Chp 15 depression and anxiety Flashcards
Clinical depression dx requires
aka major depressive disorder
five or more symptoms occurring on most days of the week for more than TWO weeks
AND must be associated with some sort of impairment at home
Depression coincides with other mental health issues such as…
Alcohol use disorder - 40%
Drug use disorder - 17%
Anxiety - 41%
Personality d/o - 14%
Binge eating disorder, moreso with obese individuals
Screening questionnaire name and score indicator
PHQ-9
Score of 5 or greater = possible depression - referral
Evidence based tx for depression (3)
1) medication
2) psychotherapies
3) brain stim therapies
Psychotherapies are…
behavioral activation
cognitive behavioral therapy
interpersonal therapy
problem solving therapy
ACT
Self control therapy
What do psychotherapies do?
focus on helping the client learn healthy coping skills
avoid negative thinking patterns
practice emotional regulation skills
Brain stimulation therapies are…
ECT
Transcranial stimulation
Vague nerve stimulation
Why is exercise not recommended consistently for depression?
Lack of awareness of its efficacy - mixed research results
skepticism re: the evidence
skepticism that pts will follow through
Anxiety defn
characterized by nervousness, fear, and/or worry.
Can be acute or chronic
Chronic anxiety – dx criteria
Sx must last 6 months or longer and be severe enough to interfere with ADLs, relationships and/or work
Identifying anxiety and stress, what does it gauge?
High score is?
Alternate ID test
10 item Perceived Stress Scale
Gauges the level of stress a person has been experiencing
27 and higher indicate high stress – at risk for depression and/or anxiety disorder – REFER to HCP
Generalized Anxiety Disorder 7 Item (GAD-7)
Treatment options (3)
Medication
Psychotherapies
Meditative therapies
First line tx for anxiety disorders is?
Antidepressants
Effective psychotherapies?
Highly fear based anxiety d/o benefit from what type of therapy?
CBT - cognitive based better for rumination or obsessive thoughts
EXPOSURE based – structured approach to helping someone confront the fear stimulus
Best responders to meditative therapies are?
people with SUBCLINICAL anxiety and/or stress
Higher or lower intensity exercise associated with negative mood?
Higher
What should guide intensity of exercise with depression/anxiety
Continuous self monitoring of how pleasant/unpleasant the exercise is - adjust intensity PRN
Behavioral strategies (6)
1) mood monitoring - KEY STRATEGY
2) goal setting
3) positive reinforcement
4) social support
5) dealing with negative thinking
6) distress tolerance
Goal setting, why/benefit?
Confidence ruler, what rating to pursue a goal?
provides structure for forward motion and for progress to be MEASURED
80% or 8 on 1-10 scale
Low motivation? 2 approaches
1) encourage client to think about how the healthy behavior ties into things he/she/they value
2) collaboratively structure behavior to enable client to accomplish something else that is important
Positive reinforcement - headline take away
Reviewing multiple metrics of success during each session, validating, providing affirmations
Distress tolerance defn
Results of low distress tolerance?
Best strategies to deal with this?
one’s perceived capacity to tolerate physical discomfort or emotional distress
avoiding or stopping the activity causing it
Acceptance based strategies
3 acceptance based strategies and how they work
1) mindful awareness - tolerating the discomfort - view it as a subjective experience that eventually subsides
2) acceptance – acknowledging discomfort is present, but knowing it does not DEFINE the experience
3) commitment to values - knowing that escaping discomfort is NOT more important than the values driving the lifestyle changes
