underlying mechanisms behind depression
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Rona ChongDecember 13, 2012
Psych 30Dr. Brown
Depression
Depressed? The Definition• Major Depressive Episode• A. Depressed mood or loss of interest/pleasure• B. Several of these symptoms for 2 weeks or more:
– Change in appetite or significant change in weight– Consistent insomnia or hypersomnia– Restlessness or slowness– Fatigue or loss of energy– Feelings of worthlessness or excessive or inappropriate guilt – Diminished ability to think or concentrate, or indecisiveness– Recurrent thoughts of death, suicidal ideation
• C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• D. The symptoms are not due to drugs or another illness• E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved
one; the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
Personal Connection
Personal Connection
What this person said…
diagram from Graffiti – Tony White, psychotherapist
Advances in the Neurobiology of Depression
• Genetic• Molecular• Neuroimaging
Genetic Findings
• Shift away from focus on genes affecting monoamines (neurotransmitters)
• New focus on metabolic pathways related to antidepressants– glucocorticoid receptor genes– Monoamine oxidase A gene– BDNF gene– glutamate receptor genes
• Genes related to serotonin reuptake
Molecular Findings
• Peripheral hormone-type factors affect the physiology of the brain depression
• Altered levels of growth/neurotrophic factors– e.g. decreased levels of BDNF
• Increased levels of proinflammatory cytokines• Altered regulation of the hypothalamic-
pituitary adrenocortical axis
Findings from Neuroimaging
• Specific functional abnormalities in neural systems• In reaction to negative stimuli:– Increased activity in amygdala, ventral striatal, and
medial prefrontal cortex• In reaction to positive stimuli (also reward stimuli):– Reduced ventral striatal activity
• Reduced grey matter in amygdala; pathology in neural and glial cells in prefrontal cortex
Findings from Neuroimaging
• Reduced resting activity in dorsolateral prefrontal cortex
The Big Picture
The Bigger Picture
References• Clark, D. A., & Beck, A. T. (2010). Cognitive theory and
therapy of anxiety and depression: Convergence with neurobiological findings. Trends In Cognitive Sciences, 14(9), 418-424.
• Disner, S. G., Beevers, C. G., Haigh, E. P., & Beck, A. T. (2011). Neural mechanisms of the cognitive model of depression. Nature Reviews Neuroscience, 12(8), 467-477.
• Kupfer, D. J., Frank, E., & Phillips, M. L. (2012). Major depressive disorder: New clinical, neurobiological, and treatment perspectives. The Lancet, 379(9820), 1045-1055.
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