Mood Disorders Flashcards
Major Depressive Disorder
Depressed for 2 wks Impaired social/occupational functioning No manic behavior hx Not attributed to drugs or medical condition 5 or more diagnostics
Depression Criteria
Depressed Weight gain/loss insomnia/hyperinsomnia Psychomotor agitation/retardation Fatigue Worthless, guilt Low concentration Recurrent SI/death thoughts
Depression Tools
MSE
Beck Depression Inventory
Patient Health Questionaire-9
Suicide Assessment
Depression Biologic
NE and serotonin
Caring for Depressed Patients
- patience and express belief
- avoid overaggressive or lighthearted actions
- step by step reminders
- time with (even in silence
- self care
Kindling
Sensitization
- less stimuli to produce equal response
- more susceptible to recurrence
Persistent Depressive Disorder
Milder than major depressive
-chronically depressed mood for most of days, for more days than not, for 2 yrs
Premenstrual Dysphoric Disorder
5 symptoms 1 wk before menses
- improve within a few days after menses onset
- minimal/absent week postmenses
Premenstrual Criteria
- mood swings
- irritability, anger, conflicts
- marked anxiety, tension
- anhedonia: can’t feel pleasure
- difficulty w/ concentration
Premenstrual Criteria
- mood swings
- irritability, anger, conflicts
- marked anxiety, tension
- anhedonia: can’t feel pressure
- difficulty w/ concentration
Seasonal Affective Disorder
- shortened daylight
- abnormal melatonin
- recurring
- lethargy, irritability, depressed, increased appetite
Postpartum
- Blues: brief, 1-4 days, tx: reassurance/support
- depression: 2 wks-12 mos
- psychosis: 2-3 days
Persistent Complex Bereavement Disorder
grief beyond 12 mos
Disenfranchised Grief
“not congruent with socially recognized relationship”
Grief
- insomnia, poor appetite, depressed
- gradually gets better
Psychopharm Depression
- take 1-3 wks to work
- 3 mos to determine if effective
- stay on 6-9 mos
Post Treatment in ECT
- recovery monitoring
- frequent reassurance/reorientation
- criteria for discharge
ECT Potential SE
- headache
- muscle soreness
- nausea
- confusion, memory loss
Light Therapy
decrease melatonin
For SAD
St. John’s Wort
Homeopathic
-for mild depression
Holistic Nursing Care
- Regulate: sleeping, eating, exercise, etc
- reframe: unhealthy beliefs
- health teaching/education
- spiritual
- family, comorbidity
Bipolar
2 million americans
- RF: female, family hx
- mood swings
- may or may not have hallucinations/delusions
Bipolar 1
1 or more episodes of major depression + 1 or more periods of mania
Bipolar 2
1 or more periods of major depression + periods of hypomania
Cyclothymia
chronic (at least 2 yrs)
-recurrent sx of hypomania alternating with dysthmic depression
Bipolar DSM Criteria
4 days for hypomania
1 week for mania
-hypomania: change in functioning
-mania: impairment in functioning
Mania DSM-IV Criteria
3 or more:
- increased self-esteem
- decreased need for sleep
- increased, pressured speech
- flight of ideas, racing thoughts
- destractibility
- increased activity, agitation
Manic interventions
- risk for injury
- need consistency, limit setting
- remain neutral
- high calorie fluids/foods frequently
Suicide Assessment
- thoughts/attempts
- feelings on failing
- frequency/duration
- controllability
- deterrents, reasons
Risk Factors for Suicide
Sex
Age
Depression
Previous attempts ETOH Rational thinking loss Social support lacking Organized plan No spouse Sickness
HIPPA Suicide
HIPPA permits a clinician to make contact with friends, family, outpatient treatment providers without consent
Suicide Safety Plan
- List your specific warning signs:
- Personal coping strategies to calm and comfort:
- Reasons for living:
- Activities for distraction:
- Professional contacts with phone numbers:
- Steps to make environment safe:
- Where to go if still needing help
