Mood Disorders and Management
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Questions and Answers

What is the key to effective management of mood disorders?

  • Psychotherapy alone
  • Early Diagnosis (correct)
  • Medication only
  • Understanding family history

Euthymia is characterized by significant functional impairment.

False (B)

What mood disorder involves an absence of depressed mood for at least 2 years?

Dysthymia

People with bipolar 2 disorder display _____ rather than full mania.

<p>hypomania</p> Signup and view all the answers

Which of the following is a major risk factor for suicide?

<p>Suicidal ideation (A)</p> Signup and view all the answers

Normal fluctuations in mood are indicative of a disorder.

<p>False (B)</p> Signup and view all the answers

Name one type of depressive disorder mentioned in the content.

<p>Major Depressive Disorder</p> Signup and view all the answers

Match the following terms with their definitions:

<p>Euthymia = Normal range of mood Hypomania = Less severe form of mania Dysthymia = Chronic low mood Major Depressive Disorder = Severe depression with significant impairment</p> Signup and view all the answers

What behavior might very young children exhibit as a sign of emotional distress?

<p>Crying (D)</p> Signup and view all the answers

School-age children often show a significant increase in emotional reactivity.

<p>False (B)</p> Signup and view all the answers

What type of behavior might a teenager exhibit if they are experiencing emotional instability?

<p>Irritability</p> Signup and view all the answers

Adolescents may engage in substance use or sexual ________ as a response to emotional instability.

<p>promiscuity</p> Signup and view all the answers

What is an important factor to assess in relation to affective instability?

<p>Loss of contact with reality (A)</p> Signup and view all the answers

Match the age group with their potential emotional expression:

<p>Very young child = Crying Young child = Sudden refusal to go to school School-age child = Withdrawing Teenager = Irritability</p> Signup and view all the answers

Name one risk factor that could lead to a potential suicide attempt in adolescents.

<p>Mood disorder</p> Signup and view all the answers

Functional ability in relationships and work is important for determining the severity of a mood disorder.

<p>True (A)</p> Signup and view all the answers

What is the most dangerous aspect of major depressive disorder?

<p>Suicidal ideation (B)</p> Signup and view all the answers

Initiation of antidepressants decreases the risk for suicide by increasing both energy and cognition.

<p>False (B)</p> Signup and view all the answers

List two behaviors that may become dangerous and reckless during a manic episode.

<p>Gambling and violence</p> Signup and view all the answers

Persistent and negatively focused thoughts about death are known as __________.

<p>suicidal ideation</p> Signup and view all the answers

Match the following risk factors with their corresponding descriptions:

<p>Hopelessness = Increases risk for suicide Substance use = Can lead to impaired judgment Recent loss = A significant trigger for suicidal thoughts History of past suicide attempts = Higher likelihood of future attempts</p> Signup and view all the answers

Which cognitive change is commonly seen in major depressive disorder?

<p>↓ Short-term &amp; working memory (A)</p> Signup and view all the answers

Severe depression may lead to the presence of psychotic features like hallucinations.

<p>True (A)</p> Signup and view all the answers

Name one common issue faced by individuals suffering from major depressive disorder.

<p>Difficulty in making decisions</p> Signup and view all the answers

Selective serotonin reuptake inhibitors (SSRIs) are considered the first line of defense in most __________ related disorders.

<p>anxiety</p> Signup and view all the answers

What common behavior might individuals with major depressive disorder exhibit regarding advice?

<p>They frequently reject it (D)</p> Signup and view all the answers

Match the following features with their descriptions:

<p>Delusions = False beliefs that are firmly held despite contradictory evidence Hallucinations = Perceptions of things that are not present Attention deficits = Decreased ability to maintain focus Poor judgment = Inability to make reasonable decisions</p> Signup and view all the answers

Individuals with major depressive disorder often respond positively to nursing interventions.

<p>False (B)</p> Signup and view all the answers

What should one recognize when caring for a patient with major depressive disorder?

<p>It is an illness</p> Signup and view all the answers

Which of the following is a common vegetative behavior associated with depression?

<p>Weight gain due to overeating (B)</p> Signup and view all the answers

A hallmark of depression can include hypersomnia, where an individual may sleep excessively.

<p>True (A)</p> Signup and view all the answers

What changes in appearance might indicate someone is experiencing depression?

<p>Neglect of grooming, dressing, and personal hygiene.</p> Signup and view all the answers

Individuals with depression may make little to no _____ contact.

<p>eye</p> Signup and view all the answers

Which of the following might suggest a decrease in sexual interest in someone suffering from depression?

<p>Impotence (B)</p> Signup and view all the answers

Match the symptoms of depression with their descriptions:

<p>Loss of libido = Decreased sexual desire Psychomotor retardation = Slowed physical movements and responses Insomnia = Difficulty falling or staying asleep Poor grooming = Neglecting personal hygiene and appearance</p> Signup and view all the answers

Depression can lead to a heightened speech and thought process.

<p>False (B)</p> Signup and view all the answers

What is a common sleep disturbance experienced by individuals with depression?

<p>Insomnia or hypersomnia.</p> Signup and view all the answers

What speech pattern involves talking nonstop with no interest in feedback?

<p>Pressured speech (D)</p> Signup and view all the answers

Circumstantial speech typically conveys a clear and coherent point quickly.

<p>False (B)</p> Signup and view all the answers

What pattern of speech is characterized by a continuous flow of ideas with rapid changes in topic?

<p>Flight of ideas</p> Signup and view all the answers

The speech pattern characterized by abrupt changes from topic to topic is known as __________.

<p>flight of ideas</p> Signup and view all the answers

Match the following speech patterns with their descriptions:

<p>Circumstantial speech = Adding unnecessary details before getting to the point Pressured speech = Loud, rapid, and incoherent communication Loose associations = Thoughts loosely connected to each other Flight of ideas = Rapid changes from topic to topic</p> Signup and view all the answers

Which of the following is true about 'loose associations' in speech?

<p>They represent a disordered way of processing information. (C)</p> Signup and view all the answers

Individuals displaying manic speech patterns often show insight into their disorganized speech.

<p>True (A)</p> Signup and view all the answers

What is the main intervention needed for a person displaying excessive spending in a manic state?

<p>Needs intervention to prevent financial ruin</p> Signup and view all the answers

Flashcards

Euthymia

A stable emotional state characterized by a normal range of mood fluctuations.

Mania

A mood state characterized by abnormal euphoria, elevated mood, and increased energy levels.

Hypomania

A milder form of mania, defined by a period of elevated mood that is less severe and doesn't significantly impair functioning.

Bipolar disorder

A mood disorder characterized by alternating periods of mania or hypomania with periods of depression.

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Dysthymia

A mood disorder characterized by depressed mood lasting at least 2 years, with symptoms not severe enough to be classified as Major Depressive Disorder.

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Psychotic depression

A severe form of depression accompanied by psychotic symptoms such as hallucinations or delusions.

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Major Depressive Disorder

A state of prolonged sadness, loss of interest, and feelings of worthlessness.

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Postpartum depression

A mood disorder characterized by a depressed mood that occurs after childbirth.

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Suicidal Ideation in MDD

The most dangerous aspect of major depressive disorder, characterized by thoughts of death, suicidal ideation, and potentially a plan for suicide.

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Antidepressant-Induced Suicide Risk

The increased risk of suicide when antidepressants are initiated in patients with major depressive disorder during the early stages of treatment. This occurs because the medication can boost energy and cognition before mood improves, creating a dangerous window where the patient might have the motivation to act on suicidal thoughts.

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Psychotic Symptoms in Depression

Hallucinations and delusions that may accompany severe depression. They are defined as sensory experiences or beliefs that lack a basis in reality.

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Constricted and Significant ↓ in Emotional Reactivity

A significant decrease in emotional reactivity. This can be observed in various ways, such as a lack of emotional response to positive or negative events, a flat or dull emotional state, or difficulty expressing emotions.

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Mania & Euphoria

A state of abnormal and persistent cheerfulness, elation, or excitement. This is often accompanied by increased energy levels, decreased need for sleep, racing thoughts, and impulsive behavior.

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What is Bipolar Disorder?

A mood disorder characterized by alternating periods of mania and depression.

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What is the content of the patients thoughts?

The content and quality of a person's thoughts, including their ability to think abstractly or concretely, the presence of illogical or irrational thoughts, and the content of their thoughts (e.g., delusions, obsessions).

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What is Functional Status?

A term that describes a person's ability to function in everyday life, such as their work, social interactions, and self-care. This can be affected by the intensity of their mood disorder, the presence of other mental health issues, and their access to support and resources.

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What is Affective Instability?

The assessment of a person's emotional state and its stability. This includes evaluating the range and intensity of their emotions, any inconsistencies or sudden shifts in mood, and their ability to manage and express their emotions appropriately.

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How do you determine the severity of a mood disorder?

The process of determining the severity of a mood disorder, taking into account the individual's functional status, the intensity and duration of their symptoms, and any associated risk factors or behaviors.

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How do you assess risk for suicide?

The assessment of an individual's risk for suicide, including their thoughts, plans, and behaviors related to self-harm. This is an essential part of the mental health assessment process to ensure the individual's safety and well-being.

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Functional Impairment

The inability to realistically solve problems of daily living.

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Appearance Changes in Depression

Neglecting personal hygiene, appearing unkempt, making little eye contact, and having a slumped posture.

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Vegetative Behavior

Changes in basic life functions like eating, sleeping, and sexual desire.

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Sleep Disturbance in Depression

Issues with sleep, often characterized by insomnia (waking up early) or hypersomnia (sleeping excessively).

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Loss of Libido in Depression

Decreased sexual interest or libido.

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Slowed Speech in Depression

Speaking slowly, softly, and with a monotone voice.

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Poverty of Thought

Thinking slowly and experiencing difficulty with thoughts.

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Psychomotor Retardation

This refers to an overall decrease in energy levels and activity.

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Cognitive Changes in Depression

Cognitive deficits, such as decreased attention, impaired short-term and working memory, and difficulties with learning and processing information, that can occur in major depressive disorder.

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Rejection of Advice and Support in Depression

A condition where someone with depression may reject advice, support, and understanding from others, making it difficult for them to connect and engage in treatment.

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Generalized Anxiety Disorder (GAD) in Depression

A type of anxiety disorder commonly co-occurring with major depressive disorder, characterized by high scores on anxiety assessments.

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SSRIs for Anxiety and Depression

Selective serotonin reuptake inhibitors (SSRIs) are often the first-line treatment for anxiety-related disorders, including GAD, and they are also used in depression.

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Problem-Solving and Processing Speed in Depression

Challenges in problem-solving and processing speed, often present in depression, can hinder the ability to make decisions and cope with daily tasks.

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Decision-Making Difficulties in Depression

The inability to make simple decisions, such as what to wear or what to eat, can be a symptom of depression when judgment and decision-making abilities are impaired.

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Muteness in Severe Depression

A state of depression so intense that an individual may become mute, lacking the ability or motivation to speak.

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Pressured Speech

An individual speaks rapidly, conveying a sense of urgency. They may talk incessantly with little regard for feedback or conversation.

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Loose Associations

The individual's thoughts are loosely connected. One idea jumps to another with little or no logical connection.

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Circumstantial Speech

Speech pattern marked by excessive detail. The speaker eventually reaches the point of their statement, but their journey is winding.

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Tangential Speech

Speech pattern similar to circumstantial speech. However, the speaker loses track of their original point and cannot find their way back to it.

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Flight of Ideas

The hallmark of mania. A continuous and accelerated flow of speech with abrupt changes from one topic to another, often connected by associations or wordplay. It's still possible to follow the speech, even though the trajectory keeps shifting.

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Grandiose Schemes and Excessive Spending

Individuals require intervention to prevent financial ruin. They might spend excessively even when resources are depleted. This may involve making extravagant efforts to achieve wealth or fame.

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Excessive Contact with Famous People

Individuals with mania may make frequent and unnecessary phone calls or send emails to well-known people to seek attention.

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Insight into Thought Disturbances

Individuals may be aware of their thought disturbances and express regret for their actions. This can be viewed as a sign of insight.

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Study Notes

Mood & Affect Introduction/Assessment

  • Giddens Concept 31 is referenced
  • Chapter 13 covers Bipolar & related disorders
  • Chapter 14 covers Depressive Disorders
  • Dr. Michele Nye's contact information is provided

Mood & Affect

  • NUR 1120: Introduction/Assessment
  • NUR 1125: Post-partum depression
  • NUR 2225: Dysthymia, Major Depressive Disorder, Psychotic Depression, Suicide, Bipolar Disorder

Early Diagnosis is Key!!! Mood Spectrum

  • Euthymia: Normal range of mood, absence of depressed or elevated mood
  • Depressed mood: Sporadically for at least 2 years.
  • Dysthymia: Depressed mood sporadically for at least 2 years. Euthymia is normal to fluctuate.
  • Abnormal Euphoria: Affects mood, thoughts, & behavior. Differences from mania include no impairment. Symptoms are similar to mania but differ in degree.
  • Hypomania: Displays in bipolar 2 disorder, different in degree from mania.

Assess Affect

  • Risk for Suicide
  • Antidepressants can increase energy & cognition, potentially increasing suicide risk
  • Mood, energy, and cognition are assessed for suicide risk
  • Consider if mood is good, increased energy, and improved cognition, the risk of suicide is likely increased

Assessment of Suicidality

  • Preoccupation with death is a key aspect of major depressive disorder
  • Fantasies about death, funerals and recurring dreams of death are common
  • Suicidal ideation, a plan and ability to carry it out require immediate intervention

How We Feel & What We Observe

  • Mood is pervasive & sustained emotion
  • Affect = patient's emotional responsiveness.
  • Observed by facial expressions, tone of voice, body movements, and the absence of emotional expression(flat affect/blunted/constricted)

Affect

  • Affect is an objective representation of a person's internal state
  • Affective feelings may be congruent or incongruent with mood
  • Constricted, blunted, flat affect are common in mood disorders

Don't Overlook Depression in Children

  • Core symptoms are similar to adults.
  • Display variations in presentation
  • Young children may cry or suddenly refuse to go to school
  • School-age may withdraw, display irritability, or become involved with substance use or sexual behaviors
  • Risk factors like preoccupation with death or ideation of suicide are significant

Mania & Euphoria

  • Upbeat, more talkative, rapid speech, inflated self-esteem are common signs of mania.
  • Irritable, agitated, aggressive, restlessness, and rage are associated with dysphoric mania

Mood & Affect and Cognitive Function

  • Assess patient abstract thinking or if it is concrete
  • Affective instability - is pt crying, rage, euphoria, flatness?
  • Is pt unstable with or without reality contact?

Depression Impairment

  • Inability to solve problems and conduct daily living

Sexual Interest Loss of Libido

  • Loss of interest or experience of impotence
  • Affects relationships

Speech & Thought Process

  • Slow, soft monotone speech, decreased spontaneity.
  • Poverty of thought- difficulty communicating or responding
  • Patient needs repetition of questions for response
  • Serious depression cases can lead to muteness.

Thought Content & Perceptions

  • Psychotic features (delusion and hallucinations) often present in depression
  • Difficulty in problem-solving and making decisions

Mania and Hypomania Recognition

  • Can last from days to longer periods of time.
  • Experience intense feelings & elevated energy levels.
  • Behavior and thought patterns can be elevated or disordered
  • May or may not recognize distorted feelings for themselves or for others

Thought Content Mania (Grandiose Delusions, Persecutory Delusions, Clang Associations)

  • Grandiose delusions involve inflated self-regard, exaggerating achievements or importance
  • Persecutory delusions concern the belief that they are being harmed, watched, or spied on, and is common in mania.
  • Clang associations is an aspect of mania when people string words together because they rhyme.
  • Ideas in the content are often false and distorted, but these are considered delusions.

Major Depressive Disorder

  • Attention deficits, short and working memory deficits, problems in verbal and nonverbal learning, problems with processing speed are common.

Generalized Anxiety Disorder

  • Often comorbid with major depressive disorder
  • High anxiety scores on evidence-based anxiety assessments may point to major depressive disorder

Pharmacological and Parenteral Therapies

  • Medication administration (blood products, calculations, IV access)
  • Potential interactions, client response, educational material, safety measures

Suicide Risk Assessment

  • Conduct proper assessment of affect, mood (constricted, blunted, flat) for risk of suicide
  • Assess for the existence of hopelessness, substance use
  • Assess for past suicide attempts
  • Identify recent loss or separation

Assessment Guidelines for Mood and Affect

  • Assess patients that are experiencing mania or symptoms related to mania, bipolar disorder, or other mood disorders

Connect What You Are Learning Regarding Mood Disorders

  • Anxiety disorders are common in the United States
  • Frequent co-occurrence with major depressive disorder and/ or substance use

Other Considerations

  • Comorbid medical conditions requiring treatment
  • Medical or drug-related contributing causes of presenting symptoms

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Description

Explore the complexities of mood disorders through this quiz covering essential concepts such as euthymia, bipolar disorder, and risk factors for suicide. Test your knowledge on emotional expression across different age groups and learn about the signs of emotional distress in children and adolescents.

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