8. Traditional Mental Health Part 2

Anxiety

• Contributors

• Strong link between anxiety and ____

• Fears is the biggest reason why patients get anxiety

Anxiety presentation

Phobias

• Are they common or rare

• Types of social phobias

• Signs and Symptoms

Define generalized anxiety

• Signs and Symptoms

Non-pharmacological treatment

• Do what!

• Avoid what!

• “rearrange” within reason

• A lot of things that keep geriatrics on the right track/decrease anxiety is consistency

• Ginko actually causes a lot of anxiety but used for their dementia

Pharmacological Treatment

Controversy with BZDs

• BZDs: Shorter-acting ones are NOT safer than longer-acting ones

Aggression and agitation

• General term encompassing

  • Combativeness

  • Shouting

  • Hyperactivity

  • Disinhibition

• Troublesome for patient and Caregivers alike

• Beers criteria tries to address these

Agitation and aggression - Treatment

Depression

• Causes

• Signs and Symptoms

• Exam Question: Depression is common BUT it is NOT normal

• Causes:

  • Death

  • Health problems

  • Noticing a Decreased physical functioning

  • Financial difficulties

• Just because there is a reason for depression doesn’t mean it cannot be treated

Depression - Treatment

Depression - How can Pharmacists help

• Differential Diagnosis

What is Sundowning Syndrome

• As the sun goes down shadows are cast, which can scare/trigger geriatrics

  • only occurs at nigh, symptoms ramp up “pts go circular”

• though to be caused by circadian dysregulation - body may not “tell” body that it is sleep time

Pharmacological treatment - sundowning syndrome

Non-pharmacological treatment - Sundowning Syndrome

Should treating sundowning be done at the first sign of it?

• No because we do not want to add more meds/side effects for the patient

• Nurses/caregivers “deal with” the sundowning syndrome

• Only treat when it becomes problematic

  • Benefits must outweigh risks