Mood Disorders & Suicide (NUR 322)

Anergia

Lack of energy

Euthymic

Normal or level mood

Mood Disorders (Affective Disorders)

Pervasive alterations in emotions that are manifested by (1) depression, (2) mania, or (3) both; interfere with life by plaguing a person with long-term sadness, agitation, or elation; most commonly associated with suicide

10 Categories of Mood Disorders

Primary Disorders…

1.) Major Depressive Disorder (MDD) → depressed mood or loss of pleasure (episodes ≥ 2 weeks)

2.) Bipolar Disorder (Manic-Depressive) → mood fluctuates to extremes of mania/depression; two types of bipolar disorder

Related Disorders…

3.) Dysthymic (Persistent Depressive Disorder) → chronic, persistent disturbance with milder symptoms of MDD

4.) Cyclothymic Disorder → mild mood swings between hypomania and depression (without impaired function)

5.) Seasonal Affective Disorder (SAD) → winter depression or fall-onset; may also occur in the spring or summer months

6.) Postpartum Blues → mild, predictable mood disturbance occurring in the first several days after delivery

7.) Postpartum Depression → symptoms consistent with those of depression with onset within 4 weeks of delivery

8.) Postpartum Psychosis → severe/debilitating psychiatric illness with acute onset days after childbirth

9.) Premenstrual Dysphoric Disorder → recurrent, moderate psychological/physical symptoms that occur the week before menses

10.) Nonsuicidal Self-Injury → deliberate, intentional injury (i.e. cutting, burning, hitting)

Major Depressive Disorder (MDD)

Patient experiences depressed mood or loss of pleasure in nearly all activities; major depressive episodes last ≥ 2 weeks with symptoms causing functional impairment (i.e. social, occupational, distress)

Psychotic Depression

Type of major depressive disorder that affects 10-20% of people; characterized by symptoms of MDD combined with delusions and hallucinations

9 Signs/Symptoms of Major Depressive Disorder

1.) Change in eating habits

2.) Unplanned weight gain or loss

3.) Changes in sleep habits (i.e. hypersomnia, insomnia)

4.) Impaired cognition (i.e. concentration, problem-solving, decision-making)

5.) Inability to cope with daily life

6.) Feelings of worthlessness, hopelessness, guilt, or despair

7.) Thoughts of death/suicide

8.) Overwhelming fatigue

9.) Rumination (with pessimistic thinking)

Bipolar Disorder (Manic-Depressive)

Patient’s mood fluctuates to extremes of mania and/or depression; periods of mania typically last at least 1 week, followed by periods of depression similar to MDD

Mania

Distinct period (at least 1 week) during which mood is abnormally and persistently elevated, expansive, or elevated; characteristic of bipolar disorder

11 Signs/Symptoms of Mania

1.) Inflated self-esteem

2.) ↓ Sleep

3.) Pressured speech

4.) Flight of ideas

5.) Distractibility

6.) ↑ Activity and psychomotor agitation

7.) Excessive involvement in in pleasure-seeking or risk-taking activities

8.) Excessively cheerful or enthusiastic mood

9.) Excessive irritability (especially when told “no” or to follow rules)

10.) Denial of problems or transfer of blame

11.) Delusions and hallucinations

Pressured Speech

Unrelenting, rapid, often loud talking speech pattern that occurs without pause; characteristic of mania

Hypomania

Period of abnormally and persistently elevated, expansive, or irritable mood accompanied by some other mild manic symptoms; hypomanic episodes do not impair the ability to function and feature no psychotic symptoms

Bipolar I Disorder

Patient experiences one or more manic/mixed episodes usually accompanied by major depressive disorder

Bipolar II Disorder

Patient experiences one or more major depressive episodes accompanied by at least hypomanic episode

Mixed Episode

Diagnosed when a person experiences both mania and depression nearly every day for at least 1 week; relatively rare

Hamilton Rating Scale for Depression (HRSD)

Gold standard measure of depression; evaluates reliable symptoms related to general depression across diverse cultures

Electroconvulsive Therapy (ECT)

Used to treat depression in select groups such as clients who do not respond to antidepressants or those who experience intolerable medication side effects at therapeutic doses

4 Major Categories of Antidepressants

1.) Selective Serotonin reuptake Inhibitors (SSRIs) → most frequently prescribed

2.) Tricyclic Antidepressants → oldest antidepressants

3.) Atypical Antidepressants → prescribed for inadequate response to SSRIs

4.) Monoamine Oxidase Inhibitors (MAOIs) → higher potential for serious adverse effects

Interpersonal Therapy

Type of psychotherapy that focuses on difficulties in relationships (i.e. Child who never learned how to make/trust friends outside of the family has difficulty as an adult)

Behavior Therapy

Type of psychotherapy that seeks to increase the frequency of the client’s positively reinforcing actions with the environment; may also focus on improving social skills

Cognitive Therapy

Type of psychotherapy that focuses on how the person thinks about self, others, and the future and interprets their experiences; aims to correct distorted thinking

Suicide

Intentional act of killing oneself

Suicidal Ideation

Thinking about killing oneself

Disruptive Mood Dysregulation Disorder (DMDD)

Diagnosed in children and adolescents between 6-18 years old; symptoms must be present for at least 12 months (onset before age 10) and include mood swings with severe temper outbursts (3x/week average)