Low Mood Flashcards
what does euthymic mood mean
normal mood
what does hypothermic mood mean
elevated mood
what does cyclothymic mean
low mood
what is anhedonia
loss of enjoyment/pleasure
what is anergia
lack of energy
what is amotivation
lack of motivation
what is diurnal variation
(mood) varies over the day
what is early morning wakening
wakening at least 2 hours before the expected/normal waking time
what is psychomotor retardation
slowing of thoughts and/or movement
what is stupor
absence of relational functions i.e action and speech
what does MSE appearance and behaviour look like in depression
reduced facial expression
brow ‘furrowed’ - look worried
reduced eye contact
limited gesturing, movements may be slow or absent
rapport is often difficult to establish
In MSE what does speech sound like in depression
Reduced rate
lowered in pitch
reduced in volume
reduced intonation (speech is monotonous)
increased speech latencies (longer time between end of a q and them starting to speak)
limited content (short, brief answers, unembellished)
what is mood
prevailing state or deposition
how the patient describes that they feel - subjective
what is affect
Mood applies to things (events, people etc) so how their mood changes in response to whats going on around them
not described, but observed - objective
terms used to describe mood in depression
low, down, miserable, unhappy, sad, flat, empty, numb etc
terms used to describe affect
Depressed (low)
Reduced range (stays low throughout)
Limited reactivity (doesn’t respond or react to changes in subject, context, emotion etc)
May report emotional paralysis (numbness)
in MSE how are thoughts in depression
Normal form
Slow flow, almost absent
Content - negative, self-accusatory, failure, guilt, low self-esteem, pessimism
Delusions can occur - guilt, poverty, nihilism, hypochondriasis
suicidal thinking common
What is phenomenology - perception in depression
Increased self consciousness/self referential - hear people laughing and think its about them
Hallucinations
- usually second person auditory and derogatory (you are a bad person and deserve to die)
- typically reflect negative and depressive themes
how is cognition impacted by depression
Subjectively cognition is slow with complaints of poor memory (more to do with inattention and not registering info that’s said to them)
pseudo-dementia - mind is elsewhere so not registering info
deficits involve working memory, attention and planning
often compounded by anxiety
how is insight impacted in depression
Usually preserved in depression
however can recognise that they are depressed but not realise it isn’t something directly related to sins, personal failings, weakness etc
typically observations made of someone with depression
Slower movements Fiddling with fingers, tissues etc 'Defeated' posture Reduced facial expression Speech intonation reduced Mood low Poor sleep Exhaustion Worrying Libido reduction
how does ICD-10 (uk and eu classification) classified mood disorders
Mania
bipolar
depressive disorder
dysthymia
how does DSM-5 classify depressive disorders
Major depressive disorder
Persistent depressive disorder (dysthymia in ICD10)
keeps bipolar disorders separate
what is major depressive disorder the equivalent of in ICD-10
moderate/severe depressive disorder
what is the diagnostic criteria for depression
depressive episode should last at least 2 weeks
there have been no hypomanic or manic symptoms sufficient to meet criteria for hypomanic or manic episodes at any time
meet 3 core symptoms:
- depressed mood >2 weeks
- loss of interest or pleasure in activities they used to enjoy
- decreased energy or increased fatiguability
‘it’s all about MEE’
Mood
Enjoyment
Energy
what are some additional symptoms of depression
Loss of confidence/self esteem
Guilt
Suicidal behaviour
Unable to think/concentrate
Agitation or retardation
Sleep disturbance (increased or decreased)
Change in appetite (increased or decreased)
What classifies as moderate depressive episode
2 core symptoms + 4 others to give a total of at least 6
What classifies a severe depressive episode
all 3 core symptoms +5 others to give a total of at least 8
what are the subtypes of depression
Somatic depression
Atypical depression
Psychotic depression
What is psychotic depression
Paranoid, typically ‘mood-congruent’ or hypochondriacal
costard syndrome:
nihilistic delusions
may be as extreme as ‘im dead.. the world doesn’t exist anymore’
what is chronic depression
DSM-IV criteria (in America) meaning persistent depression for 2 years
