Depressive Disorders Flashcards
Seasonal depression is also called?
Seasonal affected disorder (SAD)
Most often in fall/winter
Major depressive disorder (MDD) s/s
Depressed mood
Loss of interest or pleasure in usual activities
Impaired social/occupational functioning
Symptoms present for at least 2 weeks
Persistent depressive disorder
comparing to
major depressive disorder?
PDD similar to or milder than MDD
Essential feature is chronically depressed mood
(Most of day, more days than not, for at least 2 years)
Early onset: before 21 y.o.
Late onset: after 21 y.o.
Premenstrual dysphoric disorder (PMDD) s/s
Anxiety, mood swings, decreased interest in activities, depressed mood.
Improves shortly after onset of menstruation
Reoccur for majority of cycles over a year
What can cause substance/medication induced depressive disorder?
Alcohol, opioids, street drugs, anesthetic, cardiac med, steroids, anticholinergic
Impressed mood associated with intoxication or withdrawal
What is psychoanalytical theory?
A loss is internalized and becomes directed against ego
What are the 3 cognitive distortions that causes depression?
Neg expectations of the environment, self, or future
What is transactional model?
No clear explanation for depressive disorder, evidence continues to mount for multiple causation, this model recognizes combined effects on individual’s susceptibility to depression (genetic, biochemical, and psychosocial influences
What does 40%-90% of youth with depression have?
Comorbid psychiatric conditions
What’s used for childhood depression?
Parent and family therapy
Signs of adolescence depression
Behavioral change that lasts for several weeks
What is the third leading cause for teen death?
Suicide (perception of abandonment)
What is the best clue for mood disorder?
Invisible manifested in behavior change that last for several weeks
Whatbis senescense?
Bereavement overload, often confused for neurocognitive disorder
Senescence tx
- Antidepressant medication
- Psychotherapies
- Electroconvulsive therapy (ECT)
What can cause postpartum depression?
Combination of hormonal, metabolic, and psychosocial influences
Postpartum depression s/s
Fatigue, irritability sleep disturbances, loss of appetite and libido
How long can postpartum depression last?
A few weeks to several months
4 spheres of human functioning ex
- Affective: apathy（冷漠）
- Behavioral: social isolation
- Cognitive: hallucination, self-blame, thoughts of suicide
- Physiological: slow down of body
What is transient depression’s symptoms like?
Not necessarily dysfunctional.
1. Affective: sadness, having the blues
2. Behavioral: some crying
3. Cognitive: difficulty getting mind off disappointment
4. Physiological: feeling tired and listless
Mild depression 4 symptoms
Similar to normal grieving.
1. Affective: denial, anger, anxiety, helplessness
2. Behavioral: tearfulness, regression
3. Cognitive: preoccupied with loss, self-blame
4. Physiological: anorexia, insomnia
Moderate depression 4 symptoms
Enduring for at least 2 years.
1. Affective: rejection, helplessness, low self-esteem
2. Behavioral: slow movements, slumped posture, limited verbalization
3. Cognitive: slowed thinking, difficulty concentrating, obsessive and repetitive thoughts
4. Physiological: anorexia or overeating, sleep disturbances, headaches, low energy
Severe depression 4 symptoms
Intensification of moderate depression symptoms
1. Affective: feelings of total despair and worthlessness, flat affect, inability to feel pressure
2. Behavioral: psychomotor retardation, curled-up position, absence of communication, isolation
3. Cognitive: prevalent delusional thinking, confusion, suicidal thoughts
4. Physiological: general slow-down of the entire body
What do you need to assess frequently on patient with depressive disorders?
Suicidal thoughts/ideation
What is something you can do with the patient for their safety?
Encourage patient to help establish a safety plan
How should you make rounds while patient is getting medication?
Make rounds at frequent, irregular intervals
Short term goal for maladaptive grieving
Pt express feeling of loss
Long term goal for maladaptive grieving
Pt express own position in loss
What can you teach maladaptive grieving patients?
Tech about the stages of grieving and behaviors of each stage
Short term goal for patients who have low self-esteem
Participate in own ADL, usually in 5 days
Long term goal for patients who have low self-esteem
Able to solve problems
For patients who feel powerless, what can we do?
Help patient set realistic goals
Help pt identify what they can control
Discuss areas in life that are not in patient’s control
What is individual psychotherapy?
Focus on patient’s current interpersonal relations
What is phase 1 of individual psychotherapy about?
Assessment, education, therapeutic contract
What is phase 2 of the individual psychotherapy about?
Tx to resolve maladaptive grief reaction
What is phase 3 of individual psychotherapy about?
Therapeutic contract terminated, individual has improved relationship skills and functioning
What do cognitive therapy do?
Focus on changing “automatic thoughts”
Ex: personalizing, all or nothing, mind reading, discounting positives
What is electroconvulsive therapy (ECT)?
Electrical currents applied to brain, causing grand mal (generalized) seizure.
Usually do this only if antidepressant med are not effective
What does repetitive transcranial magnetic stimulation (rTMS) do?
Short pulses of magnetic energy, most effective in treating depression, equally effective as pharmacotherapy
What does bright light therapy do?
Reduce melatonin, increase serotonin
Effective for short term tx for SAD
What is vagal nerve stimulation (VNS)?
Electrode implantation under skin
What is deep brain stimulation (DBS)?
Electrode implantation that requires craniotomy
What’s the first line tx for depression?
Psychopharmacology
Can patients stop med abruptly?
No!
What should you educate pt on meds?
- Avoid driving and operating machinery
- Use sunscreen and protective clothing
- Change positions slowly
- Oral care
- No alcohol or smoking
- No double doses
- Carry card describing meds
What should patients taking psych meds carry with them at all times?
A card with all the meds they are taking described on there
What should the patient avoid while taking MAOIs?
Foods high in tyramine!!
What are some foods that are high in tyramine?
Wine, beer, chocolate, coffee, tea, cheese, yogurt, smoked meats, raisins, yeast products, soy sauce
(basically all the good stuff hhh)
