HLTHAGE 1CC3 Lecture Notes - Lecture 4: Dysthymia, Individualism, Biomarker
10 Jan 2017
School
Department
Course
Professor
Major Depressive Disorder
1 or more major depressive episodes without mania
5 or more symptoms within a 2 week period
Depressed mood most of day
□
Anhedonia
□
Weight gain/loss
□
Insomnia/ hypersomnia
□
Psychomotor agitation/retardation
□
Fatigue or loss of energy
□
Worthless/guilty
□
Suicidal ideation
□
Indecisiveness/ difficulty concentrating
□
§
○
•
Persistent DD (Dysthymia)
Low grade depressive
○
•
**Bereavement exclusion (2 months)
Removed from DSM 5 - critics say:
Medicalizing human experience (natural feelings)
○
Doctors should have the autonomy to decide
○
How do you put a number on grief/bereavement?
○
•
Mood Disorder and Gender
Women are 3x more likely to be diagnosed with depression, BPD, (3:2 ratio to men)
Biological?
○
Postpartum? Hormones?
○
Roles? Women play fewer roles (stay at home more and tend to work in more marginal industries)
○
Women are more likely to see doctor?
○
Women are more likely to be victimized?
○
Diagnostic Bias?
○
•
The Great Depression 2.0
Higher rates of depression
Onset is much younger
○
1960 avg. age 30- now less than 15
○
10% of global disability due to depression
○
•
How is this possible? We have more knowledge and access to various treatment options. Some may argue:
Growth of the ‘me’ culture- self focused, less community and family involvement
•
Culture of ‘victimology’- learned helplessness, blame others for our shortcoming
•
Parenting to ‘prevent failure’- neutralizes “good uses” of feeling bad
Learning opportunity
○
Successes feel better after you’ve failed
○
Self discovery
○
“Flow”- state where time seems to stop (when you love something so much) is achieved by overcoming challenges
○
•
By avoiding negative feelings- we’re teaching people When life gets hard we don’t need to persevere
•
Modernization
Diet, Physical Activity, Obesity
○
Individualism, inequality, competition; causes isolation and loneliness
○
•
Increase Substance use (more for younger children)/ substance focused society
•
False epidemic
Diagnostic change (easier to get diagnosed)
○
Stigma reduction- willing to go forward and get help
○
Promoting depression- new language for an old experience
○
•
Social Media and Depression
“Facebook intrusion” linked to lower subjective happiness. Why?
Online social activity is less gratifying than real life
○
Evolutionary comparative value, looking at all people with high social value and less than ourselves
○
Causes Moral Panic
○
Study design- Sadness is natural, Depression is medical clump of symptoms (“social media causes depression”- no it caused someone sadness not a complete medical diagnoses)
○
Perhaps Social Media and depression are less about causation but more about correlation- depressed people are drawn to Facebook
○
Social media predicting depression:
Tweets prior to depression: negative tone, less socially active, heightened health concerns, etc.
§
○
•
Depression and Culture
Specific language usage surrounding mental health
•
Between languages can have translation variation
•
Depression was essentially a punishment for white people vs. African (black people) don’t have the intelligence to conceptualize depression
•
Across culture (Asia): some depression complaints are weighted in Somatization (body pains) vs. mood complaints here
•
Mania more present in the developing world vs. Western culture is depression
•
Bio-marker: Urine, blood test, etc.
•
Treatments:
Psychological Model:
CBT, DBT
○
•
Medical Model
SSRIs
○
•
ECT (argued)
•
Why is it that rates of depression are increasing?
Wednesday, September 21, 2016
Depression
Major Depressive Disorder
1 or more major depressive episodes without mania
5 or more symptoms within a 2 week period
Depressed mood most of day
□
Anhedonia
□
Weight gain/loss
□
Insomnia/ hypersomnia
□
Psychomotor agitation/retardation
□
Fatigue or loss of energy
□
Worthless/guilty
□
Suicidal ideation
□
Indecisiveness/ difficulty concentrating
□
§
○
•
Persistent DD (Dysthymia)
Low grade depressive
○
•
**Bereavement exclusion (2 months)
Removed from DSM 5 - critics say:
Medicalizing human experience (natural feelings)
○
Doctors should have the autonomy to decide
○
How do you put a number on grief/bereavement?
○
•
Mood Disorder and Gender
Women are 3x more likely to be diagnosed with depression, BPD, (3:2 ratio to men)
Biological?
○
Postpartum? Hormones?
○
Roles? Women play fewer roles (stay at home more and tend to work in more marginal industries)
○
Women are more likely to see doctor?
○
Women are more likely to be victimized?
○
Diagnostic Bias?
○
•
The Great Depression 2.0
Higher rates of depression
Onset is much younger
○
1960 avg. age 30- now less than 15
○
10% of global disability due to depression
○
•
How is this possible? We have more knowledge and access to various treatment options. Some may argue:
Growth of the ‘me’ culture- self focused, less community and family involvement
•
Culture of ‘victimology’- learned helplessness, blame others for our shortcoming
•
Parenting to ‘prevent failure’- neutralizes “good uses” of feeling bad
Learning opportunity
○
Successes feel better after you’ve failed
○
Self discovery
○
“Flow”- state where time seems to stop (when you love something so much) is achieved by overcoming challenges
○
•
By avoiding negative feelings- we’re teaching people When life gets hard we don’t need to persevere
•
Modernization
Diet, Physical Activity, Obesity
○
Individualism, inequality, competition; causes isolation and loneliness
○
•
Increase Substance use (more for younger children)/ substance focused society
•
False epidemic
Diagnostic change (easier to get diagnosed)
○
Stigma reduction- willing to go forward and get help
○
Promoting depression- new language for an old experience
○
•
Social Media and Depression
“Facebook intrusion” linked to lower subjective happiness. Why?
Online social activity is less gratifying than real life
○
Evolutionary comparative value, looking at all people with high social value and less than ourselves
○
Causes Moral Panic
○
Study design- Sadness is natural, Depression is medical clump of symptoms (“social media causes depression”- no it caused someone sadness not a complete medical diagnoses)
○
Perhaps Social Media and depression are less about causation but more about correlation- depressed people are drawn to Facebook
○
Social media predicting depression:
Tweets prior to depression: negative tone, less socially active, heightened health concerns, etc.
§
○
•
Depression and Culture
Specific language usage surrounding mental health
•
Between languages can have translation variation
•
Depression was essentially a punishment for white people vs. African (black people) don’t have the intelligence to conceptualize depression
•
Across culture (Asia): some depression complaints are weighted in Somatization (body pains) vs. mood complaints here
•
Mania more present in the developing world vs. Western culture is depression
•
Bio-marker: Urine, blood test, etc.
•
Treatments:
Psychological Model:
CBT, DBT
○
•
Medical Model
SSRIs
○
•
ECT (argued)
•
Why is it that rates of depression are increasing?
Wednesday, September 21, 2016
Depression
Major Depressive Disorder
1 or more major depressive episodes without mania
5 or more symptoms within a 2 week period
Depressed mood most of day
□
Anhedonia
□
Weight gain/loss
□
Insomnia/ hypersomnia
□
Psychomotor agitation/retardation
□
Fatigue or loss of energy
□
Worthless/guilty
□
Suicidal ideation
□
Indecisiveness/ difficulty concentrating
□
§
○
•
Persistent DD (Dysthymia)
Low grade depressive
○
•
**Bereavement exclusion (2 months)
Removed from DSM 5 - critics say:
Medicalizing human experience (natural feelings)
○
Doctors should have the autonomy to decide
○
How do you put a number on grief/bereavement?
○
•
Mood Disorder and Gender
Women are 3x more likely to be diagnosed with depression, BPD, (3:2 ratio to men)
Biological?
○
Postpartum? Hormones?
○
Roles? Women play fewer roles (stay at home more and tend to work in more marginal industries)
○
Women are more likely to see doctor?
○
Women are more likely to be victimized?
○
Diagnostic Bias?
○
•
The Great Depression 2.0
Higher rates of depression
Onset is much younger
○
1960 avg. age 30- now less than 15
○
10% of global disability due to depression
○
•
How is this possible? We have more knowledge and access to various treatment options. Some may argue:
Growth of the ‘me’ culture- self focused, less community and family involvement
•
Culture of ‘victimology’- learned helplessness, blame others for our shortcoming
•
Parenting to ‘prevent failure’- neutralizes “good uses” of feeling bad
Learning opportunity
○
Successes feel better after you’ve failed
○
Self discovery
○
“Flow”- state where time seems to stop (when you love something so much) is achieved by overcoming challenges
○
•
By avoiding negative feelings- we’re teaching people When life gets hard we don’t need to persevere
•
Modernization
Diet, Physical Activity, Obesity
○
Individualism, inequality, competition; causes isolation and loneliness
○
•
Increase Substance use (more for younger children)/ substance focused society
•
False epidemic
Diagnostic change (easier to get diagnosed)
○
Stigma reduction- willing to go forward and get help
○
Promoting depression- new language for an old experience
○
•
Social Media and Depression
“Facebook intrusion” linked to lower subjective happiness. Why?
Online social activity is less gratifying than real life
○
Evolutionary comparative value, looking at all people with high social value and less than ourselves
○
Causes Moral Panic
○
Study design- Sadness is natural, Depression is medical clump of symptoms (“social media causes depression”- no it caused someone sadness not a complete medical diagnoses)
○
Perhaps Social Media and depression are less about causation but more about correlation- depressed people are drawn to Facebook
○
Social media predicting depression:
Tweets prior to depression: negative tone, less socially active, heightened health concerns, etc.
§
○
•
Depression and Culture
Specific language usage surrounding mental health
•
Between languages can have translation variation
•
Depression was essentially a punishment for white people vs. African (black people) don’t have the intelligence to conceptualize depression
•
Across culture (Asia): some depression complaints are weighted in Somatization (body pains) vs. mood complaints here
•
Mania more present in the developing world vs. Western culture is depression
•
Bio-marker: Urine, blood test, etc.
•
Treatments:
Psychological Model:
CBT, DBT
○
•
Medical Model
SSRIs
○
•
ECT (argued)
•
Why is it that rates of depression are increasing?
Wednesday, September 21, 2016
Depression
Document Summary
1 or more major depressive episodes without mania. 5 or more symptoms within a 2 week period. Women are 3x more likely to be diagnosed with depression, bpd, (3:2 ratio to men) Women play fewer roles (stay at home more and tend to work in more marginal industri. 1960 avg. age 30- now less than 15. We have more knowledge and access to various treatment options. Growth of the me" culture- self focused, less community and family involvement. Culture of victimology"- learned helplessness, blame others for our shortcoming. Parenting to prevent failure"- neutralizes good uses of feeling bad. Flow - state where time seems to stop (when you love something so much) is achieved by ove. By avoiding negative feelings- we"re teaching people when life gets hard we don"t need to persevere. Increase substance use (more for younger children)/ substance focused society. Stigma reduction- willing to go forward and get help.
