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affective mood

QuestionAnswer
pervasive/sustained emotion that may have a major influence on perception (depression, elation, anger). Mood (affect)-
alteration in mood or feelings(sadness, despair, pessimism). Depression
alteration in mood or feelings (hyperactivity, agitation, hyperactivity, grandiose). Mania
Major Depressive Disorder & Dysthymic Disorder are aka __________ Depressive (Unipolar)
Mania is AKA _______ (Bipolar)
depression is > in woman, young age,lower income,single,divorced,>spring,fall and > in whites but more sever in_____ more severe in blacks- less likely to be treated.
Bipolar is = in both men and woman, 1st manic episode is at age ___ 20
how does Pathological Depression occur when ADAPTATION is ineffective.
*Features: delusions-include guilt/punishment, hallucinations are auditory, berating is known as Psychotic ;Major Depressive Disorders Subtype
*Features (psychomotor retardation)is known as Catatonic ;Major Depressive Disorders Subtype
*Features (severe form of depressive episode) worse in AM, suicidal ideation is known as Melancholic ;Major Depressive Disorders Subtype
*Features dominant vegetative symptoms is known as Atypical ;Major Depressive Disorders Subtype
features fall/winter months is known as (SAD-seasonal affective disorder)Major Depressive Disorders Subtype
4weeks postpartum( with psychotic features-infant at risk)is known as PostPartum-onset;Major Depressive Disorders Subtype
Major Depression Proposed Subtypes are Premenstrual dysphoric disorder- characterized by more severe symptoms than premenstrual syndrome. Mixed anxiety/depression Recurrent brief depression-(1day/1wk,1x per month over 12 months.*high risk of suicide. Minor depression-chronic (self pity )
Change in previous function. Impaired social/occupational function existing for at least 2weeks. No history of Manic Behavior. Symptoms not attributed to medical conditions/substance abuse Depressive Disorders Major Depressive Disorder MDD
1. 5>symptoms presented in same 2 wks. Every day, most waking hours. 2. 1 of the symptoms is depressed mood (loss of interest/pleasure). 3. Clinically significant distress/impairment in social/occupational or other important Areas. Major Depressive Disorder Diagnostic Criteria
Depressed (SAD) most of the day nearly every day.Child/Adolescent-irritable.Older adults- subsyndromal depression.Marked diminished interested in pleasure.Significant wgt. Loss/gain.Insomnia/Hypersomnia 5.Psychomotor agitation/retardation.Fatigue Major Depressive Disorder Diagnostic Criteria r/t 1,2,3 named systems mentioned
Feelings of worthlessness/guilt (may be delusional). Decreased ability to think/concentrate/indecisive.Recent thoughts of death or SUICIDAL ideation. Major Depressive Disorder Diagnostic Criteria r/t 1,2,3 named systems mentioned
B. Never a MANIC Episode. C. Clinically significant distress or impairment. D. Symptoms have no direct physiological cause. E. Symptoms longer than 2months,suicidal ideation, psychotic/psychomotor (not related to bereavement). Major Depressive Disorder Diagnostic Criteria
Early onset (before 21yrs.) Childhood/ teens Late onset (21yrs>) early adulthood *MDD/DD-Main differences are duration and severity of symptoms.DD no psychotic symptoms Dysthymic Disorders Classification
Feature –chronically depressed mood(2yrs>); most of the day, more days than not . irritable mood in child/adolescent(1yr>). No evidence of psychotic symptoms. Milder than major depression “down in the dumps”, able to function. Depressive Disorders Dysthymic Disorder DD
What is the *Dominent Symptom in childhood depression *Dominent Symptom:Irritability and disruptive behavior, sadness and hopelessness core issues
What is the common denominator in childhood DD *Common denominator = LOSS
BEHAVIORAL changes lasting several weeks.Change in mood, thinking motivation. (sadness,loneliness,anxiety,delinquency,sexual acting out, substance abuse, anger,apathy are implications of ADOLESCENTS DD
*Perception of Abandonment by parents or peers can precipitate what in childhood DD SUICIDE .(3rd leading cause of death in 15-24yr olds)
What is the tx for DD in children and adolescents TX:psychosocial interventions, antidepressant
Senescence- (Low self-esteem, helplessness, hopelessness).Symptoms of depression often confused with dementia. Bereavement Overload. Highest % of suicides among the _______ Elderly -> TX: antidepressants, electroconvulsive therapy, psychotherapy (behavioral, group, cognitive, family).
Postpartum Depression-may last a week to several months. a. “blues”-50-85% (within 48hrs.) b. moderate-10-20% (start later-vary day to day) c. severe/psychotic-1to2 out of 1000 (risk of suicide/infanticide) what is the TX TX.-antidepressents,psychosocial therapy,support.
Many older adults suffer from depression. They experience many but not all symptoms of Major Depression. Note: Depression is common in older adults but it is.... NOT a normal result of aging.
what neurotransmitter deals with stress norepinephrine
What neurotransmitter regulates psychobiological factors (irritability, poor impulse control,arousal seritonin
What neurotransmitter exerts strong influence over mood/behavior dopamine
What neurotransmitter is excessive in depression, inadequate in mania. Acetylcholine
This theory states that depression results from the dynamic interplay of biology/environment. *Diathesis –Stress model
This theory states that ”learned helplessness”. Repeated failure to control life leading to feelings of helplessness and dependence on others, a possible predisposition for depression. *Learning theory
This theory states that negative cognitive distortion BECK’s TRAID (negative expectations of :envirorment, self, future). *Cognitive theory
This belief is associated with lower rates of depression. *Religious/Spiritual Belief-
This stage of Depression shows helpless, powerless,Behavioral-slow movement,limited communication, slumped, retarded thinking, difficulty concentrating anorexia or overeating, h/a, sleep disturbance. Moderate-associated with Dysthymic Disorder.
What stage of depression shows Affective-total despair, worthlessness, flat affect.Behavioral- psychomotor retardation, no communications,fetal position.Cognitive- Delusional thinking,confusion, suicidal thought.Physiological- slow-down entire body Severe- major depression or bipolar depression
ND for depression Risk for violence (self-directed) Powerlessness Self care deficit Low self esteem
Treatment Modalities Mood Disorders Psychopharmacology;Depression (pp.261-269) Mania (pp.290-296) Psychotherapy Group/Family Cognitive- Behavioral Therapy (CBT)-change negative thought patterns and behavior. Interpersonal Therapy (IET)-work through personal relations.
Electroconvulsive Therapy (ECT)Absolute contraindication increased intracranial pressure. High risk: CVA,MI,Aneurysm,>BP,CHF.
At least 1 episode of mania alternates with depression.(Psychosis may accompany the manic episode) Bipolar I (Mania)-
recurrent bouts of hypomania(euphoric) alternate with major depression (at risk for suicide). P.282 Bipolar II (hypomania)-
*Psychosis not present in Bipolar ___ II
hypomanic episodes alternate with minor depressive episodes (at least 2 years). They tend to have irritable hypomanic episodes. Cyclothymia-
-(4>mood episodes in 12 month period) severe symptoms resistance to conventional tx. Rapid Cycling
Bipolar Disorder Developmental Implications *Suicide Risk: rage, aggression, self-injurious behavior
Child/Adolescent- Treatment Strategies Bipolar . Psychopharmacology: Librium, Divalproex, Carbamazepine, Atypical antipsychotics. *ADHD- most common comorbid condition. ADHD Agents may >mania-only give after bipolar symptoms controlled.
What type of mainia *Does not require hospitalization usually Hypomania
What type of mania *Usually requires hospitalization Acute Mania
What type of mania * At risk for injury to self/others Delirious Mania
Intervention (NIC) Mania(Safety) Set limits on client’s behavior when needed. Reminded the client to respect distance between self & others Use short, simple sentences to communicate.Clarify the meaning of client’s communication. provide finger foods that are high in calories and prote
Suicide is a behavior, who has the highest rate of suicide Elderly rate very high
What affiliation decreases suicide risk. Religion-
What is a primary intervention for suicide Activities that provide support, education, information to prevent suicide. (schools, conferences).
What is a secondary intervention for suicide : Treatment of actual suicide crisis. (hot-lines, hospitals).
What is a tertiary intervention for suicide Working with family/friends of suicide victim.
Nursing Intervention (NIC) Suicide Ask client directly: do you want to harm yourself?, Do you have a plan?,Do you have the means (gun)? Safe environment: eliminate harmful objects. Contract not to harm self. Close Observation.Possibly 1:1. Make rounds at frequent,irregular,intervals.
Created by: troop27