25 - Depression, Self-harm, Suicide Flashcards
What characterises bipolar (manic) depression?
Excessive elation, irritability, talkativeness
Inflated self-esteem followed/preceded by period of depression
What is unipolar depression?
No mania
What is dysthmyia?
Persistent mild depression (perhaps with severe episodes dispersed within it)
What are the 3 major types of depression?
- Bipolar (manic) depression
- Unipolar depression
- Dysthymia
What questions should be asked when diagnosing depression?
Is the depression:
- an illness or normal unhappiness?
- secondary to a physical illness or alcohol/other drugs?
- presenting with physical symptoms?
- co-occurring with anxiety?
- placing person at risk of suicide?
What are the 3 core features of depression?
- pervasive low mood
- loss of interest & enjoyment (anhedonia)
- reduced energy, diminished activity
What are the screening questions for depression?
How have you been feeling recently?
Have you been low in spirits?
Have you been able to enjoy the things you usually enjoy?
Have you had your usual level of energy, or have you been feeling tired?
How has your sleep been?
Have you been able to concentrate on your favourite television or radio programmes?
What antidepressants are commonly used?
MAOIs, tricyclics, SSRIs
Are MAOIs commonly used?
Generally, been replaced by other antidepressants with fewer side effects (can cause hypertension)
Are MAOIs commonly used?
Generally, been replaced by other antidepressants with fewer side effects (can cause hypertension)
How do SSRIs work?
Monoamine reuptake inhibitor: blocks reuptake of one or more of the 3 major monoamine neurotransmitters, causing increase in monoamines within synapse.
What are TCAs?
Tricyclic antidepressants (monoamine reuptake inhibitors)
What role can exercise play in depression?
Can be as effective as treating mild depression as antidepressants or CBT (cognitive behavioural therapy)
What is ECT?
Electro-convulsive therapy: small electric currents are passed through the brain, intentionally triggering a brief seisure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions.
What is ECT used to treat?
Intractable or psychotic depression
What is Beck’s cognitive theory of depression?
The cognitive triad are three forms of negative thinking that are typical of individuals with depression. These thoughts tended to be automatic in depressed people. Together produce depression.
Forms basis for Cognitive Behaviour Therapy
What forms the cognitive triad for Beck’s theory?
- Negative views of the world (e.g. everyone is against be because I’m worthless)
- Negative views about oneself (I’m worthless and inadequate)
- Negative views about the future (I’ll never be good at anything)
What is Cognitive Behaviour Therapy?
A short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behaviour that are behind people’s difficulties, and so change the way they feel.
What predictable errors did Beck’s find in the way that people with depression people think about themselves/the world?
- Overgeneralisation (fail at one thing so useless at everything)
- Magnification and minimisations (making disasters, failure to take praise)
- Personalisation (taking all the blame)
Study of Winnie the Pooh: what disorders could the animals potentially have?
Eeyore - Depression
Owl - Reading disorder
Piglet - Generalised anxiety disorder
Tigger - ADHD, hyperactivity, impulsivity subtype
Christopher Robin -Possible gender identity disorder
What are cognitive therapy techniques?
Reality testing automatic thoughts (elicit and check evidence for and against)
Changing depressogenic assumptions (e.g. if i make a mistake, it means that I am inept)
What are the 2 main types of self harm?
- Self-poisoning
2. Self-injury
What does self-poisoning involve?
- Prescribed drugs
- Recreational drugs
- Non-ingestible substances
What does self-injury involve?
- Self-cutting
- Jumping from a height
- Attempted hanging
- Swallowing foreign bodies
- Self-burning
What did Hawton find in his 2002 school survey on 15/16 year olds on self harm?
- 13% lifetime, 7% past year (11% girls vs 3% boys)
- 65% cutting, 31% self-poisoning
- Only 6% episodes result in hospital visit (poisoning more likely to lead to hospital)
Describe gender differences and age in self harm
Age gap decreases with age (girls far more likely at ages 11-13 but 1:1 ration at 23-25)
What are potential motivations for self-harm?
- Get relief from state of mind, coping mechanism
- Escape from impossible situation
- Show how much you love somebody
- Show somebody how you feel
- Find out if somebody loves you
- Seek help
- Frighten somebody/make them sorry
- Influence somebody
How does age differ in self-harm and suicide?
Self-harm reduces with age
Suicide increases with age
How does gender differ in self-harm and suicide?
Self-harm M=F
Suicide M>F
How does link to mental illness differ in self-harm and suicide?
Self harm has weak link with mental illness
Suicide has strong link with mental illness
What are the similarities between self-harm and suicide?
- Increasing in young men
- Associated with alcohol misuse
- Occur in the same people
What is suicide contagion?
Exposure to suicide or suicidal behaviours within one’s family, one’s peer group, or through media reports of suicide and can result in an increase in suicide and suicidal behaviours.
What methods are easily available regarding suicide?
- Coal gas
- Paracetamol
- Appeal of high places
- Guns in USA
What % of survivors of near-lethal suicide attempts commit suicide thereafter?
Only 10%
