MOOD DISORDERS: DEPRESSIVE MOOD DISORDERS AND BIPOLAR DISORDERS
Unit 7 mood disorders online
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Transcript of Unit 7 mood disorders online
Mood Disorders
Major depressionDysthmyic disorderBipolar Type 1
mixed rapid cycling
Bipolar Type 2
Etiology
Genetic factors ---current hypothesisCatecholamine hypothesisSerotonin hypothesis
weaker hypothesisHypothalamus-pituitary-adrenalsHypothalamus-pituitary-thyroidCircadian rhythms
Psychosocial factors
Psychoanalytic theoryCognitive Behavioral
ReinforcementLearned helplessnessCognitive theory
negative cognitive triadself-world-future
Major depression
Depressed moodMarkedly diminished interest in pleasureSignificant weight lossInsomnia or hypersomniaPsychomotor agitation or retardation
Depression
Fatigue or loss of energyFeelings of worthlessnessDiminished concentrationRecurrent thoughts of death
Vegetative Signs of Depression
Severe weight lossPsychomotor retardationSleep disturbance
early morning awakening (EMA)Decreased libido
Dysthymia
Depressed moodPresence of at least 2 of the following:
poor or increased appetiteinsomnia or hypersomnialow energypoor concentrationfeelings of hopelessness for 1 year
Nursing Assessment
Present complaintHx. of problemPast 4 hx.Social hx.Medical hx.Mental status exam
Bipolar Disorders 1 and 2
Type 1RegularMixedRapid cycling
Type 2
Bipolar Disorder
Mania
energy activities self-esteemflight of ideaseasy agitationpoor self controlhyperphagia or appetite need for sleep
Mixed disorderboth sets of symptoms in a 24 hour period
Rapid cycleboth symptoms within one week
Mental Status Exam
AppearanceDepression-poor hygieneMania-bizarre dress-frequent change of clothesSpeech
depressed-retarded & concretemania-flight of ideas-pressured speech-intrusive-expansive
Thought contentDepression-worthlessness-hopelessness-
helplessness-guilt-somatic concernsMania-grandiosity-distractibility
AffectDepression-flat, dull, sad moodMania-labile
PsychomotorDepression- retardationMania- hyperactive
DelusionsDepression-negative triadMania-grandeur, bizarre
Hallucinations
Suicide potentialOrientationConcentration v distractibilityRecent memoryInsight Judgment
Nursing Diagnosis
Risk for self-directed violenceSelf-esteem disturbanceSelf-care deficitSocial isolationAltered nutrition
Nursing Intervention
Suicide preventionSocial interactionMaintain adequate nutritionMaintain fluid & electrolytesMaintain sleep wake cycleSupportive care re: judgmentElectroconvulsive therapy
Sleep therapy
Cognitive behavioral therapydaily activitiestesting of depressive thoughts
Anti-depressant medication
Tricyclic antidepressantsTofranilElavil
Monoamine oxidase inhibitorsParnateNardilMarplan
Serotonin Selective Reuptake inhibitorsProzac ZoloftPaxilCelexa
OthersWellbutrinSerzone
Anti-mania Medication
LithiumAnti-convulsants
Depakote Tegretol Lamictal