Depression Flashcards
state the secondary symptoms of depression?
poor appetite with marked weight loss disturbed sleep psychomotor retardation decreased libido difficultly concentrating feelings of self worthlessness, inappropriate guilt recurrent thoughts of death and suicide
what are some differentials for depression?
BAD schizophrenia anorexia nervosa dysthymia substance misuse dementia sleep disorders neurological disorders physical illness medication SEs (b blockers)
what are the 5 stages of grief?
denial anger bargaining depression acceptance
what is the management for mild depression ?
low intensity psychological interventions focussed on sleep hygiene, anxiety management and problem solving techniques
antidepressants should only be used if symptoms persist 8 weeks or previous Hx of depression
what is the management for moderate depression ?
combination of antidepressants and high intensity psychological intervention
- SSRI is recommended
what is the management for severe depression ?
rapid specialist mental health assessment with inpatient admission consideration or ECT
what is the management for recurrent depression ?
intervene early continue antidepressants CBT psychoeducation normalise recurrence
what are some life style options for depression?
exercise yoga social interaction reading clubs mediation poetry rest from work - always plan a phased return
what follow up is considered for depressed patients ?
investigate response to any interventions any side effects and their compliance alcohol and drug misuse suicide risk safe guarding for children promote healthy lifestyle options reflection on positive changes
what are the indications for ECT ?
prolonged/severe mania
severe depression
catatonia
what is the typical course length of ECT?
6-12 sessions
what are CIs to ECT?
CIs to general anaesthetic
no consent
what antidepressant is recommended for <18yrs?
fluoxetine (SSRI)
what antidepressant is recommended for ischaemic heart disease?
sertraline
what blood tests should be done before an SSRI?
FBC (anaemia due to GI bleeds) and U&Es (hyponatraemia)
