anxiety/ depression Flashcards
Describe sx of anxiety?
agitation, feeling impending doom, insomnia, tension, tremble, sweat, palpitation, nausea, lump in throat, N+V
Name some triggers of anxiety
caffeine, exams, some meds, skipping meals, socialising, bullying, financial difficulty, bereavement, diagnosis of severe illness
Describe the biopsychosocial aeitology of depression?
Bio: Fhx; low monoamines eg noradrenaline/ dopamine/ serotonin + hypercortisolemia + postnatal
Psycho: OCEAN (personality traits to predispose you to depression - low self-esteem; childhood exp; sensitivity);
Social: disruption in life circumstance eg finance, ill health, bereavement, divorce etc.
describe the sx of depression
low mood; anergia; anhedonia (at least 2 core sx) + 3 or 4 other sx: change sleep; appetite; libido; diurnal mood variation; agitated; loss confidence; loss conc; guilt; hopelessness; suicidal;
How is mild vs mod vs severe depression managed?
Severe: ECT; antipsychotics if psychotic sx
Mod: CBT; IPT; antidepressant
Mild: self-help; physical activity; computerised CBT; couples therapy
Describe the 1st vs 2nd vs 3rd line antidepressants?
SSRI first line → alt SSRI 2nd line → then 3rd line mirtazapine and venlafaxine
Describe some SE of anti cholinergics?
cholinergic sx eg dry mouth, dizzy, diarrhoea, nausea (though tends to settle down), sexual dysfunction and low libido
What are the SEs of mirtazapine?
wt gain and sleepiness
What are the RF for suicide?
RF: difficulty accessing help e.g. phobia, low motivation, pain, language barrier etc. + access to means of suicide + socioecomic eg trauma, migrants, poverty, discrimination + lack of support/ isolation or relationship breakdowns + past suicide attempts; self-harm behaviours; drug or alcohol misuse; fhx suicide
What are the protective factors for suicide?
Protective factors: effective support and treatment; employment or school support; friends and family; problem solving and coping mechanisms; hopes and dreams for the future
How may you risk assess suicide?
Risk assess: Employment; single or relationship, how are things at home, any plans for the future, how would you kill yourself; is there anything stopping you from taking your life
Mx of anxiety?
1: self-help; guided self-help (20-30 mins - 6 weekly sessions); group session (2 hrs long for 6 weeks)
2: GAD- CBT or applied relaxation
3: drug treatment - sertraline first line
propranolol
Benzos - short term solution
What is the screening tool for depression?
Depression - PHQ-9- score 1-27 eg moving slowly or fidget, suicide or self harm thoughts,
What is the screening tool for anxiety?
Anxiety - GAD 7
Feeling nervous, anxious, or on edge 0 1 2 3
2. Not being able to stop or control worrying 0 1 2 3
3. Worrying too much about different things 0 1 2 3
4. Trouble relaxing 0 1 2 3
5. Being so restless that it’s hard to sit still 0 1 2 3
6. Becoming easily annoyed or irritable 0 1 2 3
7. Feeling afraid as if something awful might
happen
What is the screening tool for alcoholism?
Alcoholism - CAGE (cut down, annoyed criticise drinking, guilty, eye openers); AUDIT
