Nursing Care of Clients with Mood Disorders.docx

Nursing Care of Clients with Mood Disorders Objectives ========== At the end of the session participants will be able to List the Types of Mood Disorders Discuss Medical and Nursing Management of clients with Mood Disorders Introduction A mood disorder is a mental health condition that p...

Nursing Care of Clients with Mood Disorders Objectives ========== At the end of the session participants will be able to List the Types of Mood Disorders Discuss Medical and Nursing Management of clients with Mood Disorders Introduction A mood disorder is a mental health condition that primarily affects the emotional state. The client will experience long periods of extreme happiness, extreme sadness or both. Certain mood disorders involve other persistent emotions, such as anger and irritability. It is normal for your mood to change, depending on the situation. However, for a mood disorder diagnosis, symptoms must be present for several weeks or longer. Mood disorders can cause changes in the clients\' behavior and can affect their ability to perform routine activities, such as work or school. Types of Mood Disorders ======================= Depression and its subtypes. Bipolar disorder and its subtypes. Premenstrual dysphoric disorder. Disruptive mood dysregulation disorder. Depression ---------- Depression (major or clinical depression) is a common mental health condition and symptoms include feeling sad or hopeless. The condition can also cause difficulty with thinking, memory, eating and sleeping. For a diagnosis of clinical depression to be made, symptoms must last for at least two weeks. ### Types Depression #### Postpartum Depression (peripartum depression): This type of depression occurs during pregnancy or after the end of a pregnancy in women and people assigned female at birth (AFAB). They experience hormonal, physical, emotional, financial and social changes after having a baby. These changes can cause symptoms of postpartum depression. #### Persistent Depressive Disorder: This is a chronic form of depression that must last for at least two years. Symptoms may occasionally lessen in severity during this time. It is less severe than major depressive disorder, but it is ongoing. #### Seasonal Affective Disorder (SAD): This occurs during certain seasons of the year. It typically starts in the late autumn or early winter and lasts until spring or summer. Less commonly, SAD episodes may also begin during the late spring or summer. Seasonal Affective Disorder (SAD) contd. Symptoms of winter seasonal affective disorder may resemble those of major depression. They tend to disappear or lessen during spring and summer. #### Depression with Psychosis: This is a type of severe depression combined with psychotic episodes, such as hallucinations (visual or auditory) or delusions (having fixed but false beliefs). People who experience depression with psychosis have an increased risk of thinking about suicide. Bipolar Disorder ---------------- This is a lifelong mood disorder and mental health condition that causes intense shifts in mood, energy levels, thinking patterns and behavior. There are a few types of bipolar disorder, which involve experiencing significant fluctuations in mood referred to as hypomanic/manic and depressive episodes. ### Types of Bipolar Disorder 1\. Bipolar 1 Disorder 2\. Bipolar II Disorder 3\. Cyclothymia Disorder 4\. Other specified and unspecified bipolar and related disorders #### Bipolar 1 Disorder: People with bipolar 1 disorder have experienced one or more episodes of mania. Most people with Bipolar 1 will have episodes of both mania and depression, but an episode of depression is not necessary for a diagnosis. #### Bipolar II Disorder: This disorder causes cycles of depression similar to those of Bipolar 1. A person with this illness also experiences hypomania, which is a less severe form of mania. Hypomanic periods are not as intense or disruptive as manic episodes. Someone with bipolar II disorder is usually able to handle daily responsibilities. #### Cyclothymia Disorder (cyclothymia) People with cyclothymic disorder have a chronically unstable mood state. They experience hypomania and mild depression for at least two years. Other specified and unspecified bipolar and related disorders: Symptoms of this type of bipolar disorder do not meet the criteria for one of the other types, but people still have significant, abnormal mood changes. Premenstrual Dysphoric Disorder (PMDD) contd. Researchers believe this condition is brought about by the hormonal changes related to the menstrual cycle. Symptoms may include anger, irritability, anxiety, depression and insomnia. Other Mood Disorders ==================== Premenstrual Dysphoric Disorder (PMDD): --------------------------------------- This type of mood disorder occurs seven to 10 days before menstruation and goes away within a few days of the start of the menstrual period. It is a more serious form of premenstrual syndrome (PMS). Disruptive Mood Dysregulation Disorder (DMDD): ---------------------------------------------- This affects children and adolescents. It involves frequent anger outbursts and irritability out of proportion to the situation. DMDD is 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 for mood disorders depends on the specific condition and symptoms. Usually, treatment involves a combination of medication and psychotherapy. There are also 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) the most widely used drugs to treat depression and depressive episodes of bipolar disorder. Although studies show that different types of antidepressants work equally well, some antidepressants may be more effective depending on the person. Usually, an antidepressant takes four to six weeks before it begins to work. It is important to take the antidepressants as prescribed and continue taking them even if the client feels better. ### Mood Stabilizers These medications help regulate the mood swings that occur with bipolar disorder or other disorders. They reduce abnormal brain activity. The clinician may prescribe mood stabilizers along with antidepressants in some cases. Some of the most widely used mood stabilizers include lithium and anticonvulsant drugs. ### Antipsychotics (neuroleptics) People with bipolar disorder who experience mania or mixed episodes may be treated with an atypical antipsychotic (neuroleptic) drug, such as aripiprazole (AbilifyR). Clinicians sometimes prescribe atypical antipsychotics to treat depression if symptoms are not controlled with an antidepressant alone. Psychotherapy for Mood Disorders -------------------------------- Psychotherapy (talk therapy) is a term for a variety of treatment techniques that aim to help a person identify and change unhealthy emotions, thoughts and behaviors. It can provide support, education and guidance to the client and their family to help them function better and increase their well-being. ### Cognitive behavioral therapy (CBT) This is a structured, goal-oriented type of psychotherapy. Mental health professionals use it to treat or manage mental health conditions and emotional concerns. ### Dialectical Behavior Therapy (DBT) DBT is a type of talk therapy that is based on cognitive behavioral therapy (CBT), but it is specially adapted for people who experience emotions very intensely. ### Psychodynamic Therapy This type of therapy is based on the idea that behavior and mental well-being are influenced by childhood experiences and problematic repetitive thoughts or feelings that are outside of the clients awareness (they are unconscious). Cleveland Clinic, 2032 ### Interpersonal Psychotherapy (IPT) This is a form of psychotherapy that focuses on relieving symptoms by improving interpersonal functioning. · It addresses current problems and relationships rather than childhood or developmental issues. (CAMH. n.d) ### Group Therapy Group therapy is the treatment of multiple patients at once by one or more healthcare providers. It can be used to treat a variety of conditions (Malhotra & Baker, 2022) ### Family Therapy Family therapy is a form of talk therapy that focuses on **the improvement of relationships among family members** and can involve any combination of family members. It is form of group therapy ### Mindfulness-based Cognitive Therapy This is a type of psychotherapy that involves a combination of cognitive behavioral therapy (CBT), meditation, and the cultivation of a present-oriented, non-judgmental attitude called \"mindfulness.\" (Schimelpfening, 2024) Meditation quiet space for peace of mind. Other Treatments for Mood Disorders =================================== Electroconvulsive Therapy (ECT) ------------------------------- · This is a medical procedure that involves passing a mild electric current through the brain, causing a short seizure. It has proven to have strong positive effects on severe, treatment-resistant mental health conditions, including depression and bipolar disorder. Transcranial Magnetic Stimulation (TMS) --------------------------------------- TMS is a treatment for persons with severe depression that has not been helped by at least one antidepressant medication. It is a type of brain stimulation therapy elicits magnetic energy, which turns into an electrical current underneath the skull, to help regulate emotions. Light Therapy ------------- This technique has long been used to treat seasonal affective disorder (SAD). It is based on the idea of supplementing natural sunlight with bright artificial light during the fall and winter. Nursing Problem Priorities for Clients with Bipolar Disorders ============================================================= Mood Stabilization ------------------ Managing and stabilizing mood fluctuations to minimize the severity and duration of manic and depressive episodes in patients with bipolar disorder. 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 Medication Adherence -------------------- Ensuring consistent adherence to prescribed medications to effectively manage symptoms and prevent relapses. Suicide risk assessment and Prevention -------------------------------------- Assessing and monitoring the risk of suicide in clients with bipolar disorder, implementing appropriate interventions, and providing support to prevent self-harm. Psychoeducation and Self-management skills ------------------------------------------ Providing education to clients and their families about bipolar disorder, its symptoms, triggers, and strategies for managing the condition to enhance self-awareness and empower them to actively participate in their treatment. Psychosocial Support and Therapy -------------------------------- Offering psychosocial support, counseling, and therapy to address emotional challenges, improve coping skills, and enhance overall quality of life for clients with bipolar disorder.