Depressive Disorder Flashcards
Signs/Findings of Depression:
- Disturbances in daily patterns (sleep, appetite, weight, libido)
- Disturbances in cognition (attention, memory, thinking)
- Disturbances in impulse control (suicide, homicide)
- Disturbances in behavior(withdrawal, lack or pleasure, fatigability)
- Physical symptoms: headache, stomachache, muscle tension
Major Depressive disorder (MDD)
is a single or recurrent episodes of unipolar depression (not associated with mood swings from major depression to mania) resulting in a significant change in the clients normal functioning, (lasting longer than 2 weeks) accompanied by at least 5 of the following specific clinical findings, which must occur almost every day for a min. of 2 weeks, and last most of the day.
Specific Classifications of MDD
- Psychotic features- auditory hallucination, delusions
- Postpartum onset- begins 4 weeks after childbirth, delusions
- Seasonal Characteristics- Seasonal affective disorder (SAD) occurs in winter may be treated by light therapy.
Dysthymic Disorder
A milder form of depression that usually has an early onset, such as in childhood or adolescence, and lasts for 2 years in length for adults (1 year for children). Contains at least 3 findings of depression and may, later in life become MDD
Premenstrual dysphoric disorder (PMDD)
A depressive disorder associated with the luteal phase of the menstrual cycle. Primary manifestations include emotional lability and persistent or severe anger and irritability. Other manifestations include lack of energy, overeating, and difficulty concentrating.
Phases of MDD
- Acute
- Continuation
- Maintenance
Acute Phase
- Severe clinical findings of depression
- Treatment generally 6-12 weeks
- goal is to reduce depressive manifestations
- Assess suicide risk and implement safety precautions or 1:1 observation as needed
Continuation Phase
- Increased ability to function
- treatment 4-9 months
- Relapse prevention through edu., meds, and psychotherapy is goal of treatment
Maintenance Phase
- Remission of manifestations
- May last for years
- Prevention of future depressive episodes is the goal of treatment.
Risk Factors for MDD:
- Family history/ prior episode
- 2x as common in females between 15-40 yrs. than in males
- Very common among clients over 65 yrs.
- Stressful life events
- medical illness
- postpartum female period
- Poor social support
- Comorbid substance abuse disorder
- Being unmarried
Subjective data of MDD:
- Anergia (lack of energy)
- Anhedonia (lack of pleasure in normal activites)
- Anxiety
- Reports of sluggishness or feeling unable to relax an sit still
- Fatigue, GI changes, pain
Objective Data in MDD:
- Sad or Blunted affect
- poor grooming and lack of hygiene
- psychomotor retardation (slowed physical movement, slumped posture)
- Social isolation,
- slowed speech, decreased verbalization, delayed response
Exercise recommendation:
Thirty minutes of exercise daily for 3-5 days each week improves clinical findings of depression and may help to prevent relapse. Exercise should be regarded as an adjunct to other therapies for the client who has major depressive disorder.
Postpartum Depression
10-15% of pregnant women meet criteria for depression they often remain undiagnosed. 2x higher in teen mothers
Situational depression
Dramatic life event, changes (Adjustment disorder)
