Depression, Bipolar, Anxiety Flashcards
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What is depression and how common is it?
Depression is a mood disorder characterized by prolonged sadness or lack of interest in activities. It affects one-third of people at some point and 3% of Canadians currently.
When is depression diagnosed?
Depression is diagnosed when 5 or more symptoms (e.g., depressed mood, insomnia, weight change) occur for at least 2 weeks and interfere with daily functioning.
List the 9 diagnostic symptoms for depression.
- Depressed mood most of the day
- Loss of interest/pleasure
- Weight change
- Insomnia/hypersomnia
- Psychomotor changes
- Fatigue
- Worthlessness/guilt
- Impaired concentration
- Suicidal ideation
What is the difference between exogenous and endogenous depression?
Exogenous is triggered by external events. Endogenous may or may not be related to external stimuli.
What are characteristics of pathological grief and adjustment disorder?
Pathological grief: prolonged grief + guilt. Adjustment disorder: depression after failure or rejection. Both respond better to psychotherapy.
What are features of major and severe depression?
Major: loss of interest, worse in morning, insomnia, weight loss. Severe: same + suicidal ideation and psychoses.
Define atypical depression, dysthymia, SAD, postpartum depression, and bipolar disorder.
Atypical: hypersomnia, hyperphagia, obesity. Dysthymia: chronic mild depression. SAD: winter-related. Postpartum: within 3–12 months of birth. Bipolar: mood swings between mania and depression.
What is the monoamine hypothesis of depression?
Depression is caused by altered monoamine (serotonin, NE, dopamine) levels, receptor sensitivity, or post-synaptic function.
What are the mechanisms of antidepressants?
- Inhibit monoamine reuptake
- Inhibit monoamine metabolism
List the 4 major classes of antidepressants.
- TCAs
- SSRIs
- SNRIs
- MAOIs
What is the MOA and use of TCAs?
Inhibit serotonin and norepinephrine reuptake. Used for major depression.
What are the adverse effects of TCAs?
Anticholinergic effects, sedation, hypotension, seizures, cardiac toxicity, weight gain, sexual dysfunction
What is the MOA and use of SSRIs?
Inhibit serotonin reuptake. Commonly used for major depression.
Adverse effects of SSRIs?
Weight gain, sexual dysfunction, insomnia, serotonin syndrome
What is the MOA and benefit of SNRIs?
Block NE and 5-HT reuptake. Faster onset than TCAs.
Adverse effects of SNRIs?
Nausea, diastolic hypertension, sexual dysfunction
What is the MOA and use of MAOIs?
Inhibit MAO-A (5-HT, NE) and MAO-B (DA). Used for atypical depression and dysthymia.
Adverse effects of MAOIs?
CNS excitation, orthostatic hypotension, hypertensive crisis with tyramine
What is bipolar disorder and its symptoms?
Mood disorder with alternating mania (euphoria, irritability, poor judgment) and depression.
What drugs treat bipolar disorder?
- Mood stabilizers (Lithium, Valproic acid)
- Antipsychotics (Atypical preferred)
- Antidepressants (with mood stabilizer)
How does lithium work and what are its concerns?
MOA unclear; alters glutamate, serotonin. Narrow therapeutic range; toxicity increased with sodium loss.
When is anxiety considered a disorder?
When it causes functional impairment in daily life.
