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Depression2

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  • How one views themselves How one views their experiences How one views their future
  • Transcript

    • 1. WHAT IS A MOOD DISORDER?
      • A disturbance of mood
    • 2. BACKGROUND
      • All respond to treatment
      • Treatments vary on type of depression
      • Multiple occurrences
      • Physical Examination
      • Myths
    • 3. COGNITIVE TRIAD
      • How one views themselves
      • How one views their experiences
      • How one views their future
    • 4. DEPRESSION
      • DSM-IV CRITERIA
      • Major Depressive Disorder – Single Episode
      • Major Depressive Disorder – Recurrent
      • Major Depressive Episode
      • Depressed mood most of the day nearly every day
      • Diminished interest in activities
      • Weight loss/gain
      • Insomnia/hypersomnia nearly every day
      • Psychomotor agitation/retardation
      • Fatigue/loss of energy
      • Feelings of worthlessness/inappropriate guilt
      • Difficulty concentrating
      • Recurrent thoughts of death
    • 5. Most Common Physiological Symptoms
      • Sleep disturbance
      • Appetite
      • Sexual
    • 6. Self-Help Strategies
      • Set Realistic Goals
      • Break Large Tasks into Smaller Ones
      • Don’t Isolate
      • Participate in Activities
      • Gradual Improvement
      • Postpone Major Decisions
    • 7. DYSTHYMIA
      • “Mild Depression”
      • Long-term and chronic but does not disable
      • Many experience Major Depression at some point
    • 8. DYSTHYMIA
      • DSM-IV Criteria
      • 1) Depressed mood most days, more
      • days than not, at least 2 years
      • 2) Presence of:
      • A) Increased/Decreased appetite
      • B) Insomnia/Hypersomnia
      • C) Low Energy/Fatigue
      • D) Low Self-Esteem
      • E) Poor Concentration, Difficulty making
      • decisions
      • F) Hopelessness
      • 3) During two Years, never symptom free for more than two
      • months
      • 4) No Major Depressive Episode
      • 5) No Manic/Mixed/Hypomanic episodes
      • 6) No Psychosis
      • 7) No Substance Abuse
      • 8) Clinically significant distress
    • 9. DYSTHYMIA
      • Symptoms
      • 1) Critical/Irritable/Complaining
      • 2) Prone to worry
      • 3) Feelings of worthlessness, inferiority,
      • Lack of self-confidence
      • 4) Excessive guilt/Self-critical
      • 5) Low stress tolerance, easily
      • overwhelmed
      • 6) Overly cautious
      • 7) Difficulty being assertive
    • 10. BIPOLAR DISORDER
      • Bipolar I – “Classic Bipolar”
      • Long bouts of Depression + Long bouts
      • of Mania or Mixed episodes
      • DSM-IV Criteria – Six separate
      • 1) Single Manic Episode
      • 2) Most recent episode Hypomanic
      • 3) Most recent episode Manic
      • 4) Most recent episode Mixed
      • 5) Most recent episode Depressed
      • 6) Most recent episode unspecified
    • 11. BIPOLAR DISORDER
      • Bipolar Disorder II – hypomanic episodes
      • + depressive episodes
      • One or more MD episodes
      • At least one Hypomanic episode
      • Never had a Manic Episode
    • 12. BIPOLAR DISORDER
      • Don’t recognize how it affects their life or
      • others
      • Typically begins in adolescence/early adult
      • Sometimes dramatic – most often gradual
    • 13. SYMPTOMS
      • SUBJECTIVE REPORTS OF BD
      • Lack of motivation vs increased productivity
      • Dulling of thinking process vs clarity of thought
      • Low self-esteem vs inflated ego/over confidence
      • Pessimistic brooding/worry vs carefree
    • 14. SYMPTOMS
      • UNSTABLE MOOD CHARACTERISTICS
      • Easily bored
      • Difficulty holding enthusiasm
      • Easily irritated if don’t get their way
      • Impulse control problems
      • Reckless behavior
      • Stormy relationships
      • Multiple relationships/marriages
      • Frequent moves
      • Multiple job/career changes
    • 15. SYMPTOMS
      • MANIC PHASE
      • Euphoria, optimism, inflated self-esteem
      • Rapid speech, racing thoughts,increased physical activity
      • Poor judgement and recklessness
      • Easily distracted
      • Inability to concentrate/Flight of ideas
      • Extreme instability
      • Restlessness
      • Goal-directed activity
      • Decreased need for sleep
      • Increased sexual desire
      • Inappropriate social behavior
    • 16. SYMPTOMS
      • DEPRESSIVE PHASE
      • Persistent sadness, anxiety, guilt, hopelessness
      • Sleep/appetite disturbance
      • Anhedonia
      • Difficulty concentrating
      • Recurring thoughts od suicide
      • Chronic pain not caused by physical problems
      • Restlessness, irritability, agitation
      • Decreased energy
    • 17. TREATMENT
      • SELF-CARE
      • Bipolar Disorder is NOT an illness one can treat on their own
      • Med compliance
      • Warning signs
      • Avoid drugs and alcohol
      • Check for interaction before taking other meds
      • Find enjoyable activities
      • Enhance friendships and relationships
    • 18. CYCLOTHYMIA
      • Everything is pretty much o.k.
      • Irregular, short cycles of depression and hypomania
      • DSM IV Criteria
      • For two or more years hypomanic
      • symptoms and depressive symptoms
      • that don’t meet criteria for MD
      • During 2 year period, not without symptoms
      • for more than 2 months
      • No Major Depressive Episode, Manic Episode, nor
      • Mixed Episode
      • No Psychotic Disorder
      • No physiological problem
      • Causes significant distress or impairment
    • 19. SUICIDE
      • Suicide assessment is critical
      • MYTH – talking about suicide will put the idea in their head
      • Consider:
      • Method contemplated
      • Access to method
      • Environmental resources
      • Assistance if attempt is made
    • 20. SUICIDE
      • Assessment
      • Newspaper reporter
      • Ideation, Plans, Attempts/Intent
      • Clues
      • Secretive
      • Making a will suddenly
      • Verbal Statements
    • 21. SUICIDE
      • Motives
      • To die
      • Based on reality
      • Influence others
      • Tipping the scale against suicide
      • Play for time
      • No-Harm Contract
      • Elicit reasons to live and die
    • 22. SUICIDE
      • Dealing with Hopelessness
      • Problem solving
      • Stress inoculation
      • Training people to think differently
      • Increases in suicidality