Mod. 28 Mood and Affect

Seasonal affective disorder (SAD) Clinical Therapies

* Bupropion extended-release * Light Therapy * Cognitive-behavior therapy

Risk factors for depression

* Hx of child abuse or neglect, spousal abuse, loss of a loved one * Dysfunctional family relationship, with or without the presence of substance abuse * Personal or family history of mental illness or substance abuse.

Define Seasonal affective disorder (SAD)

Not an official DSM diagnosis, but rather a specifier of MDD "with seasonal pattern. Natural light may help modulate daily rhythms that influence sleep and activity patterns, neuroendocrine functions, and brain chemical systems.

Define Anhedonia

No longer enjoying activities that previously brought please, such as hobbies, sports, and sex

Persistent depressive disorder (dysthymic disorder) Clinical Manifestations

Symptoms are not as severe as those of major depressive disorder, but last beyond 2 years with period of relief lasting less than 2 months

Major Depressive Disorder (MDD) Clinical Manifestations

Symptoms must last 14 days or longer and may include: Feelings of sadness and hopelessness Somatic complaints such as pain, stomachaches Anxiety, anger, irritability Loss of interest in pleasurable activities Sleep Disturbances

True or False: The symptoms of dysthymic disorder; while distressing, tend to be less severe than those in MDD, with fewer physiological symptoms, but the degree of impact to individual functioning can be as great or greater than that of MDD.

True

True or False: Assess all clients for suicide risk by using direct questioning?

True

Define Terminal Insomnia

Waking at the end of the night and being unable to return to sleep.

Define Middle Insomnia

Waking up during the night and having difficulty falling asleep again.

Define Emotional Contagion

Working with clients with depression may eventually lower your own mood and make you feel "down" yourself

Priorities of nursing care with depression, are focused on ________ and meeting functional needs until the client's condition improves

Safety

Define Depression:

A disorder characterized by a sad or despondent mood or loss of interest in usual activities.

Define Major Depressive Disorder (MDD)

Characterized by a change in several aspects of an individual's emotional state and functioning consistently over a period of 14 days or longer. My consist of a single episode or may exhibit as recurrent major depression at various points in life.

Define Persistent Depressive Disorder aka Dysthymic disorder

Chronic depression for the majority of most days for at least 2 years (1 year for children and adolescents). Throughout those 2 years no more than 2 months can be described as symptom free.

Seasonal affective disorder (SAD) Clinical Manifestations

Depressive symptoms occur in relation to the seasons; usually during the winter months, when days are shorter.

Strategies useful in modifying stressors that can contribute to depressive illnesses include:

Exercise Proper diet and rest Avoiding alcohol and illicit drugs

True or False: Individuals with persistent depressive disorder are at a lower risk of developing other mental health disorders than those with MDD.

False At a higher risk

True or False: There is a definitive way to prevent depression.

False There is no definitive way to prevent depression.

Define Anergy or Anergia

Fatigue and decreased energy. Individuals report being tired upon awakening regardless of how long they sleep.

Define Insomnia

Inability to fall or stay asleep or, in some individuals, early morning awakening.

Define Hypersomnia

Individual sleeps for prolonged periods at night as well as during the day but still wakes up tired or fatigued.

Persistent depressive disorder (dysthymic disorder) Clinical Therapies

Pharmacologic therapies are the same as for MDD. * Selective serotonin reuptake inhibitors (SSRIs) * Tricyclic antidepressants (TCAs) * Atypical antidepressants * Electroconvulsive therapy (most often used for those who are resistant to treatment with medications) * Cognitive-behavioral therapy

Major Depressive Disorder (MDD) Clinical Therapies

Pharmacologic therapies include: * Selective serotonin reuptake inhibitors (SSRIs) * Tricyclic antidepressants (TCAs) * Atypical antidepressants * Electroconvulsive therapy (most often used for those who are resistant to treatment with medications) * Cognitive-behavioral therapy

Depression associated symptoms

lack of energy sleep disturbances anxious distress abnormal eating patterns psychomotor retardation or agitation feelings of despair, guilt, and hoplessness