Mood Disorders & Suicide Prevention Flashcards
Major depressive disorder
- depressed mood or loss of interest or pleasure in usual activities
- may be single episode or recurrent
- evidence will show impaired social and occupational functioning for at least 2 weeks
- no hx of mania and s/s not attributable to substance abuse or a medical condition
Major depressive disorder - manifestations
- depressed mood
- loss of interest
- no pleasure in usual activities
- symptoms can be mild, moderate or severe
- may be evidence of psychotic, catatonic or melancholic features
Dysthymic disorder
- chronically depressed mood for more days than not for at least 2 yrs (1 yr in kids and adolescents)
- early onset: occurring before 21
- late onset: occurring after 21
Dysthymic disorder - manifestations
- individuals describe mood as sad or “down in the dumps”
- no evidence of psychotic symptoms
Substance- or medication-induced depressive disorder
Symptoms considered to be a direct result of physiological effects of a substance
Substance- or medication-induced depressive disorder - manifestations
Disorder causes clinically significant distress or impairment in social, occupational or other important areas of fxning
Depressive disorder due to another medical condition
Characterized by symptoms associated with a major depressive episode that are the direct physiological consequence of another medical condition
Depressive disorder due to another medical condition - manifestations
Clinically significant distress or impairment in social, occupational or other important areas of functioning
Post-partum depression
- depression in the post-partum period ranging from the blues to moderate depression, to psychotic depression, to melancholia
- begins within 48 hrs after delivery, peaks ~3-5 days, and lasts ~2 weeks
Post-partum depression - manifestations
- tearfulness
- despondency
- anxiety
- subjectively impaired concentration
Bipolar I
- an individual who is experiencing a manic episode, of has a hx of one or more manic episodes
- the client may have also experienced episodes of depression
Bipolar I - manifestations
- mania
- depression
- psychotic or catatonic features may also be noted
Bipolar II
- characterized by recurrent bouts of major depression with episodic occurrence of hypomania
- the client has never experienced a full manic episode and the symptoms are not severe enough to cause a marked impairment in social or occupational fxning or to necessitate hospitalization
Bipolar II - manifestations
- depression
- hypomania
Cyclothymic disorder
- chronic mood disturbance of at least 2 yrs
- involving numerous periods of elevated mood that do not meet the criteria for a hypomanic episode
- numerous periods of depressed mood of insufficient severity or duration to meet the criteria for a major depressive episode
- the individual is never without symptoms for >2 mos.
Cyclothymic disorder - manifestations
- elevated mood
- depression
Interventions for depressive disorders
- individual psychotherapy
- group therapy
- cognitive therapy
- electroconvulsive therapy
- transcranial magnetic stimulation
- vagal nerve stimulation/deep brain stimulation
- light therapy
- psychopharmacology (antidepressants)
Interventions for bipolar disorders
- individual psychotherapy
- group therapy
- family therapy
- cognitive therapy
- the recovery model
- electroconvulsive therapy
- psychopharmacology (mood-stabilizing agents [lithium])
Depressive disorders - client and family education: nature of the illness
- stages of grief and s/s associated with each stage
- what is depression?
- why do people get depressed?
- what are s/s of depression?
Depressive disorders - client and family education: management of the illness
- medication management
- assertiveness techniques
- stress-management techniques
- ways to increase self-esteem
- electroconvulsive therapy
Depressive disorders - client and family education: support services
- suicide hotline
- support groups
- legal/financial assistance
Bipolar disorders - client and family education: nature of the illness
- causes of bipolar disorder
- cyclic nature of the illness
- symptoms of depression
- symptoms of mania
Bipolar disorders - client and family education: management of the illness
- med management
- assertive techniques
- anger management
Bipolar disorders - client and family education: support services
- crisis hotline
- support groups
- individual psychotherapy
- legal/financial assistance
Suicide risk factors
- marital status (single, never married 2x more likely)
- gender (more women attempt, men succeed)
- age (highest 45-65 y/o, 2nd >85)
- religion (affiliation w religion decreases likelihood)
- socioeconomic status (very highest and lowest most likely)
- hx of mental disorders
- recent psychiatric hospitalization
- insomnia
- LGBTQ
- family hx
- hx of being bullied
Suicidiality: nursing interventions
- do not kea e suicidal person alone
- no-suicide contract may be established
- establish rapport and promote trusting relationship
- accept clients feelings w/o judgement
- discuss current crisis and clients’ life
- help client identify areas of life within control and not within control
- admin therapeutic pharm (antidepressants) as Rx
