depression Flashcards
healthy mood
- individuals are able to experience a full range of emotions appropriate to situation
- changes in mood are restored to harmony through adaptation
depression
- sadness
- despair
- pessimism
- loss of interest/pleasure
- change in eating/sleeping patterns
- vague somatic symptoms
- anhedonia
- diminished libido
depressive disorders
impairment of
- interpersonal function
- social function
- occupational function (go to work, but do nothing)
co-morbidities of depression
- etoh abuse/dependence
- OCD
- anxiety
major depressive disorder (MDD)
- s/s at least 2 wks
- no mania
- not r/t substances
- not r/t GMC
classifications of MDD
- single or recurrent
- severity
- seasonal patterns
- psychosis or no psychosis
causes of depression
- deficiency in norepinepherine & serotonin
- dopamine, acetycholine
- elevated HPA activity
- thyroid dysfunction
- genetic/familial factors
hippocampus in depression
- memory impairments
- feeling worthless, hopelessness, guilt
amygdala in depression
- anhedonia
- anxiety
- decreased motivation
hypothalamus in depression
- increased or decreased sleep & appetite
- decreased energy & libido
frontal cortex in depression
- depressed mood
- difficulty concentrating
cerebellum in depression
- psychomotor retardation
- agitation
learned helplessness
animals exposed to an electrical stimulation where they could not escape. later, given the opportunity to escape, reacted with helplessness and made no attempt to escape
cognitive theory
cognitive distortions
-negative expectations of self, environment and future
ages 3-5 in depression
- accident proneness
- phobias
- aggressive
ages 6-8 in depression
- vague physical complaints
- aggression
- cling to parents/avoid new people & challenges
ages 9-12 in depression
- morbid thoughts
- excessive worrying
- self-hurting actions
teens in depression
- difficulty to recognize d/t perception of normal emotional stressors of that age
- major cause of suicide
- SSRIs are not effective with teens, increased chance of suicide
elderly in depression
- most common psych illness
- bereavement overload
- highest suicide rate
premenstrual dysphoric disorder
- not official in DSM-IV
- 1 wk prior to period
- depressed mood
- excessive anxiety
- mood swings
- decreased interest in activities
- goes away after onset of period
dysthymic disorder
- milder than MDD
- down in the dumps for at least 2 years
- always grumpy
- don’t usually get treated
assessment in depression
- affective
- behavioral
- cognitive
- physiological
tx for depression
- group tx
- CBT
- family tx
- peer support groups
- meds (NE/S 5HT reuptake inhibition or antipsychotics)
- vagal nerve stimulation
- phototherapy
indications for ECT
- depression
- psychotic s/s
- psychomotor retardation
- neurovegetative changes - mania
- very dangerous behavior
- those who do not tolerate/fail to respond to lithium - acute schizophrenia
contraindications for ECT
increased ICP
side effects/risks of ECT
- death
- permanent memory loss
- brain dmg
postpartum depression
- affects your functioning as a mother
- acute, insidious
- 4 wks within childbirth
- psychotic, moderate, maternity blues
psychotic postpartum depression tx
- antidepressant (expressed in breast milk)
- supportive psycho tx, group tx
moderate postpartum depression tx
- supportive psycho tx
- assistance with home mgmt
maternity blues tx
no tx, only reassurance
