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psych depression

mood disorders-depression,MDD,dysthymia,ECT,Bipolar

depression prevalence 4th leading cause of disability in the U.S. symptoms of anxiety occur in 70% of cases of major depression. 2nd to medical condition
cause of depression serotonin and norepinepherine are two major neurotransmitters involved.
serotonin job important regulator of sleep, appetite,and libido.
serotonin dysfunction poor impulse control, low sex drive, decreased appetite, and irritability
norepinepherine decrease anergia, anhedonia, decreased concentration, diminished libido in depression
MDD depressed mood,loss of interest, impaired social and occupational functions, sx last @ least 2wks-9mths, no hx of manic, can have hallucinations
MDD symptoms(need 5 or more over 2wk period) depressed mood most of day, anhedonia, sig. wt loss, insomnia or hypersomnia, I/D motor activity, anergia, feeling worthlessness, D concentration, thoughts of death. NO HX MANIC
Dysthemic Disorder DD same sx as MDD but milder, 2 years, chronic sad and depressed most of time, no psychotic features, children express by irritability
DD sx(2 or more are present) D/I appetite, insomnia or hypersomnia, low energy, D self esteem, poor conc, difficult making decisions, feelings hopelessness
pt w/ DD not normally severe enough for hospitalization, usually starts in childhood and teenage years to early adult, at risk for developing MDD as well as other psych disorders
difference between MDD and DD main difference is the severity of symptoms, DD is much less severe than an episode of MDD
anhedonia lack of enjoyment in life
meds for depression TCAS, SSRIS, atypical antidepressants, MAOIS, SNRIS
TCAS ELAVIL,ENDEP. sedation and wt gain common, dangerous for OD, if it does not get the heart it will get the liver.
SSRI CELEXA,PROZAC,PAXIL,LUVOX,LEXAPRO, ZOLOFT. rare but serotonin syndrome can happy and is greatest when mixed w/ serotonin enhancing agent like MAOI
serotonin syndrome overactivation of serotonin receptors, caused by high dose of drug interactions like MAOIS
serotonin syndrome S/S abd pain, D, sweatring, fever, tachycardia, elevated BP, delirium, muscle spasms, I motor activity, irritability, hostility, and mood change
newer atypical antidepressants WELLBUTRIN,ZYBAN,DYSEREL,AND SSRI (cymbalta,remeron,effexor)
MAOIS NARDIL,PARNATE. used when no response to other meds, prevents breakdown of monoamine I levels and resulting in increased mood
MAOI problems inhibit breakdown of tyramine in liver. I levels lead to high BP, HTN crisis, cerebrovascular accident and death. restrict foods high in tyramine
foods high in tyramine avocados,figs,bananas,meat(fermented, smoked,aged),most cheeses, yeast extract, beers, most aged foods
Bipolar Disorder labile mood-extreme euphoria to depression, periods of nl moods between, some happen at certain seasons, sx may become psychotic
criteria for bipolar 4days hypomania,1wk mania. 3 or more sx including;high self-esteem, D sleep, more talkative, flight of ideas, distractibility, I goal directed activity, excessive pleasurable activites w/ painful consequences
mania mood elevated, impairment of occupational and social functioning, excessive motor activity, may be harmful, may have psychotic features, often need hospitalization
hypomania mood elevated but milder than mania, no hospitalization, no psychotic features
mixed episodes rapidly alternate moods, mania and depression, causes severe occupationl and social dysfunction, usually requires hospitalization, may have psychotic features
predisposing factors of mood disorders genetic, biochemical(D serotinin and dopamine), endocrine disorder (hypersecretion of cortisol, hypothyroidism)
psychiological factors of mood disorders meds(steroids),neurological disorders (parkinsons), electrolye imbalance(I Na&Ca),nutritional deficiencies(B vit)
other causes of mood disorder SLE, CHF, DM
psychosocial causes of mood disorder loss, chronic anxiety
assess for presence of suicidal thoughts, plan, means,any use of substances, previous attempts and what they were,contact for safety
tx meds, therapy, electric shock therapy(electric convulsive therapy ECT)
meds for bipolar disorder lithium carbonate,antiepileptic drugs(AED-depakote,tegretol, lamictal),anxiolytics(klonopin, ativan),antipsychotics(zyprexa, seroquel)
Created by: gudknecht