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NUR 114
Major Depressive Disorder
| Question | Answer |
|---|---|
| What is depression commonly thought to be caused by? | Insufficient monoamine neurotransmitters — can be physical, social, or environmental causes |
| What are some monoamine neurotransmitters | Norepinephrine, serotonin, dopamine |
| Why might the depressed elderly population go untreated for their depression? | Their symptoms commonly resemble dementia (memory loss, confusion, behavioral problems) |
| Who is at higher risk for depression? | Seniors (chronic illness, loss) and LGBTQ+ (Sigma) |
| What kinds of children are at higher risk for depression? | Those who have experienced significant stress/ trauma, loss, or those with family history of depression |
| What are some co-occurring disorders that increase the risk for depression? | ADD/ ADHD, anxiety disorders, Oppositional defiance disorder Sleep disturbances, chronic illness/pain, anxiety |
| What symptoms will some children develop instead of feeling “depressed”? | Aches and pains |
| At what point should a teens behavior be very concerning? | When they start engaging in risky behavior and/or abusing drugs/alcohol |
| What is oppositional defiance disorder? | Children are aggressive towards authoritative figures because they view them as peers |
| What are characteristics of disruptive mood dysregulation disorder (DMDD)? | Irritable/ angry mood for most of the day (every day) with sever temper outbursts that inhibits daily functioning |
| When do children typically get diagnosed with DMDD? | Before 10 y/o |
| Time frame for DSM-V diagnosis of MDD | 5/9 listed symptoms lasting longer than 2 weeks |
| DSM-V symptoms for diagnosing MDD | -anhedonia -weight/ appetite change -sleep disturbances -psychomotor retardation -loss of energy/ fatigue -low self worth -difficulties concentrating -physical aches/pains -suicidal thoughts |
| What is anhedonia? | Loss of interest or loss of pleasure in activities once found enjoyable |
| When may electro-convulsant therapy (ECT) be used? | When pt has not responded to medications or is very suicidal |
| What are the common side effects of ECT? | MEMORY LOSS, headaches, nausea, muscle aches |
| How many ECT treatments do pts usually undergo? | 6-12 initially, then 2-3x per week |
| Does ECT require informed consent? | YES |
| Is a pt on antidepressants during ECT? | NO, they should be weaned off antidepressants |
| Can pts drive home after their ECT session? | NO, they are put under general anesthesia and muscle relaxants (needs help breathing) |
| What is Milieu Therapy? | Therapeutic environment meant to promote self-care, communication, safety, and counseling |
| What is light therapy? | Light box used to expose a person to full spectrum light |
| Purpose of light therapy? | Regulate melatonin hormone (Used a lot for Seasonal Affective Disorder (SAD)) |
| Other non-pharmacological therapies for MDD (not light or milieu) | Exercise, aromatherapy, pet therapy, acupuncture, meditation, faith, etc |
| 1st line of defense to treat MDD | Selective serotonin reuptake inhibitors (SSRIs) |
| Antidepressants used to treat MDD | SSRIs, Selective serotonin and norepinephrine reuptake inhibitors (SSNRIs), Tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs) |
| Side effects of anti-depressants | -Anti-cholinergic effect -N/V -weight gain -insomnia -sedation -sexual dysfunction -orthostatic hypotension -photosensitivity -seizures (TCA & Wellbutrin) -^increase HR -hypo/hyperglycemia |
| What is important to remember about tricyclic antidepressants | Overdose may result in arrhythmias and/or hypotension |
| Tricyclic antidepressants — try to think | TRI = 3x harder on the heart |
| What is important to remember about MAOIs? | Eating foods high in tyramine can cause a hypertensive crisis |
| Foods high in tyramine | Think charcuterie board: Cheese, cured meats, smoked/ processed meats, pickled foods, dried fruit, soybeans, podded beans (snow peas/ fava) ALSO: alcoholic beverages, soy, shrimp, miso and teriyaki sauces, yeast spreads (MARMITE), spoiled foods |
| S/S of a hypertensive crisis | Sweating, tremors, dizziness, severe headache, tachycardia (pounding heartbeat), nosebleeds, chest pain, SOB, confusion |
| Antidepressant used to help with smoking cessation | Bupropion (Wellbutrin) |
| Antidepressant used to promote sleep | Trazodone hydrochloride (SE extreme sedation) |
| What are Anxiolytics? (drugs) | Benzodiazepines and non-barbiturate anxiolytics |
| What do anxiolytics do? | potentiates (enhances) the effects of GABA, which calms nervous activity |
| Examples of Benzodiazepines: | Diazepam (valium), lorazepam (ativan), alprazolam (xanax) |
| side effects of benzodiazepines: | drowsiness, sedation, resp. depression |
| What are non-barbiturate anxiolytics? (Drugs) | Buspirone (Buspar) |
| what are non-barbiturate anxiolytics used for? | long term management of depression (2-4 wks for effect) |
| What anxiety disorders are related to low GABA activity? | panic attacks, seizure disorders, addiction, parkinson's syndrome |
| What happens when GABA is inhibited? | the less GABA the more nerve transmissions occur (caffeine inhibits GABA, think about what happens when you drink coffee) |
| What does St. John's wort do? | increases serotonin levels |
| should you take st. john's wort with other antidepressants? | NO! it may increase serotonin levels too much |
| Black box warning on antidepressants? | suicide risk |
| what is discontinuation syndrome? | withdrawal like symptoms (including tingling) due to stopping antidepressant therapy/ treatment abruptly or missing several doses |
Created by:
ginnyfoscue
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