WEEK 5 Flashcards
1
Q
MOOD DISORDERS
A
- Mood is a pervasive and sustained emotional state→ ‘colours’ one’s view of the world, and affects behaviour and cognition
- A group of disorders in which pathological mood- a sustained and pervasive emotional state, affecting psychosocial, physical and occupational functioning- is experienced
- The disordered mood is distinct from that which is usually experienced and there is a sense of loss of control over the mood
- The primary mood disorders are → Major depressive disorder and Bipolar disorder
2
Q
MAJOR DEPRESSIVE EPISODE- COMMON FEATURES OF DEPRESSION
A
- Depressed mood
- Loss of interest/pleasure in all or almost all activities
- Significant weight loss or gain
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Diminished ability to think or concentrate: indecisiveness
- Recurrent thoughts of death, recurrent suicidal ideation, or suicide attempt
3
Q
CLINICAL FEATURES/ SYMPTOMS ASSOCIATED WITH DEPRESSION: Appearance and Behaviour
A
- Decreased interest in grooming and cleanliness
- Psychomotor retardation or agitation
- Sleep disturbance
4
Q
CLINICAL FEATURES/ SYMPTOMS ASSOCIATED WITH DEPRESSION: MOOD AND AFFECT
A
Anger, Anxiety, Apathy, Bitterness, Dejection, Denial of feelings, Despondency, Flat, Guilt, Helplessness, Hopelessness, Loneliness, Low self-esteem, Restricted, Sadness, Sense of personal worthlessness,
5
Q
CLINICAL FEATURES/ SYMPTOMS ASSOCIATED WITH DEPRESSION: THINKING AND SPEECH
A
- Egocentric, ambivalence, confusion, poor concentration, delusions or hallucinations, indecisiveness, loss of interest or motivation, pessimism, self-blame, guilt, self-deprecation, self-destructive thoughts, uncertainty
- Spectrum of thinking narrows- focus on negative thoughts and ideas
6
Q
CLINICAL FEATURES/ SYMPTOMS ASSOCIATED WITH DEPRESSION: PERCEPTION
A
- Major depression may also be accompanied by delusions and hallucinations (delusions of guilt, worthlessness, failure, hallucinations- negative voices reaffirming the nihilistic themes)
7
Q
CLINICAL FEATURES/ SYMPTOMS ASSOCIATED WITH DEPRESSION: OTHER FEATURES
A
- Sleep disturbance, fatigue, lack of appetite, decreased sexual interest, significant weight loss
- Somatisation - people may describe pain conditions or other physical symptoms rather than a depressed mood (e.g. backache, chest pain, constipation, dizziness, headaches)
8
Q
BIPOLAR
A
- Bipolar I disorder- One or more manic episode, or mixed episodes and may be accompanied by major depressive episodes (not necessary for diagnosis)
- Bipolar II disorder- recurring mood episodes consisting of 1 or more major depressive episode and at least one hypomanic episode
9
Q
MANIA
A
- Mood state characterised by abnormally and persistently elevated, expansive mood, increased activity and poor judgement
- Hypomanic: Milder symptoms of mania, shorter time period
- Mania (without psychotic symptoms) more severe symptoms; impairment in functioning
- Mania (with psychotic symptoms) usually requires hospitalisation, delusions and or hallucinations, usually mood congruent
10
Q
COMMON FEATURES OF A MANIC EPISODE
A
- Distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased goal directed activity or energy, lasting 1 week.
- Inflated self esteem or grandiosity
- Decreased need for sleep
- More talkative than usual
- Flight of ideas or racing thoughts
- Distractibility
- Increase in goal directed activity or psychomotor agitation
- Excessive involvement in activities with high potential for painful consequences
11
Q
OTHER MOOD DISORDERS
A
- Persistent depressive disorder (dysthymia) → Chronic mild depression (requires 2 years of symptoms for a diagnosis)
- Cyclothymia→ Chronic bipolar disorder- with milder depressive and mildly elevated symptoms (requires 2 years of symptoms for a diagnosis)
- Postpartum ‘blues’ → Transient disturbances in mood, characterised by lability, sadness, dysphoria, subjective confusion
- Perinatal depression → Characterised by depressed mood, excessive anxiety, insomnia and change in weigh
12
Q
AETIOLOGY OF MOOD DISORDERS: Genetic Factors
A
- Play a role in a person’s predisposition towards developing depression and bipolar disorder
- Neurochemical factors, hormonal systems, circadian rhythms and the immune system
13
Q
AETIOLOGY OF MOOD DISORDERS: Sex Differences
A
- Women more than twice as likely to develop depression as men
- Theories proposed range from biological, social, psychological and male and female differences in immune system responses to stress
14
Q
AETIOLOGY OF MOOD DISORDERS: ENVIRONMENTAL/ PSYCHOSOCIAL FACTORS
A
- Physical illness
- The ageing brain
- Stress and life events- loss often precedes the first episodes of mood disorders
- Personality types
- Drug and alcohol use
15
Q
ANXIETY
A
- Common human experience that is a normal emotion felt in varying degrees by everyone.
- Stress, fear and anxiety are normal internal experiences that occur in response to a stressor (internal or external stimulus)
- Evolutionary, inbuilt survival trait → allows for the identification and development of necessary responses to potentially dangerous stimulus
- Fight/flight/freeze response
16
Q
ANXIETY DISORDERS
A
- Most prevalent of all mental health disorders
- Commonly experienced anxiety disorders:
- Generalised Anxiety Disorder
- Post Traumatic Stress Disorder
- Social Phobia
- Agoraphobia
- Obsessive Compulsive Disorder
- Higher prevalence in females and younger people
- Often comorbid with depressive disorders and substances use disorders
17
Q
SYMPTOMS COMMONLY ASSOCIATED WITH:
A
- High levels of fear with thoughts of imminent danger and perception of risk
- Escape/ avoidance behaviours
- Notable physiological arousal on presentation of anxiety trigger
- Although a common experience, it is a diagnosable disorder when feelings of anxiety
- Are ongoing
- Occur for no apparent reason or continue after the stressful event has passed
18
Q
ANXIETY SYMPTOMS
A
- Physical→ panic attacks, hot and cold flushes, racing heart, tightening of the chest, quick breathing, restlessness or feeling tense, edy
- Psychological→ Excessive fear, worry, catastrophizing, obsessive thinking
- Behavioural: Avoiding situations that make you feel anxious
19
Q
AETIOLOGY OF ANXIETY DISORDERS
A
- It’s often a combination of factors that can lead to a person developing anxiety
- Family history
- Stressful life events→ abuse, trauma, job/ relationship problems, significant life events (e.g. having a baby)
- Some physical health problems are associated with→ Endocrine disorders, diabetes, asthma, heart disease
20
Q
GENERALISED ANXIETY DISORDERS (GAD)
A
- Excessive, difficult to control anxiety and worry about multiple activities (e.g. school/work difficulties)
- Accompanied by symptoms such as restlessness/feeling on edge, muscle tension
21
Q
OBSESSIVE COMPULSIVE DISORDER (OCD)
A
- Obsessions: recurrent and persistent thoughts, urges or images that are experienced as intrusive and unwanted, causing marked anxiety or distress
- Compulsions: Repetitive behaviours (e.g. handwashing) or mental acts (e.g. counting) that the individual feels driven to perform to reduce the anxiety generated by the obsessions
22
Q
PANIC DISORDER
A
- Recurrent unexpecte panic attacks (overwhelming physical sensations- pounding heart, choking, nausea, faintness, dizziness, chest pain, hot/cold flashes, perspiration)
- Panic attacks reach a peak within 10 mins and usually last for up to 30 mins
- Persistent concern about additional panic attacks and/or maladaptive change in behaviour related to the attacks
23
Q
SPECIFIC PHOBIAS
A
- Marked, unreasonable fear of anxiety about a specific object or situation, which is actively avoided (e.g. flying, heights, animals, seeing blood, receiving an injection)
- Often aware that fears are exaggerated/irrational but feel the anxious reaction is automatic/uncontrollable
- For example: Agoraphobia: Marked excessive or unrealistic fear or anxiety about social situations in which there is possible exposure to scrutiny by others
24
Q
POST TRAUMATIC STRESS DISORDER (PTSD) AND ACUTE STRESS DISORDER (ASD)
A
- Set of reactions that can develop in people who have been through a traumatic event- e.g. exposure to actual or threatened death, serious injury or sexual violation
- Reliving a traumatic event- Intrusive symptoms, e.g. distressing memories or dreams, flashbacks, intensive distress
- Being overly alert or wound up (e.g. sleep difficulties, irritability, hypervigilance, lack of concentration)
- Avoidance of stimuli associated with the event
- Negative alterations in cognitions and mood (e.g negative beliefs and emotions, detachment)
25
Q
DEPRESSION TREATMENTS
A
Pharmacology
- Antidepressants- Selective Serotonin reuptake inhibitors (SSRIs) selective noradrenaline reuptake inhibitors (SNRIs) Monoamine oxidase inhibitors (MAOIs) Tricyclics
- Improvement in mood can take 3-5 weeks to start
Electroconvulsive Therapy (ECT)
- When urgent response is needed- if clients life is threatened in a severe depressive disorder
- For a treatment resistant depressive disorder, where symptoms have not respond to medication treatment
Hospitalisation
- May be required when illness is not responding to treatment, or if risk of harm is too great
26
Q
BIPOLAR DISORDER TREATMENTS
A
Pharmacology
- Mood stabilisers→ Lithium Carbonate, Sodium Valproate
- Antipsychotics→ Some antipsychotics have mood stabilising properties and are useful in treating acute mania and also depression (aripiprazole, olanzapine, quetiapine)
Hospitalisation
- May be required when illness is not responding to treatment, or if risk of harm is too great
27
Q
ANXIETY TREATMENTS
A
Psychoeducation
- Powerful therapeutic tools in the alleviation of distress caused by anxiety disorders
- Teaching people about the function and purpose of anxiety
- Providing information- self directed learning through websites, handouts, books
Social Support
- Identifying person’s current level of social support
- Assisting to enhance support from family, friends, wider community
- Exploring socioeconomic needs (housing, isolation, poverty)
Relaxation techniques/diversional therapy
- Slow breathing, progressive muscle relaxation, meditation, visualisation, exercise
Pharmacology
- Not usually used for as a first line therapy
- SSRIs and Benzodiazepines
- Atypical antipsychotics (Quetiapine)
28
Q
THERAPIES FOR MOOD AND ANXIETY DISORDERS: COGNITIVE BEHAVIOURAL THERAPY
A
- Effective evidence- based talking therapy
- Proposes that our cognitions (day to day thoughts, beliefs) play a major role in affecting out behavioural responses, and our resulting physiological responses, as well as promoting or reinforcing our emotional states
- Each factor can perpetuate both distress and dysfunction within the other areas and can create a cycle
- CBT interventions are psychotherapeutic approaches addressing problematic emotions, behaviours and cognitions through a goal- orientated systematic approach
