BIPOLAR:

THEORIES AND TREATMENT

Princess Zena M. Avery
III-9 BS Psychology




Biological
Psychological
Theories of Mood Disorders
Biological Theories of Mood Disorders
Genetic Theory
Disordered genes predispose people to depression
or bipolar disorder.
Family history studies
Family history studies of people with bipolar disorder
find that their first-degree relatives have rates of both
bipolar disorder and unipolar depression at least two to
three times higher than the rates of relatives of people
without bipolar disorder.
Twin Studies
Twin studies of bipolar disorder have shown that the
probability that both twins will develop the disorder, or
its concordance rate, is about 60% among monozygotic
(identical) twins, compared with about 13% among
dizygotic (non-identical) twins.

-- Specific Genetic Abnormalities

Neurotransmitter
theories
Dysregulation of
neurotransmitters
and their receptors
causes depression
and mania. The
monoamine
neurotransmitters-
norepinephrin,
serotonin, and
dopamine- have been
most researched.

Neurophysiological
(Brain) Abnormalities
Abnormalities in the
structure and
functioning of the
prefrontal cortex,
hippocampus,
anterior cingulate
cortex and amygdala.
Neuroendocrine abnormalities
Depressed people show chronic hyperactivity in
the hypothalamic-pituitary-adrenal axis and slow
return to baseline after a stressor, which affects
the functioning of neurotransmitters.
Psychological Theories of Mood
Disorders
(The psychological theories of depression have focused
on aspects of the environment, of thinking and of a
persons past.)
Behavioral theories
LEWINSOHNS THEORY
Depressed people experience a reduction in positive
reinforcers and an increase in aversive events, which
leads to their depression.
LEARNED HELPLESSNESS THEORY
Depressed people lack control which leads to the belief
that they are helpless which leads to depressive
symptoms.

Cognitive Theories
AARON BECKS THEORY
Depressed people have a negative cognitive triad of
beliefs about the self, the world, and the future which is
maintained by distorted thinking.
REFORMULATED LEARNED HELPLESSNESS THEORY
Depressed people have the tendency to attribute
events to internal, stable, and global factors which
contributes to depression.

RUMINATIVE RESPONSE STYLES THEORY
Depressed people tend to ruminate about their
symptoms and problems.

Psychodynamic Theory
Depressed people are unconsciously punishing
themselves because they feel abandoned by
another person but cannot punish that person;
dependency and perfectionism are risk factors for
depression.

Interpersonal Theories
Depressed people have poor relationships with
others.
Treatments
Pharmacotherapy
Psychotherapy
Social interventions
ECT (Electroconvulsive Therapy)
rTMS (Repititive Transcranial Magnetic
Stimulation)
VNS (Vagus Nerve Stimulation)

Available Types of Pharmacotherapy
Tricyclic antidepressants (TCA)
MAOIs
SSRIs
SNRIs
Atypical antidepressants
Mood stabilizers
Antipsychotics
Psychotherapy in Depression
Supportive
Insight-oriented
Interpersonal
Cognitive-behavioral
Psychodynamic
Individual, group or family

THANK YOU!!!