Exam 3: Mood Disorders

Mood disorders

-spectrum of mood disorders (range from depression to mania)

-very prevalent and disabling illness

-often go undetected and/or untreated

Etiology of mood disorders

combination of biological, psychological, genetic factors, and other factors

What are the different types of mood disorders?

Major Depressive Disorder (MDD)

-aka major depression; unipolar depression

Dysthymic Disorder (Persistent Depressive Disorder–PDD)

-no fluctuation (unipolar)

Bipolar Disorder (BPD) Spectrum

-BPD I

-BPD II

-Cyclothymia

What are the clinical symptoms (general symptoms) of mood disorders?

affect

anhedonia

avolition

dysphoria

euphoria

flight of ideas

grandiosity

hypomania

psychomotor agitation

psychomotor retardation

psychosis

The display, experience, or feeling of emotion; particularly facial expressions. Can be positive or negative emotions.

affect

Lack of interest in previously pleasurable activities

anhedonia

Lack of drive or ambition to complete goal-directed tasks or activities

avolition

A depressed or negative mood; a state of low senses

dysphoria

A highly elevated, exaggerated mood; a state of heightened senses

euphoria

Rapidly changing, disconnected thoughts

flight of ideas

Inflated self-esteem or an exaggerated sense of self-importance and self-worth (e.g., believing one has special powers or superior abilities).

grandiosity

An elevated mood that is less intense than full mania

hypomania

Increased physical movements that are purposeless and reflective of an agitated or anxious state (e.g. wringing hands, fidgeting, pacing)

psychomotor agitation

Abnormally slowed or reduced movements or speech

psychomotor retardation

The presence of delusions or hallucinations without insight

psychosis

T or F: Both MDD and BPD are marked by a complex set of symptoms

true

symptoms interfere with daily functioning

There are higher rates of suicide in _______

higher rates of suicide in BPD

Signs and symptoms of Major Depressive Disorder (MDD)

-anhedonia (loss of interest in previously enjoyed activities)

-weight loss or gain

-altered sleep

-change in psychomotor behaviors

-low affect

-fatigue/loss of energy

-feelings of worthlessness or guilt

-thoughts of death or suicide

-sadness

-irritability

-hopelessness

-cognitive impairment (impaired concentration, impaired problem-solving)

-psychomotor retardation

You're conducting an initial assessment with a female patient who presents with symptoms including anhedonia, altered sleep patterns, fatigue, feelings of worthlessness, and cognitive impairment. During the interview, she also expresses thoughts of death and exhibits low affect and psychomotor retardation. These symptoms are most typical of what disorder?

Major Depressive Disorder (MDD)

Children and teens with MDD may not exhibit the same symptoms as do adults. Symptoms may instead include _________

-irritability

-negativity

-acting clingy or overly needy

-behavioral problems in school

-refusing to attend school

-fear of parents death

T or F: To be diagnosed with with MDD, an individual must have experienced at least one major depressive episode, in the absence of any manic, mixed, or hypomanic episodes.

true

absence of any manic, mixed, or hypomanic episodes

To be diagnosed with MDD, a depressive episode must include at least _______ symptoms during a _______ period, and at least one of the symptoms observed must be either _______.

5 symptoms

2 week period

depressed mood or loss of interest or pleasure

What is key when diagnosing MDD?

anhedonia or depressive mood

What is the average age onset of MDD?

average age is mid to late 20's

T or F: MDD does not have a significant impact on occupational engagement

FALSE

it DOES have a significant impact on occupational engagement which is part of the diagnosis of MDD

What are the signs and symptoms of Bipolar Disorder ONE (BPD I)?

-euphoria

-irritability

-grandiosity

-decreased sleep

-flight of ideas

-impulsivity or participation in dangerous or risky activities

-psychosis

-increased distractibility

-excessively talking

-excessive goal-directed activity

-psychomotor agitation

To be diagnosed with Bipolar Disorder I, an individual must have a ______ episode ______ a major depressive episode.

manic episode WITH OR WITHOUT a major depressive episode

What is key when diagnosing BDP I?

euphoria and grandiosity

having a manic episode with or without a major depressive episode

Regarding bipolar disorder type one in an adult, which scenario is most likely to align with the diagnostic criteria for this condition?

A. Consistently experiencing mild fluctuations in mood without significant impact on daily functioning.

B. Periodically alternating between episodes of depression and hypomania, with hypomanic episodes not severe enough to cause marked impairment.

C. Experiencing episodes of mania characterized by elevated mood, extreme energy levels, and impulsivity, often requiring hospitalization or intensive outpatient treatment.

D. Displaying chronic symptoms of anxiety and irritability with occasional brief episodes of low mood.

C. Experiencing episodes of mania characterized by elevated mood, extreme energy levels, and impulsivity, often requiring hospitalization or intensive outpatient treatment.

Diagnosis of Bipolar Disorder II is characterized by having a _______ episode ______ a major depressive episode.

hypomanic episode WITH a major depressive episode

milder form of BPD, still manic just not as heightened

T or F: To be diagnosed with Bipolar Disorder II, an individual must have a presence or history of an MDD and a predominantly depressed mood.

true

What is a hypomanic episode?

-like manic episode except mood disturbance is not severe enough to cause marked impairment in social and/or occupational functioning or to necessitate hospitalization

-lower intensity symptoms than in mania

-less severe manic episode, no psychotic features

Cyclothymic disorder

chronic (at least 2 years) mood disorder characterized by numerous periods of hypomanic symptoms and depressive symptoms but not severe enough to qualify as either a manic or major depressive episode

How is MDD managed?

pharmacology

-antidepressant medications

How is BPD managed?

pharmacology

-mood stabilizers

When is electroconvulsive therapy (ECT) used?

when medications and traditional treatment are ineffective

What is repetitive transcranial magnetic stimulation?

-intervention used for treatment-resistant depression

-noninvasive procedure that creates a magnetic field that passes through the skull inducing electrical currents in the brain that activates specific nerve cells

-daily treatments repeated over a period of time

What is a major hindrance to occupational engagement for individuals diagnosed with MDD or BPD?

side effects of their medications

What is the impact of MDD or BPD on occupational performance? How can OTs help?

-impacts all occupations

-low volition so don't want to engage in anything (we can do motivational interviewing)

-medication side effects

-cognitive impairments i.e. problem-solving, concentration (we can do cognition training, CBT, self-regulation techniques, adaptive training to improve energy, coping strategies, problem-solving skills)

-can do group or individual therapy