OT 882 Mood and Occupation

Emotional functions

appropriateness of emotion, regulation, and range of emotions

Affect

this includes emotions, physical sensations, attitudes and moods

Mood

gradual onset; lack a specific referent or object; more enduring; lower intensity; may sneak up on us; global signal of the person's general state

Emotions

quicker onset; connected to specific referent or object; limited duration; more intense; aware of them; provide specific information

Depression

low mood, passive, withdrawn; lack of pleasure in daily activities; hopelessness; feelings of worthlessness or inappropriate guilt; fatigue or lack of energy; poor appetite or over eating; insomnia or too much sleep; recurring thoughts of death, suicidal ideas

Behavioural and genetic roots

What are the causes of depression?

14% ; 2:1 W/M

What is the lifetime prevalence of depression in Canada? What is the ratio of men to women?

absence of mania

What does unipolar depression mean?

decreased self-care and home management

difficulty in social and work situations

What are some occupational performance issues associated with depression?

Affect; motivation; self-evaluations; thought processes; actions; interpersonal processes

What psychosocial factors are affected by depression?

Bipolar disorder - mania

euphoric mood; creative/imaginative (expansive thinking); boundless energy (drive); high sense of self-worth and empowerment; decreased concentration and attention; racing thoughts; diminished judgement; loss of appetite; sleep disturbances; agitation

Bipolar I Disorder

this type of bipolar focus on episodes of mania but may also experience depressive episodes. Has the most drastic fluctuations - higher swings

(4 or more episodes in 12 months for diagnosis)

Bipolar II Disorder

this type of bipolar is depressive episodes as well as hypomanic episodes. Impairment is mostly during depressive episodes

Cyclothymic Disorder

this type of bipolar is chronic (2 years +) of fluctuation depressive and hypomanic experiences

biological factors (HPA-axis, genetics); environmental stress (abuse, loss); cognitive style (self-defeating, negative)

What are some causes of mood disorders?

Strong genetic roots; unexpected or traumatic experiences; exposure to substances; changes to brain chemistry

What are causes of bipolar disorder?

~3%

What is the lifetime prevalence of bipolar disorder in Canada?

increased energy, decreased sleep, changes to judgements and decision making

- issues of memory, concentration, attention

- risk for accidents or exposure to unsafe situations

What are performance component issues of bipolar manic episodes?

difficulty in social and work situations

- self-awareness and regulation are decreased

- difficulty reading social cues or relating to others

-unrealistic appraisal of abilities

Occupational performance issues of bipolar manic episodes?

Affect, motivation, self-evaluations, thought processes, actions, interpersonal processes

What psychosocial factors are affected by bipolar disorder?

anti-depressants (SSRIs/SNRIs) and psychotherapies like CBT and interpersonal therapy (IPT)

Treatments for depression:

mood stabilizers, anticonvulsants, antipsychotics

psychotherapies like CBT, IPT and interpersonal and social rhythm therapy (IPSRT)

Treatments for bipolar disorder:

their warning signs, internal coping strategies, social supports and settings, professionals and resources to reach out to

What should be part of someone's safety plan?

Coping Strategies Inventory (CSI)

What assessment is a self-report that looks at these categories in relation to coping: problem solving, cognitive restructuring, social support, express emotions, problem avoidance, wishful thinking, and social withdrawal?

resiliency and vulnerability

what are important factors in occupational adaptations (2)?

positive sense of self, internal locus of control, occupationally engaged lives, seek assistance and social support

What do resilient individuals have (4)?

sleep, nutrition, exercise

positive coping strategies

mindfulness

emotional connect

healthy support systems

optimism

sense of humour

spirituality

What leads to greater resilience (8)?

encouragement for engaging in occupation

what is the OT approach for someone in a depressed state?

honest and realistic appraisal of behaviour and end products while engaging in occupation

what is the OT approach for someone in a manic state?

concrete simple activities, clear expectations, repetition, distraction-free environment, prompting - redirecting when distracted, self-exploration activities, self-expression

what is the OT approach for someone in either a depressed or manic state?

Occupational profile, occupational function and meaning, others

What are the categories of assessments for people with mood disorders?

role inventory, interest checklist

What assessments are part of occupational profile?

time use log, AOI, OQ, EMAS, COPM

What assessments are part of occupational function and meaning?

GAS, Readiness ruler, coping strategies inventory

What assessments are in the 'other' category?

employment/education

psychoeducation

creative occupations/activities

time use/occupational balance

skills/habit development

group/family approaches

animal-assisted therapy

What are the 7 OT interventions in mental health?

Use graded strategies

Use knowledge about the personal meaning of occupation

Use occupational engagement to enable health and well-being

How can OTs enable participation?