lifespan depression from ppt (and tiny bit from readings) Flashcards
assessment findings of depression in children
Restlessness Inability to concentrate Hyperactivity May be misdiagnosed as ADD or ADHD Highly emotional or flat affect Lying to relieve anxiety
If kid has consistently high emotionality it may indicate depression
assessment findings in depressed young adult/adolescent
Change in hygiene, usually diminished
Lack of interest in usual activities
Less social activity or major shift in friendships
More time alone
Unable to rouse self from bed/TV/video games
Self medication?
Tears or lashing out ++ (more emotional)
Or much less emotional
Cutting, self mutilation
Decreased apetite
If you see sudden change in YA social behaviour, if they are no longer grooming themselves this can be depression
should you let a teen create their daily routine or should they be very regimented and follow a strict schedule
(this is accoring to ledger house a place for teens in Vic)
Very regimented. They are often living in very chaotic situations and the security of the routine is comforting
are males or females more at risk of depression in teens
• In adolesc it is twice as common in females
if you are new to a unit of teens should you go talk to them about their issues and start making decisions about their care?
If you are new, don’t engage in conversations about their issues unless it is general. All specific concerns, decisions and disclosures must go to the primary worker(s)
All care discussion and care decisions must go through primary workers.
t or f. rules create a feeling of safety
t
when providing care teens like to see many new faces?
freq alterations to their care plan are good?
BE CONSISTENT with staffing, there should only be one primary at the most two workers running the show.
BE CONSISTENT with care plan and follow through
what kind of antagonizing behaviour should nurse be ready for with teens?
Children/Teens may try to split or “triangle” new staff that don’t know the rules. (push boundaries and manipulate)
what are the basics of behaviour shaping
There are many models of care however the basics are:
Positive behaviour is recognized/rewarded
Negative behaviour is given no mileage
Daily check ins and goals are established they must be SMART
As much control is given to the patient as possible
what phases can you expect for kid oing through depression
Expect a “honey moon” phase while all is going well and the transition seems smooth
Expect a “sabotage” phase where the child pushes back against rules and the workers
Expect a swing back to middle ground where some behaviours are improved and others need work and support
from text
what mnfts of depression might you expect in kids and adolescents thatre different than in adults
the mnfts are often similar but:
-symtoms of anxiety which can be internalized or external behav abnormalities
-eg fear of
somatic symptoms eg stomach aches and headaches maria emphasized that it can show up as GI symptoms for kids!
who is psychosis less likely in
-in major depressive disorder the kids are less likely to have psychosis
how might mood be in a teen
they may be irritable instead of sad
when does suicide risk for adolescents
in mid teens
as we age our mood declines and this is natural?
Depression is one of the most common mental health problem for older adults, but it is not a normal part of aging.
who is most likely to be depressed?
o adult in LTC
in community
in hospital
In hospital 12 – 45%
In the community 14 – 20%
In LTC 40 - 90%
when older pt has depression what are they at risk of
will their depression come back?
Depression late in life is associated with significant functional decline, family stress, greater risk of development of medical illness and reduced recovery of medical illness, and premature death from suicide of other causes.
Depression is a recurrent condition, particularly when it begins in later life.
non modifiable risk factors of depression in o adult
Old age Male gender Being widowed or divorced Previous attempt at self-harm Losses (e.g., health status, role, independence, significant relations)
potentially modifiable risk factors of dep in o adult
Social isolation
Presence of chronic pain
Abuse/misuse of alcohol or other medications
Presence & severity of depression
Presence of hopelessness and suicidal ideation
Access to means, especially firearms
how does depression present in o adult
Remember that depression in the elderly does not necessarily present with sadness or a typically depressed state.
symptoms are more somatic
Pay attention to nutrition and diet, elimination, sleep, pain as these may be contributing to depression or depression may be expressed within these systems.
what is depression often assoc with in o adult
medical comorbidities
what must you ask abt in assessment of o adult?
All assessment should include asking directly about suicidal ideation, intent & plan.
who are you gathering info from and what info?
Collateral information from family and friends is essential to determine:
Normal mood & personality
Normal functioning
Changes from normal
Stressors
*** Remember that this information too has its limitations.
what could cause depressive symptoms or confound your assessment of o adult
Many somatic symptoms mask or mimic psychiatric symptoms in the elderly.
Remember to include the medical conditions and medications the older patient has or takes; these can confound or cause some psychiatric symptoms.
Consider sensory deficits when conducting assessments (ie. Hearing loss), and the pace of conversation may need to be slower.
Pay attention to nutrition and diet, elimination, sleep, pain as these may be contributing to depression or depression may be expressed within these systems.
what does SIG E CAPS stand for?
S!!leep disturbance low I!!nterest excessive feelings of G!!uilt decreased E!!nergy problems with C!!oncentration changes in A!!ppetite P!!sychomotor retardation or agitation thoughts of death or S!!uicide.
sleep, interest, guilt, energy, psychomotor, suicide
male or female who is more at risk of suicide in o adult
male much higher
