Mood Disorders, Suicide Prevention, and Related Psychopharmacology

Comprehensive vocabulary flashcards covering mood disorders, electroconvulsive therapy (ECT), bipolar disorder stages, suicide assessment frameworks, and psychopharmacology.

Mood

A pervasive and sustained emotion that may have a profound influence on an individual's perception of the world.

Affect

The external, observable emotional reaction associated with an experience.

Major Depressive Disorder (MDD)

A depressive disorder characterized by depressed mood or loss of interest or pleasure in usual activities, resulting in impaired social and occupational functioning that persists for at least $2\,\text{weeks}$ with no history of manic behavior.

Psychomotor Retardation

A common clinical manifestation of severe depression involving a visible and generalized slowing of physical movement, speech, and mental processing.

Depression Continuum

A clinical model conceptualizing depression along a spectrum of severity: transient depression (everyday disappointments), mild depression (normal grief response), moderate depression (dysthymia), and severe depression (Major Depressive Disorder).

Object Loss Theory

A psychosocial theory positing that depressive illness stems from an absence of maternal attachment or significant loss during the first six months of life, predisposing the individual to lifelong vulnerability.

Repetitive Transcranial Magnetic Stimulation (rTMS)

A non-invasive treatment modality for depression that applies short pulses of magnetic energy to stimulate nerve cells in localized regions of the cerebral cortex.

Electroconvulsive Therapy (ECT)

The medical induction of a grand mal (generalized) seizure through the targeted application of electrical currents to the brain, dosed sufficiently to exceed the patient's seizure threshold.

ECT Treatment Schedule

A standard therapeutic regimen typically consisting of $6\text{--}12$ treatments (up to $20$ in select cases), administered every other day at a frequency of $3\,\text{times per week}$.

High-Risk Conditions for ECT

Pre-existing cardiovascular and intracranial disorders carrying elevated hazard during ECT, including myocardial infarction (MI) or CVA within the preceding $3\text{--}6\,\text{months}$, aortic or cerebral aneurysms, severe hypertension, congestive heart failure (CHF), and space-occupying intracranial lesions.

Post-ECT Cognitive Side Effects

Transient neuropsychological deficits including impaired processing speed, attention, verbal/visual memory, and executive function that typically resolve within $3\,\text{days}$, with complete cognitive baseline recovery seen within $6\,\text{months}$.

Mania

A mood disturbance marked by feelings of elation, inflated self-esteem, grandiosity, physical hyperactivity, agitation, accelerated thinking, and pressured speech.

Bipolar I Disorder

A bipolar disorder diagnosis characterized by the occurrence or history of at least one full manic episode lasting more than $1\,\text{week}$, frequently alternating with depressive episodes.

Bipolar II Disorder

A diagnostic classification defined by recurrent bouts of major depression and hypomanic episodes lasting at least $4\,\text{days}$, without ever meeting the criteria for a full manic episode.

Cyclothymic Disorder

A chronic mood disturbance lasting at least $2\,\text{years}$ ($1\,\text{year}$ in children/adolescents) marked by numerous periods of elevated and depressed mood that do not meet full criteria for hypomania or major depressive disorder, never remaining symptom-free for more than $2\,\text{months}$.

Hypomania (Stage I Mania)

A mild manic stage characterized by cheerful, expansive mood, rapid irritability when thwarted, inflated self-worth, and increased psychomotor agitation without causing marked social or occupational impairment.

Acute Mania (Stage II Mania)

An intensified stage of mania typically requiring psychiatric hospitalization, characterized by continuous euphoria, pressured speech, flight of ideas, poor impulse control, hyper-sociability, and possible hallucinations or delusions.

Delirious Mania (Stage III Mania)

A grave manic manifestation featuring marked clouding of consciousness, severe emotional lability alternating between despair and ecstasy, disorientation, stupor, hallucinations, and frenzied, purposeless motor activity.

Suicide

The deliberate act of intentionally taking one's own life, classified clinically as an act or behavior rather than a psychiatric diagnosis.

IS PATH WARM

An assessment mnemonic for suicide warning signs denoting: Ideation, Substance abuse, Purposelessness, Anger, Trapped, Hopelessness, Withdrawal, Anxiety, Recklessness, and Mood.

Suicidal Intent Categories

The three forms of suicide intent evaluated by clinicians: stated intent (direct explicit disclosures), reflected intent (implicit behavioral cues or preparation), and withheld intent (deliberately concealed plans).

Protective Factors for Suicide

Individual and systemic buffers that lower suicide risk, including social and family connectedness, pregnancy, parenthood, and religious participation or ethical beliefs against self-harm.

Lithium Carbonate

The gold-standard antimanic mood stabilizer that slows accelerated psychomotor processes without sedation, characterized by a narrow therapeutic range, short half-life, and nearly complete renal excretion.

Lithium Therapeutic Range

Target serum lithium concentrations: $0.8\text{--}1.4\,\text{mEq/L}$ for acute mania symptom control and $0.4\text{--}1.0\,\text{mEq/L}$ (or $0.6\text{--}1.2\,\text{mEq/L}$) for long-term maintenance.

Lithium Toxicity

A dangerous physiological state induced when blood levels exceed therapeutic targets, manifested by persistent GI upset, coarse hand tremors, muscle hyperirritability, mental confusion, ataxia, sedation, and potential mortality.

Divalproex Sodium (Depakote)

An anticonvulsant mood stabilizer prescribed for manic episodes when lithium is ineffective or contraindicated, requiring clinical vigilance for hepatotoxicity, pancreatitis, and thrombocytopenia.

Carbamazepine (Tegretol)

An anticonvulsant medication utilized as a mood stabilizer in bipolar disorder, which requires routine laboratory monitoring due to the risk of agranulocytosis.

Lamotrigine (Lamictal)

An anticonvulsant mood stabilizer carrying a black-box warning for Stevens-Johnson Syndrome, a potentially life-threatening dermatological rash typically developing within $2\text{--}8\,\text{weeks}$ of starting therapy.

Selective Serotonin Reuptake Inhibitors (SSRIs)

First-line antidepressants (including fluoxetine, sertraline, citalopram, and escitalopram) that selectively block serotonin reuptake, characterized by minimal adverse effects and lower lethality in overdose.

Serotonin Syndrome

A potentially fatal toxic state occurring $2\text{--}72\,\text{hours}$ after initiating serotonergic therapy, manifested by confusion, agitation, hallucinations, hyperreflexia, ataxia, diaphoresis, tremors, diarrhea, and hyperpyrexia.

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

Dual-mechanism antidepressant medications (such as venlafaxine, duloxetine, and desvenlafaxine) that inhibit the neuronal reuptake of both serotonin and norepinephrine.

Bupropion (Wellbutrin)

A dual-mechanism, atypical psychostimulant-like antidepressant that exhibits minimal sexual side effects and aids in smoking cessation, but is strictly contraindicated in patients with seizure disorders.

Tricyclic Antidepressants (TCAs)

First-generation antidepressants (e.g., amitriptyline, imipramine) that inhibit monoamine reuptake, noted for potent anticholinergic side effects, lowered seizure threshold, cardiotoxicity, and high lethal potential in overdose.

Monoamine Oxidase Inhibitors (MAOIs)

An antidepressant class (e.g., phenelzine, tranylcypromine, isocarboxazid) that blocks monoamine oxidase, demanding rigorous dietary restriction of tyramine-containing foods to avert hypertensive crisis.

Tyramine-Induced Hypertensive Crisis

A life-threatening elevation in blood pressure triggered when MAOIs interact with dietary tyramine or sympathomimetic drugs, treated pharmacologically with IV phentolamine or oral nifedipine.