Nursing Care of Clients with Mood Disorders

Types of Mood Disorders

• Mood disorders primarily affect the emotional state, causing long periods of extreme happiness, extreme sadness, or both.
• Types of mood disorders include:
  • Depression and its subtypes
  • Bipolar disorder and its subtypes
  • Premenstrual dysphoric disorder
  • Disruptive mood dysregulation disorder

Depression

• Depression is a common mental health condition characterized by feelings of sadness or hopelessness.
• Symptoms of depression include:
  • Difficulty with thinking, memory, eating, and sleeping
• A diagnosis of clinical depression requires symptoms to last for at least two weeks.

Types of Depression

• Postpartum depression (peripartum depression):
  • Occurs during pregnancy or after the end of a pregnancy in women and people assigned female at birth (AFAB).
  • Caused by hormonal, physical, emotional, financial, and social changes after having a baby.
• Persistent depressive disorder:
  • A chronic form of depression that must last for at least two years.
  • Symptoms may occasionally lessen in severity during this time.
• Other specified and unspecified bipolar and related disorders:
  • Symptoms do not meet the criteria for one of the other types, but people still have significant, abnormal mood changes.

Premenstrual Dysphoric Disorder (PMDD)

• A more serious form of premenstrual syndrome (PMS).
• Occurs seven to 10 days before menstruation and goes away within a few days of the start of the menstrual period.
• Symptoms include:
  • Anger
  • Irritability
  • Anxiety
  • Depression
  • Insomnia

Disruptive Mood Dysregulation Disorder (DMDD)

• Affects children and adolescents.
• Characterized by frequent anger outbursts and irritability out of proportion to the situation.
• More severe than intermittent explosive disorder (IED), and anger is present most of the time, occurring before the age of 10.

Treatment for Mood Disorders

• Treatment depends on the specific condition and symptoms.
• Usually involves a combination of:
  • Medication
  • Psychotherapy
  • Other types of treatment, such as brain stimulation therapy

Medications for Mood Disorders

• Antidepressants:
  • Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Most widely used drugs to treat depression and depressive episodes of bipolar disorder
• Mood stabilizers:
  • Help regulate mood swings that occur with bipolar disorder or other disorders
  • Reduce abnormal brain activity
  • Examples include lithium and anticonvulsant drugs
• Antipsychotics (neuroleptics):
  • Used to treat bipolar disorder who experience mania or mixed episodes
  • Examples include aripiprazole (AbilifyR)

Psychotherapy for Mood Disorders

• Psychotherapy (talk therapy) aims to help a person identify and change unhealthy emotions, thoughts, and behaviors.
• Types of psychotherapy include:
  • Cognitive behavioral therapy (CBT)
  • Dialectical behavior therapy (DBT)
  • Psychodynamic therapy
  • Interpersonal psychotherapy (IPT)

Nursing Care Plans and Management

• Nursing care planning goals for clients with bipolar disorder include:
  • Providing a safe environment
  • Improving self-esteem
  • Enhancing social support
  • Encouraging self-care independence
  • Guiding clients toward socially appropriate behavior
  • Promoting family involvement
  • Providing education about the condition and how to manage it effectively
• Priorities for clients with bipolar disorders include:
  • Mood stabilization
  • Medication adherence
  • Suicide risk assessment and prevention
  • Psychoeducation and self-management skills
  • Psychosocial support and therapy