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45 Cards in this Set
- Front
- Back
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melancholia
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a severe form of depressive disorder in which symptoms are exaggerated and intrest or pleasure in virtually all activites are lost
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what did Hipocrates believe caused melancholia?
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excessive black bile produced by the spleen which affects the brain
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mood is also called?
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affect
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an aleration in mood that is expressed by feelings of sadness, despair, and pessimism. there is a loss of intrest in usual activites and somatic symptoms may be evident, also changes in appetite and sleep patterns are common
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depression
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is depression more common in male or females?
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females 2:1
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is depression more common in younger women or older women
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higer in younger women and decrease with age, oppisite in men. tend to be more prevalent in older men
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major depressive disorder
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characterized by depressed mood or loss of intrest or pleasure in usual activity. client will have impaired social and occupational functioning that has existed for two weeks or greater, with no history of manic behavior and not associated with substance abuse or a general medical condition and identified to the degree of the symptoms, mild moderate and severe
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what is a single episode of
MDD? |
it is the individuals first encounter with MDD
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what is a recurrent episode of MDD?
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the client has a history of previous episodes of MDD
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dysthymic disorder
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chronically depressed mood for most of the day,more days than not for two years
(1 year for childern and adolescents) |
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what is late onset of dysthymic disorder?
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occuring after 21 years or older
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what is early onset of dysthymic disorder?
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occuring before the age of 21
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premenstrual dysphoric disorder
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features include markedly depressed mood, excessive anxiety, mood swings, decreased in intrest in activities during the week prior to menses and subsiding shortly after the onset of menstruation, pt usually has somatic complaints
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biological theories include genetic, biochemical influences,neuroendocrine disturbance
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genetic theroy-
*twin study suggest that there is a concordance of 10-25% in monozygotic twins *family studies suggest that depression is 1.5-3 times more likely to have depression among first-degree relatives with the disorder *adoption studies suggest that biological childern of affected parents still remain at an increased risk. Biochemical influence- neurotransmitters norepinephrine, serotonin and dopamine are altered in the brain neuroendocrine disturbances- *hypersecretion of cortisol *deminished THS |
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what is secondary depression
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may be related to med side effects, neurological disorder, electrolyte or hormonal disorder, nutritional deficiences and other physiological and psychological disorders
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medication side effects r/t depression
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most drugs with direct effect on the CNS can cause secondary depression (anxiolytics, antipsychotic, sedatives)
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neurological disorders r/t depression
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CVA- can cause depression
brain tumors (area of temporal lobe) alzheimers parkinsons huntingtons disease |
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electrolyte disorders r/t depression
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excessive levels of sodium bicarbonate or calcium also deficits in mag and sodium. symptoms of depression can be seen with high or low levels of potassium
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nutritional deficiencies r/t depression
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deficiencies in b1, b6, b12, niacin, vit c, iron, folic acid, zinc, calcium, and potassium
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other physiological conditions r/t depression
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SLE (systemic lupus erythematosus)
cardiovascular disease heart faliure MI CVA pneumonia syphilis metabolic disorder |
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psychosocial theories
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psychoanalytical theroy
learning theroy object loss theory cognitive theory |
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psychoanalytic theory
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freud believes that melancholia occurs after the loss of a loved object, actually by death or emotionally by rejection or the loss of another abstraction of value to individual. once the lost has been incorportated into the self (ego) the hostile part of the ambivalence that has been felt for the lost object is then turned inward against the ego
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learning theory
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"learned helplessness" person experiences numerous failures (real or perceived) and the person abandons any further attempts to succeed.
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object loss theory
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suggest that depressive illness occurs as a reslut of having been abandoned byor otherwise seperated from a significant other during the first 6 months of their life
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cognitive theory
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seen as cognitive distortion that result in neg defeated attitudes
negative expectations of the environment negative expectations of the self negative expectations of the future depression is the product of negative thinking |
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s/s of childhood depression
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up to age 3- feeding problems, lack of playfulness and emotional expressiveness
ages 3-5- accident prone, phobias, excessive self-reaproach ages 6-8- vague physical complaints and aggressive behaviors, may cling to parent and avoid new people/challanges ages9-12- morbid thoughts and excessive worrying, they may say the reason they are depresssed is they feel they have dissapointed their parents |
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what is the focus of therapy with depressed childern?
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alleviate the symptoms and strengthen the child's coping and adaptive skills, with the hope of preventing future psychological problems
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why is depression harder to recognize in adolescence?
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feelings of sadness, loneliness and anxiety are seen as normal stresses of growing up
depression/suicide is the 3rd leading cause of death in this age group |
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what are some common symptoms of depression in adolescence?
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inappropriately expressed anger, aggressiveness, running away, delinquency, social withdrawl, sexual acting out, substance abuse, eating distrubances
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how can you determine if the adolescent is depressed or its consider "normal" behavior?
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behavioral changes that lasts for several weeks
exp: a person who is *normally outgoing becomes socially withdrawn *good grades and now failing |
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_______ occurs when an individual experiences so many losses in their lives that they are unable to resolve one grief response before another begins
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bereavement overload
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in the elderly, they are often misdiagnosed with ________ instead of depression
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senile dementia- their memory loss, confused thinking, or apathy is symptomatic of senile but they suffer from depression
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what are symptoms of maternity blues?
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tearfulness, despondency, anxiety, impaired concentration, symptoms usually appear 3-4 days after delivery
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postpartum depression
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depressed mood varying from day to day, more bad days then good, worse towards the evening, with fatigue, irriability, loss of appetite, sleep disturbances, loss of libido
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postpartum melancholia- or - depressive psychosis
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depressed mood, agitation, indecision, lack of concentration, guilt, and abnormal attitude about normal bodily functions. mom may reject the baby or morbid fear that the baby may be harmed
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symptoms of transient depression (not necessarily dysfunctional):
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affective: sadness dejection, feeling downhearted, having the "blues"
behavioral: some crying possible cognitive: difficulty getting mind of ones disappointment physiciological: feeling tired and listless |
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symptoms of mild depression (associated with normal grieving)
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affective: denial of feelings, anger, anxiety, guilt, helplessness, sadness, despondency
behavioral: tearfulness, regression, restlessness, agitation, withdrawl cognitive: preoccupation with the loss, self-blame, ambivalence, blaming others physiological: anorexia, overeating, insomnia, hypersomnia, ha, back ache, cp |
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symptoms of moderate depression (more problematic distrubances)
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affective: feelings of sadness, powerlessnss, hopelessness, gloomy, pessimistic outlook, low self esteem, no pleasure in activity
behavioral: slow physical movements, slumped posture, slow speech, limit verbilization, regrets on life, substance abuse, self destructive behavior, decreased personal hygiene cognitive: retarded thinking process, diff concentrating/attention, obsessive/repetitive thoughts, negativism, si physiological: under/over eating, excessive/not enough sleep, amenorrhea, decreased libido, feeling good in the morning then worse as the day goes |
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symptoms of severe depression (Major depressive disorder/ bipolar depression)
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affective: total despair, worthlessness, flat affect, devoid of emotionall tone, nothingness/emtiness, apathy, loneliness, cant feel pleasure
behavioral: physical movement may come to a stand still, purposeless movements, slumped posture, slow gait, nonexistent communication, no hygiene/grooming, social isolation cognitive: prevalent delusional thinking, delusions of persecution, somatic delusions, hallucinations reflecting misinterpretation of environment, self-deprecation, self blame, thoughts of SI physiological: slow down of entire body, sluggish GI, urianry retention, anorexia, amenorrhea, feeling worse in the morning then better throughout the day (to some degree) |
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what are the three phases of individual psychotherapy?
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phase 1- assessed to determine extent of illness
phase 2-help the client resolve dysfunctional grief reactions phase 3- theraputic alliance is terminated |
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why is TCA drugs widely used to treat depression?
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has been subjected to hundreds of of controlled trials amd their efficacy in treating depressive illness is firmly est
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what is electroconvulsive therapy?
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a type of somatic treatment in which electric current is applied to the brain through electrodes placed on the tempels, a grand mal sz produces the desired effect, usually done in severly depressed pt refactory to antidepressant medication.
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what is the mechanism of action for ect?
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exact is unknown, but thinks it stimulates neuromtransmitters ( serotonin, norepinephrine, dopamine) to increase in activity and circulation
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what are the side effects of ect?
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temp loss of memory and confusion (short term)
brain damage- very controversial. |
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what is the mortality rate?
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2 per 100,000 and is from cardiovascular complications
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