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NUR372 Mental Health > Alterations in Mood > Flashcards

Alterations in Mood Flashcards

1
Q

Mood Disorders

A

characterized by two extremes of the spectrum of feelings

mania and depression with a “normal mood” in the centre

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2
Q

Pathological Mood

A
  • more intense and prolonged
  • interferes with ADLs
  • pervades an individual’s thinking and emotions
  • there is a specific onset, course, duration and outcome
  • CHANGE in the individual
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3
Q

Facts about suicide

A
  • men are four times more likely to complete suicide..less likely to seek help, more lethal ways
  • suicide can be disguised, ie. MVA or other accidents
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4
Q

Risk Factors for Suicide (women)

A
  • women who never married
  • women with many children
  • ++ incidence in those in work force (harassment, sexism)
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5
Q

Suicide and Age

A
  • most prevalent in young: 15-24 yo
  • transition, identity, bullying
  • very old: over 75..less impulsive with a plan
  • elders are 10 times more likely to complete suicide, realist life assessment
  • loneliness, losses, illness
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6
Q

At Risk Populations

A
  • widowed or divorced and living alone
  • LGBTQ
  • high stress occupations
  • indigenous
  • completed suicide in family
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7
Q

Indigenous Populations and Suicide Rates

A
  • leading cause of death for youth to 44yo adults
  • Inuit youth suicide rates are 11 times the national average
  • family violence, sexual abuse, incarceration, emotional distress from historical trauma
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8
Q

Comorbidities that ++ risk of suicide

A
  • schizophrenia, depression, substance abuse
  • 15% of people with depression commit suicide
  • elderly white male with AIDS, 3 times more likely
  • common within 6 mths of dx
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9
Q

Signs and Symptoms of feeling suicidal (warning signs)

A
  • sudden change in mood
  • sense of hopelessness and helplessness
  • express wish to die
  • increase substance use
  • withdrawn from people and activities
  • changes in sleeping patterns
  • decreased appetite
  • give away possessions, make preparations
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10
Q

Protective Factors for Suicide

A
  • positive social support
  • sense of responsibility to others (having young children, except if pp depression)
  • positive coping skills
  • medical and clinical support
  • religious belief that suicide is wrong
  • self-efficacy
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11
Q

Major Depressive Disorder (MDD)

A
  • depressed mood
  • cognitive, physical and behavioural symptoms that impair functioning

56% of people will experience one epi
29% will experience two epi
15.4% will experience three or more epi

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12
Q

Major Affective Disorder (MAD)

A

a. Major Depression (unipolar)
- only DEPRESSED episodes

b. Bipolar Disorder (manic depression)
- at least one MANIC episode with an epi of depression

c. Bipolar 2 Disorder
- majority of depressed epi with at least one HYPOMANIC episode

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13
Q

Cyclothymic Disorder

A

alternating episodes of depression and hypomania not severe enough to be labelled bipolar

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14
Q

Dysthymic Disorder

A

degree or severity of depression is much less, history of depressive character, chronic low mood lasting two or more years with moderate symptoms

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15
Q

Atypical Affective Disorder

A

used sparingly when symptoms are not severe enough to fit other categories of illness

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16
Q

Biological Model of Major Depression

A

alterations in the levels of CNS neurotransmitters

  • dopamine
  • norepinephrine
  • serotonin

areas that regular appetite, sleep and emotional processes

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17
Q

Behavioural Model of Depression

social learning theory

A

continuous reciprocal interaction between cognition, behaviour and environmental influences

  • stress disrupts social involvement
  • reduced social positive reinforcement
  • negative self evaluation
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18
Q

Behavioural Model of Depression

interpersonal theory

A

the role of environmental and familial factors

- one’s response to change and stress from early developmental experiences in family or social group

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19
Q

Antecedents of depression

A

Children - parental neglect, abuse, rejection, family disharmony, loss of parent

Adults - separation, divorce, marital problems, losses, absence of supportive social relationships

20
Q

Consequences of depression

A

interpersonal difficulties

21
Q

Cognitive Theory

A

Aaron Beck

  • depression stems from a world view based on false beliefs about self, future and the world
  • as depression becomes more severe, ability to think logically decreases immensely

CBT breaks and challenges cycle of thought distortion

22
Q

Learned Helplessness

A

Seligman

  • individuals feels they have no influence over their environment, feelings of powerlessness and helplessness
  • passivity, lack of assertiveness
23
Q

Risk Factors for Depression

A
  • twice as many women
  • no age limit, most commonly 20-50yo
  • family hx of depression, bipolar or alcoholism
    50-70% if two parents with bipolar
    25% if one parent with bipolar
  • personality..not conclusive but trends
    shy, insecure, worry a lot, internalize feelings, take things personally, not assertive, difficulty managing stress
  • recent life stressors
24
Q

Risk Factors for Bipolar

A
  • equal in men and women
  • age, onset around 32 years old
  • increasing age decreases interval between while increases length
  • social class, high achievers and ambitious
  • genetics, 8-18 times more likely
25
Q

Symptoms of Depression

A

Physical

  • vegetative symptoms (biological)
  • physiologic functions disruptions, limbic system that regulates mood
  • sleep disturbance and fatigue
  • loss of or decrease appetite, anorexia
  • decreased libido

Emotional/Cognitive

  • sad, blue, low
  • profound unhappiness, boredom, loneliness, emptiness
  • tremendous anguish
  • constricted or flat affect
  • decreased motivation and diminished sense of pleasure
  • worse in the morning and better as the day goes on
  • distortions in perceptions
  • guilt, pessimism, negativism, self criticism, worthy of punishment
  • time is slowed
  • suicidal thoughts: fleeting, detailed plans, active or more passive like starving self
  • sometimes accompanied by psychosis, delusions or hallucination

Behavioural

  • slow speech, stooped posture, agitated or retarded motor activity, restless
  • may attempt to look cheerful
  • withdrawn from social contact
26
Q

Symptoms of Mania

A

Physical

  • endorse good feeling with increased energy and increased sexual interest and activity
  • sleep disturbances, appear deteriorates, eccentric or flamboyant

Emotional/Cognitive

  • happy, carefree, euphoric, labile
  • expansive moods, heightened sense of pleasure with mundane tasks
  • perceptual distortions: grandiosity, inflated sense of self
  • sexual or religious thoughts
  • poor cognition: concentration, distractible, flight of ideas

Behavioural

  • hyperactive, playful, pressured speech with rhyming and punning, disinhibited
  • poor impulse control: spending money, gambling, engage in senseless activity
  • gregarious, ++ social contact, wear more make up
27
Q

Treatments for Depression

A

a. antidepressants (may take up to 3 weeks)
b. exercise
c. light therapy
d. trans-magnetic stimulation
e. ECT
f. mood stabilizers
g. health promotion/self-care/preventive coping

28
Q

Treatments for Bipolar

A

a. mood stabilizers
b. ECT
c. environmental considerations
d. health promotion and safety
e. psychotherapy
f. personal medicine

29
Q

Interaction strategies (depression)

A
  • frequent and consistent interactions
  • sit
  • one topic at a time
  • focused questions
  • concise and clear questions
  • avoid finishing sentences
  • active listening
30
Q

Interaction strategies (mania)

A
  • calm interactions
  • listen for themes and clarify
  • model slower and lower volume speech
  • reduce environmental stimuli
  • closed-ended questions
  • brief interactions
31
Q

Anxiety Disorders

A

a. Generalized Anxiety Disorder
b. Panic Disorder
c. Phobias
d. Obsessive Compulsive Disorder
e. Post Traumatic Stress Disorder

32
Q

Generalized Anxiety Disoder

A
  • excessive anxiety and worry occurring more days than not for at least 6 months
  • difficult to control the worry
  • 3 out of 6 symptoms
    restlessness, easily fatigue, difficulty concentration, irritability, muscle tension, sleep disturbances
  • impairment
33
Q

Panic Disorder

A

abrupt surge of intense fear or discomfort that reaches a peak within minutes

34
Q

Treatment for Anxiety Disorders

A

a. Anxiolytics
b. anti-depressants
c. psychotherapy
d. biofeedback
e. distraction
f. self-talk
g. mindfulness

35
Q

Fear

A

an unpleasant emotional response to a real or perceived threat

36
Q

Phobia

A
  • fear so intense that it interferes with daily functioning
  • an extreme or irrational fear
  • highly associated with panic attacks
37
Q

Obsessive Compulsive Disorder

A

Obsessions are recurrent, persistent, unwanted ideas, thoughts, images or impulses that are experienced involuntarily, appear to be senseless and feel out of control

Compulsions are a need to perform a repetitive behaviour or to manage incessant thoughts by doing something to try to settle them

38
Q

Interventions for OCD

A

a. CBT (exposure and response prevention)
b. relaxation and meditation techniques to suppress/manage
c. anti-depressants

39
Q

Post Traumatic Stress Disorder

A

caused by a psychologically traumatic event involving actual or threatened death or serious injury to self or others
- symptoms usually begin within 3 months

40
Q

Signs and Symptoms of PTSD

A
  • re-experiencing the event or trauma, intrusive recollection
  • avoidance and emotional numbing
  • depression, cognitive difficulties, changes in sleeping patterns
  • hypervigilance
  • nightmares
  • flashbacks
  • panic, despair, anxiety
41
Q

Interventions for PTSD

A

a. CBT (exposure, desensitization, recognize and manage triggers)
b. trauma-informed nursing care
c. self-soothing techniques; control, grounding
d. psychotherapy, relaxation, group therapy
- medication: anxiolytics, anti-depressants

42
Q

Borderline Personality Disorder

A

pattern of instability in interpersonal relationships, self-image and affects, marked impulsivity

2-3% of population
many experienced traumatic events during childhood

43
Q

Signs and Symptoms of BPD

A
  • impulsive behaviour
  • destructive behaviour
  • large mood component (negative affect, emptiness, isolation, anger, rage)
  • unstable interpersonal relationships
  • self-image instability
  • intense fear of abandonment
  • antagonistic , “splitting”
44
Q

Nursing Care for BPD

A
  • understand the condition
  • non-judgmental approach
  • limit setting
  • assurance that client is safe
  • medication (anxiolytics, antidepressants)
  • hospitalization can be detrimental because of the controls, brief duration is important
45
Q

Antisocial Personality Disorder

A
  • evidence of conduct disorder in early childhood
  • antagonistic behaviour
  • disinhibited behaviour
  • lack of appropriate emotional response
  • lack of remorse
  • finds pleasure and enjoyment at the hands of others vulnerabilities
46
Q

Dissociative Identity Disorder

A
  • multiple personality disorder
  • 2 or more alters with unique identity, feelings and memories
  • complex disorder in response to extreme trauma

NUR372 Mental Health (16 decks)

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