depression

Question 1

what is depression

Answer 1

it is a loss of interest, a lack of energy and low mood effecting how you feel about yourself, affecting how you manage your life

Question 2

what are the causes of depression

Answer 2

• traumatic life event
• genetic predisposition
• experiencing trauma early in life

Question 3

what are symptoms of depression

Answer 3

• guilt, worthlessness, hopelessness
• lack of energy
• lack of enjoyment
• sleep disturbance
• automatic negative thinking
• emotional and tearful
• excessive rumination
• change in weight
• continuous low mood
• irritability and intolerance
• withdrawal

Question 4

diagnosis of depression

Answer 4

feelings of sad low mood needs to have been present for more than 2 weeks

Question 5

what are treatment options for depression

Answer 5

• CBT
• social support
• life style changes
• medication
• mindfulness and meditation
• counselling
• group exercises

Question 6

what are the types of medications used for depression

Answer 6

• SSRIs
• SNRIs
• TCAs
• Monoamine oxidase inhibitors

Question 7

what are the types of depression

Answer 7

• melancholia
• psychotic
• antenatal/ postnatal
• dysthymic disorder
• bipolar
• cyclothymic disorder
• seasonal affective disorder

Question 8

what is stepped care management

Answer 8

stepping up the patients care from least to most intrusive

Question 9

what is matched care

Answer 9

offering higher steps first due to patients presentation and treatments

Question 10

what considerations need to be made with antidepressants and suicidal patients

Answer 10

• increased prevalence of suicidal thoughts and self harm at the early stages of treatment
• need reviews within 1 weeks

Question 11

what considerations need to be made with antidepressants and older people

Answer 11

• physical health
• monitor regularly for side effects
• increased risk of falls and fractures
• increase risk of hyponatraemia

Question 12

how do SSRIs work as antidepressants

Answer 12

• inhibit the re-uptake of serotonin so increases the serotonin activity
• they are present in the presynaptic axon terminal and inhibit the serotonin transporter
• increase amounts of serotonin and the synaptic cleft stimulate the postsynaptic receptors for a longer period

Question 13

how do SNRIs work as antidepressants

Answer 13

• block the reuptake of both serotonin and norepinephrine
• increasing the levels of active neurotransmitters in the brain
• norepinephrine - attention and mental focus
• serotonin - memory formation, learning, sleep, mood, appetite

Question 14

how to TCAs work in depression

Answer 14

• inhibit serotonin and norepinephrine uptake in the presynaptic terminals
• the neurotransmitters act as competitive antagonist on postsynaptic cholinergic muscarinic and histamine receptors

Question 15

how do monoamine oxidase inhibitors (MAOIs) work in depression

Answer 15

• block the monoamine oxidase enzyme - this breaks down different types of neurotransmitters form the brain
• this helps to increase their levels allowing them to influence the cells

Question 16

pathophysiology of depression

Answer 16

• serotonin hypothesis: low levels of serotonin in the brain causes symptoms (linked to medication) NOT FULLY true
• dysregulation in the hypothalamic-pituitary adrenal axis

Question 17

how does dysregulation in the hypothalamic-pituitary adrenal axis cause depression

Answer 17

• the hypothalamus, pituitary gland and adrenal gland are involved in the secretion of the stress response cortisol (gives energy in stress)
• abnormalities in the HPA axis can increase levels of cortisol
• High levels of cortisol can disrupt the functions of the brain regions and can impair the ability to think and reason clearly, regulate emotions and learn new ways to cope with challenges