depressive disorder Flashcards
disruptive mood dysregulation disorder
m or f
treatmnt
- Symptoms: Constant and severe irritability and anger in individuals between ages 6 and 18 y.o.
- Temper tantrums with verbal or behavioral outbursts out of proportion to the situation happen at least three times a week (home and school)
- males
- children
- system base approach
- adressing irritability
- accompied with adhd
- cognitive behavior therapy
- parents can go through therapy
persistent depressive disorder
most common in
symptoms
onset
treatment
- Formerly known as dysthymia
- Low-level depressive feelings through most of each day, for the majority of days
- At least 2 years in adults
- At least 1 year in children and adolescents
- “theyve always been like that”
- female
- insomonia, hypersonmia, decreased/overeating, low energy, difficult paying attention, hopelessness
- onset in teenage years
- treatment: antidepressants and therapy
Premenstrual Dysphoric Disorders
treatment
- Symptom cluster in last week prior to onset of a woman’s period; include
- Mood swings, irritability, depression, anxiety, feeling overwhelmed, and difficulty concentrating
treatment:
- aerobic exercising
- well balanced diet
- sleep
- acupuncture
- light therapy
- contraceptive
Substance-induced depressive disorder
Person does not experience depressive symptoms in the absence of drug or alcohol use or withdrawal
Depressive disorder associated with another medical condition
- Can be caused by kidney failure, Parkinson’s disease, and Alzheimer’s disease
- Symptoms that result from medical diagnoses or certain medications are not considered major depressive disorder
magor depressive disorder
Five (or more) of the following in 2-week period
- Weight loss and appetite changes
- Sleep disturbances
- Fatigue
- Worthlessness or guilt
- Loss of ability to concentrate
- Recurrent thoughts of death
PLUS—at least one symptom is also either
Depressed mood or
Anhedonia
- depression underrecognized in kids
- old adults not considered normal of aging
- comorbidities
anergia
abnormal lack of energy
anhedonia
lack of pleasure in things the perosn found pleasure in
nursing process assessment
Assessment
- Assessment tools
- Assessment of suicide potential
- Key assessment findings
Areas to assess
- Affect: what you see
- Thought processes: distracted, slow on feet
- Mood: sibjective what they express
- Feelings: extended feelings
- Physical behavior: phsycomotor attigation/retardation
- Communication: miminal, allow silence/active listening
- Religious beliefs and - spirituality
- vegitive: not able to do adls (use encouragement)
nursing diagnosis
- Risk for suicide—safety is always the highest priority
- Hopelessness
- Ineffective coping
- Social isolation
- Spiritual distress
- Self-care deficit
- Outcomes identification: goals met and obtained
- Recovery model: evidence based interventions, healing is possible, pt. centered care, being there best self, saftey is prioritized
nursing process planning
Planning
Geared toward
- Patient’s phase of depression
- Particular symptoms
- Patient’s personal goals
nursing process implementation
Implementation
Three phases
- Acute phase (6 to 12 weeks): reduction of depressing symtoms
- Continuation phase (4 to 9 months): prevention of relapse
- Maintenance phase (1 year or more): prevention of further ep of depression
counseling and communication
- active listening
- simple sentences
- not a lot of direct questions
- avoid minmizing there behaviors
health teaching and health promotion
life style changes
promotion of self care activites
nutrition/ sleep/ selfcare deficits
teamwork and saftey
priority
- q15 checks
- coin
- keep an eye on them
nursing process evaluation
Suicide ideation Intake Sleep pattern Personal hygiene and grooming Self-esteem Social interaction
Selective serotonin reuptake inhibitors SSRIs
First-line therapy
Rare risk of serotonin syndrome
Serotonin norepinephrine reuptake inhibitors (SNRIs)
SSRIs may be tolerated better
Tricyclic antidepressants
Anticholinergic adverse reactions
- risk for people who are sucidal
Monoamine oxidase inhibitors
Effective for unconventional depression
- risk for people who are sucidal
ect
need conset, medical work up, cbc, cant be on benzo, cant be on antiseziures (defecto)
transcranial magnetic stimulation (TMS)
mri strength stimuli cortex
deep brain stim (DBS)
inplanting electrodoes regulate abnormal impluses
light therapy
seasonal depression, caredul w headahces anf gitters
exercise
increases serotonin
advanced practice interventions
Psychotherapy
- Cognitive-behavioral therapy (CBT)
- Interpersonal therapy (IPT)
Group therapy
