Unit 5 Depressive Disorder Chapter 14 Flashcards
Is depression a normal part of aging
A.Yes
B. No
B. No
Depression is common, but not normal part of aging
Depression in Older adults
Older Adult
Depression is common, but not normal part of aging
May be overlooked because they are more likely to complain of physical illness
Subsyndromal depression
Pseudodementia
Geriatric Depression Scale
Pseudodementia vs Depression
Pseudodementia refers to a set of symptoms that mimic those of dementia, but there is typically no degeneration in the brain. Depression in older adults may cause similar symptoms,
What is Persistent Depressive Disorder?
Dysthamia , bad or low mood
is basically a lower level of depression .
MILD DEPRESSION
is diagnosed when low-level depression occurs most of the day, for the majority of days. These depressive feelings last at least 2 years in adults and 1 year in children and adolescents.
What is the criteria for Persistent Depression Disorder
Depressed for most of the DAY, more days than not
At least 2 years
Plus, two or more of the following:
Decreased or increased appetite
Insomnia or hypersomnia
Low energy or chronic fatigue
Decreased self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness or despair
What is the treatment for Persistent Depression Disorder
Treatment for this disorder is similar to that of major depres- sive disorder, which we will discuss in more depth later in this chapter. Psychotherapy, particularly CBT, is quite useful in managing the symptoms. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepi- nephrine reuptake inhibitors (SNRIs), and tricyclics (TCAs) are the other main treatments.
What schedule of depressive episodes would indicate Perisitent Depression Disorders?
A. 1 day out of 5 days for 3 hours of those days
B. 4 out of 5 days for 12 hours of those days
C. 3 out of 4 days for 2 hours a day.
D. 1 day out of 7 days fro 5 hours a day
B. 4 out of 5 days for 12 hours of those days
patient with
-“always felt this way” and that being depressed seems like normal functioning.
-It is not uncommon for people with this low-level depression to also have periods of full-blown major depressive episodes.
What is Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder is a relatively new addition to the diagnostic system for psychiatry. It refers to a cluster of symptoms that occur in the last week before the onset of a woman’s period.
Serious enough to disrupt functioning
Sx: mood swings, irritability, depression, anxiety, feeling overwhelmed difficulty
concentration
Physical sx: lack of energy, overeating, hypersomnia or insomnia, breast
tenderness, aching, bloating and weight gain
Tx – regular exercise, diet with complex carbs and getting sufficient sleep
Acupuncture, light therapy, relaxation
S/s of Premenstrual Psyphoric Disorder
Other physical manifestations include lack of energy, overeating, hypersomnia or insomnia, breast tenderness, aching, bloating, and weight gain. Symptoms decrease significantly or disappear with the onset of menstruation.
Which of the following meals would you recommend your client to eat who has been recently diagnosed with Premenstrual Disphoric Disorder?
A. Banana , strawberries , and celery
B. Cheese stick with fruit salad
C. Bowl of rice with red beans with a side of oats
D. Cup of milk with hasborwns
C. Bowl of rice with red beans with a side of oats
HIGH CARB DIET, RELAXATION , EXECISE ,
Tx –
regular exercise,
diet with complex carbs
and getting sufficient sleep
Treatment for this disorder includes regular exercise, partic- ularly aerobic exercise. Other recommendations include eating food rich in complex carbohydrates and getting sufficient sleep. Acupuncture, light therapy, and relaxation therapy have also been used to reduce symptoms.
Drug therapy for Premenstrual Dysphoric Disorder
S A drospirenone and ethinyl estradiol combination (Yaz, Gianvi) is a contraceptive that improves symptoms.
* SSRIs have been used successfully and three have FDA approval. They are fluoxetine (Prozac, Sarafem), sertraline (Zoloft), and controlled-release paroxetine (Paxil CR).
- Diuretics may be useful in reducing bloating and weight gain brought on by water retention.
What is Substance/Medication-Induced Depressive Disorder and cause
cause
-Substance/medication-induced depressive disorder is a result of prolonged use of or withdrawal from drugs and alcohol.
Is Substance/Medication-Induced Depressive Disorder symptoms longterm for short term?
A. Short term
B. Long term
A. Short term
Symptoms appear within 1 month of use. Once the substance is removed, depressive symptoms usually remit within a few days to several weeks.
What is the cause of DEPRESSIVE DISORDER DUE TO ANOTHER MEDICAL CONDITION?
Depressive disorder due to another medical condition may be caused by disorders that affect the body’s systems or from long- term illnesses that cause ongoing pain.
Medical disorders that are highly associated with Depressive Disorder
-Parkinson disease, Huntington disease, Alzheimer disease, and traumatic brain injury are also clearly associated with depressive disorders.
-Arthritis, back pain, metabolic conditions (e.g., vitamin B12 deficiency), HIV, diabetes, infec- tion, cancer, and autoimmune problems may also contribute to depression.
Can chronic pain cause depression?
A. Yes
B. No
A. Yes
-Arthritis, back pain, metabolic conditions (e.g., vitamin B12 deficiency), HIV, diabetes, infec- tion, cancer, and autoimmune problems may also contribute to depression.
What is Seasonal affective disorder
-depression and settings
Sometimes there is a regular relationship between the seasons and depressive symptoms. Commonly known as seasonal affective disorder (SAD), the exact diagnosis used in the DSM-5 is major depressive disorder with seasonal pattern.
When does seasonal affective disorder normally occur
Typically, individuals with this variation experience depressive symptoms in the fall and winter and then gain a full remission in the spring.
S/s of Seasonal affective disorder
Symptoms of the seasonal variety of depression are similar to what you would expect with hibernation: hypersomnia, over-eating, weight gain, and craving carbohydrates.
This disorder is more common in women and typically begins between the ages of 18 to 30. Populations that lie farthest from the equator are most affected.
Treatment for seasonal affective disorder
. Treatment is similar to that of major depressive disorder, with the addition of light boxes to mimic natural outdoor light.
● First-line treatment for SAD, light therapy inhibits nocturnal secretion of melatonin.
● Exposure of the face to 10,000-lux light box 30 min/day, once or in two divided doses
along with antidepressants if needed
What is the difference between Major Depressive Disorder vs Peristent Depressive Disorder?
-PDD depression symptoms last at least 2 years
-MDD depression symptoms last more than 2 years
PDD only required to meet 2 criterias for diagnoses
MDD requires at least 5 criteria for diagnoses
Clinal Picture of MDD
Major depressive disorder, or major depression, is char- acterized by a persistently depressed mood lasting for a mini- mum of 2 weeks.
The length of a depressive episode may be 5 to 6 months (Parikh et al., 2019). About 20% of cases become chronic (i.e., lasting more than 2 years).
MDD AGE CONSIDERATIONS
Children & Adolescents
Core sx are the same as adults, but differ in how they are displayed
Young child : cry,
adolescent : withdrawal,
teenager : irritable
Older Adult
Depression is common, but not normal part of aging
May be overlooked because they are more likely to complain of physical illness
Subsyndromal depression
Pseudodementia
Geriatric Depression Scale
Symptoms of Major depressive disorder
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
B. Note: Do not include symptoms that are clearly attributable to another medical condition.
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, it can be irritable mood.)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month) or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by
others, not merely subjective feelings of restlessness or being slowed
down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may
be delusional) nearly every day (not merely self-reproach or guilt about
being sick).
8. Diminished ability to think or concentrate or indecisiveness nearly every
day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan
for committing suicide.
C. The symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
D. The episode is not attributable to the physiological effects of a substance
or to another medical condition.
E. Note: Criteria A through C represent a major depressive episode.
Risk factors for depression
Female
Adverse Childhood experiences
Stressful life events
First-degree family member with MDD(predisposition through genetics
Negative Personality trait characterized by anxiety, fear, moodiness, envy, jealousy
Other disorder (substance use, anxiety)
Chronic or disabling medical conditions
