Mood Disorders (17) Flashcards
anergia
lack of energy
euthymic mood
average or normal mood
dysthymia
unusually low mood
2 major mood disorders
depressive and bipolar
manifestations of major mood disorder
anhedonia
sleep abnormalities
appetite changes
restlessness (psychomotor agitation),
suicidal thoughts
subtypes of depression
1) melancholic
2) mood congruent psychotic features
3) seasonal pattern
4) peripartum
peripartum onset
depression that affects pregnant women, manifesting with psychotic features
in which age group is depression less common?
older adults
which gender is more affected with depression?
women
etiology of depression
pessimism, cognitive distortions (mind reading, all-or-nothing thinking, discounting positives)
which deficiency of neurotransmitters is associated with depression?
serotonin, norepinephrine, dopamine
other etiologies of depression
hypothyroidism, withdrawal from stimulants, beta-blockers, steroids, alcohol
effective psychotherapy for depression
CBT and group therapy
medications for depression
Fluoxetine, Sertraline, Paroxetine, Citalopram, Escitalopram
why are SSRIs safer?
produces few sedating, anticholinergic, and cardiovascular side effects
allows patients to be more compliant
nursing interventions for patients w/ depression
teach assertiveness techniques, explain that medications take 4 weeks for effect, teach the stages of grief and explain their feelings are normal
what are the nursing implications for antidepressants?
administer medications in AM (if nervous) or PM (if drowsy), with food, adequate fluid intake, monitor for hyponatremia, avoid excess sugar, report sexual dysfunction
manifestations of bipolar disorder
exhibits extreme manic and depressive mood
manic mood
exuberant, highly creative and colorful, sexually suggestive, attention-getting
flight of ideas, pressured speech, no sleep, reckless behavior, highly distractible, agitated outbursts, grandiose delusions, auditory hallucinations
labile affect
what is the rating scale for depression?
Hamilton Rating Scale
how is hypomania different from mania?
likewise similar to mania but does not cause significant impairment
etiology of Bipolar Disorder
stressful life events in childhood
which neurotransmitters are involved with Bipolar Disorder?
excessive norepinephrine and dopamine
deficient serotonin
medications for Bipolar Disorder
Lithium, Valproate and Carbamazepine (anticonvulsants), Risperidone and Clozapine (antipsychotics)
antidepressants are ineffective
psychotherapy for bipolar disorder
CBT and group psychoeducation
nursing interventions for bipolar
1) do not isolate the patient
2) decrease stimuli
3) set boundaries
4) give immediate feedback when boundaries are not respected
5) provide high protein and portable food and drink
imminent risk factors of suicide
Ideation
Substance Abuse
Purposelessness
Anger
Trapped
Hopelessness
Withdrawing
Anxiety
Recklessness
Mood Shifts
nursing interventions for suicide risk
normalize the client’s feelings that may lead to suicide, directly ask them, one-on-one constant supervision (also in the bathroom)
why is a sudden improvement in mood dangerous for someone who is suicidal?
it’s an indication for immediate plans for suicide
considerations for ECT consent
informed consent is highly important, but sometimes a court order is necessary for those who are too ill
ECT anesthesia
short-acting anesthetics and paralytics
ECT regimen
2-3 times per week for six to twelve treatments
maintenance ECT is also possible
interventions for ECT
airway is highly important, anticholinergics must be administered beforehand, maintain IV
what does dopamine do to the brain?
it is responsible for feelings of pleasure, motivation, and satisfaction
what does serotonin do to the brain?
regulates mood
what does norepinephrine do to the brain?
responsible for memory and attention
