Low mood

Question 1

Describe the phenomenology of appearance and behaviour?

Answer 1

Reduced facial expression
Brow furrowed
Reduced eye contact (not held)
Limited gesturing
Difficult to establish rapport

Question 2

Describe the phenomenology of speech?

Answer 2

Reduced rate of speech
Lowered in pitch
Reduced in volume
Reduced intonation
Increased latencies
Limited content

Question 3

Describe the phenomenology of mood and affect?

Answer 3

MOOD-Low, down, miserable, unhappy, sad, flat, often empty, black, numb

AFFECT-Depressed, reduced range, limited reactivity, emotional paralysis

Question 4

Describe the phenomenology of thought?

Answer 4

Thoughts are slow, pondering, almost absent

CONTENT- negative, self-accusatory, failure, guilt, low self-esteem, pessimism, delusions can occur; guilt, poverty, nihilism, hypochondriasis
Suicidal thinking

Question 5

Describe paranoia in depression?

Answer 5

Increased sensitivity to criticisms of others; often tied to guilt/self-blame

Much more self-conscious and aware in busy places

Feel under scrutiny

Question 6

Describe the phenomenology of perception in low mood?

Answer 6

Mostly notmal
Some people have increased self-referential thinking
Hallucinations can occur

Question 7

Describe the phenomenology of cognition in low mood?

Answer 7

Subjectively cognition is slow with complaints of poor memory
Pseudo-dementia
Typical deficits in working memory, attention and planning
Often compounded by anxiety

Question 8

Describe the phenomenology of insight in low mood?

Answer 8

Typically preserved
Recognition of symptoms is in tact

Attribution can be affected- symptoms tend to be blamed on sins, physical illness, personal failings or weakness.

Question 9

What are some common observations?

Answer 9

• Slightly slower movements
• Fiddling with fingers, tissues
• Defeated posture
• Reduced facial expression
• Speech reduced in intonation
• Mood low (miserable, black) tearful
• Poor sleep (initial insomnia, broken sleep)
• Exhausted
• Worrying

Question 10

What are the ICD-10 mood (Affective disorders?)

Answer 10

Mania
Bipolar
Depressive
Dysthymia