Depression

Question 1

Based on the DSM V, someone must have 5 or more of the following 9 symptoms present during the same 2-wk period and present a change from previous functioning. List the 9 symptoms and what does at least one of the symptoms be?

Answer 1

One of the symptoms must be either depressed mod or loss of interest or pleasure.

1) depressed mood most of the day, nearly every day made by oneself or others
2) anhedonia
3) significant weight loss/weight gain; decrease or increase in appetite
4) insomnia or hypersomnia nearly every other day
5) psychomotor agitation or retardation nearly every day
6) fatigue or loss of energy nearly every day
7) feelings of worthlessness or excessive or inappropriate guilt nearly every day
8) diminished ability to think or concentrate or indecisiveness, nearly every day
9) suicidial ideations

Question 2

What is atypical depression?

Answer 2

more likely to have weight gain and hypersomnia, report a feeling of heaviness in the arms and legs (leaden paralysis), craving for carb-rich food

Question 3

What is pseudodementia?

Answer 3

cognitive symptoms in depressed elderly often misdiagnosed as dementia

Question 4

What is diurnal variation?

Answer 4

more depressed in AM, better in PM

ex. Melancholic type depression

Question 5

What is seasonal affective disorder? How to treat?

Answer 5

MDD usu assoc with shorter days in winter, usu with atypical symptoms, treat with full-spectrum light exposure, psychotherapy, antidepressants

Question 6

What is masked depression?

Answer 6

person seems stoic; is depressed with vague physical ailments but unaware/in denial of depression; more typically seen in elderly pts, OCD/narcissitic personality as well as ppl who believe they have no time to be depressed.

Question 7

What are some possible medical causes of depressive symptoms?

Answer 7

• hypothyroidism
• cushing’s syndrome
• anemia
• brain injury, stroke
• vitamin deficiency
• obstructive sleep apnea

Question 8

What’s the monoamine deficiency theory and monoamine receptor excess theory in depression?

Answer 8

decrease levels of DA, 5-HT and NE and high levels of receptors may cause depression

Question 9

What are some effects of stress and cortisol on development of depression?

Answer 9

Stress leads to higher cortisol levels which destroy brain derived neurotrophic factors (BDNF)

Question 10

List the 3 frontline anti-depressants?

Answer 10

SSRI
SNRI
NDRI

Question 11

Anti-depressants take up to 8 weeks to work. What’s the fastest most effective way to improve depression?

Answer 11

Shock treatment

Question 12

What are some “augmenting” strategies for when antidepressants alone aren’t enough?

Answer 12

• lithium
• thyroid hormone
• atypical antipsychotic

Question 13

List 4 other neurostimulation techniques in treatment of depression

Answer 13

• vagus nerve stimulation
• transcranial magnetic stimulation
• deep brain stimulation
• transcranial direct current stimulation

Question 14

What is learned helplessness in depression?

Answer 14

keep failing to get away from negative situations –> feeling of helplessness and hopelessness

Question 15

Best treatment for depression: 1) anti-depressants 2) therapy 3) both

Answer 15

both