L4 Depression and Bipolar Disorder Flashcards
definition of mental illness
Mental Health Act, 2001
- A state of mind which affects a person’s thinking, perception, emotion or judgement
- Serious impairment of mental function requiring care or treament in the interest of the person or others
key characteristics of mental illness
- clinically recogniable symptoms or behaviours
- associated with distress and interference in personal functioning
what is the definition of learning disabilities and neurodevelopmental disorders
arrested or incomplete development of cognitive and social functioning
depression facts
- affects people of all ages
- one of the most common mental illnesses
- many cases remain undiagnosed due to to lack of seeking help
what percentage of people will experience depression in their lifetime
over 15%
are women or men more often diagnosed
women, possibly due to more help-seeking tendencies
symptoms of depression
- low mood
- loss of interest or enjoyment
- fatigue or reduced energy
- poor motivation
- feelings of worthlessness or excessive guild
- poor concentration
- increased irritability
- psychomotor agitation or retardation
- hopelessness or suicidal ideation
- insomnia or hypersomnia (though usually insomnia)
- loss of or increase in appetite
- weight change (usually related to appetite changes)
- reduced libido
dysthymia
low mood
apathy
loss of interest or motivation
anhedonia
loss of enjoyment
anergia
lack of energy
what is a possible protective factor against depression
- good self-esteem - it’s hard to be depressed when you feel good about yourself
- conversely, changes in self-esteem can be a risk factor
diagnostic criteria for a depression diagnosis
at least one of these three must be present:
- low mood
- loss of interest or enjoyment
- fatigue or reduced energy
causes of depression
- life events (bereavement, job loss, trauma)
- genetic factors
- social adversity
- hormonal factors (post-natal, menopause)
- physical illnesses (thyroid, childbirth, cardiac issues)
- alcohol and drugs
- often no one or clear cause - can be multifactorial
types of depression
- mild depression
- moderate depression
- severe depressive episode
- depression with psychotic features (hallucinations and delusion)
- post-natal depression
- seasonal affective disorder
post-natal depression
- usually lasts a few months post-birth
- most women recover
- however, it places them at risk of further depressive episodes later on
- it is difficult to treat - many medications cannot be taken while breastfeeding
Seasonal Affective Disorder
- not as severe as depression
- can present with all depression symptoms
- most common in northern regions
- best treatment is light therapy
two biological approaches to depression
- antidepressants (SSRIS)
- electroconvulsive therapy (ECT)
psychological approach to depression treatment
CBT (strong evidence base)
other approaches to depression treatment
- mindfulness
- counselling
- self-help strategies
- social support
who are most people with depression treated by
GPs
what percentage of people with depression are referred to psychiatrists
10%
how long does it usually take those hospitalised with depression to recover
5 - 12 months
how long does it usually take less severe cases to recover
within 3 months
when is depression considered chronic
when it persists for 2 years
what percentage of people with depression experience multiple episodes
85%
how common is bipolar affective disorder
affects about 1% of the population
what is bipolar affective disorder characterised by
dramatic mood swings between:
- extreme highs (mania/hypomania)
- extreme lows (depression)
in most cases there is a clear demarcation between phases
what are mixed affective states
simultaneous features of both phases (rarely occurs)
when will psychotic symptoms never occur
during hypomania
symptoms of mania
- Increased energy, activity, restlessness.
- Excessively high, elated, or euphoric mood.
- Irritability.
- Inflated self-esteem or self-worth.
- Pressured speech → talking so fast that separate thoughts blur together.
- “Flight of ideas” → the more mental component of pressured speech, they’re thinking so fast that their mouth can’t keep up.
- Poor concentration or distractibility.
- Insomnia → people won’t sleep for days and won’t experience fatigue.
- Unrealistic beliefs in personal abilities or powers (delusions of grandeur).
- Poor judgment and impulsivity (e.g., shopping sprees, gambling).
- Increased sociability.
- Provocative, intrusive or aggressive behavior.
hallucinations
sensing things that aren’t there
delusions
stongly held irrational beliefs, which the person cannot be argued or challenged out of
psychotic features of bipolar affective disorder
- Psychotic symptoms mirror mood states:
- Manic episode: grandiose beliefs (e.g., having special powers, often having a religious tone - thinking they’re a prophet etc.).
- Depressive episode: irrational guilt, feelings of inferiority, or nonexistence.
biological treatments of bipolar disorder once out of acute phases
- mood stabilisers such as lithium
- antipsychotics such as olanzapine
biological treatments for depressive phases
- antidepressants
risk of causing a manic phase (“manic switch”)
biologial treatments for manic phases
- Antipsychotics and benzodiazepine
- risk of being followed by a depression due to realisation of consequences of actions taken during the manic phase
other treatments for bipolar affective disorder
psychological and social treatments can be used in case-specific interventions
