Exam 5 - Mood and Suicide Flashcards
An individuals sustained emotional tone which influences behavior, personality, and how they perceive the world
mood
the behavioral expression of mood
affect
what are the two categories of mood
bipolar
depression
when does depression become a illness?
when they are unable to adapt
what are the differences between grief and depression?
in grief, mood changes
in grief, they respond to warmth
in grief, they don’t lose connections
what are the 9 diagnostic signs of major depressive disorder?
depressed mood loss of interest and pleasure significant weight loss of gain insomnia or hypersomnia psychomotor agitation or retardation fatigue or loss of energy feelings of worthlessness decreased ability to think or concentrate constant thought of suicide
what has to happen for someone to be diagnosed with major depressive disorder?
they must have 5 or more depressive symptoms for 2 or more weeks
characteristics of persistent depressive disorder?
less severe symptoms of MDD
chronic.. for 2 or more years
what do TCA’s do?
inhibit the reuptake of serotonin and norepinephrine
what do SSRIs do?
block reuptake of serotonin
what do MAOIs do
Prevents inactivation of norepinephrine and
what are the most common side effects of TCAs
orthostatic hypotension
sedation
anticholinergic effects
what are the most common side effects of SSRIs
- sexual dysfunction
- nausea
- weight gain/loss
- CNS stimulation
what is bipolar disorder?
a condition in which mood swings go from depressed to really high
what are the 7 criteria of a manic episode?
inflated self esteem decreased need for sleep more talkative distractibility increase in goal directed activity excessive risky actions lasts a week
what is cyclothymia
more mild form of bipolar disorder
how does cyclothymia differ from bipolar disorder?
less manic and less depressive episodes
many cycles over the span of 2 yrs
what is the goal for treating bipolar disorders?
we want a more stable mood
what are the different types of treatment for bipolar disorder?
lithium
anticonvulsants
antipsychotics
what bipolar disorder treatments need blood tests to measure levels
lithium
anticonvulsants
major concerns with lithium use
excreted by kidneys
lithium and sodium compete!
not safe in pregnancy
adverse effects of lithium at therapeutic levels
NVD Anorexia fatigue, muscle weakness, confusion polyuria and thirst tremor
toxic levels of lithium and adverse effects
gi upset coarse tremors ataxia confusion seizures increase dilute urine excretion
what are some anticonvulsant medications names
depakote (valproate)
lamotrigine (lamictal)
carbamazepine (tegretol)
side effects of anticonvulsant medications
sedation
weight gain
nausea
why are anticonvulsants used for bipolar disorder
they have mood stabilizing effects
why are antipsychotics used for bipolar disorder?
when they aren’t responding to lithium or anti convulsants
what are some antipsychotic drug names?
i. aripiprazole (abilify)
ii. quetiapine (Seroquel)
iii. risperidone (Risperdal)
iv. olanzapine (Zyprexa)
- Profound sense of hopelessness
- History of depression
- History of substance abuse
- Verbalize suicidal thoughts, plans or wishes
- Prior suicide attempt
- Family history of suicide
- History of mental illness
- Physical illness with poor prognosis
all may lead to what
suicide
who is most at risk for suicide
- Has access to lethal methods Such as guns or medications
- Has suffered significant loss or multiple losses (Death of loved one, job loss, financial setback)
- LonelyPoor social network
- Feels ambivalent toward treatment or doesn’t cooperate
- Has impulsive or aggressive tendencies
- Depressive body language
- Eating, sleeping, concentration difficulties
- Using words like hopeless or helpless
- Making statements of finality
- Giving away prized posessions
- Making plans to leave
- Be alert to sudden improvement in mood
example what
suicidal behavior
what are the levels of suicide on the continuum
ideation
suicidal gestures
suicidal attempts
suicide
what is ideation
the thinking of committing suicide
what is suicidal gestures
actions not likely to be lethal and may be a call to help
what is suicidal attempts
lethal action taken with no desire to be saved
what is suicide
act of intentionally killing one self
- Encourage the survivor to talk about the suicide
- Avoid and guide away from blame
- Listen to feelings of guilt and gently present the reality of the situation
- Encourage discussion of the relationship with the victim
- Focus on both positive and negative qualities of the deceased
- Refer for support, resources
is nursing implications for what?
helping the suicide survivor
what is central serotonin syndrome
too much available serotonin available
what is patient education involving the administration of antidepressants
don’t stop taking abruptly
take with plenty food and water, may cause nausea
avoid alcohol
what antidepressant is at most risk of causing withdrawal?
SSRI
what are FDA approved antidepressants for children?
prozac (fluoxetine)
lexapro (escitlopram)
celexa (citralopram)
what antidepressant can be used for children 8 and older
prozac (fluoxetine)
what antidepressant can be used for children 12 and older
lexapro (escitalopram)
what antidepressant has effects from off label use?
celexa (citralopram)
what does affect does burpropion have?
suppress appetite
increase sexual desire and pleasure
what is the common adverse affects of burpropion?
agitation
headache??
what is the most serious effect of bupropion?
seizures
