Suicide Prevention and Depressive Disorders

suicide risk factors

widows/widowers, women, age, socioeconomics, ethnicity, mental illness, substance abuse, painful losses, exposure to violence, isolation

depression

•Alteration in mood-Sadness, Despair, Pessimism

•Loss of interest in usual activities

•Somatic symptoms

•Changes in appetite, sleep, and cognition

major depressive disorder (MDD)

•Depressed mood most of the day

•Loss of pleasure in usual activities

•Impaired social/occupational functioning

•Insomnia or hypersomnia

•Feelings of worthlessness

•Recurrent thoughts of death

persistent depressive disorder (dysthymia)

•Milder that MDD

•"Down in the dumps" mood

•Depressed most of day for at least 2 years

premenstrual dysphoric disorder

•One week prior to period

•Markedly depressed mood

•Excessive anxiety

•Mood swings

•Decreased interest in activity

developmental implications - childhood

•Depression manifests differently than adult

•Irritable mood

•Excessive self-reproach

•Excessive-clinginess to parents

•Delinquency

•Psychosomatic complaints (stomachache)

developmental implications - adolescence

•Hard to recognize

•Sadness

•Loneliness

•Anxiety

•Inappropriately expressed anger

•Aggressiveness

•Delinquency

•Suicide

developmental implications - senscence

•Depression and dementia one of most common psychiatric d/o among elderly

•Symptoms may be misdiagnosed as neurocognitive disorder

•Accompanies other illnesses (cancer, dementia, etc)

postpartum depression

•May begin prior to delivery

•"baby blues" usually subside within 1-2 weeks

•Mood varies, but more bad days than good

medications for depression

•Tricyclics: Amitriptyline

•Selective Serotonin Reuptake Inhibitors (SSRIs): Citalopram

•Atypical Antidepressants: Bupropion

•Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Duloxetine

•Psychotherapeutic combinations: Olanzapine and fluoxetine

antidepressant medication pt education

•Do not abruptly stop the medication

•Therapeutic effects may take 2-4 weeks to be seen

•Use sunscreen

•Avoid alcohol