Low mood/Affective problems Flashcards
What are mood/affective disorders
Illnesses where mood is excessively high (hypomania/mania) or low (depression)
- Unipolar episodes of depression
- Bipolar affective disorder (BPAD) = episodes of mania/hypomania AND depression
What are the causes of low mood/affective problems
Non-organic:
Depression
Bipolar affective disorder
Adjustment disorder
Dysthymia
Schizoaffective
Life stressors e.g. bereavement, recent unemployment, separation/divorce
Organic:
Endocrine: Hypothyroidism, Cushing’s syndrome, Addison’s disease, hyperparathyroidism
Stroke
Hypoactive delirium
Parkinson’s disease, dementia
Multiple sclerosis
Substance misuse
What is Beck’s model
Negative thinking can depress mood → generation of negative thoughts → downward spiral
- Helplessness (world)
- Hopelessness (future)
- Worthless, guilty (self)
What are the Stages of grief
5 stages
1. Denial, feeling numb, auditory and visual pseudo-hallucinations of the deceased
2. Anger, commonly directed against other family members and medical professionals
3. Bargaining
4. Depression
5. Acceptance
Other
1. Shock
2. Anger
3. Guilt
4. Searching (vivid dreams of the person being alive, pseudohallucinations)
5. Sadness
6. Acceptance
What is a normal grief reaction
It is normal for people to see or hear the deceased, or to experience anger, guilt, anxiety, sadness, or sudden ‘pang’ of grief.
Pseudo-hallucinations are a false sensory perception in the absence of external stimuli when the affected is aware that they are hallucinating.
What are the risk factors for an Atypical/abnormal grief reactions
Women
Death is sudden and unexpected
Problematic relationship before death
Lack of social support
What is delayed grief
may occur >2 weeks after the bereavement
What are the features of prolonged grief disorder
> 6 months without any relief
Extremely intense, longing for the deceased or persistent preoccupation with intense emotional pain
Exceeds expected social, cultural, or religious norms for their context
Significantly impairs functioning
Define adjustment disorder (ICD-10)
States of subjective distress and emotional disturbance, usually interfering with social functioning and performance, arising in the period of adaptation to a significant life change * or a stressful life event
- Beginning within 1 month of the stressful event
- Not lasting longer than 6 months
- doesn’t need to be a death, could be going to university
What are the symptoms and signs of adjustment disorder
Depressed mood
Anxiety and worry
Feeling of inability to cope
Disability in the performance of daily routine
Usually without biological symptoms of depression
(associated with conduct disorder in adolescents)
What distinguishes grief reactions from depression
The sadness and symptoms are focussed around the person that was lost
In depression, the symptoms are more free-floating and not focussed on anything in particular
What is the management for adjustment disorder
Bio: antidepressants, anxiolytics/hypnotics
Psychosocial: supportive counselling
What is the management for abnormal/prolonged grief reactions
Bio: antidepressants
Psychosocial: supportive counselling
Define schizoaffective disorder
a group of disorders in which BOTH affective and schizophrenic (psychotic) symptoms are prominent equally (50/50) but do not justify a full diagnosis of either schizophrenia or depressive/manic episode
2x Psychotic states > 2 weeks
What are the types of schizoaffective disorder
Manic type: schizophrenic and manic symptoms prominent (develops at the SAME time). Single episode, or recurrent disorder (majority manic episodes)
Depressive type: schizophrenic and depressive symptoms prominent (Develops at the SAME time). Single episode, or recurrent disorder (majority depressive episodes)
