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FMHN > WEEK 5 > Flashcards

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
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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
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3
Q

CLINICAL FEATURES/ SYMPTOMS ASSOCIATED WITH DEPRESSION: Appearance and Behaviour

A
  • Decreased interest in grooming and cleanliness
  • Psychomotor retardation or agitation
  • Sleep disturbance
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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,

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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
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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)
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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)
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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
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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
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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
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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
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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
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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
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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
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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
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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

FMHN (7 decks)

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