american psychologist, and professor of psychiatry,kay redfield jamison, is one of the world's foremost authorities on bipolar disorder.she's spent her career researching, lecturing, and writing seminal books on the condition. a condition that she also happens to havehad her entire adult life. in her memoir, "an unquiet mind," jamisondetails what it really means to be bipolar.
crash diet in 5 days, she writes of not sleeping for days on end,of feeling long periods of euphoria, and filling whole notebooks with her racing thoughts andgrandiose ideas. while in these manic states, she experienceda tremendously inflated sense of self-esteem and did impulsive things that felt good atthe time but had painful consequences, like
going on lavish shopping sprees, engagingin promiscuous behavior, racking up credit card debt, and emptying her bank accounts. but these episodes were followed by emotionalcrashes: crippling bouts of depression that sent her into a suicidal spiral. at the ageof 28, jamison tried to kill herself by taking an overdose of lithium, lapsed into a coma,but thankfully emerged from it determined to find help through medication and therapy. through her research and writing, dr. jamisonhas pioneered our understanding of bipolar disorder, depression, and the nexus of mentalstruggles that we now think of as mood disorders. and she's probably one of the best ambassadorswe have for all those people who live successful,
productive lives with mental illness. just like the anxiety disorders we talkedabout last time, mood disorders are misunderstood. they're diluted by depictions of depressionas something that can be treated with one day at a spa or descriptions of people asmanic depressive just because they were sad yesterday and aren't today. as students of psychology, our job is to understandwhat mood disorders really are, how they manifest themselves, and what might cause them. andas you probably guessed, this can be pretty tough terrain to explore. these disorderscan take people from terrifying highs to pits of despair that seem all but bottomless.
but! in between there's what jamison has called, "a rich, imaginative life" -- all made possible by your moods. we've been talking a lot about terms and conceptsthat mean something different than what you think they mean, but this time, the term "mood"is not one of those. in a psychological context, moods are prettymuch exactly what you think they are: emotional states that are even more subjective and harderto define than the emotions themselves. and while psychologists have defined about10 basic emotions, moods tend to fall into two broadly and infinitely variable categories.you got the good moods and the bad moods. probably the most important distinction betweenemotion and mood is that moods are long-term
emotional states rather than discreet, fleetingfeelings. and "mood-disorders," which are characterizedby emotional extremes and challenges in regulating mood tend to be longer-term disturbances. these include depressive disorders, typifiedby prolonged hopelessness and lethargy, and bipolar disorders, the most prominent of whichinvolve alternating between depression and mania. depression has been called the common coldof psychological disorders. which is not to say that it isn't serious, but it's commonand it's pervasive and it's the top reason people seek out mental health help. we've all felt down before, obviously, oftenin response to a specific loss: a breakup
or a lost job or the death of a loved one. and the fact is, you probably should feelbad at times like those. it can actually be good for a mind and body to slow down, tohelp digest losses that you experience, but in general, sadness is temporary. it's whensadness and grief extend beyond the generally accepted social norms, or plunge into a depththat causes serious dysfunction that you find yourself in the territory of depressive disorders. the dsm-5, our handy (if super flawed) user'sguide to psychological disorders officially diagnoses a major depressive disorder whena patient has experienced at least five signs of depression for more than two weeks.
these symptoms include not just depressedmood, but also significant weight or appetite loss or gain, too much or too little sleep,decreased interest in activities, feeling worthless, fatigued, or lethargic, difficultyconcentrating or making decisions, and recurrent thoughts of death or suicide. so while everyone experiences sadness, depressionis a physiological as well as psychological illness. it messes with your sleep, and appetite,and energy, and neurotransmitter levels, all interfering with the way your body runs itself. plus in keeping with our definition of psychologicaldisorders, to be considered a true disorder this behavior needs to cause the person orothers around them prolonged distress - the
feeling that something is really wrong. just as a person with a severe, generalizedanxiety disorder may never want to leave the house, a clinically depressed person oftenfeels so hopeless and overwhelmed that they have trouble living a normal life. and unlikethe bipolar disorders, the depressive disorders tend to be all lows. you've probably heard of manic depression.it's the outdated term for bipolar disorders. these include those classic dark lows of depression,but also bouts of the opposite - of extreme mania in more severe cases. someone sufferingfrom a bipolar disorder may flip back and forth between normal and depressive and manicphases within a single day or week or month.
and a true manic episode doesn't just meanbeing energetic or happy, it's a period of intense, restless, but often optimistic hyperactivityin which your estimation of yourself and your abilities and your ideas can often get skewed.like, really, really skewed. some patients experience mania only rarely,but when they do, it can be destructive. kay jamison has testified to that. once during a manic episode, she bought upa drug store's entire supply of snake-bite kits, convinced of an imminent attack of rattlesnakesthat only she knew was coming. in another, she purchased 20 books by thepenguin publishing house because she said, "it could be nice if the penguins could forma colony."
in other words, bad judgment is common. andit can get worse. full blown manic episodes often end up inpsychiatric hospitalization, since the risk to self or others can become severe. whenthe highs eventually end, they're often followed by dark periods of depression. when left untreated,suicide or suicide attempts are common, another element of the disorder that jamison herselfcan attest to. like so many things in psychology, the causeof mood disorders is often a combination of biological, genetic, psychological, and environmentalfactors. we know, for example, that mood disorders run in families - genes matter. and you'remore likely to experience a bipolar or depressive disorder if you have parents or siblings whosuffer from them.
studies have of identical twins show thatif one twin has a bipolar disorder, that the other has a seven in ten chance of also beingdiagnosed, regardless of whether they were raised together or apart. and while a stressful life can't give youbipolar disorder, it could trigger a manic or depressive episode in someone with a pre-existingcondition. or start a descent into a major depressive episode in someone who never beforehad experienced depression. in other words, a person who loses a loved one could go fromsad to depressed or slide into a bipolar episode, but it couldn't cause them to have the disorderto begin with. in the case of depressive disorders, for mostpeople, after weeks, months, or even years,
their depression can end, hopefully with thereturn to baseline healthy functioning. world-wide, women tend to be diagnosed withmajor depression more often than men, but many psychologists think this is simply becausewomen tend to seek treatment more. it's also possible that depression in men tends to manifestitself more in terms of anger and aggression, than as sadness and hopelessness. this is just an example of how depressionis much more than just being sad and that the characteristic lack of purpose and helplessnesscan manifest itself in a lot of different ways. looking at mood disorders from a neurologicalperspective, we see that depressed, manic, and average brains show very different brainactivity in neural imaging scans. as you might
expect, a brain in a depressed state slowsdown. while a brain in a manic state shows a lot of increased activity, making it hardfor that person to calm down or focus or sleep. our brain's neurotransmitter chemistry alsochanges with these different states. for example, norepinephrine, which usually increases arousaland focus, is severely lacking in depressed brains, but kind of off the charts duringmanic episodes. in fact, drugs that seek to reduce mania in part do it by reducing norepinephrinelevels. you may have also heard about how low serotonin levels correlate with depressivestates. exercise, like jogging or break dancing or whatever, increases serotonin levels, whichis one reason exercise is often recommended to combat depression. and most medicationsdesigned to treat depression seem to work
by raising serotonin or norepinephrine levels. and of course there's yet another way to lookat things. the social-cognitive perspective examines how our thinking and behavior influencedepression. people with depression often view bad eventsthrough an internal lens or mind set that influences how they're interpreted. and howyou explain events to yourself, in a negative or positive way, can really effect how yourecover from them - or don't. say you were humiliated in the lunch roomwhen someone tripped you and chicken soup flew all over the place, and you sat downon a brownie, and it was just a bad day. a depressive mind might immediately start thinkingthat the humiliation will last forever, that
no one will ever let you live it down, thatit's somehow your own fault, and you can't ever do anything right. that negative thinking, learned helplessness,self-blame, and over-thinking can feed off itself and basically smother the joy out ofthe brain, eventually creating a vicious self-fulfilling cycle of negative thinking. the good news is that the cycle can be brokenby getting help from a professional, turning your attention outward, doing more fun things,and maybe even moving to a different environment. but again, that social-cognitive prospectiveis just part of a much bigger puzzle. positive thinking is important, but it's often inadequate on its ownown when up against genetic or neurological factors.
so mood disorders are complicated conditionsand rarely are they eliminated with a single cure. instead, they're often things you justlive with. and as dr. jamison has shown us, you can live well. today we talked about what mood disordersare, as well as what they aren't. you learned about the symptoms of depressive and bipolardisorders, and the possible biological, genetic, environmental, and social-cognitive causesof mood disorders. thank you for watching this episode, whichwas brought to you by marshall scott and crediblefind.com. thank you so much to allof you that have supported us! to find out how you can become a sponsor or supporter,just go to suppable.com/crashcourse.
this episode was written by kathleen yale,edited by blake de pastino, and our consultant is dr. ranjit bhagwat. our director and editoris nicholas jenkins. the script supervisor is michael aranda who is also our sound designer.and the graphics team is thought cafe.
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