RNSG 2539 Mood and Effects Notes

Mood and Affect Student Notes
Mood and Affect (Concepts Page 301)
Definition
 The term mood is defined as the way a person feels. The term affect is defined as the observable response a
person has to his or her own feelings.
 The mood spectrum is a continuum, or spectrum, of all possible moods that any person may experience. Mood
disturbances disrupt an individual’s ability to function normally.
Key Terms
 Affective instability
 Functional status
 Depression
 Melancholy: don’t feel low or high just feels “nothing”
 Mania: very high
 Perceptual disturbance: what they perceive: in bipolar
(everyone is out to get them)
Scope of Mood and Affect
 Ranges from low or depressive, normal range, and elevated
range
 Normal range itself is a range of cycles -happy
o Normal happiness
o Normal sadness
Normal Physiological Process
 Reduced blood flow and abnormal phosphorus metabolism in
the prefrontal aspect of the cerebral cortex
 Disturbed activity in neurotransmitters of the brain
o Dopamine
o Norepinephrine
o Serotonin
Variations and Context
 Depressive spectrum
o Overwhelming sadness and despair
o May lead to suicidal ideation
o No energy they may feel sad and empty and suicidal thought
 Mania spectrum the very high state.
o Euphoric or agitated affective states
o Varying degrees of perceptual disturbances
o They have difficulty concentrating: Bipolar Pt have a tendency of reckless activities
Consequences: Mood Spectrum Disorders
 Change in interpersonal relationships
 Limited productivity
 Reduced functional ability
 Higher use and need for medical care
 Increased potential for suicide
Risk Factors for Mood Disturbances
 Populations at greatest risk
o Females
o Individuals in the second and sixth decades of life
o Abusive households,
o Family Hx
o Hx of suicide in family
o Adolescents, (bully)

, Mood and Affect Student Notes
o PTSD
o Childhood trauma
 Individual risk factors
o Stress, early trauma, neglect, abuse, family history, comorbid medical and psychiatric disorders,
personality disorders, substance dependence
Identifying Mood Spectrum Disturbances
 Affective instability may present as any combination of the following behaviors:
o Agitation
o Sadness
o Elation
o Blunting
 Speech may be in a monotone during blunting, and responses may be unusually brief
 Nurses should know the common indicators of these key findings
o Persistent mood disturbance: sadness, melancholy, irritability. lack of interest in normal activities,
euphoria, rage, or lack of feeling anything at all
o Melancholy 2 weeks
o Mnic 4 weeks persistently feels low or high patient is unstable
o Functional impairment (mood should not fluctuate so rapidly or extreme that functional ability is
disruptive)
o Disturbed vegetative functioning
o Very Low -you’ll see increase sleep, low libido decrease energy, decreases appetite
 Diagnostic Test
o There are no specific tests to confirm the diagnosis of mood spectrum disorders
o Mental Status Assessment
o Tools to quantifiably measure mental status
 Mini-Mental State Exam:
 Neecham Confusion Scale: test to see if you are confused
 Confusion Assessment Method Instrument
Clinical management
 Primary Prevention
o Prevention efforts focus on societal egalitarian interventions
o Programs that target prevention tend to be early interventions
o Don’t abuse children
o Try to help patients in poverty
o Help with Stress
 Secondary Prevention (screening)
o Aimed at early detection
o Questions
 “Over the past 2 weeks, have you ever felt down, depressed, or hopeless?”
 “Have you felt little interest or pleasure in doing things?”
o Questionnaire will help see S/Sx and referral may be needed
 Collaborative Care
o Motivational interviewing : help them get out of certain situation emotionally
o Psychotherapy
o Pharmacotherapy
o Brain stimulation therapy
o Management of emergent situations (potential for suicide and/or violence to others)
o Cognitive: help change thought and believes for a healthy lifestyle
o Family therapy
o Play therapy