Depression an Overview In-service

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Transcript Depression an Overview In-service

Depression Overview
October 2011
Experience. Education. Excellence.
Harvest is a leading full-service behavioral health provider,
specializing in the delivery of progressive and innovative
consultative behavioral health services for patients and
residents residing in skilled nursing, rehabilitation, and
assisted living facilities. Our multidisciplinary team of
highly skilled professionals work together to offer a broad
menu of services including but not limited to 24-hour
prescriber on-call services and hospitalization support,
comprehensive cognitive assessments, documentation
review, OBRA compliance support and customized
educational programs designed for the individual needs of
your facility.
Introduction to Harvest
This presentation was developed for the
continuing education of healthcare
 At the conclusion of this presentation the
audience will have a basic understanding
of depression including symptoms and
 Mental health professionals should be
consulted for the management of patients
with depression.
Depression may be described as feeling
sad, blue, unhappy, miserable or down in
the dumps.
 Most of us feel this way at one time or
another for short periods of time.
 True clinical depression is a mood disorder
in which feelings of sadness, loss, anger,
or frustration interfere with everyday life
for weeks or longer.
Exact cause is not known
Researchers believe it is caused by
chemical changes in the brain, which may
be genetic or triggered by stressful
 Some types of depression run in families,
but depression can occur if you have no
family history of the illness.
 Anyone can develop depression, even kids
and elderly.
Causes, incidence, and risk factors
Alcohol or drug abuse
Certain medical conditions: underactive
thyroid, cancer, chronic pain, heart
disease, diabetes
 Some medication such as steroids
 Sleeping problems
 Stress such as death or illness of
someone close to you, loss of job, loss of
independence, chronic medical problems,
social isolation
The following may play a role in
Depression can change/distort the way
you see yourself, your life and those
around you
 Everything seems more negative
 Becomes difficult to see how problems will
get resolved
 Untreated symptoms of depression may
evolve into psychotic symptoms such as
hallucinations and delusions.
Symptoms of Depression
Agitation, restlessness, irritability
Dramatic change in appetite, often with weight
gain or loss
 Very difficult to concentrate
 Fatigue and lack of energy
 Feelings of hopelessness and helplessness
 Feelings of worthlessness, self-hate, and guilt
 Becoming withdrawn or isolated
 Loss of interest or pleasure in activities that were
once enjoyed
 Thoughts of death or suicide
 Trouble sleeping or excessive sleeping
Major Depressive Episode
Hypomanic Episode
Manic Episode
Mixed Episode
Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder
Major Depressive Disorder
Dysthymic Disorder
9 Types of Depression in DSM IV
Studies show that 74% of people seeking
help for depression go to their PCP and
that 50% of those cases are
 Of the cases correctly diagnosed, 80% are
given too little medication for too short of
a time.
 The American Psychiatric Association has
clearly outlined criteria for each of the
nine types of depression.
Diagnosis of Depression
You have had an episode of depression lasting at least two weeks with at
least five of the following symptoms:
(1) You are depressed, sad, blue, tearful.
(2) You have lost interest or pleasure in things you previously liked to do.
(3) Your appetite is much less or much greater than usual and you have
lost or gained weight.
(4) You have a lot of trouble sleeping or sleep too much.
(5) You are so agitated, restless, or slowed down that others have begun
to notice.
(6) You are tired and have no energy.
(7) You feel worthless or excessively guilty about things you have done or
not done.
(8) You have trouble concentrating, thinking clearly, or making decisions.
(9) You feel you would be better off dead or have thoughts about killing
 These symptoms are severe enough to upset your daily routine, or to
seriously impair your work, or to interfere with your relationships.
 The depression does not have a specific cause like alcohol, drugs,
medication side effect, or physical illness.
 Your depression is not just a normal reaction to the death of a loved one.
Criteria for Major Depression
Healthcare provider will ask questions
about medical history and symptoms.
 Information from family or caregivers will
be collected.
 Blood and urine tests may be done to rule
out other medical conditions similar to
 Depression inventories and or mental
status exam questionnaires may be used
Process of Diagnosing Depression
In general treatment includes both
medication and psychotherapy.
 Medication used to treat depression is
called antidepressant medication.
 Psychotherapy (talk therapy) has been
found to be as beneficial as
antidepressant medication in the
treatment of depression in the early
phases of depression.
May take weeks before there is a
consistent response
 May have transient side effects in the first
few days that can be treated
 May cause a worsening in depression and
even suicidal thoughts
 May induce agitation or impulsive
Antidepressant Medication
Talk therapy is counseling to talk about your
feelings and thoughts, and help you learn how to
deal with them.
Cognitive behavioral therapy teaches one how to
fight off negative thoughts. Learning how to
become more aware of symptoms and how to
spot things that make depression worse creates
problem-solving skills.
Psychotherapy can help one to understand the
issues that may be behind thoughts and feelings.
Joining a support group of people who are
sharing similar problems can also help
Do not drink alcohol or use illegal drugs. These
substances can make depression worse and
might lead to thoughts of suicide.
Take medication exactly as instructed. Ask the
prescriber about the possible side effects and
how to manage them.
Learn to recognize the early signs that your
depression is getting worse.
The following tips might help you feel better:
Get more exercise
Maintain good sleep habits
Seek out activities that bring you pleasure
Volunteer or get involved in group activities
Talk to someone you trust about how you are feeling
Try to be around people who are caring and positive
 How
is the syndrome of depression
different from feeling sad?
 What is the most common treatment
for depression and how fast does it
 How can you make a referral for the
evaluation of a patient with
Thought Provoking Questions