will ever improve

Depression

INTERPERSONAL PERSPECTIVE

Depressed individuals tend to

have sparse social networks see these networks as providing insufficient support

INTERPERSONAL PERSPECTIVE

Depressed individuals also elicit negative reactions from others. Depressed people behave in ways that cause peers to reject them.

INTERPERSONAL PERSPECTIVE

Depressed people are often low in social skills.

Low interpersonal problem solving Speaking slowly Hesitating More negative self-disclosure

Im such a loser, I just spilled on myself, I never get invited to parties, listen to this stupid thing I did yesterday.

TREATMENT OF MOOD DISORDER

MEDICATION FOR DEPRESSIVE

Tricyclics Antidepressants (TCAs) Elavil Norpramin Sinequan Tofranil Pamelor

Monomine Oxidase Inhibitors (MAOIs)

Nardil Parnate

Selective Serotonin Reuptake Inhibitors (SSRIs) Celexa Lexapro Paxil Zoloft Prozac (most widely used)

SIDE EFFECTS OF DEPRESSIVE MEDICATIONS

Tricylics Antidepressants (TCAs) Blurred Vision Dry Mouth Constipation Difficulty Urinating Drowsiness Weight Gain Sexual Dysfunction Monamine Oxidase Inhibitors (MAOIs) Allergic to tyramine (cheese, red wine) Insomnia Hypertensive Ocasionally Death Gastrointestinal Upset Selective Serotonin Reuptake Inhibitors (SSRIs) Physical Agitation Sexual Dysfunction Gastrointestinal upset

Which one of these antidepressant medication have fewer side effects?

MEDICATION FOR BIPOLAR

Anticonvulsant
Lithium Lithobid Sodium Valproate Carbamazepine Lamotrigine

Antipsychotic Aripiprazole Olanzapine Quetiapine Risperidone

SIDE EFFECTS OF BIPOLAR MEDICATIONS

Lithium Thyroid problem Diarrhea Vomiting Kidney problem Muscle pain

Anticonvulsant Damage an unborn child Kidney problem Nausea Sleep problem Headche

Antipsychotic Blurred vision Dry mouth Constipation Weight Gain Sensitivity to the sun Drowsiness

PSYCHOTHERAPY
COGNITIVE BEHAVIORAL THERAPY ( CBT ) INTERPERSONAL PSYCHOTHERAPY ( IPT )

FAMILY THERAPY

PROBLEM SOLVING THERAPY

How much time does it take?

COGNITIVE BEHAVIORAL THERAPY ( CBT )

# The most common therapy being used

# Therapist will help the client to identify the negative depressive # Replace the negative thoughts with healthy & positive attitudes

# Therapist help the client to develop effective coping behaviors and

skills ( Problem-Solving Skills ) # At the end of each session, the therapist will give homework assignments # This task is to help in increasing a persons activity level, monitor thoughts & mood and practice interpersonal skills.

INTERPERSONAL PSYCHOTHERAPY ( IPT )

# A short-term therapy # Usually, more focusing on the problematic relationships # The therapist will help the client to identify interpersonal disputes ( marriage conflict ) # The therapist tries to adjust the lost of relationship ( death ) # The therapist will help to acquire new situations (getting married)

# The therapist will identify and correct deficits in social skills

(maintaining relationships)

FAMILY THERAPY ( FT ) * http://www.helpguide.org/mental/bipo lar_disorder_diagnosis_treatment.ht m

# This therapy is focusing on the strain cause in family. # Therapist will addresses the issues. # Tries to restore a healthy and supportive home environment. # Tries to educate family members about the disease.

# Working through problems in the home.

# Improving communication between family members.

PROBLEM SOLVING THERAPY ( PST ) * http://www.dcoe.health.mil

# This is a newer approach. # This therapy provide work through a step by step process. # Try to define the problems that are face of. # Try to learn & apply structured problem solving

techniques.
# Provide the necessary therapy.

TECHNOLOGIES TREATMENT

ELECTRO CONVULSIVE THERAPY ( ECT )

DEEP BRAIN STIMULATION ( DBS ) MAGNETIC SEIZURE THERAPY ( MST )

TRANSCRANIAL MAGNETIC STIMULATION ( TMS )

ELECTROCONVULSIVE THERAPY (ECT)

DESCRIPTION
A machine is used to send small electrical currents to the brain These currents cause a seizure that lasts about 30 seconds. Treatment is usually repeated 2 or 3 times a wek.

SIDE EFFECTS
Confusion Memory loss

FDA APPROVAL
Not been oficially reviewed through the FDAs standard process because of was developed long time ago.

TRANSCRANIAL MAGNETIC STIMULATION ( TMS )

DESCRIPTION A special electromagnetic device is placed on the scalp in order to send magnetic field pulse to parts of brain that help regulate mood. Doesnt invove injection or incisions. Treatment session lasts 30 to 40 minutes. SIDE EFFECTS Scalp pain Discomfort Dry mouth Sleepiness Trouble with memory FDA APPROVAL FDA approved the TMS device in October 2008.

DEEP BRAIN STIMULATION ( DBS ) DESCRIPTION Experimental treatment that uses electrical impulses to activate areas of the brain related to mood.

SIDE EFFECTS
Bleeding in the brain. Stroke Breathing Heart problems Movement disorders Seizures

FDA APPROVAL
Still under research and not yet aprroved by FDA.

MAGNETIC SEIZURE THERAPY ( MST ) DESCRIPTION Uses powerful magnetic fields to activate parts of the brain associated with mood. Similar to ECT. SIDE EFFECTS Similar to ECT but shorter recovery times. FDA APPROVAL Still under research.

PSYCHO-SPIRITUAL TREATMENT
http://www.fiqh.org/about/chicagoland/Syeikh Omar Baloch

USEFUL WORK

examples of the Prophets and the Pious

PRAYER

BELIEF IN GOD

PSYCHO-SPIRITUAL TREATMENT
1. Work towards increasing your Imaan by increasing the performance of righteous deeds. 2. ( 16: 97 ): Whoever works righteousness, male or female, and has faith, verily, to him We will give a good life that is good and pure, and We shall pay them certainly a reward in proportion to the best of what they used to do.

3. The person becomes resilient, his willpower becomes stronger.

4. He becomes more patient, the hope of reward is further increased.

PSYCHO-SPIRITUAL TREATMENT
1. The Prophets and the Pious undoubtedly suffer more distress in this world than any other people. Each person is tested according to their strength. One thing is for sure that when Allah (swt) takes a liking to a person. He tests him.
2. (6:152) No burden do We place on any soul, but that which it can bear

3. A man will be tested according to the strength of his faith. If his faith is strong, then the distress with which he is tried will be greater; if his faith is weak, he will be tested in accordance with the level of his faith.

PSYCHO-SPIRITUAL TREATMENT

1. Seek refuge in prayer (salaat)

2. ( 2:153) Allah says: O you who believe! seek help with patient perseverance and prayer (salaat); for God is with those who patiently persevere.

PSYCHO-SPIRITUAL TREATMENT
1. Keep your self busy with useful work, the pursuit of beneficial knowledge and strive in the path of Allah. 2. Keeping one self busy in those activities that bring one closer to Allah (swt) are of great benefit. Reciting the Holy Quraan regularly or listening to the Holy Quraan being recited is a very beneficial act to overcome ones anguish and 1 anger.

3. Sincerity and devotion in worship is more important than the amount of worship one performs as this will truly relieve anxiety. It is important that the work with which you keep yourself busy in, is something that you like to do and is pleasing to Allah (swt). It will then be more effective in bringing about the desired good results.

SUICIDE

15-20% of mood disordered patients commit suicide 50% of completed suicides occur as a result of a mood disorder Suicide rates among Canadian adolescents have doubled over the past 30 years Ratio of attempted suicides to completed suicides are 10:1 More women than men attempt suicide, however, men are 4x more likely to kill themselves

SUICIDE: DURKHEIMS CLASSIFICATION

egoistic

sense of meaninglessness sacrifice self for the group social crisis traumatic conditions

altruistic

anomic

fatalistic

TREATMENT OF SUICIDAL INDIVIDUALS

crisis centres/hot lines medication involuntary hospitalization psychotherapy

reduce lethality negotiate agreements offer support expand perspective

ABNORMAL PYSCHOLOGY ABD 7043 MDM. NURHAFIZAH BINTI MOHD SUKOR

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ABNORMAL PYSCHOLOGY ABD 7043 MDM. NURHAFIZAH BINTI MOHD SUKOR

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