DEPRESSIVE DISORDERS Flashcards
A mood disorder that causes a persistent feeling of sadness and loss of interest
Depression
Painful feelings come in waves
Grief
Natural response to a loss
Grief
Self-esteem is maintained
Grief
Dysregulation in serotonin (5HT), NE, Dopamine systems
Biogenic Amine Theory
Weak ego and punitive superego
Psychoanalytic Theory
Feelings of worthlessness and self-loathing
Depression
Mood and interest are decreased
Depression
Etiology of Depressive Disorders
-Genetic
- Biogenic Amine Theory
-Psychoanalytic Theory
- Object Loss Theory
-Learned Helplessness
Abandonment or separation from a significant other during the first 6 months of life
Object Loss Theory
At least 2 weeks of depressed mood or loss of interest
Major Depressive Disorder (MDD)
Major Depressive Disorder has atleast 4 of the following
-Appetite and /or weight disturbance
- Sleep disturbance
- Psychomotor agitation or retardation
- Fatigue
- Feelings of worthlessness
- Recurrent suicidal thoughts
Depressed mood for atleast 2 years
Persistent Depressive Disorder (Dysthymia)
Manifestations of Persistent Depressive Disorder (Dysthymia)
-Appetite and/or weight disturbance
-Sleep disturbance
- Fatigue
- Feelings of worthlessness
- Feelings of hopelessness
- Poor concentration or difficulty making decision
Milder form of depression
Persistent Depressive Disorder
First Line treatment of depressive disorders
SSRI
Second line treatment of depressive disorders
Atypical, Cyclic antidepressants
Third line treatment of depressive disorders
MAOI
Key nursing interventions of depressive disorders
-Explain to the patient the importance of continued intake of antidepressants even if it takes time to show the desired effects
-WOF suicidal tendencies especially when energy returns during antidepressant therapy
Involves the delivery of an electrical impulse to the brain to cause a seizure
Electroconvulsive Therapy (ECT)
Indications of ECT
-Unresponsive to antidepressants
- Patients who experience intolerable S/E at therapeutic doses
- Pregnant women
- Actively suicidal patients
Pre-Procedure Care of ECT
-Facilitate signing of informed consent
- NPO post-midnight
- Remove nail polish
- Instruct to void before procedure
-Start IV line
Pre-Procedure Medications of ECT
-Atropine
-Methohexital
-Succinylcholine
To reduce secretions (anticholinergic)
Atropiine
for immediate anesthesia (barbiturate)
Methohexital
for neuromuscular blocking effect
Succinylcholine
Side effects of ECT
-Mild confusion/brief disorientation
- Fatigue
- Headache
- Short-term memory loss
Post-Procedure Care of ECT
-Mechanically ventilate with 100% oxygen until the patient can breathe unassisted.
-Monitor for respiratory problems.
-Reorient patient (to time, place, person) as he or she emerges from a groggy state.
-Administer benzodiazepines, as needed for agitation.
Atypical
Pertains to teenager
Melancholic
Happens to elderly and adults
Negative aspect of melancholic
Despair
