Major Depressive Disorder Flashcards
uncontrolable stressors result in oversescretion of adrenal glucocorticoids -
chronic overaction of hypothalamus, pituitary, & adrenal cortex
“MAJOR DEPRESSION”
M - mood depressed, memor problems A - anxious, apathetic, appetite changes J - "just no fun" O - occupational impairment R - restless D - doubt self, difficulty making decisions E - empty feeling P - pessimistic, persistant sadness, psychomotor retardation R - report vauge pains E - energy gone S - suicidal thoughts S - sleep disturbances I - irritable, inable to concentrate O - oppressive guilt N - "nothing can help"
vegetative signs of depression
alteration in sleep
alteration in appetite
loss of energy
cognitive distortion
over generalizations self-blaming mind reading discounting postitve attributes negative labeling fortune telling all or nothing "should statements"
assume something without facts
mind reading
creating worst case and knowing it will turn out that way
fortune telling
DSM IV diagnoses
dysthymia
sesonal affective disorder
post-partum depression
psychotic depression
chronically depressed mood for at least 2 years; not symptom free for over 2 months
dysthymia
depression accompanied by delusions & hallucinations
psychotic depression
interventions: chronic low self-esteem
reframe cognitive distortions so they are reality oriented
use visualizations to create positive images
assertiveness training
nurse - role model assertive behavior
role play difficult situations
interventions: self-care - intake
encourage pt to join others
eat small, calorie rich meals
have family bring favorite foods
interventions: communication
silence & active listening use direct simple sentences avoid asking too many questions be comfortable sitting w/ pt in silence allow & encourage crying - stay for support use topics comfortable w/ pt assign same staff to pt uses moderate tone of voice avoid being overly cheerful/joking use a soft voice give positive feedback ecnourage pt to express self non-verbally
interventions: cognition
recognize negative thoughts - teach to reframe
electroconvulsive therapy
induction of a grand mal seizure through the application of electrical current to the brain
theory of ECT
electrical stimulation results in significant ^ of norepi, serotonin, & dopamine
