Mood and Affect Flashcards
What is mood?
The way a person feels
What is affect?
observable response a person has to his or her own feelings
What is labile?
a condition that causes a person’s emotions to shift rapidly and dramatically, often in an exaggerated or disproportionate way.
What does depressed patient’s mood and affect seem like?
moves slowly, lack of ADL, blunted affect, poor hygiene, poverty of thoughts
What is melancholy?
Prolonged sadness
What is euthymia?
normal range of emotion
What are somatic symptoms of anxiety?
abdominal pain, dyspepsia, chest pain, fatigue, dizziness, insomnia, and headache.
What are somatic symptoms of depression?
sleep disturbance, appetite disturbance, and fatigue or loss of energy.
What is anhedonia?
a condition that makes it difficult to feel pleasure or joy in activities that were previously enjoyable
What is transference?
Transference is the redirection of feelings about a specific person onto someone else (in therapy, this refers to a client’s projection of their feelings about someone else onto their therapist)
What is counter-transference?
Countertransference is the redirection of a therapist’s feelings toward the client.
What is vegetative symptoms?
disturbances in the body’s functions that are necessary for life
What are some examples of vegetative symptoms?
Changes in appetite, weight, or sleep
Fatigue and loss of energy
Insomnia
Disordered salivation and transpiration
Cardiac arrhythmias and dyspnea
Change in body temperature
Altered sexual functions
Inattention
What is anergia?
a continual feeling of tiredness, lack of energy, or sleepiness
What are some symptoms of mania?
thoughts racing, speaking quickly, loose associations
What is the difference between mania and hypo-mania?
Type 1 goes to full mania and type 2 only goes to hypo-mania
Where are suicide risks the highest?
shortly after starting anti-depressants
What is psychosis?
loss of reality; poor judgements
How would you treat depressed psychosis?
ECT treatment when needed instant relief. Treatment lasts over the span of a couple weeks
What is the diathesis-stress model?
predisposed then triggered by life stressors and negative events.
Does mental illness affect women more than men?
yes
What hormonal alterations might cause a change in mental status?
adolescents, post-partum, menopause
How can the inflammatory process cause mental health issues?
Reduced blood flow and abnormal phosphorus metabolism in the prefrontal aspect of the cerebral cortex
How can NT changes cause mental illness?
Neuropathway changes, imbalanced neurotransmitters, low serotonin, GABA,
What are psychological factors that cause mental illness?
-cognitive theory; negative self talk
-learned helplessness
How to communicate with a patient who is depressed?
speech so simplify; speak slowly, state observations; non-judgmental; give time for processing & responses
What is citalopram and sertraline?
SSRI
How to communicate with a person who is manic?
racy & pressured so need to be calm, clear & simplify; consistent limits (boundaries); don’t argue; avoid power struggles
What is Venlafaxine?
SNRI
What is Amitriptyline?
TCA
What is Phenelzine?
MAOI
What do you use to treat bipolar?
Lithium
Why is renal function important if patient is taking Lithium?
They need good renal function to excrete lithium
What is normal therapeutic range for Lithium?
0.8 and 1.2 for acute goals or 0.8 and 1.0 mEq/L for maintenance goals
What are signs of lithium toxicity?
Vision changes, diarrhea, flu like symptoms, tremor, vomiting
High levels of salt->low levels or lithium
Low sodium (confusion, tremor, seizures)-> give anti-convulsant
What dietary considerations for people on Lithium?
Inverse relationship of Na and lithium
Educate patient on keeping sodium intake is consistent
Why do bipolar pts often quit taking Lithium?
They enjoy the increased productivity that occurs in mania
What are risk factors for suicide?
-genetics
-low serotonin
-feelings of hopelessness
-ACE score
-relative/peer suicide
What is active suicidal ideation?
current specific plans/thoughts
What is passive suicidal ideation?
general wish to die but no active self harm
How do males and females usually die by suicide?
males usually use more lethal means like firearms and women usually OD
What is the speech like with someone in a manic state?
pressured, tangential, flight of ideas
What is pressured speech?
fast, loud, incoherent
What is circumstantial?
adding unnecessary detail
What is tangential speech?
loose point they were trying to make
What are loose associations?
thoughts are loosely connected
What is a flight of ideas?
a continuous flow of accelerated speech with changes from topic to topic
What is clang associations?
string of words that rhyme with no meaning
What is anergia?
-abnormal lack of energy
-slowed facial expressions
-fixed gaze
What is a constricted affect?
reduction in range/intensity of normal expression
What is a blunted affect?
more severe constriction
What is a flat expression?
none or no emotional expression
What is anhedonia?
absence of happiness
What is poverty of thought?
slow/absent response
What is impoverished speech?
speak less often
What is the onset of bipolar 1?
18 years onset
What is a special consideration of MAOI?
foods high in tyramine can cause a HTN crisis
Examples of MAOI?
Phenelzine and Seleginline
What does lithium do?
it is a mood stabilizer that regulates glutamate
What to monitor with lithium?
monitor thyroid/kidney function
What level of lithium is toxic?
around 1.5
What is the therapeutic range of lithium?
0.6-1.2
What are symptoms of lithium toxicity?
diarrhea, muscle weakness, blurry vision, drowsiness, tinnitus, ataxia
What are special considerations of Tricyclics?
they are more sedating and it is lethal if there is an overdose
