Transcript MOOD DISORDERS

Mood Disorders
ETIOLOGY
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Neurobiology
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Psychosocial
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Genetics
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Neurotransmission
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Neuroendocrine
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Psychoanalytic
Cognitive
Learned
Helplessness
Life Events
Stress
Personality
Epidemiology
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Females
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Bipolar
Major Dep
Dysthym.
Types of Mood Disorders
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Depressive Disorders
Bipolar Disorders
Mood Disorders due to a general medical
condition
Substance-Induced Mood Disorder
Mood Disorders NOS
Seasonal Affective Disorder
Depressive Disorders
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Major Depressive
Episode
Major Depressive
Disorder
Dysthymic Disorder
Seasonal Affective
Disorder
Depression NOS
Symptoms of Depression
If a person experiences five or more of the following symptoms each day
during a two-week period or if
these symptoms interfere with work or family activities, criteria for
a major depressive episode are met:
Prolonged sadness or unexplained crying spells
Significant changes in appetite, sleep patterns
Irritability, anger, worry, agitation, anxiety
Pessimism, indifference
Loss of energy, persistent tiredness
Feelings of guilt, worthlessness
Inability to concentrate, indecisiveness
Inability to take pleasure in former interests, social withdraw
Unexplained aches and pains
Recurring thoughts of death and suicide
Bipolar Disorders
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Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder
Bipolar NOS
Symptoms of Mania
Heightened mood, exaggerated optimism and self-confidence
Decreased need for sleep (less than three hours) without fatigue
Grandiose delusions, inflated sense of self-importance
Excessive irritability, aggressive behavior
Increased physical, mental activity
Racing speech, flight of ideas, impulsiveness
Poor judgement, easily distracted, difficulty concentrating
Reckless behavior without concern for consequences, such as spending sprees,
rash business decisions,
erratic driving, sexual indiscretions
In severe cases, auditory hallucinations (hearing voices) or
delusions (strong convictions about things that aren't true)
Other Mood Disorders
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Mood Disorders due
to a General Medical
condition
Substance Induced
Mood Disorder
Mood Disorder NOS
Specifiers
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Mild, Moderate, Severe with or without psychosis
Partial or Full remission, Chronic
With Catatonic Features
With Melancholic Features
With Atypical Features
With Postpartum Onset
Longitudinal Course with or without full interepisode
recovery
With Seasonal Pattern
With Rapid Cycling
Postpartum Depression
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Feeling sad or crying a lot.
Having no energy.
Having headaches, chest pains, heart palpitations (the heart being fast
and feeling like it is skipping beats), numbness, or hyperventilation
(fast and shallow breathing).
Not being able to sleep or being very tired, or both.
Not being able to eat and weight loss.
Overeating and weight gain.
Trouble focusing, remembering, or making decisions.
Being overly worried about the baby.
Not having any interest in the baby.
Feeling worthless and guilty.
Being afraid of hurting the baby or yourself.
No interest or pleasure in activities, including sex. Feeling restless or
irritable.
Treatment
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Pharmacology
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antidepressants
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Tricyclics
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Clomipramine(anafranil)
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Amitriptyline(elavil)
Mirtazapine(remeron)
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Mood Stabilizers
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Phenelzine(nardil)
SSRIs
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Fluoxetine(prozac)
Sertraline(zoloft)
Bupropion(wellbutrin)
Lithium
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MAOIs
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0.5-1.2 mEq/L acute
treatment and
maintenance
toxic above 2.0
Carbamazepine
Valproate acid
Foods with High Tyramine Levels
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Aged Cheese, Yogurt
Red Wine, Beer, Liqueurs
Smoked or Pickled Foods, Pate
Overripe fruit, avocados
Yeast
Fava Beans
Certain Over the Counter Medications
Side Effects and Lithium Toxicity
Mild<1.5 mEq/L
Moderate 1.5-2.5
Toxicity <2.5
Metallic taste
Severe Diarrhea
Nystagmus
Fine hand tremor
N and V
Course tremors
Nausea
Ataxia
Dysarthria
Polyuria
Blurred vision
Confusion
Polydipsia
Tremors, twitching
Halluciations
Diarrhea
Slurred speech
Oliguria
Fatique
Tinnitus
Convulsions
Dizziness
Coma
Uncoordination
Death
Treatment
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Electroconvulsive
Therapy
Phototherapy
Family Intervention
Group Intervention
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Psychotherapeutic
Intervention
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Cognitive
Behavioral
Interpersonal
Psychodynamic
Phototherapy
Electroconvulsive Therapy
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Indication- Major Depression with Psychosis, Mania
Action- Unknown. Thought to increase levels of
norepinephrime and serotonin the brain.
Contraindication: Increased intracranial pressure
High Risk: Recent MI or CVA, aneurysm, severe
hypertension, respiratory infection, cardiac arrhythmias,
thrombophlebitis, narrow-angle glaucoma
Side effects: Temporary memory loss, headache and
confusion
Medications: Atropine, short acting anesthetic and
muscle relaxant given IV
Pre and post care as a surgery patient
Nursing Diagnosis
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Depression
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Risk for Violence
Self-care deficit
Sleep alterations
Fatigue
Constipation
Impaired social
interactions
Sexual Dysfunction
Knowledge deficit
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Mania
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Self-care deficit
Impaired
communication
Altered thought
processes
Self-esteem
disturbances
Noncompliance
Altered family
The End