Depression & Depression/Psychosis-Post Partum Flashcards
Depression criteria
- major: one or more major depressive episodes (depressed mood or loss of interest or pleasure in nearly all activities) must be present for at least 2 weeks
- 4/7 of the following: sleep disruptions, change in appetite or weight, difficulty concentrating, lack of energy, psychomotor agitation or retardation, excessive guilt or feelings of worthlessness, suicidal ideation
risk factors for depression
- prior episode of depression
- family history
- lack of social support
- stressful life event
- current substance use
- medical comorbidity
- economic difficulties
what medical conditions is depression associated with
- endocrine disorders
- cardiovascular disease
- neurologic disorders
- autoimmune conditions
- viral or other infectious diseases
- certain cancers
- nutritional deficiencies
- direct physiologic effect of a substance
nursing assessment for depression
assess for neurovegetative symptoms: appetite & weight changes, dehydration in older adults, sleep disturbance, decreased energy, tiredness, fatigue, mood (anhedonia), affect (downcast), negative thought content, feelings of helplessness, cognition and memory impairment
hypersomnia
- prolonged sleep episode at night or increased daytime sleep
initial insomnia
difficulty falling asleep
middle insomnia
waking up during the night and having difficulty returning to sleep
Tricyclic
Antidepressant
- Amitriptyline
- Clomipramine
- Nortriptyline
Side effects
- anticholinergic
Tricyclic
Antidepressant
- Amitriptyline
- Clomipramine
- Nortriptyline
Side effects
- anticholinergic
SSRIs
selective serotonin reuptake inhibitors
Side effects
- Nausea
- Weight gain
- sexual dysfunction
- dry mouth
- dizziness
- tremors
- vision changes
Sertraline
Fluoxetine
Nursing interventions for depression
- Therapeutic relationship is MOST effective tool
- Establishingtrustand a supportive relationship
psychotherapy treatment for depression
cognitive therapy, behaviour therapy, interpersonal therapy, family & marital therapy, group therapy,
pharmacological treatment of depression
SSRI’s, tricyclic, SNRI, SARI, NaSSA, NDRI
- antianxiety meds (benzos), mood stabilizers, antipsychotics
side effects of depression medication
nausea, vomiting, diarrhea, changes in appetite or weight, dry mouth, yawning, dizziness, headache, anxiety, tremors, fatigue
- What are the ‘baby blues’?
Characterized by emotional lability, crying easily and for no apparent reason, a let-down feeling, restlessness, fatigue, insomnia, headache, sadness, anger
Symptoms are usually mild and short lived
The “blues” are normal.
- How long do the baby blues usually last?
Start 2-3 days after childbirth and last for up to 2 weeks (Often goes way 10-14 days after delivery)
Perinatal Depression
Some women may experience a deep and ongoing depression which lasts much longer
Risks of ECT
- Although Generally safe, risks and side effects may include:
- confusion:
Immediately after treatment for a few minutes to several hours) Rarely, confusion may last several days or longer.
More noticeable in older adults. - Memory loss
Some people have trouble remembering events that occurred right before treatment or in the weeks or months before treatment or, rarely, from previous years. - Physical side effects
Nausea, headache, jaw pain or muscle ache
what is ECT
- General anesthesia and small electric currents are passed through the brain, intentionally triggering a brief seizure
- Causes changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions
- What are the signs & symptoms of Perinatal depression
- lack of interest in baby,
- negative feelings towards baby,
- worry about hurting the baby,
- mother lacks concern for herself,
- lack of energy & motivation,
- feelings of worthlessness & guilt,
- changes in appetite or weight,
- sleeping more or less than usual,
- recurrent thoughts of death or suicide,
- loss of pleasure
- Increased anxiety due to need to care for newborn
- Trouble feeling connected to your developing baby (called poor fetal attachment)
- Crying frequently
Causes of Perinatal Depression
- exact reason unknown
- interrelated causes & risk factors contribute: hormonal changes, physical changes, stress
perinatal psychosis
- rare but serious disorder that can develop after childbirth
- characterized by loss of contact with reality
- considered a medical emergency
- high risk of suicide or infanticide, hospitalization usually required
S/S of perinatal psychosis
hallucinations, delusions, rapid mood swings, bizarre behaviour, inability or refusal to eat, extreme agitation & anxiety, suicidal thoughts & actions, confusion & disorientation, thoughts of harming or killing their baby
- When does Perinatal/Peripartum Depression usually develop?
- 50 % of major depressive episodes begin prior to delivery
- Can be applied to the current or, if full criteria are not currently met for a major depressive episode, most recent episode of major depression if onset of mood symptoms occurs during pregnancy or in the 4 weeks following delivery.
