Low Mood Flashcards
pathology behind depression
hippocampal atrophy
low 5HT/noradrenaline activity
how does depression affect cortisol production
increased production
which gender is depression more common in
females
core symptoms of depression
low mood
anhedonia
anergia
what is anhedonia
loss of enjoyment
what is anergia
lack of energy
what are some key features of depression
diurnal variation
- mood varies over the day (typically worse in the morning)
early morning wakening - waking up at least 2 hours before normal time
psychomotor retardation - slowing of thoughts / action s
MSE findings: appearance + behaviour
reduced facial expresión + eye contact
difficult to establish report
poor posture
MSE findings: speech
slow speech
reduced volume
monotone
limited content- short answers
MSE findings: mood + affect
mood: low, miserable, flat, empty, black
affect: depression, stays low throughout, limited reactivity (doesn’t respond or react to changes in subject, context or emotion)
MSE findings: thought
slow thoughts
content: negative, self accusatory, failure, guilt, low self esteem
delusions can occur
MSE findings: cognition
poor memory
trouble planning
thought block
is there loss of insight?
no- typically preserved + aware of symptoms
criteria for diagnosis of depression
at least 2 of the following must be present for >2 weeks
- depressed mood
- anhedonia
- anergia
additional >1 symptoms from:
- loss of confidence
- excessive/ unreasonable feelings of guilt
- recurrent thoughts of death/suicide
- agitation
- sleep disturbance
- change in appetite + corresponding weight change
- decreased concentration
tools used to assess depression severity
Hamilton rating scale
Montgomery- asperg depression rating scale
Beck depression inventory
mild depression
4 symptoms in total
at least 2 core + 2 others
moderate depression
6 symptoms in total
at least 2 core + 4 others
severe depression
8 symptoms in total
at least 2 core + 6 others
what is post baby blues
brief episode of emotional instability - low mood, irritable, tearful
resolves within a few days
what is post-natal depression
onset within 1 month of delivery
most resolve within weeks-year
negative thoughts around ability as a mother/ enstrangement from child
what is puerperal psychosis
onset within weeks of delivery
psychosis + confusion
features of somatic syndrome
4 of the following symptoms:
- anhedonia
- waking in the morning
- loss of appetite
- weight loss
- loss of libido
- lack of emotional response
features of atypical depression
1) mood that reacts strongly to circumstances
2) +2 of:
- weight gain + increase in appetite
- hypersomnia
- leaden paralysis - heavy feeling in arms+legs
- extreme sensitivity
what is dysthymia
persistent, mild symptoms of depression
worse at times of stress
lack of pleasure in life but can still cope
management of low mood
CBT for all levels of depression
SSRIs first line in mild-moderate
if unsuccessful, try another from that class or different class
ECT recommend if severe long term depression that is not responding to treatment
