4. Depression Assessments & Treatment

what are key clinical manifestations of depression?

• anergia

• anhedonia

• anxiety

• sluggishness

• vegetative findings

• thoughts of suicide

what is anergia?

low energy

what is anhedonia?

loss of interest or pleasure in things once enjoyed

what are vegetative findings in depression? *

• changes in eating & sleeping

• low energy

• poor concentration

• changes in daily behavior

• low self-esteem

• changes in bowel habits

• decreased interest in sexual activity

what psychomotor changes can happen in depression? *

• psychomotor agitation (restlessness)

• psychomotor retardation (slowed movement, speech, responses)

what physical assessment findings can be seen in depression?

• psychomotor retardation (slowness, stumped posture)*

• psychomotor agitation (restlessness, pacing, finger tapping)*

• sad mood with blunted affect

• poor grooming or hygiene

• social isolation

• slowed speech, delayed responses

what does psychomotor retardation look like? *

slowness, slumped posture, slowed speech, and delayed responses

what does psychomotor agitation look like? *

restlessness, pacing, and finger tapping

what medication classes are used to treat depressive disorders?

• selective serotonin reuptake inhibitors (SSRIs)

• serotonin norepinephrine reuptake inhibitors (SNRIs)

• tricyclic antidepressants (TCAs)

• monoamine oxidase inhibitors (MAOIs)

• second-generation antipsychotics (SGAs)

• mood stabilizers

• anticonvulsants (anti-epileptic agents)

what food interaction can happen with monoamine oxidase inhibitors? *

tyramine can cause hypertensive crisis

what nonpharmacologic treatments are used for depression?

• cognitive behavioral therapy (CBT)

• electroconvulsive therapy (ECT)

• transcranial magnetic stimulation (TMS)

how does cognitive behavioral therapy help treat depression?

it helps change behavior by changing thinking

when is electroconvulsive therapy used for depression?

it is used for treatment-resistant depression, when medications are not working, or when the client is highly suicidal

how is transcranial magnetic stimulation different from electroconvulsive therapy?

it uses magnetic pulses and does not require anesthesia, so it is less invasive