Mental Health Issues and Behavioral Disorders Flashcards
Affective Disorders
Depressive and Bipolar disorders.
Disorders affecting mood.
Major Depressive Disorder - Definition
Sad, empty or irritable mood, accompanied by somatic and/or cognitive changes.
Recurrent episodes of at least 2 weeks.
Symptoms cause distress or impairment in social , occupational or other important areas of functioning.
Cause and consequence of physiological + structural changes in the brain.
Major Depressive Disorder - Specific Symptoms (9)
- Depressed mood*
- Diminished interest in all/almost all activities*
- Weight loss or gain, decreased or increased appetite.
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feeling of worthlessness or excessive/delusional guilt
- Diminished ability to think, concentrate, make decisions
- Recurrent thoughts of death, suicide ideation, plan or attempt.
Major Depressive Disorder - Additional Manifestations
Idiopathic pain
Anxiety and irritability
Motivation loss and isolation
Hypochondria
Attentional Disorders
Memory impairment
Mechanism of Depression
Neurochemical imbalance in dopamine receptors in PFC and limbic system. ↓ DA.
↑ Cortisol → ↓BDFN, GDFN
→ Loss of gray matter volume in HPC, PFC, aCC, Caudate, Thalamus.
Bipolar Disorder - Key Features
Combination of manic, hypomanic and major depressive episodes.
Impairment in social, occupational or other important areas of functioning.
Type I or II.
Bipolar Disorder - Type I
Manic episodes, maybe followed by hypomanic or major depressive episodes. Mania itself impairing.
Bipolar Disorder - Type II
Hypomanic and major depressive episodes, no mania. Major depressive symptoms or unpredictable shifts between the two is impairing. Most common.
Bipolar Disorder - Episodes (4)
Euthymia: Stable neutral mood.
Manic: abnormally and persistently elevated, expansive or irritable mood and goal-directed behavior. At least one week.
Hypomanic: Less severe than manic, not impairing, lasting at least 4 days.
Major depressive: Low mood and excitability, lasting 2 weeks.
Mania - Diagnostic Criteria (DSM5) (7)
Inflated self esteem
Decreased need for sleep
More talkative than usual
Flight of ideas or racing thoughts
Distractibility
Increase in goal-directed behavior (socially, work, school, or sexually)
Involvement in activity with high risk of painful consequences (shopping spree, foolish investment, illegal activities)
Treatment - Bipolar Disorder
Pharmacological
Physical activity
Diet
Problem solving therapy
Cognitive behavioral therapy
Acceptance and commitment therapy
Mindfulness based interventions
Anxiety Disorders - Definition
Excessive, irrational, non-adapted or persisting fear and anxiety and related psychological and somatic disturbances and symptoms.
Fear: response to real or perceived imminent threat.
Anxiety: anticipation of future threat.
Anxiety Disorders - Characteristics
Physiological and structural (dlPFC) changes in the brain.
Affects executive functions: attention, memory, self control.
Agitation can lead to damage to body and social interaction affecting all ADLs.
Panic attacks common manifestation.
Panic Attack - Definition
Abrupt surge of intense fear or intense discomfort, reaches a peak within minutes.
Not a disorder but a manifestation of mental or medical condition.
Can occur from a calm or anxious state, expected (trigger) or unexpected.
Panic Attack - Specific Symptoms (13)
Palpitations, accelerated heart rate.
Sweating
Trembling
Sensation of shortness of breathe
Feeling of choking
Chest pain/discomfort
Nausea, abdominal distress
Dizzy
Chills or heat sensation
Numbness
Derealization or depersonalization
Fear of losing control
Fear of dying
Anxiety and neuroplasticity
↑ AM activity → ↓ HPC and aCC activit
→ ↓ Dorsal executive network
→ Emotional reasoning takes over pragmatic reasoning in decision making.
Generalized Anxiety Disorder - Definition, Impairments
Excessive persistent anxiety and worry a nr of different things, with out of proportion intensity, duration and frequency.
Symptoms interfere with tasks, leading to attention disorder.
Often also experience depression and panic disorder.
Impair social interaction, job, studies etc.
Specific Symptoms of Generalized Anxiety Disorder
Restlessness or feeling on edge
Easily fatigued
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance (falling asleep, staying asleep, restless sleep)
3 symptoms for more days than not, for the past 6 months.
Social Anxiety Disorder - Definition
Excessive, systematic and persistent fear or anxiety related to social situations for more than 6 months. Afraid of being negatively evaluated by others.
Avoidance behavior.
Impaired social interactions, job, studies.
Panic Disorder - Definition
Recurrent panic attacks that occur without any obvious triggers.
Worry about having panic attacks and avoidance behavior.
High level of social, occupational and physical disability.
High risk of suicide.
Specific Phobia - Definition
Irrational fear of an object, animal or situation.
Avoidance behavior.
Belief that the trigger is life threatening. Greater fear/avoidance than the normal reaction.
Can have a full panic attack.
impairs social, occupational or other important areas of functioning.
Anxiety Disorders - Treatment
Cognitive behavioral therapy and mindfulness-based interventions very effective.
Pharmacological therapy.
Physical activity.
How to manage a panic or anxiety attack (5)
Recognize thoughts and feelings, accept, identify triggers.
Reassure feelings are not dangerous and will pass.
Slow deep breathes.
Refocus attention
Listen to music
Post Traumatic Stress Disorder - Definition
Reaction following exposure to one or more traumatic events.
Reliving the traumatic event, panic attacks, anhedonia, dissociative state, recurrent, involuntary and intrusive memories of the event for more than 1 month.
Avoidance of triggers.
Amnesia can be present.
Impacts attention and memory, may lead to depression.
Impairing social, occupational or other important areas of function.
Role as a Physio (4)
Be able to recognize
Prevent development or aggravations
Be patient and understanding
Counsel and redirect to other health professionals
