Chapter 1-7 Depression and Mood Disorders - Lecture Notes Flashcards

Females are twice as likely to develop depression as males.
Adverse Childhood Experiences (ACEs): traumatic or poor childhood upbringing increases risk of depression.
Stressful life events: divorce, custody issues, losing a home, job loss.
Genetics and neurochemistry: genetics is a major component; neurotransmitters involved include serotonin, dopamine, and norepinephrine.
No simple blood tests or routine brain imaging to diagnose depression; tests/imaging are not practical for routine screening.
Age considerations: depression can affect any age, but is especially common in people 65 and older; major triggers include decline in health and loss of a spouse.
Menopause and retirement can contribute to depressive symptoms due to health changes and reduced purpose/support networks.
Protective strategies in aging: senior centers, volunteering, social engagement, and purposeful activities.

Depression commonly co-occurs with major medical illnesses, chronic pain, and substance use.
Consequences include increased healthcare utilization, role impairment, disability, and work absence.
Concept: depression and physical health issues often create a cycle that worsens both mental and physical health.
Holistic approach is essential: assess diet, exercise, sleep, social support, and activity levels.

Depression can reduce activity and healthy behaviors, which worsens medical conditions and pain.
Chronic pain can contribute to depression due to decreased mobility and quality of life.
Substance abuse can both contribute to and result from depression, creating a vicious cycle.
Empathy and understanding of the patient’s experience are key to effective care.

Mood disorder must persist for at least two weeks (not just a single day of sadness).
At least one core symptom: depressed mood or loss of interest/pleasure (anhedonia).
Plus at least five of the following symptoms: depressed mood; loss of interest or pleasure; weight change or appetite change; sleep disturbance; psychomotor changes; fatigue; feelings of worthlessness or guilt; difficulties concentrating or making decisions; suicidal thoughts.
Familiarity with the DSM-5 criteria is expected, but you do not need to memorize every detail for exams; focus on clinical recognition and judgment.

Seasonal Affective Disorder (SAD)
- Definition: depression that occurs with changing seasons, typically worse in winter.
- Common symptoms: oversleeping, carb cravings, depressed mood, low energy.
- Treatment: antidepressants, light therapy, psychotherapy.
Persistent Depressive Disorder (PDD, dysthymia)
- Definition: a chronic depressive mood that lasts for at least two years in adults.
- Symptoms: fewer or less severe than major depression, but persistent.
- Treatment: psychotherapy and/or medications.
Premenstrual Dysphoric Disorder (PMDD)
- Definition: symptoms occurring in the last week before the onset of menses.
- Symptoms: emotional and physical symptoms that are more disabling than typical premenstrual symptoms.
- Treatment: antidepressants and hormonal therapy as needed.
Substance-Induced Depressive Disorder
- Definition: depressive symptoms caused by substance use or withdrawal.
- Considerations: symptoms can occur with polysubstance use and may be severe (e.g., substance-induced psychosis or delirium in extreme cases).
- Treatment focus: address substance use while managing mood symptoms; integrated care is often necessary.

In most cases, hospitalization is not required; outpatient treatment is common.
Effective management often involves a combination of pharmacologic and non-pharmacologic approaches.
Emphasize a holistic, patient-centered approach; consider the biopsychosocial context (medical illness, pain, sleep, nutrition, social support).
Substance use requires integrated care (co-occurring disorders unit or integrated treatment models) rather than treating depression and substance use in isolation.
Medication discussions are typically led by psychiatry; nurses should understand indications, safety, and psychosocial aspects, but detailed psychotropic prescribing is beyond some exams.

Do not rely on memorizing every diagnostic criterion; focus on core concepts and clinical patterns.
Recognize key risk factors: gender, ACEs, major life events, genetics, aging, and retirement.
Understand bidirectional relationships between depression, chronic illness, pain, and substance use.
Know the major types of depression and their defining features, typical symptoms, and general treatment approaches.
Remember SAD as a seasonal pattern with light therapy and psychotherapy as core treatments.

The discussion emphasizes empathy and holistic assessment; consider how chronic illness and social factors contribute to depressive symptoms when planning care.
Be prepared to discuss how to support patients in staying active, engaged, and connected, especially in older adults.