Depression and anxiety

Question 1

Obj: list common symptoms of depression

Answer 1

persistent negative mood
loss of pleasure and reduced interest in daily actvities
lack of concentration
changes in sleep (insomnia/sleeping more usual)
changes in appetite (too little or too much)
restlessness
fatigue/loss of energy
feelings of worthlessness or excessive guilt

to be diagnosed: 5 or more symptoms on most days of week for more than 2 week and symptoms must be associated with impairment at home, work, daily functioning

can occur without a triggering event
heterogenoues mental disorder

Question 2

Obj: examine the impact of depression on health behvaiors

Answer 2

people with Depression–>
higher rates of obesity, diabetes, and CVD
depression can lead to——> poor diet, alcohol consumption, tobacco use and a sedentary lifestyle, intense aches and pains (= less likely to exercise), poor sleep quality (fatigue= low activity and poor eating)

Chronic disease–> depression–> chronic disease worsens viscous cycle

Question 3

Obj: discuss the relationship between exercise and mood

Answer 3

more research is needed to clarify a positive effect of exercise on depression

DRs also rarely prescribe exercise but they deem it unlikely the patient will follow through anyways (Where coach can help)

Question 4

obj: explain behavioral strategies that can help clients with depression, anxiety, or chronic stress adopt and adhere to healthy lifestyle changes

Answer 4

1. Mood monitoring : keeping a log of mood (both + and -) each day as well as before, during and after implementing a target health behavior (ex: exercise, sleep, stress mangenmnt) thus allowing client to see impact of lifestyle changes on mood

Have clients rate moods before and after workouts could improve the impact of exercise on their depression by drawing their attention to how exercise improves their mood so have client pay attention to workout and intensity in the moment so they may decide what they find enjoyable –> improved mood

exercise can be experienced as pleasant or unpleasant; if found to be unenjoyable (in the case with many high inetsity workouts that offer no joy like videos or music) it will exavrerbate negative moods and thus negatively impact motivation to work out

2. goal setting:
   keep it small and manageable (with a 80% confidence on confidence rule for this weeks goal)
   find ways to tie healthy lifestyle behaviors to clients values is key
3. postive reinforcement: tie legitimate and credible metrics of success ( showing up to all coaching session, logging journal daily..etc) to affirmations of the clients strengths
4. add in social support: increases accountability and sense of healthy competition plus inclusion
5. Deal with negative thinking: challenge negative beliefs with evidence so that negative talk statements can be debunked as not 100% true; Do not try to just spin it into a positive note
6. enhance distress intolerance: low capacity to tolerate physical/ emotional discomfort leads to viscous cycle where stress is constantly causing setbacks and motivation to be healthy slowly degrades : combat with acceptance based strategies in which acknowledging feelings of discomfort in moment but allowing it to subside, not define the experience and is not more important than the values driving the lifestyle change
7. adhering to a healthy eating plan and losing weight–> improved mood

Question 5

Obj: Recognize when to refer clients to a mental health professional

Question 6

Q: what is a positive effect of exercise on mental health?

Answer 6

improves negative mood

Question 7

Q: what is a nutrition strategy for a client who has anxiety?

Answer 7

Decrease fat and sugar

Question 8

Q: when should a health coach consider referring a client with mental health issues to a healthcare professional?

Answer 8

The client has chronic insomnia

Question 9

Q: Which of the following statements about depression is MOST accurate?

a. It is caused by a traumatic event
b. its a homogeneous mental disorder
c. it can cause obesity
d. it can recur throughout a person life

Answer 9

d. it can recur throughout a person life

Question 10

Q: which of the following is an evidence-based treatment for depression?

a. incorporating meditative therapies
b. taking medications
c. working with a health coach
d. identifying the depression

Answer 10

b. taking medications

……….
other options include
psychotherapy: (behavioral activation , cognitive behavioral therapy, interpersonal therapy, problems. solving therapy, acceptance and commitment therapy, and self- control therapy)—> help clients learn healthy coping skills, avoid negative thinking patterns, practice emotional regulation skills

Med+ pyschotherapies= better outcome than just 1 alone

brain stimulation: Electroconvulsive therapy, transcranial stimulation, and vagus-nerve stimulation

Question 11

Q: Which of the following statements about the association between exercise and depression is MOST accurate?

a. there is a weak association between exercise and depression
b. exercise is as effective as a placebo in reducing depression sypmtoms
c. exercise is moderately more effective than psychotherapy and medications in reducing depressive symptoms
d. more research is needed to establish the relationship

Answer 11

d. more research is needed to establish the relationship

Question 12

Q: for anxiety to be diagnosed,———————–

Answer 12

The symptoms must be severe enough to interference with daily activities, relationships and/or work for at least 6 months

Question 13

Q: For what is the 10-item perceived stress scale used?

Answer 13

To guage the level of stress a person has been experiencing over the past month (from possible anxiety and chronic stress)

…………………….
not meant to diagnose
client rates each of the 10 statements on a scale of 0-4; where scoring high (27 and higher) indicates referral to a healthcare provider for further evaluation

Question 14

Q: Who are the best candidates to benefit from meditative therapies?

Answer 14

individuals with subclinical anxiety and/or stress

………………
those with formal anxiety disorder would best be treated with medication or physiotherapy , though there is some promise with mindfulness-based stress reduction and mindfulness based cognitive therapy

Question 15

Q: what is the main reason why a client with depression, anxiety, or chronic stress should monitor their mood?

Answer 15

For a client to understand the impact of their lifestyle changes on mood
………………..
mood monitoring

Question 16

Q: which of the following is an appropriate use of a confidence ruler?

Answer 16

To guage how confident a client feels about accomplishing the weeks goal
…………….
goal setting

Question 17

Q: once a health coach has helped a client identify their negative beliefs regarding their ability to develop a healthy lifestyle, the next step is to ———–

Answer 17

Have the client challenge any negative beliefs with evidence
……………………………

dealing with negative thinking

Question 18

Q: what is one reason why exercise has not consistently been recommended to patients as away to treat depression?

Answer 18

There is skepticism regarding the evidence

Question 19

Obj: examine the impact of anxiety and chronic stress on health behaviors

Answer 19

chronic stress–> increased risk for obesity, diabetes, hypertension, smoking and CVD, intensified effect of a diet high in sugar and fat on metabolic syndromes,

–> high rates of fast food consumption, sedentary lifestyle, insomnia, smoking and inappropriate alcohol use

Question 20

what is the difference between stress and anxiety?

Answer 20

when people feel stress they have a clear sense of the cause and it can be relieved once cause is settled; with anxiety the fear is often out of proportion to the circumstance and avoidance behavior is a common reaction

anxiety diagnosis: symptoms must last 6 months or longer and be enough to interfere with daily activities, relationships and work

Question 21

How is anxiety often treated?

Answer 21

Antidepressants are the 1st line of treatments for anxiety disorders while benzodiazapenes are 2nd ( short term effects and habit forming)

cognitative behavioral therapies are highly effective to treat all anxiety disorders (the specific type like exposure based behavior therapies or cognitive therapies depend on the anxiety)

Question 22

Q: which of the following statements about indicudals with depression is MOST accurate?

a. person with depression re not likely to benefit from working with a health coach and need to be referred to a mental health porvider

b person with depression likely to benefit from working wiht health coach as it provides an added layer of support

c. person with depression need to address their mental health issues before progressing with any healthy outcomes

d. person with depression need to be screened, diagnosed and refered to a mental health provider for best outcomes

Answer 22

b person with depression likely to benefit from working with health coach as it provides an added layer of support

pg395
The health coach can be useful in ensuring follow through on referrals, adherence to self-management instructions and follow up visits to providers when necessary.

Question 23

Q: which is the one of the 1st steps to take when meeting with someone who has depressive symptoms but not diagnosed?

Answer 23

Use the PHQ-9 to screen the client for depression

pg 396-397

when depression is suspected but the client has not been previously diagnosed, the health coach can use the PHQ-9 to determine whether to refer the client for further assessment . scores 5 and greater= possible depression

Question 24

Q: client who smokes and is stressed ( recently stopped working out due to stress) scores a 28 on perceived stress scale what should coach do next?

a. recommen stress management and smoking cessation classes
b. identify clients values and strengths
c. refer the client to a healthcare provider for further evaluation
d. discuss clients desires, collaborate on smart goals and develop a strategic plan

Answer 24

c. refer the client to a healthcare provider for further evaluation

Question 25

excessive tv watching and overating from lack of motivation and mood swings can be refered to as ……….

Answer 25

maladaptive coping disorders

Question 26

Q: which of the following best reflects a clients low distress tolerance?

a. lack of motivation for continuing with the plan
b. regular exercise causing client soreness
c. bagging lunches assist with healthy eating adherence
d. lapses back to eating fast foods

Answer 26

d. lapses back to eating fast foods

Question 27

What is the GAD-7 used for ?

Answer 27

a screening tool to identify whether a complete assessment for anxiety by a mental health progression is indicated (score of 10= point form refferal)