Oct15 A1,2-Mood Disorders Introduction Flashcards
nuance to know in mood disorders
- episodes and disorders are diff things described
- criteria help dx an episode
- then dx a disorder in a certain way
3 groups of symptoms for depression episode dx and done how
- feeling (2)
- physical (4)
- thinking (3)
- must have 5 of 9 for 2 weeks* AND see significant clinical distress or impairment (occupational, social, other) AND exclude substances (drugs and meds) or medical causes
2 ‘‘feeling’’ sx of depression
- depressed mood (sadness or numbness)
- loss of interest (anhedonia)
4 ‘‘physical’’ sx of depression
-sleep changes (insomnia. specifically initial insomnia most frequently and sometimes early awakening insomnia) (rarely, atypical = sleep too much)
-decrease in apetite
(bc of anhedonia) + weight changes (rarely, atypical = eat too much and gain weight)
-loss of energy and fatigue
-motor slowing (possibly with pain), agitation
3 ‘‘thinking’’ sx of depression
- poor concentration, indecisiveness, mental slowing
- worthlessness and guilt (for things done before, which is normal, or things it’s abnormal to be worried about)
- suicidal ideation
types of insomnia
- initial insomnia = beginning of the night (can’t fall asleep) = most common in depression. also bc of stress in life
- middle insomnia (interruptions in the night)
- terminal insomnia (early morning awakening) (also possible in major depression but is more serious)
continuum of suicidal thoughts
- I wish I wasn’t around, I wasn’t born, I didn’t wake up
- It wouldn’t matter if I fell, if I got hit by a car
- plan suicide
concept about depression tx
each category of symptoms (feeling, physical, thinking)
antidepressants in depression
- increase mood and sense of well being
- helps for the physical sx
social support in depression
helps being in new environment being isolated is a risk factor for depression
structured physical activity in depression
for mild to moderate depression
- helpful for tx
- getting things done, going out the house regularly, etc.
sleep hygiene in depression
- sleep 7 to 9 hours in one period over 24 hours
- usually between 11 pm and 7 am
- 5 hours of continuous sleep helps you get 80% of sleep debt so is very important (so pt woke up at 4 or 5 am = less worried than if wake up at midnight)
- no naps
light therapy in depression
light therapy lamps to use if people have seasonal frequency to their illness
- schedule thing
- wake up early to expose themselves to light
- start to use usually in November
cognitive behavioral therapy and interpersonal therapy (IPT) in depression
helpful, especially for the thinking sx (poor conc, mental slowing, indecisiveness , worthlessness and guilt + suicidal ideation)
mania episode groups of sx + dx done how
- feeling (1)
- physical (3)
- thinking (4)
- need 4 out of 8 sx for 1 week* AND see significant clinical distress or impairment (occupational, social, other) AND exclude substances (drugs and meds) or medical causes
feeling sx in mania (1)
elevated euphoric mood + sometimes irritable (when know they’re annoying for others after many episodes)
physical sx in mania (3)
- decreased need for sleep (really energized, do same nbr of activies as usually but in 2-3 hours)
- talkative and pressure speech (faster speech rate)
- psychomotor agitation
thinking sx in mania (4)
-increased goal-directed activity (busy and organized schedule, move a lot, understand others well, very focused, feel like given a mission, do mass communication, very distractible) -flight of ideas, racing thought -distractibility -pleasurable risky behavior
hypomania episode criteria and dx done how
- feeling (1)
- physical (3)
- cognitive and thinking (4)
- need 3 (if expansive elevated mood) or 4 (if irritable mood) out of 8 sx for 4 week* AND change in functioning WITHOUT impairment AND exclude substances (drugs and meds) or medical causes
