Influenced by age, culture, socioeconomic background, gender
Seen more in men - usually manifests as substance abuse
What are the S/S of HTN Crisis?
- occipital HA
- fever, palpitations
- bounding HR
What are ADS symptoms?
(Anti-depressant discontinuation syndrome)
- light headedness
- sensory disturbances
What herbal remedies can be used to treat depression?
- Folic acid & other B vitamins
- omega 3 fatty acids
- Light for SAD (seasonal affective disorder)
When is suicide risk greatest for a person with depression?
When pt. is coming out of depression
What are bipolar spectrum disorders?
- Mood disorder
- when a pt. has manic episodes characterized by euphoria, hyperactivity, irritable moods, flight of ideas, extreme self confidence/grandiosity, and little need for sleep or food, alternating with episodes of depression.
What is egosyntonic?
ideas & instincts that are comfortable to someone. They have no knowledge of their disorder.
What is ego dystonic?
Impulses thoughts and behaviors that go against our personal beliefs.
They are completely aware their disorder is wrong.
What are the comparisons of depression for men vs. women?
- 1 in 4 women will develop depression.
- 1 in 10 men will develop it.
What are s/s of depression?
- Anxiety 60-80%
- sense of worthlessness
- low self-esteem
- hopelessness, helplessness
-anhedonia (no interest in anything)
- spiritual distress, loss of sense of meaning
What affect (emotion) does depression show?
- grey colored glasses
- poor posture
- facial lines all go down
- fearfulness or unable to cry
What is the difference between bipolar 1 & 2?
Bipolar 1 ranges from severe depression --> Euphoric mania
Bipolar 2 ranges from severe depression --> hypomania
Bipolar 2 people are fully functioning during hypomania
What is cyclothymic disorder?
Mood range from moderate depression to hypomania
Alternating cycles of each
What is dystmic disorder?
Mood ranges from moderate depression to normal.
What are the psychobiological interventions for bipolar disorder?
What is the mood range for major depression?
Unipolar - severe depression to normal.
What are the physical signs of depression including the 4 vegetative signs?
- Psychomotor retardation or agitation
- Poor personal hygiene
- Vegetative change in eating, sleep, elimination, and libido
Prior to treatment, what tests are done to separate depression from other illnesses?
-EKG check before meds
What is ECT?
Electroconvulsive therapy used when pharm therapy doesn't work for depression.
Electric shock induces seizure while under local anesthesia.
3-4 times/week for 4 weeks. After w/ propholactic antidepressant.
Discuss St. John's Wart.
Can cause hypomania and serotonin syndrome when taken with SSRIs
Could decrease production of monoamine oxidase, possible HTN when used with MAOI's
What are the symptoms of a manic attack?
- Flight of ideas
- Activity increase
- Sleep deficit
How can lithium help bipolar disorder?
Lithium alone can reverse mild to moderate manic symptoms in 1-3 weeks for some patients.
What diseases can cause depression?
- Cushings Disease
According to the psychoanalytic theory where does MDD come from?
Anger turned inward
According to the cognitive theory, what causes MDD?
- Pessimistic world view
- Negative view of self
- Negative expectations
- Belief that nothing will change
According to the Biological theory what causes MDD?
-Genetics - chromosome 15
-Biochemical - stress and hormones
What causes depression?
What helps depression besides antidepressants?
Depression is caused by a decrease in serotonin, stress response gone awry & huge influx of cortison.
What are some drugs that can cause depression?
- Antiparkinsonian agents
- Alcohol, depressant drugs
- Withdrawal from stimulant drugs
A system assessment called Bleuler's 4 A's are what?
Affect - inappropriate, bizarre
Associative Looseness - lack of much or even any logic connecting thoughts