Depression Flashcards
Mania
Distinct period of abnormally and persistently elevated, expansive or irritable mood
Abnormally and persistent increased goal-directed activity or energy
True manic episode lasts 1+ week
Severe enough to cause more than 1:
Impaired functioning
Hospitalization (prevent harm)
Psychotic features
3/7 sx: “DIG FAST” Distractibility Irresponsibility Grandiosity Flight of ideas Activity/agitation Sleep – less needed Talkativeness – pressured speech, louder
Hypomania
Same mania sx, less severe
4+ days
no impairment in social or occupational functioning
Bipolar treatment
Mood stabilizer
- lithium
- atypical antipsychotics: risperidone, aripiprazole, olanzapine
- antiepleptics : lamotrigine, valproic acid, carbamazepine
If give antidepresent to bipolar -> mania
Lithium
Narrow TI
SE:
Sedation and dizziness
Tremors – first start or increased dose
Arrhythmias – sick sinus sn, bradycardia, heart block
Hypothyroidism, goiter
Polyuria and diuresis– block ADH effects in kidney -> nephrogenic DI
Teratogenic – Epstein anomaly
Bipolar I vs Bipolar II
I: manic episode +/- major depression
II: hypomanic episode + episode of major depression
Cyclothymic ds
Milder bipolar disorder
-mild hypomania sx, mild depressive sx
lasts 2+ yrs
don’t have to be continuous
normal mood lasts only up to 2 mo
Dissociative identity ds
“multiple personality ds”
2+ identities or personalities
MC in women
Assoc w/ sexual abuse
Depersonalization/derealization ds
Persistent feelings of detachment from own body and thoughts
Outside observer, like dream
Dissociative amnesia
Event/series of events
Generalized amnesia of identity and life hx
Major depressive ds w/ atypical features
MC subtype Mood reactivity – respond to + with + Increased appetite or wt gain Hypersomnia Leaden paralysis Hypersensitivity to rejection
Responds to MAOIs
Major depressive disorder w/ peripartum onset
5/9 DIGS CAPES sx 2+ wks
-not just baby blues
during preg or w/in 4 weeks of delivery sx start
postpartum psychosis
- may hurt baby
- > hospitalize
- > anti psychotic meds
- electroconvuslive tx
Major depressive disorder w/ psychotic features
Delusions/hallucinations
Psychotic features always w/ depressive
Major depressive disorder w/ seasonal pattern
Recurrent
Temporal/seasonal patterns – fall/winter
Sunlight exposure
Dx 2+ yrs to establish
No non-seasonal episodes of major depression during this period
Tx: light exposure
Persistent depressive ds
Chronic persistent depression
2+ yrs in adults, 1+ yr kids and adolescents
no more than 2 mo w/o sx in 2 yrs
Prementstral dysphoric ds
Sx connected to menstrual cycle
Severe enough to interfere w/ function
Kubler Ross stages of Grief
“DABDA”
Denial Anger Bargaining Grieving (depression) Acceptance
Major risk factors for suicide
Psychiatric disorders Feelings of hopelessness or worthlessness Impulsivity more likely to act Increased age Males Access to weapons – firearms Hx of suicide attempts
Young females more likely to attempt, older males more likely to succeed
