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Mood Disorders Chapter
Mood Disorders Chapter
As the name implies, mood disorders are defined by pathological extremes of certain moods -
specifically, sadness and elation. While sadness and elation are normal and natural, they may
become pervasive and debilitating, and may even result in death, either in the form of suicide or
as the result of reckless behavior. In any one year, roughly 7% of Americans suffer from mood
disorders.
Pervasive alterations in emotions that are manifested by depression, mania, or both, and
interfere with the person’s ability to live life
Categories:
• Major depression: 2 or more weeks of sad mood, lack of interest in life activities, and
other symptoms
Related Disorders
• Dysthymia: sadness, low energy, but not severe enough to be diagnosed as major
depression disorder
• Postpartum depression
• Postpartum psychosis
• Involves 2 or more weeks of sad mood, lack of interest in life activities, and at least four
other symptoms:
-Antidepressants
• SSRIs (Prozac, Zoloft, Paxil, Celexa) prescribed for mild and moderate depression
• TCAs (Elavil, Tofranil, Norpramin, Pamelor, Sinequan) used for moderate and severe
depression
• MAOIs (Marplan, Parnate, Nardil) used infrequently because interaction with tyramine
causes hypertensive crisis
-Electroconvulsive therapy (ECT) is used when medications are ineffective or side effects are
intolerable.
• Preparation of a client for ECT is similar to preparation for any outpatient minor
surgical procedure
Assessment
• History: the client’s perception of the problem, behavioral changes, any previous
episodes of depression, treatment, response to treatment, family history of mood
disorders, suicide, or attempted suicide
• General appearance and motor behavior: slouched posture, latency of response,
psychomotor retardation or agitation
• Mood and affect: hopeless, helpless, down, anxious, frustrated, anhedonia, apathetic;
affect is sad, depressed, or flat
• Thought processes and content: slowed thinking processes, negative and pessimistic,
ruminate, thoughts of dying or committing suicide
• Self-concept: low self-esteem, guilty, believe that others would be better off without them
Data Analysis
• Anxiety
• Ineffective Coping
• Hopelessness
• Self-Care Deficit
Intervention
• Managing medications
Evaluation
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual
shifts in a person’s mood, energy, and ability to function. Different from the normal ups and
downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result
in damaged relationships, poor job or school performance, and even suicide. But there is good
news: bipolar disorder can be treated, and people with this illness can lead full and productive
lives.
• The mean age for a first manic episode is the early 20s
• Involves mood swings of depression (same symptoms of major depressive disorder) and
mania. Major symptoms of mania include:
• Pressured speech
• Flight of ideas
• Distractibility
Medication
• Anticonvulsant drugs are used for their mood-stabilizing effects: Tegretol, Depakote,
Lamictal, Topamax, and Neurontin, as is Klonopin (a benzodiazepine)
Psychotherapy
• Useful in mildly depressive or normal portion of the bipolar cycle. It is not useful during
acute manic stages
• Mood and affect: euphoria, exuberant activity, grandiosity, false sense of well-being,
angry, verbally aggressive, sarcastic, irritable
• Sensorium and intellectual processes: oriented to person and place but rarely to time,
impaired ability to concentrate, may experience hallucinations
• Roles and relationships: rarely can fulfill role responsibilities, invade intimate space and
personal business of others, can become hostile to others, cannot postpone or delay
gratification
Data Analysis
• Ineffective Coping
• Noncompliance
• Self-Care Deficit
Outcomes
The client will:
Intervention
• Managing medications
Evaluation
• Safety issues
The following table summarizes the nursing care for mood disorders
MOOD DISORDERS (AFFECTIVE DISORDERS)