Epidemiology & more
The incidence of depression is higher in this gender.
What are females?
Research shows women have a higher incidence of monoamine oxidase, greater vulnerability to thyroid dysfunction, and hormonal changes. Also women have increased sensitivity to stress, multiple social roles, and poorer coping mechanisms.
This disorder lasts for at least 2 years.
What is dysthymia or persistent depressive disorder (PDD)?
Dysthymia or persistent depressive disorder is a chronically depressed mood for most of the day, more often than not, for at least 2 years (1 yr for children and adolescents).
This scale is used for assessing depression.
What is the Hamilton Depression Rating Scale?
These are the most common used antidepressants.
What are SSRIs?
SSRIs have the lowest side effect profile, and are not lethal in an overdose. Tricyclics or MAOIs are older antidepressants and may be more effective, but can be lethal especially if the patient wants to commit suicide, and have more side effects to manage.
This is true of people with past suicide attempts.
What is they are at increased risk to commit suicide in the future?
Between 50% and 80% of people who commit suicide have attempted suicide in the past.
This rate among men increases with age.
What is suicide risk?
This disorder is characterized by a depressed mood or loss of interest or pleasure in doing usual activities for at least 2 weeks, no history of mania, and symptoms are not attributed to substance use or a medical condition.
What is MDD?
These are the recommended steps for applying antidepressant medication patches.
It's important to avoid hairy areas/less prone to skin folds, and flat.
These foods or medications must be avoided when taking MAOIs.
What are aged/fermented foods and diet pills?
This is important to review because a hypertensive crisis can occur. MAOIs block tyramine from breaking down and then tyramine-rich food or medications can cause a norepinephrine release, increasing BP to dangerous levels---> stroke.
MAOIs can be very effective, but as you can imagine, it can be difficult for patients to adhere to this diet.
These are protective factors against suicide.
What are problem-solving skills, social support, connectedness to family, and cultural/religious beliefs?
These have been shown to protect or prevent patient from completing suicide.
This race is at highest risk for suicide.
What are Whites, followed by American Indians/Alaska Natives, African Americans, Hispanic Americans, and Asian Americans?
A traumatic brain injury, thyroid disorder, or multiple sclerosis causes this disorder.
What is a depressive disorder due to another medical condition?
Treatment consists of treating the underlying disorder in conjunction with standard antidepressant therapy.
The nurse should ask this type of question when assessing the suicidal patient?
What are direct questions?
Have you wished you were dead or wished you could go to sleep and not wake up? Have you actually had any thought of killing yourself?
Beyond the basic questions, there must be a recognition that patients are not always forthcoming or truthful. Sometimes it helps to normalize the communication, hinting that they are not the only one who experiences SI. "Sometimes when people are in a lot of emotional pain, they have thoughts of killing themselves. Have you had any thoughts like that?"
These are the recommended SSRIs for adolescents.
What are escitalopram (Lexapro) and fluoxetine (Prozac)?
This could be an effective way to prevent suicide in someone taking one of the classes with higher side-effect profiles.
What is limiting their amount of the medication?
Remember, the older classes can be lethal in a overdose or when combined with other substances. Limiting the amount of medication we give until we assess the patient again, may be a deterrent.
This gender succeeds more often in completing suicide.
What are men?
More women than men attempt suicide but men succeed more often as they are more likely to use hard methods.
This disorder is characterized by irritability, loss of libido, sleep disturbances, and concern about the inability to care for baby.
What is moderate postpartum depression?
The nurse should instruct the patient to do this when receiving light therapy.
What is sit in front of the light box with eyes open?
This is a common side effect from SSRIs in the elderly.
What is hyponatremia?
These are common side effects of SSRIs, often leading to nonadherence.
What are sexual side effects and insomnia?
There is evidence that depression is increasing in this age group, which is often dismissed by family members.
What are American teens, particularly adolescent girls?
This is the least severe form of depressive disorders.
What is transient depression?
This usually results after a conflict or disappointment and may last a few days. Occupational functioning isn't compromised and the individual can still attend to their ADLs.
What is teach strategies to manage the side effects>
Patients may stop taking their medications for a variety of reasons. It is critical for the nurse to educate the patient on management of expected side effects to ensure adherence.
This can occur when people younger than 25 are taking antidepressants.
What are completing suicide?
When patients start to regain energy after therapy is initiated, they still have depressed thoughts but can have enough energy to carry out their plans.
Having little to no interest in previously pleasurable activities is called this.
What is anhedonia?
This is distressing symptom. If they person doesn't find pleasure in anything, they are at a real increase for suicide.