Mood Disorders Flashcards
What is a mood disorder?
A disturbance in mood,
What is the internal manifestation of a mood disorder?
The actual mood.
What is the external manifestation of a mood disorder?
The affect.
What is the #1 public health problem?
Depression.
Why are women at a higher risk for mood disorders?
Hormones.
What is the average age of onset of depression?
Mid-30’s but decreasing.
What is the average age for manifesting bipolar disorder?
Mid to late 20’s
What is the risk of suicide if depression is left untreated?
25-30%.
What is the definition of major depression?
A state of intensely sad mood accompanied by other symptoms which exists nearly every day for at least two weeks.
What are symptoms of depression?
Anhedonia, sleep disturbance, weight gain/loss, lack of energy, unable to concentrate, nihilism, psychomotor retardation, suicidal thoughts.
What are risk factors of depression?
Past history of depression, Family history of depression, extreme stress, dysthymia
What is anhedonia?
Inability to experience pleasure physically, mentally, or sexually.
What is nihilism?
No motivation- “whats the use” attitude
What are some early warning signs of depression?
Abnormal sleep patterns, trouble concentrating, lack of pleasure, isolating self, slipping grades, irritability, spending time alone
What is hypersomnia?
Not able to sleep.
What are subtypes of depression?
Single episode, recurrent, psychotic features, atypical features, seasonal, post-partum
How is depression diagnosed?
Observing, self-report, Beck, Hamilton, Zung inventory, Dexamethasone Supression test
What is self-report?
When the patient reports their symptoms and says they are depressed.
What is a dexamethasone supression test?
A biological basis of adrenal gland over production that causes depression.
What are Beck inventory concepts?
Sadness, pessimism, sad feelings.
What are causative theories of depression?
Biological, genetic, psychoanalytic, cognitive, and behavioral.
What is the biological theory of depression?
Imbalance of serotoninand norepinephrine and the circadian rhythm is disruption.
What is the genetic theory of depression?
First degree relatives of individuals with major depression have twice the risk of developing it.
What is the psychoanalytic theory of depression?
Hostility turned inward because of a major loss.
What is the cognitive theory of depression?
The client is preoccupied with distorted, self deprecating thoughts.
What is the behavioral theory of depression?
An early traumatic experience causes depression and the person has learned that there is nothing they can do.
What percentage of clients respond to anti-depressant therapy?
70%
What is “first break” therapy?
The first time the patient is treated, may be for 6 months to 5 years, then they are tried to be weaned off of meds to see if it is with chemical levels.
What are the major categories of anti depressants?
Cyclic, Monoamine Oxidase Inhibitors, Selective serotonin reuptake inhibitors, and adjuntive therapies.
What are cyclic anti depressants and an example?
The first type of antidepressants- often used for muscle pain. Ex: Elovil.
What are monoamine oxidase inhibitors (MAO inhibitors)?
Can be dangerous, used for knowledgeable and functioning clients.
What is selective serotonin reuptake inhibitors and an example?
The most popular treatment, effective with little side effects: EX: Paxil/Prozac
What are some adjuntive therapies?
Anti-psychotics, lithium, and calcium channel blockers.
What are some types of non-pharmalogical therapies for depression?
Light therapy, herbal therapy, ECT, cognitive therapy, behavioral therapy, and deep brain stimulation.
What is electroconvulsive therapy?
A low energy electrical stimulation of the brain that causes a seizure of approx. 1 minute in duration. Usually given twice a week for 12-15 treatments.
What does the seizure during the ECT do?
It alters the levels of neurotransmitters, basically resetting them.
What are some nursing considerations for clients receiving ECT?
NPO after midnight (aspiration risk), given atropine for secretions, general anesthesia, muscle relaxant, continuous O2, Recovery room for several hours.
What are some nursing actions for clients receiving ECT?
Talk to client before and educate, VS frequently, assess orientation and reorient, DO NOT LET CLIENT DRIVE HOME
What is rigidity of thought with cognitive therapy?
Obessessed with a particular thought
What is dichotomous thinking?
good/bad, everything is black and white.
What is personalization?
feeling targeted.
What is arbitrary inference?
Jumping to conclusions
What is bipolar disorder?
Periods of depression that alternate with mania with periods of euthymia.
What is euthymia?
Normal mood.
What is the onset of bipolar disorder (usually)?
A trigger from a major psychosocial stressor or disruption in schedule.
What are symptoms of bipolar disorder?
Grandiosity, decreased sleep, flight of ideas, racing thoughts, distracted, psychomotor agitation, libido increase, impulsive/violent acts.
What is grandiosity?
exaggerated sense of self esteem- believe they have special pwoers.
What are the subtypes of biopolar disorder?
I, II, and III
What is Bipolar I?
alternating periods of depression and mania.
What is Bipolar II?
Alternating periods of depression and hypomania- Not as high highs, not as low lows.
What is Bipolar III or cyclothymia?
Hypomania alternating with dysthmia and euthymia- chance it will progress to I or II disorder.
What may clients with Bipolar I exhibit?
Psychosis, paranoia, rapid cycling, recurrent schizophrenia, bizzarre behavior, substance abuse.
What may clients exhibit with Bipolar II?
personality disturbance, depression in a seasonal pattern, often impulsive and insensitive. They have substance abuse issues.
What is the Kindling theory of bipolar disorder?
Neurotransmission affected initially by stress which creats neurophysiologic sensitivity- brain chemistry has changed and it takes less and less to trigger another break.
What enzymes are often high and low in bipolar clients?
High norepinephrine and low monoamine oxidase which degrages norepinephrine.
What is the theory with circadian rhythms and bipolar disorder?
The internal chronometer is running faster than 24 hours.
What is the genetic theory of bipolar disorder?
First degree relatives with bipolar disorder are 24x more likely to develop it.
What is the prognosis of bipolar disorder?
Poorer prognosis with earlier onsets, family history, psychotic features
