Introduction to Depression Flashcards
What are the 3 key symptoms of clinical depression & how long should symptoms be present for?
-Depressed mood - definitely abnormal for the individual
-Loss of interest or pleasure in activities
-Decreased energy or increased fatigue
—> at least 1 symptom most days, most of the time for at least 2 weeks
What are some associated symptoms with clinical depression?
-Loss of confidence or self esteem
-Guilt or self-blame
-Suicidal ideas or acts
-Poor concentration
-Agitation or slowing of movements (change in “psychomotor activity”).
-Sleep disturbance
-Change in appetite (dec or inc)
What are some psychological symptoms of depression?
-Low self esteem
-Guilt
-Hopelessness
-Worthlessness
-Suicidal idealisation
What are some biological/somatic symptoms of depression?
-Loss of interest or pleasure
-Loss of libido
-Loss of appetite
-Lack of emotional reactions - “Flattened affect”
-Diurnal variation of mood - depression worse in the morning
-Early morning wakening
-Psychomotor changes
What is psychotic depression?
-Form of severe depression - with either auditory hallucinations or delusional beliefs (or both)
-ALWAYS screen for command hallucinations = tell someone to do something - often harm themselves or others
-Delusions may be persecutors in nature
-Can have nihilistic delusional beliefs (believe in nothing - e.g., they have no blood)
-May believe they are a COVID-19 super spreader = delusions of contamination
What is the spectrum of suicidal ideation?
-One end = tired of life but no suicidal thoughts - but sat they wouldn’t care if went to sleep & didn’t wake up
-Middle = thoughts of suicide but no planning
-Other end = active suicidal planning & suicidal actions or have already attempted to take own life
-So = crucial to ask if have had thoughts that life isn’t worth living & then explore in more detail if these thoughts are present
Who gets depression?
-Per year in UK ~5% of adults have episode of depression
-More common in women than men
-About 1 in 4 women & 1 in 10 men develop depression severe enough to need treatment during lives
How can the causes (risk factors) of depression be broken down?
-Biological
-Psychological
-Social
What are some biological risk factors of depression?
*Medical illnesses:
Anaemia, Pain, COPD, Heart Disease, Cancer, Hypothyroidism
*Family history
*Drug misuse: Alcohol, Opioids, Stimulants
*Prescribed meds: Anticonvulsants, Beta Blockers, TB meds, opioids, some hormonal treatments
What are some psychological risk factors of depression?
Chronic stress due to:
*Bullying
*Abuse
*Social rejection (there are increasing concerns about the negative impact on some people of social media)
*In last year - pandemic had profound impact on many people’s psychological well being & mental health
-Loss of loved ones
-Loneliness
-Fear of becoming infected or of infecting others
-Loss of enjoyable activities
What are some social risk factors of depression?
-Poverty
-Housing problems - including being homeless
-Unemployment
When is inpatient treatment required for depression?
If pose a danger/risk to themselves or others
-Self - may be in form of self-harm, suicide or neglect (stop eating, drinking etc)
Management of mild depression?
-Most cases self resolve
-Advice on alcohol consumption & identify if substance misuse is a problem
-Provide info on self care, sleep hygiene, exercise = lifestyle changes
-Meds = not cope/respond well with antidepressants
-Psychological therapy could be helpful
Management of moderate or severe depression?
-Advice on alcohol consumption & identify if substance misuse is a problem
-Provide info on self care, sleep hygiene, exercise = lifestyle changes
-Psychological therapies - e.g., CBT
-Medication
= psychopharmacology
—> SSRIs = 1st line treatment e.g., Fluoxetine, Citalopram, Sertraline & Paroxetine
-Physical treatments = ECT & TMS (Transcranial Magnetic Stimulation - apply magnets to head)
What does ECT involve?
-General anaesthetic
-Muscle relaxant
-Psychiatrist administers electric shocks
—> small doses of electricity applied across brain = causes seizures in brain (body not affected - toes & eyelids may twitch)
