Mood & Affect
What is hypomania?
A less severe form of mania.
What is depression?
A mood characterized by low mood.
What is euthymic/norma mood?
A normal mood.
When is ECT typically administered?
After midnight.
What is mania?
An abnormally elevated mood.
What are common emotional expressions during a manic episode?
Angry, aggressive, and sarcastic behaviors.
What does 'ALGEE' stand for?
Assess, Listen, Give reassurance and information, Encourage appropriate professional help, Encourage self-help and other support strategies
What is the duration of a manic episode?
At least 1 week, or any duration if hospitalization is necessary.
What does ECT cause?
Causes a seizure.
What is distractibility?
Easily drawn to unimportant or irrelevant external stimuli.
How is ECT administered?
Electrodes applied to head to deliver electrical impulses to brain.
Mood Disorders
Emotional alterations that interfere with life
Mood
Emotional state
What is increase in goal-directed activity or psychomotor agitation?
Engaging in purposeless or excessive activities.
What is excessive involvement in activities with high potential for painful consequences?
Engaging in risky behaviors with negative outcomes.
What is the assessment for manic episode?
Evaluation of symptoms and behaviors associated with mania.
What is inflated self-esteem or grandiosity?
Exaggerated sense of self-importance or superiority.
What are the characteristics of bipolar disorder?
Extreme mood ranging from low to high.
Major Depression Risk Factors
Factors that increase the likelihood of developing depression, including gender, age, family history, marital status, stressful life experiences, history of abuse, and low levels of serotonin and norepinephrine
What are delusions of grandeur?
False beliefs of having exceptional abilities or importance.
First-Degree Relative
Family member with major depressive disorder
What are some risk factors for suicide in adolescents?
Family strife, parental mental illness/alcoholism, fighting, access to weapons, victim of bullying/cyberbullying
Anergia
Fatigue and loss of energy
What is the mood and affect during a manic episode?
Feelings of grandiosity and euphoria.
What is labile mood?
Frequent and rapid shifts in laughter and crying
What is the resulting change in brain chemistry after ECT?
Helps correct chemical imbalance.
What is electroconvulsive therapy (ECT)?
Highly effective in those with psychotic features.
What medications are used during ECT?
IV anesthetic and muscle relaxant/paralytic.
What are some behavior cues of suicide?
Ideation, substance abuse, purposelessness, anxiety, trapped, hopelessness, withdrawal, anger, recklessness, mood changes
Affect
Immediate verbal and nonverbal emotional expression
What are the symptoms of a manic episode?
Increased energy or activity, along with three or more additional symptoms.
Psychomotor Agitation
Increased physical movement and restlessness
What is sensorium?
Intellectual processes
What are the common symptoms of depression in children?
Irritability, clinginess, hyperactivity, antisocial behaviors
What are the criteria for a manic episode?
Lasting at least 1 week and present most of the day.
Anhedonia
Loss of interest or pleasure in activities
What are the risk factors for suicide?
Men, women, young women, older adults, previous suicide attempt, chronic medical illnesses, psychiatric disorders, substance abuse, starting an antidepressant, environmental factors
Depression
Mood disorder characterized by depressed mood, anhedonia, appetite changes, insomnia or hypersomnia, psychomotor changes, fatigue, feelings of worthlessness, inability to concentrate, and recurrent thoughts of death
Mania
Mood disorder characterized by elevated mood, irritability, increased energy, decreased need for sleep, grandiosity, racing thoughts, and risky behavior
Major Depression Criteria
Must experience 5 or more symptoms during a 2-week period, including depressed mood, anhedonia, appetite changes, insomnia or hypersomnia, psychomotor changes, fatigue, feelings of worthlessness, inability to concentrate, and recurrent thoughts of death
What are physiological and self-care considerations in Bipolar disorder?
Neglect of ADLs
Norepinephrine
Neurotransmitter decreased in depression and increased in mania
Serotonin
Neurotransmitter imbalanced in depression and mania
Acetylcholine
Neurotransmitter involved in mood and cognition
Dopamine
Neurotransmitter involved in mood, cognition, and reward
Does asking about suicide cause suicide?
No
What is the general appearance and motor behavior during a manic episode?
Observable physical appearance and movement patterns.
What is suicidal ideation?
Passive - thinks about/wants to die but has no plans, active - thinks about and seeks ways to commit suicide
What is judgment and insight?
Patient's ability to make decisions and understand their condition
What is mood and affect?
Patient's emotional state and expression
What is sensorium and intellectual processes?
Patient's level of consciousness and cognitive abilities
What is self-concept?
Patient's perception of themselves
What are physiological and self-care considerations in depression?
Patient's physical health and ability to care for themselves
What are roles and relationships?
Patient's social roles and interactions
What is suicidal ideation?
Patient's thoughts of self-harm or suicide
What are the treatment options for depression?
Psychotherapy, interpersonal therapy, behavioral therapy, cognitive therapy, exercise, proper diet and rest
What is the thought process and content during a manic episode?
Rapid flow of ideas and tangential thinking.
What is psychomotor agitation and pressured speech?
Restlessness and rapid speech patterns.
What are the common symptoms of depression in adolescents/teens?
Sadness, irritability, substance abuse, self-harm
Psychomotor Retardation
Slowing of thought and reduction of physical movement
What is flight of ideas?
Subjective experience of racing thoughts.
What is the severity of mood disturbance in bipolar disorder?
Sufficiently severe to cause marked impairment in social or occupational functioning.
What are some lifespan considerations for adolescents?
Suicide is a leading cause of death, protective factors include close parent-child relationships, academic achievement, family life stability, connectedness with peers, screening for risk factors
What is the 'IS PATH WARM?' acronym used for?
Suicide prevention
How many symptoms need to be present during a manic episode?
Three or more (four if the mood is only irritable).
How often is ECT treatment given?
Up to 15 treatments, three times per week.
Why is electroconvulsive therapy (ECT) used?
Used for patients who don't respond to or can't tolerate other treatments
When is hospitalization necessary in bipolar disorder?
When there is a risk of harm to self or others, or when there are psychotic features.
Single or Divorced, Stressful Life Experiences, History of Abuse, Dysfunctional Family Relationships
higher risk of depression