Affective disorders

Affective disorders include depression and bipolar disorder.

Depression

In clinical depression, the frequency, intensity, and duration of depression symptoms are out of proportion to the person’s life situation. Major depression leaves people unable to function effectively in their lives, while dysthemia, a less intense form of depression, has more chronic and long-lasting effects that can occur for years, with intervals of normal mood that last for no longer than a few weeks or months at a time.

Depression involves four sets of symptoms: emotional, motivational, cognitive, and somatic. Emotional symptoms – negative mood states, such as sadness, misery, and loneliness – are the main feature, with depressed people losing their capacity to experience pleasure. Cognitive symptoms include difficulty concentrating and making decisions, having low self-esteem, blaming failures and set-backs on one’s own inadequacies, and viewing the future with pessimism and hopelessness. Motivational symptoms include the inability start and perform behaviors that might produce pleasure or accomplishments. Somatic (bodily) symptoms often include loss of appetite and weight, sleep disturbances, fatigue and weakness, and loss of sexual desire and responsiveness.

Bipolar Disorder

Bipolar disorder involves depression (usually the dominant state), alternating with periods of mania (a state of highly excited mood and behavior, in which mood is euphoric and thoughts are grandiose). The person believes that there are no limits to what he or she can accomplish, and does not recognize the negative consequences that may occur if the grandiose plans are acted upon. The manic state is often marked by rapid or pressured speech, and a greatly reduced need for sleep.

Depression has been linked to both genetic and neurochemical factors. Twin and adoption studies show that a predisposition to develop a depressive disorder is likely inherited. A prominent biochemical theory links depression to the under-activity in a family of neurotransmitters (norepineephrine, dopamine, and serotonin) that activate brain areas involved in pleasure and positive motivation. Several highly effective drugs used to relieve depression increase the activity of these neurotransmitters. Bipolar disorder appears to be even more influenced by genetics than unipolar disorder is. Manic disorders may result from an overproduction of the same neurotransmitters that are underactive in depression.

Psychological Factors

Psychoanalytic theorists see depression as a long-term consequence of early traumatic losses and rejections. They believe that these create vulnerability for later expression by triggering a grieving and rage process that becomes part of the person’s personality. Subsequent losses and rejections reactivate the original loss and trigger a reaction to both the current event and the unresolved past loss.

Cognitive theorists focus on the role of the depressive cognitive triad (negative feelings about the self, the world, and the future) that many depressed individuals report that they cannot control or suppress. They describe a depressive attributional pattern in which negative outcomes are attributed to personal causes and successes are attributed to situational causes.

The learned helplessness theory states that depression occurs when people expect that bad events will happen and that they can do nothing to prevent or cope with them. The theory suggests that depression is fostered by attributing negative outcomes to personal (It’s all my fault), stable (I’ll always be this way”), and global (I’m a complete loser”) causes.

The behavioral approach focuses on the vicious cycle of how depression-induced inactivity and aversive behaviors reduce reinforcement from the environment and increase depression further.

Behavioral theorists believe that to begin to feel better, depressed individuals must initially force themselves to engage in pleasure-inducing activities to counteract the depressive affect.




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