Mood/Affect
mood: what the patient subjectively feel
affect: observable expression of mood
What is depression?
sad or despondent mood or loss of interest in usual activities
What is MDD?
How long can it last?
s/sx?
-loss of interest in life and mild to severe depressed mood
-months or years
-anhedonia, insomnia, guilt, powerlessness, hopelessness
What is the action of SSRIs?
What are the meds?
-Celexa (citalopram), Lexapro (escitalopram), Luvox (fluvoxamine), Prozac (fluoxetine)
what is the action of tricyclics?
which patients should NOT use these drugs?
meds?
-blocks reabsorption of serotonin and norepinephrine, which causes these to build up so the brain will have more of this available to increase mood
-patients with cardiac problems
-Amitriptyline (elavil)
What is the continuum of mood and affect?
depression: low end
euthymia (no mood disturbances): middle
mania: extreme end
What is the period when someone is experiencing depression symptoms called?
depressive episode
What's the difference between MDD and a major depressive episode?
MDD will last for months or years
major depressive episode: lasts less that 6 months
What is the action of SNRIs?
What are some meds?
-blocks reabsorption of serotonin and noepinephrine
-Cymbalta (duloxetine), Effexor (venlafaxine)
what is the action of MOAI's?
meds?
what foods should be avoided while taking these meds?
if patient eats food that should be avoided what may happen?
-blocks MOA (enzyme that breaks down neurotransmitters) so that neurotransmitters get a boost
-Nardil (phenelzine), Selegiline (zelepar)
-aged meats and chesses
-hypertensive crisis
What are some words used to describe affect?
appropriate, inappropriate, elevated, depressed, blunted and flat
lack of energy
agitation
abnormal eating patterns
feelings of hopelessness or despair
hallucinations, delusions, suicide
what is dysthmia?
Patients with dysthmia function well but will have problems with what?
-symptoms of depression everyday but sx are less severe than MDD
-relationships
-what is the action of NDRI's?
-what is the med?
-blocks the reuptake of norepinephrine and dopamine
-Wellbutrin (bupropion)
What are the two newer serotonin drugs that can be used?
why are these meds rarely prescribed?
-why do patients prefer these meds?
-Trintellix (vortioxitine), Viibryd (vilazodone)
-very expensive
-because these meds only fix the issue and doesn't leave them with other undesirable side effects
What are some things that can alter the mood?
maladaptive coping: denial, dependency
sleep disturbances: insomnia, too much sleep
somatization:physiological response to physchological stressors
difficulties adapting:day to day functioning
altered though processes: poor memory, hallucinations, impaired problem solving
Risk factors of depression?
family hx of depression or other mental illnesses
female
hx of child abuse or trauma
poverty
inadequate support systems
inneffective mental health defense mechanisms
What is SAD?
Which hormone is increased with this d/o and which is decreased?
-symptoms of sadness and low energy in the winter months
- will have decreased serotonin and increased melatonin
what is the action of SARI's?
meds?
-prevents reuptake of serotonin and block the function of serotonin transporter protein to increase amount of serotonin available in the brain
-Nefazodone (serzone), Trazodone (desyrel)
-what are two natural supplements that patients taking antidepressants should avoid?
-ginkgo biloba and st. johns wart
What are some verbal/ nonverbal cues we use for mood?
verbal: elated, happy, pleasure, frustrated, anger
nonverbal: smiling, frowning, blank look
Patho/Etiology
Patho: unknown
possible connection between depression and inflammation
Etiology: biological, environmental, genetic
what is situational depression?
when do symptoms begin and how long will this last?
-change in mood or affect following a stressor
-symptoms begin about 3 months after the event has occured and can last for about 6 months
what is the action of tetracyclics?
meds?
-stops neurotransmitters from binding to specific receptors and they build up in the synapse to increase mood
-Mirtazapine (remeron), Asamoxipine (asendin), Maprotiline (ludiomil)
Life span consideration for toddlers, preschoolers, school aged, older school aged, and adolescents (how will they act)?
-toddlers: regressive behaviors
-preschoolers: self destructive play themes
-school aged: grades plummett, loss of friends, increase or decrease in physical activity
-older school aged: running away, boredom
-adolescents: focus on violence, decreased self care, issues with parents and teachers