Working with people with mood disorders 1 PP learning objectives. Flashcards
Discuss the major mood disorders - Major depressive disorder
Condition involving seriously depressed mood and other symptoms which affect all body systoms and interfere significantly with persons ability to carry out daily living activities
Discuss the major mood disorders - Dsythymic disorder
Chronically depressed mood for most of the day, more days than not, for at least two years
Discuss the major mood disorders - Bipolar disorder / both 1 and 2
BP| - marked symptoms of mania with at least 1 episode of depression
BP || = recurrent bouts of major depression with episodic occurrence of hypomania
Discuss the major mood disorders - Cyclothymic disorder
Chronic mood disturbance of at least two years or more involving numerous periods with hypomanic and depressive symptoms that do not meet the criteria for mania or MDE
Discuss the major mood disorders - MANIA
An elevated expansive or irritable mood for at least one week. Significant impairment in social or occupational functioning. 3 or more of the seven symptoms must be present
Discuss the major mood disorders - Hypomania
Exactly the same symptoms but are only present for 4 days.
Describe the aetiology of mood disorders. [Neurotransmission and interpersonal]
Neurotransmission – Norepinephrine, serotonin and dopamine all involved. Neuroendocrine dysregulation – HPA [Hypothalamic pituitary adrenal] axis controls physiologic responses to stress. Dysregulation of HPA axis is associated with depression resulting in hypersecretion of cortisol. HPA also controls 24hr circadian rhythms – sleep wake cycle [depression v mania].
Interpersonal explanation – suggests that the person develops a depressive way of being as a result of negative interpersonal relationships and a lack of positive reinforcement
Describe the aetiology of mood disorders. Psychodynamic explanation
as a child the person experiences significant loss/or the belief that being loved was pleasing others. Results in development of a distorted self image. In adulthood person experiences loss or difficulties with relating to events in life and associates this feeling about childhood loss. Includes anger which is internalised and increases feelings of guilt and lack of self worth.
- Describe the DSM 5 criteria for a major depressive episode – condition involving seriously depressed mood and other symptoms which affect all body symptoms and affect persons ability to carry out ADL’s.
- Depressed mood most of the day, nearly every day
- Marked diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (anhedonia)
- Significant weight loss when not dieting, or weight gain
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or retardation nearly every day
- Fatigue or loss of energy every day
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day
- Diminished ability to think or concentrate, or indecisiveness, nearly every day
- Recurrent thoughts of death or suicidal ideation
Describe the DSM 5 criteria for Dysthymia – Dysthymia is a depressed mood for most of the day during a 2 year period [more chronic]. Symptoms can cause distress in social occupation, other important areas of functioning. Presence of two or more of the symptoms:
Decreased or increased appetitie Insomnia or hypersomnia Anergia or chronic fatigue Anhedonia Poor concentration or difficulty making decisions Feelings of hopelessness and despair
Describe the DSM 5 criteria for a manic episode. Mania is classified as an elevated, expansive or irritable mood for at least 1 week. Significant impairment in social or occupational functioning. 3 or more of the following
Inflated self-esteem or grandiosity
Decreased need for sleep
More talkative/pressure of speech
Flight of ideas/racing thoughts
Distractibility
Increase in goal directed activity (e.g. social, work, school or sexual activity)
Excessive involvement in pleasurable activities that may have negative consequences (e.g. shopping, sexual or business activities)
Identify the changes in functioning that occur with depression and mania / Behavioural changes
D / social and emotional withdrawal, less effective in areas of work and family. Substance abuse
M / Increased acitivty, impulsive, spending large amounts of money, starting up ill-advised business ventures
Identify the changes in functioning that occur with depression and mania / Mood changes
D / mood low, feelings of sadness and hopelessness, crying.
M / Elevated or high, irritable mood, rapidly changing intense emotions [labile]
Identify the changes in functioning that occur with depression and mania / Alterations in physical functioning
D / sleep disturbances, fatigure, appetite changes, sexual desire diminishes, somatisation
M / Reduced need for sleep, increased energy, increased appetites
Identify the changes in functioning that occur with depression and mania / Communication changes
D / don’t initiate conversation, latency and poverty of response
M / Very talkative, speech is rapid and pressured, intolerant of criticism, argumentative
