Mood Disorders: Depression Flashcards
Primary risk factors for depression
history/family history
LGBTQ
female
age 40 or less
postpartum
chronic medical illness
no social support
stress/trauma
Substance abuse
sexual abuse
Stress-Diathesis model of depression theory
biopsychosocial theory that states depression is from an environmental, interpersonal, and life events perspective
“Stressful events can cause brain damage that can lead to depression”
Beck’s Cognitive theory on depression
depression stems from negative, illogical or irrational thought processes that are dormant until stressful times
Learned helplessness
theory by Seligman
anxiety is replaced by depression if a person feels no control over the outcome of a stressful situation
What is major depressive disorder?
substantial emotional pain to the point where people cannot function
Common symptoms of MDD: SIG E CAPS
Sleep disturbance (hyper or insomnia)
Interest diminished
Guilt feelings
Energy decreased/Esteem loss
Concentration diminished
Appetite changes
Psychomotor retardation
Suicidal thoughts
What is PDD and how does it differ from MDD?
Persistent depressive disorder
Presents with less severe symptoms than episode of MDD
What is the criteria for MDD?
Five or more symptoms present during same 2 week period
at least one symptom is either depressed mood or loss of interest
Psychomotor retardation
fatigue or slowed movements/complete inactivity
increased risk of constipation
psychomotor agitation
biting nails
smokes
tap fingers
unable to relax
What is the HIGHEST priority when treating these patients no matter what?
safety!!!
What is one way a nurse can help a pt with MDD?
offering self
ex: simply sitting with patient in silence
What is one drawback with antidepressants?
takes 1-3 weeks or longer to take effect
Why is SI a stronger risk when taking an SSRI?
SSRI improves the person’s energy, but the original suicidal plans are still there
they would now have the energy to go thru with the plan
What do SSRIs do?
blocks uptake of serotonin
Common side effects of SSRIs
tension headaches
insomnia
sexual dysfunction
agitation
bleeding
dry mouth
sweating
weight change
dangerous adverse effect of SSRIs
serotonin syndrome
what is serotonin syndrome?
excess serotonin
S.H.I.V.E.R.S (serotonin syndrome symptoms)
Shivering
Hyperreflexia
Increased temperature
Vital sign instability (tachycardia)
Encephalopathy
Restlessness
Sweating
Treatment for serotonin syndrome
muscle relaxants
serotonin blockers
oxygen and fluids
drugs that control HR and BP
What must be done when switching from SSRI to MAOI?
2-5 week washout
Common side effects of tricyclic antidepressants
dry mouth
blurred vision
tachycardia
constipation
sexual dysfunction
sedation
Patient education for TCA
eat sugarless gum or sip water for dry mouth
increase fluids and make diet changes to prevent constipation
void before next dose
change positions slowly
Toxic effects of TCA
dysrhythmias
tachycardia
MI
lower threshold of seizures
What can not be taken with TCAs?
Nicotine
St. John’s Wort
antihistamine
anticoagulants
oral contraceptives
Patient education for MAOIs?
don’t consume foods with tyramine
Foods high in tyramine
bananas
sausages
avocadoes
fermented meats
all cheeses
What is Electroconvulsive therapy?
procedure done under general anesthesia
triggers brief seizures
What can the patient expect after ECT?
confusion/disorientation
headache
muscles soreness
nausea
memory deficits
How does Transcranial magnetic stimulation differ from ECT?
no seizures
last 30-60 minutes
daily sessions
safer than ECT
no anesthesia
