mood disorders etiology neurobiology genetics neurotransmission neuroendocrine psychosocial...
TRANSCRIPT
Mood Disorders
ETIOLOGY Neurobiology
Genetics
Neurotransmission
Neuroendocrine
Psychosocial Psychoanalytic Cognitive Learned
Helplessness Life Events Stress Personality
Epidemiology
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All Bipolar Major Dep Dysthym.
MenFemales
Types of Mood Disorders Depressive Disorders Bipolar Disorders Mood Disorders due to a general medical
condition Substance-Induced Mood Disorder Mood Disorders NOS Seasonal Affective Disorder
Depressive Disorders Major Depressive
Episode Major Depressive
Disorder Dysthymic Disorder Seasonal Affective
Disorder Depression NOS
Symptoms of DepressionIf 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 Bipolar I Disorder Bipolar II Disorder Cyclothymic Disorder Bipolar NOS
Symptoms of ManiaHeightened 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 Mood Disorders due
to a General Medical condition
Substance Induced Mood Disorder
Mood Disorder NOS
Specifiers 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 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 Pharmacology
antidepressants Tricyclics
Clomipramine(anafranil) Amitriptyline(elavil) Mirtazapine(remeron)
MAOIs Phenelzine(nardil)
SSRIs Fluoxetine(prozac) Sertraline(zoloft) Bupropion(wellbutrin)
Mood Stabilizers Lithium
0.5-1.2 mEq/L acute treatment and maintenance
toxic above 2.0
Carbamazepine Valproate acid
Foods with High Tyramine Levels 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 ToxicityMild<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 Electroconvulsive
Therapy Phototherapy Family Intervention Group Intervention
Psychotherapeutic Intervention Cognitive Behavioral Interpersonal Psychodynamic
Phototherapy
Electroconvulsive Therapy 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 Depression
Risk for Violence Self-care deficit Sleep alterations Fatigue Constipation Impaired social
interactions Sexual Dysfunction Knowledge deficit
Mania Self-care deficit Impaired
communication Altered thought
processes Self-esteem
disturbances Noncompliance Altered family
The End