Mood Disorders (cont.), Suicide PDF

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Summary

Prof. Olvera...

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Risk Factors for Mood Disorders

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Biological Risk Factors: Genetics

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Biological Risk Factors: Brain

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● Neurotransmitter s

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depression was described as chem. imbalance; low serotonin but more complex than just that hippocampus especially small (ctrls memory & emotion) cells & networks deteriorate longer the depression mood improves when hippocampus bigger serotonin helps release chemicals that stimulate neurogenesis which helps short genes more likely for depression (depression hereditary)

2-3x increase in risk of inheriting in 1st-degree relatives heritability estimates: ○ 0.37 - 0.50 [of the expression is related to genetics, while other part is related to enviro.] depressive disorders (higher in women) ○ 0.75 - 0.80 for bipolar disorders ■ genetics of mania = more distinct ○ can be equated into percentage ongoing research to i.d. specific groups of genes ○ mania = schizophrenia? trying to see if link here ○ depressive disorders = anxiety disorders? often comorbid prefrontal cortex ○ decision making ○ personality ○ higher-order thinking ○ expression of emotion ○ serotonin & dopamine pathways; memory ○ anterior cingulate cortex ■ goal pursuit ■ motivation, energy to follow thru limbic system ○ hippocampus (learning, memory, imprt impact on mood disorders) ○ amygdala (inhibition, emotion, emotional memory) serotonin & the “permissive hypothesis” ○ original models focused on absolute lvls of NTs (e.g. low serotonin = mood disorder) ○ serotonin → regulates mood ○ also regulates systems of dopamine & norepinephrine ○ not just absolute lvls of serotonin dopamine & mania (link to psychosis) ○ drugs that increase dopamine → hypomania ■ notch under mania; push somewhat towards that to elevate mood but not

Neurohormones

impair (& not just moderate/emotionless mood) ● ●

● HPA Axis ● ● ●

Psychobiological Risk Factors

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● ● ● Psychological Risk Factors ●

● Sociocultural Risk Factors ●

what’s going on w/ NTs? more attn on “stress hypothesis” ○ endocrine disease (e.g. hypothyroidism) → depression ○ chronic stress → reduced dopamine → depression ○ overactive stress response → increased cortisol → depression hippocampus shrinkage ○ similar to anxiety disorders ○ some depression treatments (e.g. exercise, shock therapy ECT) → neurogenesis when have high lvls of cortisol, body will still think it’s under stress & work to counteract it where cortisol is produced hypothalamus (CRH) → anterior pituitary (ACTH) → adrenal cortex (CORT); all loop back (diagram on slide) ○ pos. feedback ○ CRH: c-something… releasing hormone ○ ACTH: adreno-something… hormone ○ CORT: cortisol e.g. when mom’s hippocampus smaller, daughter is similar exhausts whole system, leads to inflammation w/in body, triggers strong stress response & hormones temperament: ability to regulate, attach; how easygoing they are; fairly set/stable; genetic component neuroticism (reacting w/ neg. affect rather than self-soothing) ○ predicts onset of depression sleep and bipolar disorders ○ sleep deprivation as trigger ○ circadian rhythm disruption as trigger cog. theories of depression ○ depressive triad: self, world, future ■ neg. schemas cause cog. biases ○ taking bio. out of picture, looking psychologically @ what’s going on hopelessness theory (“learned helplessness”) ○ stress → anxiety → helpless and out of ctrl → hopeless about coping → depression ○ internal, stable, global stress & life events lead to onset

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Protective Factors

Suicide

Suicide Risk

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interpersonal (humiliation, loss, social rejection) can lead to depression behavioral (goal achievement that inspires or non-achievement that stresses; sleep loss) can lead to mania 50-80% of ppl who experience severe stress are fine marginalized group status lack of social support (risk of depression 80% higher if living alone)

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group activity support groups pos. job/career safety in community physical health school-based programs communication decreased stigma emotional support animals increased or decreased social media healthy outlets parenting programs learn about family history etc.

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2nd leading cause of death for college-aged ppl (18-24) (2010 study) comorbid w/ many mental disorders ideation & behav. ○ intent, lvl of risk

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multidimensional model ○ intense neg. emotions from stressful life events ○ tendency to solve prob.’s by avoiding/escaping aggravated by: ○ poor social support, mood disorder ○ hopelessness, purposelessness ○ substance use (e.g. alcohol is a depressant) ○ learned helplessness strongest predictor = past suicide attempt (can’t only use this as indicator of risk b/c many people die 1st time)

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Suicide Warning Signs ●

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expressing: ○ desire to die (not always as explicit as we think; “I don’t want to be here anymore,” “want to fall asleep & not wake up,” etc.) ○ social disconnection ○ feeling like a burden

● Suicide and the Media

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● Suicide Prevention

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● ● ● Suicide Survivors

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○ no hope for the future, not being able to visualize future ○ evidence of self-harm (hurting body or risky activities) change in: ○ personality ○ behavior ○ sleep patterns (similar to depression) ○ eating habits media reporting of suicides considered risk factor (2003 study) ○ studies about celebrity suicide story were 14.3x more likely to find copycat effect ○ still data around increase in calls to crisis lines following celebrity suicide guidelines have been established ○ no front page/sensational headlines ○ no photos of site, body, or specific details of act ○ no emphasis on grief of family & friends ○ no suggestion that death was inexplicable/inevitable decrease risk factors increase coping/problem-solving ○ find way for unique person to problem-solve in the moment when feeling distressed screening and awareness suicide prevention program @ WWU: BRAVE video -- “ask the question” ○ college student said couldn’t imagine graduating, couldn’t imagine future ○ friends called social worker & she said to put him on phone ○ talked to him about how to work thru things; friends stayed w/ him ○ lot of issues stemming from sexuality ○ saw signs, helped, & he’s around today pursuing dreams evidence that suicide is crisis-oriented & impulsive, & can be prevented permanent “solution” to temporary prob. (not a solution) 94% of contacted ppl who tried to jump off bridge were still alive yr.’s later ○ survivors are very supportive of barriers on bridge ○ in 90’s, over half of ppl opposed barriers (in San Fran. about Golden Gate bridge) ○ barriers started to be built this yr....