Mood Disorders Flashcards
What are the three fundamental psychological needs?
has to be present very early in development
- Acceptance: have to see that we belong to a group of people and be accepted by them
- Predictability: the way the world is today, there is some relationship to how the world is tomorrow
- Competence: able to affect the world around you in some way (ex: a baby moving objects and playing with blocks/ if you prep for a test you actually do well on it)
If two fundamental needs are present what emerging/compound behavior may arise?
- If acceptance is predictable then you develop trust
- If acceptance and competence are present then you have self-esteem
- If you’re competent and the world is predictable then you have a sense of control
What happens if these psychological needs aren’t met?
We can experience low mood
Diagnostic Criteria for Major Depressive Disorder
- Five (or more) of the following symptoms have been present during the same 2-week period
and represent a change from the previous functioning; - at least one of the symptoms is either (1)
depressed mood or (2) loss of interest or pleasure.
Diagnostic Criteria for Adjustment Disorder
The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
Specify whether:
(F43.21) With depressed mood: Low mood, tearfulness, or feelings of hopelessness are predominant.
(F43.22) With anxiety: Nervousness, worry, jitteriness, or separation anxiety is predominant.
(F43.23) With mixed anxiety and depressed mood: A combination of depression and anxiety is predominant.
(F43.24) With disturbance of conduct: Disturbance of conduct is predominant.
(F43.25) With mixed disturbance of emotions and conduct: Both emotional symptoms (e.g., depression, anxiety) and a disturbance of conduct are predominant.
acknowledges that we can see changes in our feelings and behaviour in kids too following a big change
What do we tend to do when we feel low and weak? Is this good or bad?
- we ruminate on problems and negative things, thinking about what leads us to feel low in mood
- this can sometimes help people come to a solution to the problem
- or it can also trap us in a cycle of rumination
what is the frequency of low mood in girls and boys
- In childhood, we see about equal rates of low mood in boys and girls
- Around puberty, we see a double in girls (twice as frequently)
as we age does depression and anxiety increase or decrease?
increases with age
clinical practice guidelines for depression (mild depression vs. moderate-severe)
Mild depression
5- to 18-year-olds:
- watchful waiting: sending the client home and saying you’ll see them in a month
- digital, group, individual CBT; group supportive, attachment, interpersonal (IPT) therapy
Moderate to severe depression
- 5- to 11-year-olds: individual CBT; psychodynamic, family-based IPT, family therapy
- 12- to 18-year-olds: first line, individual CBT at least 3 months; second-line, IPT-A, family therapy, psychodynamic
if someone comes to you and says “I’m feeling depressed/anxious” why would this kind of be confusing?
- we would want to figure out if your problem is depression/anxiety or if there is a problem that is causing the depression/anxiety
Ex: a child who is in the 2nd percentile for reading and is in school every day being forced to read = anxiety, but not an anxiety disorder
what is watchful waiting?
sending the client home and saying you’ll see them in a month
- often feelings of “depression” will improve over time
- you may just be seeing them on a really bad day, they may have just needed good food and good sleep
Interpersonal Therapy
Analysis of your life and saying “What ways are some of these needs being frustrated right now?”
- Mapping out the person’s social world
Examples:
- “is there a relationship we have to repair?”
- “is there a relationship that we can’t repair and we have to mourn it?
Why don’t we admit everyone to the hospital for inpatient care?
- Disruption of your regular day-to-day life, everyone around you is in distress, you’re away from friends and family, not engaging in enjoyable activities
- Need to balance out to pros and cons of having a massive environmental shift
NICE recommendations for medication (depression)
- no antidepressant meds for the initial treatment of young people with mild depression
- consider combined therapy (SSRI+ psychological therapy) for initial treatment of mod-severe depression in young people (12-18)
- but they don’t recommend offering antidepressant medication without offering a psychological intervention unless the person has declined it
Cognitive behavioral model related to mood:
Trigger: loss of status, death, relationship dissolution
thoughts/beliefs: “I’m a failure”, “I’m unlovable”
emotions: sad, ashamed, guilty
behaviors: stay in bed, avoid family, avoid friends
these factors all affect each other, which allows us to address low mood through different directions
