Depressive Disorders
Objectives: Difficulty concentrating
Define Mood Disorders: Major Depressive Disorder; Lethargy, easy fatigue marked lack of energy
Persistent Depressive Disorder (old dysthymia); Marked change in appetite
Premenstrual Dysphoric Disorder Hypersomnia or Insomnia
Discuss Risk Factors for Depressive Disorders Breast tenderness, aching, bloating, weight gain
Assess clinical manifestations of clients with Depressive
Disorders Major Depressive Disorder (MDD)
Identify Treatment of Mood Disorders: Therapeutic Diagnostic Criteria
management, pharmacological & nonpharmacological Symptoms cause significant distress in employment,
Discuss the nurse’s role in ECT therapy social or other areas of functioning
Define Suicide risk factors, assessment, & interventions Not attributed to other medical conditions or substance abuse
5 or > must be present for TWO weeks, with a change
What is Depression? from previous functioning:
Alteration in mood that is expressed by feelings of ***Depressed Mood most of day nearly every day
sadness, despair, pessimism (Kids- irritable)
Loss of interest in usual activities ***Anhedonia – unable to experience pleasure in daily
Somatic symptoms life
Changes in appetite & sleep Weight/Appetite loss or gain
Insomnia/hypersomnia
Normal Psychomotor agitation or retardation
Transient symptoms are healthy responses to loss or change Anergia / fatigue
Feel worthless, inappropriate guilt
Pathological Trouble thinking, concentrating, indecisiveness
Occurs when adaptation fails to occur or is ineffective Recurrent thoughts of death, suicide thoughts & plans
Types of Mood Disorders Major Depressive Episode- DSM-IV specifiers
Persistent Depressive Disorder Single episode or recurrent episode
Premenstrual Dysphoric Disorder Mild, moderate, or severe
Substance/Medication-Induced Depressive Disorder With or without psychotic features
Depressive Disorder Due to Another Medical Condition With catatonic features
Major Depressive Disorder (MDD) With postpartum onset
Seasonal Affective Disorder (SAD) With seasonal pattern
o Usually Fall / Winter – lack of sunlight, decreased
melanin Developmental Considerations
Child – the younger that you have this disorder, the more
Persistent Depressive Disorder likely you will have this for the rest of your life
(Old Name: Dysthymia) Adolescence – more likely to engage in substance abuse,
Feelings of low-level Depression For: aggression, lower self-esteem.
Most of day Elderly (Senescence) – from repeated losses, diseases,
Majority of days – for at least 2 years decreased functioning.
Plus – at least 2 of the following:
o Poor appetite or overeating Risk Factors: Depression
o Insomnia or hypersomnia Biological Factors
o Low energy or fatigue Genetic
o Low self-esteem Biochemical
o Poor concentration or difficulty making decisions Deficiency of:
o Feelings of hopelessness o serotonin, norepinephrine, & glutamate, GABA,
dopamine? acetylcholine
o NOT sever enough for hospital
Hormonal
Inflammation
Premenstrual Dysphoric Disorder (PMDD)
Essential features: Psychological Factors
At least 5 symptoms appear in last week prior to menses, start
Cognitive theory:
to improve at menses onset
Views primary disturbance in depression as cognitive
Mood swings
rather than affective
Marked irritability or anger or increased conflict Depression is product of negative thinking. To improve
Marked depressed mood, feeling of hopelessness or self-
mood, need to change the way think
deprecation
Marked anxiety, tension, feeling of being keyed up or on
Three cognitive distortions that serve as the basis for
edge
depression:
Decreased interest in usual activities
Objectives: Difficulty concentrating
Define Mood Disorders: Major Depressive Disorder; Lethargy, easy fatigue marked lack of energy
Persistent Depressive Disorder (old dysthymia); Marked change in appetite
Premenstrual Dysphoric Disorder Hypersomnia or Insomnia
Discuss Risk Factors for Depressive Disorders Breast tenderness, aching, bloating, weight gain
Assess clinical manifestations of clients with Depressive
Disorders Major Depressive Disorder (MDD)
Identify Treatment of Mood Disorders: Therapeutic Diagnostic Criteria
management, pharmacological & nonpharmacological Symptoms cause significant distress in employment,
Discuss the nurse’s role in ECT therapy social or other areas of functioning
Define Suicide risk factors, assessment, & interventions Not attributed to other medical conditions or substance abuse
5 or > must be present for TWO weeks, with a change
What is Depression? from previous functioning:
Alteration in mood that is expressed by feelings of ***Depressed Mood most of day nearly every day
sadness, despair, pessimism (Kids- irritable)
Loss of interest in usual activities ***Anhedonia – unable to experience pleasure in daily
Somatic symptoms life
Changes in appetite & sleep Weight/Appetite loss or gain
Insomnia/hypersomnia
Normal Psychomotor agitation or retardation
Transient symptoms are healthy responses to loss or change Anergia / fatigue
Feel worthless, inappropriate guilt
Pathological Trouble thinking, concentrating, indecisiveness
Occurs when adaptation fails to occur or is ineffective Recurrent thoughts of death, suicide thoughts & plans
Types of Mood Disorders Major Depressive Episode- DSM-IV specifiers
Persistent Depressive Disorder Single episode or recurrent episode
Premenstrual Dysphoric Disorder Mild, moderate, or severe
Substance/Medication-Induced Depressive Disorder With or without psychotic features
Depressive Disorder Due to Another Medical Condition With catatonic features
Major Depressive Disorder (MDD) With postpartum onset
Seasonal Affective Disorder (SAD) With seasonal pattern
o Usually Fall / Winter – lack of sunlight, decreased
melanin Developmental Considerations
Child – the younger that you have this disorder, the more
Persistent Depressive Disorder likely you will have this for the rest of your life
(Old Name: Dysthymia) Adolescence – more likely to engage in substance abuse,
Feelings of low-level Depression For: aggression, lower self-esteem.
Most of day Elderly (Senescence) – from repeated losses, diseases,
Majority of days – for at least 2 years decreased functioning.
Plus – at least 2 of the following:
o Poor appetite or overeating Risk Factors: Depression
o Insomnia or hypersomnia Biological Factors
o Low energy or fatigue Genetic
o Low self-esteem Biochemical
o Poor concentration or difficulty making decisions Deficiency of:
o Feelings of hopelessness o serotonin, norepinephrine, & glutamate, GABA,
dopamine? acetylcholine
o NOT sever enough for hospital
Hormonal
Inflammation
Premenstrual Dysphoric Disorder (PMDD)
Essential features: Psychological Factors
At least 5 symptoms appear in last week prior to menses, start
Cognitive theory:
to improve at menses onset
Views primary disturbance in depression as cognitive
Mood swings
rather than affective
Marked irritability or anger or increased conflict Depression is product of negative thinking. To improve
Marked depressed mood, feeling of hopelessness or self-
mood, need to change the way think
deprecation
Marked anxiety, tension, feeling of being keyed up or on
Three cognitive distortions that serve as the basis for
edge
depression:
Decreased interest in usual activities
