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Mood disorders online

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Mood disorders online

  1. 1. Mood Disorders <ul><li>Major depression </li></ul><ul><li>Dysthmyic disorder </li></ul><ul><li>Bipolar Type 1 </li></ul><ul><ul><li>mixed </li></ul></ul><ul><ul><li>rapid cycling </li></ul></ul><ul><li>Bipolar Type 2 </li></ul>
  2. 2. Etiology <ul><li>Genetic factors ---current hypothesis </li></ul><ul><li>Catecholamine hypothesis </li></ul><ul><li>Serotonin hypothesis </li></ul><ul><li>weaker hypothesis </li></ul><ul><li>Hypothalamus-pituitary-adrenals </li></ul><ul><li>Hypothalamus-pituitary-thyroid </li></ul><ul><li>Circadian rhythms </li></ul>
  3. 3. Psychosocial factors <ul><li>Psychoanalytic theory </li></ul><ul><li>Cognitive Behavioral </li></ul><ul><li>Reinforcement </li></ul><ul><li>Learned helplessness </li></ul><ul><li>Cognitive theory </li></ul><ul><li>negative cognitive triad </li></ul><ul><li>self-world-future </li></ul>
  4. 4. Major depression <ul><li>Depressed mood </li></ul><ul><li>Markedly diminished interest in pleasure </li></ul><ul><li>Significant weight loss </li></ul><ul><li>Insomnia or hypersomnia </li></ul><ul><li>Psychomotor agitation or retardation </li></ul>Depression
  5. 5. <ul><li>Fatigue or loss of energy </li></ul><ul><li>Feelings of worthlessness </li></ul><ul><li>Diminished concentration </li></ul><ul><li>Recurrent thoughts of death </li></ul>
  6. 6. Vegetative Signs of Depression <ul><li>Severe weight loss </li></ul><ul><li>Psychomotor retardation </li></ul><ul><li>Sleep disturbance </li></ul><ul><li>early morning awakening (EMA) </li></ul><ul><li>Decreased libido </li></ul>
  7. 7. Dysthymia <ul><li>Depressed mood </li></ul><ul><li>Presence of at least 2 of the following: </li></ul><ul><li>poor or increased appetite </li></ul><ul><li>insomnia or hypersomnia </li></ul><ul><li>low energy </li></ul><ul><li>poor concentration </li></ul><ul><li>feelings of hopelessness for  1 year </li></ul>
  8. 8. Nursing Assessment <ul><li>Present complaint </li></ul><ul><li>Hx. of problem </li></ul><ul><li>Past 4 hx. </li></ul><ul><li>Social hx. </li></ul><ul><li>Medical hx. </li></ul><ul><li>Mental status exam </li></ul>
  9. 9. Bipolar Disorders 1 and 2 <ul><li>Type 1 </li></ul><ul><li>Regular </li></ul><ul><li>Mixed </li></ul><ul><li>Rapid cycling </li></ul><ul><li>Type 2 </li></ul>Bipolar Disorder
  10. 10. Mania <ul><li> energy </li></ul><ul><li> activities </li></ul><ul><li> self-esteem </li></ul><ul><li>flight of ideas </li></ul><ul><li>easy agitation </li></ul><ul><li>poor self control </li></ul><ul><li>hyperphagia or  appetite </li></ul><ul><li> need for sleep </li></ul>
  11. 11. <ul><li>Mixed disorder </li></ul><ul><li>both sets of symptoms in a 24 hour period </li></ul><ul><li>Rapid cycle </li></ul><ul><li>both symptoms within one week </li></ul>
  12. 12. Mental Status Exam <ul><li>Appearance </li></ul><ul><li>Depression-poor hygiene </li></ul><ul><li>Mania-bizarre dress-frequent change of clothes </li></ul><ul><li>Speech </li></ul><ul><li>depressed-retarded & concrete </li></ul><ul><li>mania-flight of ideas-pressured speech- </li></ul><ul><li>intrusive-expansive </li></ul>
  13. 13. <ul><li>Thought content </li></ul><ul><li>Depression-worthlessness-hopelessness- helplessness-guilt-somatic concerns </li></ul><ul><li>Mania-grandiosity-distractibility </li></ul><ul><li>Affect </li></ul><ul><li>Depression-flat, dull, sad mood </li></ul><ul><li>Mania-labile </li></ul>
  14. 14. <ul><li>Psychomotor </li></ul><ul><li>Depression- retardation </li></ul><ul><li>Mania- hyperactive </li></ul><ul><li>Delusions </li></ul><ul><li>Depression-negative triad </li></ul><ul><li>Mania-grandeur, bizarre </li></ul><ul><li>Hallucinations </li></ul>
  15. 15. <ul><li>Suicide potential </li></ul><ul><li>Orientation </li></ul><ul><li>Concentration v distractibility </li></ul><ul><li>Recent memory </li></ul><ul><li>Insight </li></ul><ul><li>Judgment </li></ul>
  16. 16. Nursing Diagnosis <ul><li>Risk for self-directed violence </li></ul><ul><li>Self-esteem disturbance </li></ul><ul><li>Self-care deficit </li></ul><ul><li>Social isolation </li></ul><ul><li>Altered nutrition </li></ul>
  17. 17. Nursing Intervention <ul><li>Suicide prevention </li></ul><ul><li>Social interaction </li></ul><ul><li>Maintain adequate nutrition </li></ul><ul><li>Maintain fluid & electrolytes </li></ul><ul><li>Maintain sleep wake cycle </li></ul><ul><li>Supportive care re: judgment </li></ul><ul><li>Electroconvulsive therapy </li></ul>
  18. 18. <ul><li>Sleep therapy </li></ul><ul><li>Cognitive behavioral therapy </li></ul><ul><li>daily activities </li></ul><ul><li>testing of depressive thoughts </li></ul>
  19. 19. Anti-depressant medication <ul><li>Tricyclic antidepressants </li></ul><ul><li>Tofranil </li></ul><ul><li>Elavil </li></ul><ul><li>Monoamine oxidase inhibitors </li></ul><ul><li>Parnate </li></ul><ul><li>Nardil </li></ul><ul><li>Marplan </li></ul>
  20. 20. <ul><li>Serotonin Selective Reuptake inhibitors </li></ul><ul><li>Prozac </li></ul><ul><li>Zoloft </li></ul><ul><li>Paxil </li></ul><ul><li>Celexa </li></ul><ul><li>Others </li></ul><ul><li>Wellbutrin </li></ul><ul><li>Serzone </li></ul>
  21. 21. Anti-mania Medication <ul><li>Lithium </li></ul><ul><li>Anti-convulsants </li></ul><ul><li>Depakote </li></ul><ul><li>Tegretol </li></ul><ul><li>Lamictal </li></ul>

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