Depression/Mania/Suicide

Question 1

What are the 2 key distinguishers for MDD

Answer 1

must cause significant dysfunction with no other explanation

Question 2

What are the antidepressant withdrawal symptoms

Answer 2

• flu like symptoms
• sleeping trouble
• anxiety
• tingling sensation
• hypertension
• sweating
• tremors
• nausea

Question 3

What are the anticonvulsant prototype drugs and what do they treat

Answer 3

Carbamazepine and valproate

treat mania and seizures

Question 4

What is the purpose of ECT? How does it work? How many treatments does it take to be effective?

Answer 4

Purpose:
- patients with poor response to antidepressants

How: causes seizure that stimulates brain chemistry to correct chemical imbalance of depression

Treatments: 6-15 to be effective

Question 5

What are the pre op and post op nursing interventions for the patient preparing for ECT

Answer 5

Pre Op

• NPO, remove jewelry, VS, voids, IV, and O2
• sedation and muscle relaxant administered

Post Op:

• short term memory impairment may be present
• may be confused and tired with a headache

Question 6

What are acute suicide risk factors

Answer 6

• psychiatric illness
• impulsivity
• situational stressors (legal, occupational, financial, relational)
• active substance abuse/dependence
• active SI
• plan, intent, means, rehearsal
• active self mutilation

Question 7

What are the chronic suicide risk factors

Answer 7

• hx of psychiatric illness
• previous attempts
• substance abuse/dependence
• age, gender
• chronic SI
• self mutilation
• chronic medical problem
• chronic pain
• unattached social status
• family hx of suicide attempts

Question 8

What is the difference between mania and hypomania

Answer 8

Mania:

• VERY elevated for at least 1 week not attributed to other causes
• flight of ideas, inflated self esteem
• risky behavior and poor judgement

Hypomania:

• same sx but less severe than mania
• at least 4 days duration
• NEVER psychosis
• sx don’t cause major effects on functioning

Question 9

What is the difference between bipolar 1 and 2

Answer 9

1:
- most serious with one episode of MANIA and one episode of depression
- may include psychosis

2:
- more common with one or more hypomanic alternating with depressive episodes
- no full mania or psychosis