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Psychoanalytical
Cognitive-Behavioral
Theory
Theory
With high familial and
Disturbance in
Depression associated
genetic patterns
interpersonal relations
with significant loss of
in early childhood
important sources of
Dysregulation of
positive reinforcements
Arouse from withdrawal of
norepinephrine and
or high rate of aversive
serotonin (biogenic mine
maternal love and
experience
hypothesis)
support during oral
(reinforcement theory)
phase and later
Low levels od tryptophan
Learned helplessness
experiences of loss
(precursor of serotonin)
Predisposed by
Cognitive triad: negative
ambivalence in love
view of the self; of the
relationships
world; and of the future
Types of Mood Disorders
The three main types of affective disorders are: depression, bipolar disorder,
and anxiety disorder. Each includes subtypes and variations in severity.
Depression
Depression, or major depressive disorder, is characterized by feelings of
extreme sadness and hopelessness. It is more than simply feeling down for a day or
two. If you have depression, you may experience episodes that last for several days
or even weeks. A milder form of depression is called dysthymia.
2 Basic Theories of Depression
A. RESULT OF LOSS (REAL OR SYMBOLIC)
B. HOSTILITY TURNED TOWARD HIMSELF
MAIN CONCERN BY THE NURSE in DEPRESSED CLIENTS: SAFETY
Types of Depression:
1. INVOLUTIONAL: severe type with loss of weight, somatic complaints, severe guilt
feelings (ECT, ANTI-DEPRESSANTS, and HYDRATION)
2. REACTIVE DEPRESSION: less severe, secondary to uncontrolled or unresolved
loss, with poor sleep and appetite, withdrawal (PSYCHOTHERAPY, ANTIDEPRESSANTS, HYDRATION AND NUTRITION)
3. MAJOR DEPRESSION: severe type, lasting for 2 weeks
4. DYSTHYMIC: less severe but lasts up to 2 years
5. NON SPECIFIC: less severe, lasting for 2 days to 2 weeks.
PRECIPITATING FACTORS
1.
2.
3.
4.
5.
Bipolar Disorder
Bipolar disorder means having periods of depression, and periods of mania.
Mania is when you feel extremely positive and active. This may sound good, but
mania is the feeling of irritable, aggressive, impulsive, and even delusional. There
are different types of bipolar, classified by the severity of depression and mania, as
well as by how often mood swings occur.
Anxiety Disorders
There are several different types of anxiety disorders. All are characterized by
feelings of nervousness, anxiety, and even fear. They are:
COGNITIVE THERAPY
Medications
ANTI-DEPRESSANTS / mood elevator ( for Depression)
INDICATIONS: Treatment of endogenous depression
1. MAO ( Monoamine Oxidase Inhibitors) (PaNaMa )
A. PARNATE ( Tranylcypromine)
B. NARDIL ( Phenelzine)
C. MARPLAN ( Isocarboxazid )
( Avoid Thyramine Rich foods)
* Aged Cheeze
* Liver
* Beer
* Sausage
* Chocolates
REMEMBER: HYPERTENSIVE CRISIS s/s--RESULTS FROM TAKING TYRAMINE
CONTAINING FOOD WHEN UNDER MAO INHIBITORS:
1. HEADACHE
2. CHEST PAIN
3. PALPITATION
4. DIAPHORESIS
2. TRI-CYCLICS (Tofel)
A. TOFRANIL
B. FLUOXETINE ( Prozac)
C. ELAVIL
Action: Block the reuptake of norepinephrine & serotonin
Adverse Effects:
a. Anti-cholinergic Effects- dry mouth/ constipation
b. Cardiovascular Effects Arrhythmias / Palpitation
General considerations:
1. Antidepressants effect may not occur until up to 3 weeks after the initial
dose !
2. Drugs must be discontinued gradually
BIPOLAR!
Is characterized by
feelings of extreme
sadness and
hopelessness
MOOD DISORDERS
Neurobiological Theory
Psychoanalytical Theory
Cognitive-Behavioral Theory
Having periods of
depression, and
periods of mania
(feeling of happy)
DEPRESSION!
ANXIETY!
S/SX:
prolonged
sadness
Irritability or
anxiety
Lethargy and
lack of energy
Lack of
interest in
normal
Diagnosis: There are no
medical tests to diagnose
mood disorders.
Psychiatrist can give a
psychiatric evaluation.
Jazzmin Angel R.
Comaling
4B1-BSN
Having periods of
depression, and
periods of mania
(feeling of happy)
S/SX:
constant
worry,
obsessive
thoughts,
restlessne
ss, trouble
concentrat
ing,
trembling,
irritability
Psychotherapies: CognitiveBehavioral Therapy, ANTIDEPRESSANTS, Electroconvulsive
therapy