Chapter 27 Mood Disorders Depression

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Psych Test 3


Concepts Of Psychiatric-Mental Health Nursing (Nova Southeastern University)




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Chapter 27- Mood Disorders-Depression

Introduction

 Depression is the oldest and most frequently described
psychiatric illness.
 Transient symptoms are normal, healthy responses to everyday
disappointments in life.
 Pathological depression occurs when adaptation is ineffective.
 Depression is an alteration in mood that is expressed by
feelings of sadness, despair, and pessimism.
 There is a loss of interest in usual activities, and somatic
symptoms may be evident.
 Changes in appetite and sleep patterns are common.
 Examples of affect aka mood Depression, joy, elation,
anger and anxiety.

 You need a dx for depression  All related to sx & behavior
 What person says or does, age and TIMEFRAMES are very
important.
 Minimum of 2 weeks.
 Can’t adapt effectively there’s a problem.
 Depression is common in females
 Inability to function-Pathological attachment

Epidemiology
 Approximately 9.5 million persons reported a depressive
episode in 2008.
 During their lifetime, about 21% of women and 13% of men will
become clinically depressed.
 Gender prevalence
 Depression is more prevalent in women than in men by
about 2 to 1.
 Depression more common in young women than young men.
 The gender difference is less pronounced between ages 44 and
65, but after age 65, women are again more likely to be
depressed than men
 Social class: there is an inverse relationship between social
class and report of depressive symptoms




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 Race and culture: no consistent relationship between race and
affective disorder has been reported; one recent survey
revealed
 Depression is more prevalent in whites than blacks
 Depression is more severe and disabling in blacks
 Blacks are less likely to receive treatment than whites
 Marital status: single and divorced people more likely to
experience depression than married persons or persons with a
close interpersonal relationship (differences occur in various
age groups)
 Seasonality: affective disorders are more prevalent in the
spring and in the fall

 Time of the year  “seasonal affective disorder” SAD is a
disorder that’s generally due to a lack of natural light. People
in Seattle mostly or Alaska have this disorder  High
Suicide Rate

Types of Depressive Disorders -MDPMS
 Major depressive disorder
 Dysthymic disorder
 Premenstrual dysphoric disorder
 Mood disorder due to a general medical condition
 Substance-induced mood disorder

 Distinguish these types! KNOW FOR TEST & KNOW
INTERVENTIONS
 MAJOR—AXIS 1 DX
 Hyperthyroid will look like a person is experiencing
depression! – mood disorder due to a general medical
condition
 Substance-induced mood disorder – ex: cns stimulants,
alcohol, beta blockers (bp meds)

Major depressive disorder
 Characterized by depressed mood
 Loss of interest or pleasure in usual activities
 Social and occupational functioning impaired for at least 2
weeks
 No history of manic behavior




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 Cannot be attributed to use of substances or a general medical
condition
 Can be dx if it's a single/recurrent episode
 Can be mild, moderate or severe
 Noted as postpartum if sx appear 4 weeks after childbirth

 S/s withdrawn, isolation from others, flat affect, apathy, loss
interest in activity, appetite disturbance, sleep disturbance,
crying & anhedonia!!
 #1 LACK OF ABILITY TO CONCENTRATE OR FOCUS-
MINDLESS ACTIVITIES ARE MORE APPOPRIATE. Ex:
have them sort out the snacks or fold laundry. Things like
word puzzles wouldn't be good for the beginning of tx. Don’t
force these people to go to group therapy.
 KEY THING: Improvement in mood, appetite improvement
would be a good thing
 Depressed teenagers may express depression with
VIOLENCE/ANGER
 TWO WEEKS OF DISFUNTION!
 You can’t have any hx of manic behavior or mania, hyper
behavior or bi-polarism to be dx w/ depression nor can it be
related to any substance/medical condition

Dysthymic disorder
 “Sad or down in the dumps”
 No evidence of psychotic symptoms
 Essential feature is a chronically depressed mood (or irritable
mood in children/adolescents) for 
Most of the day
More days than not
For at least 2 years (1 year for children/adolescents)
Early onset (before 21) / late onset (occurring at 21, or older)

 You can have agitation or psychotic depression with a major
depressive disorder.
 Very blah most of the time out of a week at least 4 days at a
time they feel low.
 Goes on for at least 2 years

Premenstrual dysphoric disorder




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