The nurse as manager of care and member of the discipline in working with patients with altered mood states

n 1.Definition of mood disorders n 2.Ethiology and statistic of mood disorders n 3.Mood disorders types 4. Who is affected by mood disorders? 4. Who is affected by mood disorders? n 5. What are the symptoms of mood disorders? n 6. Treatment of mood disorders n 7. Prevention of mood disorders

Definition n Mood is the way a person feels inside, the experience of emotion, sustained and predominant internal emotional experience. A mood disorder is characterized by a disturbance in this mood.

n Almost 44 million Americans experience some type of mental disorder. In fact, mental illnesses are among the most common conditions affecting health today.Researchers believe most serious mental illnesses are caused by complex imbalances in the brain's chemical activity. They also believe environmental factors can play a part in triggering, or cushioning against, the onset of mental illness.

n Most mental illnesses can be treated. People who have mental illnesses, even serious ones, can lead productive lives with proper treatment. Mood disorders are one form of serious mental illness.

Mood Disorders Types n Bipolar I Disorder Bipolar II Disorder Bipolar Disorder Not Otherwise Specified ( NOS ) Cyclothymic Disorder. Depressive Disorder Not Otherwise Specified ( NOS ) Bipolar I Disorder Bipolar II Disorder Bipolar Disorder Not Otherwise Specified ( NOS ) Cyclothymic Disorder Depressive Disorder Not Otherwise Specified ( NOS ) Bipolar I Disorder Bipolar II Disorder Bipolar Disorder Not Otherwise Specified ( NOS ) Cyclothymic Disorder Depressive Disorder Not Otherwise Specified ( NOS )

n Depression ( General Overview ) Dysthymic Disorder Major Depressive Disorder Mood Disorder Due to a General Medical Condition Mood Disorder Not Otherwise Specified ( NOS ) Substance-Induced Mood Disorder Depression ( General Overview ) Dysthymic Disorder Major Depressive Disorder Mood Disorder Due to a General Medical Condition Mood Disorder Not Otherwise Specified ( NOS ) Substance-Induced Mood Disorder Depression ( General Overview ) Dysthymic Disorder Major Depressive Disorder Mood Disorder Due to a General Medical Condition Mood Disorder Not Otherwise Specified ( NOS ) Substance-Induced Mood Disorder

What causes mood disorders? n What causes mood disorders is not well known. There are chemicals in the brain, called endorphins, that are responsible for positive moods. Other chemicals in the brain, called neurotransmitters, regulate endorphins.

n Most likely, depression (and other mood disorders) is caused by a chemical imbalance in the brain. Life events (such as unwanted changes in life) may also contribute to a depressed mood.

n Affective disorders aggregate in families and are considered to be multifactorially inherited. Multifactorial inheritance means that "many factors" are involved. The factors are usually both genetic and environmental, where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition.

n Often one gender (either males or females) is affected more frequently than the other in multifactorial traits. There appears to be a different threshold of expression, which means that one gender is more likely to show the problem, over the other gender.

Who is affected by mood disorders? n Anyone can feel sad or depressed at times. However, mood disorders are more intense and difficult to manage than normal feelings of sadness. Children, adolescents, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. However, life events and stress can expose or exaggerate feelings of sadness or depression, making the feelings more difficult to manage.

n Sometimes, life's problems can trigger depression. Being fired from a job, getting divorced, losing a loved one, death in the family, and financial trouble, to name a few, all can be difficult and coping with the pressure may be troublesome.

n These life events and stress can bring on feelings of sadness or depression or make a mood disorder harder to manage.

n The chance for depression in females in the general population is nearly twice as high (12 percent) as it is for males (6.6 percent). Once a person in the family has this diagnosis, the chance for their siblings or children to have the same diagnosis is increased.

What are the different types of mood disorders? major depression - a two-week period of a depressed or irritable mood or a noticeable decrease in interest or pleasure in usual activities, along with other signs of a mood disorder. major depression - a two-week period of a depressed or irritable mood or a noticeable decrease in interest or pleasure in usual activities, along with other signs of a mood disorder. dysthymia (dysthymic disorder) - a chronic, low-grade, depressed or irritable mood for at least one year. dysthymia (dysthymic disorder) - a chronic, low-grade, depressed or irritable mood for at least one year.

manic depression (bipolar disorder) - at least one episode of a depressed or irritable mood and at least one period of a manic (persistently elevated) mood. manic depression (bipolar disorder) - at least one episode of a depressed or irritable mood and at least one period of a manic (persistently elevated) mood.

mood disorder due to a general medical condition - many medical illnesses (including cancer, injuries, infections, and chronic medical illnesses) can trigger symptoms of depression. mood disorder due to a general medical condition - many medical illnesses (including cancer, injuries, infections, and chronic medical illnesses) can trigger symptoms of depression.

n substance induced mood disorder - symptoms of depression that are due to the effects of medication, drug abuse, exposure to toxins, or other forms of treatment

What are the symptoms of mood disorders? n Depending upon age and the type of mood disorder present, a person may exhibit different symptoms of depression. The following are the most common symptoms of a mood disorder. However, each individual may experience symptoms differently.

Symptoms may include: Symptoms may include: persistent feelings of sadness persistent feelings of sadness feeling hopeless or helpless feeling hopeless or helpless having low self-esteem having low self-esteem feeling inadequate feeling inadequate excessive guilt excessive guilt feelings of wanting to die feelings of wanting to die

loss of interest in usual activities or activities once enjoyed loss of interest in usual activities or activities once enjoyed difficulty with relationships difficulty with relationships sleep disturbances (i.e., insomnia, hypersomnia) sleep disturbances (i.e., insomnia, hypersomnia) changes in appetite or weight changes in appetite or weight decreased energy decreased energy

difficulty concentrating difficulty concentrating a decrease in the ability to make decisions a decrease in the ability to make decisions suicidal thoughts or attempts suicidal thoughts or attempts frequent physical complaints (i.e., headache, stomach ache, fatigue) frequent physical complaints (i.e., headache, stomach ache, fatigue)

running away or threats of running away from home running away or threats of running away from home hypersensitivity to failure or rejection hypersensitivity to failure or rejection n irritability, hostility, aggression

Treatment for mood disorders: n Specific treatment for mood disorders will be determined by your physician based on: your age, overall health, and medical history your age, overall health, and medical history extent of the condition extent of the condition type of mood disorder type of mood disorder

your tolerance for specific medications, procedures, or therapies your tolerance for specific medications, procedures, or therapies expectations for the course of the condition expectations for the course of the condition your opinion or preference your opinion or preference

. Treatment may include one, or more, of the following: antidepressant medications antidepressant medications psychotherapy psychotherapy family therapy family therapy

Antidepressant medications n heterocyclic antidepressants (HCAs), like amitriptyline (Elavil) n selective serotonin reuptake inhibitors (SSRI inhibitors), like fluoxetine (Prozac), paroxetine (Paxil), and sertra- line (Zoloft)

n monoamine oxidase inhibitors (MAOI inhibitors), like phenelzine sulfate (Nardil) and tranylcypromine sulfate (Parnate) n mood stabilizers, like lithium carbonate (Eskalith) and valproate, often used in people with bipolar mood disorders

Psychotherapy n Cognitive-behavioral therapy n Electroconvulsive therapy (ECT)

Cognitive-behavioral therapy n Cognitive-behavioral therapy explores how the patient's view of the world may be affecting his or her mood and outlook

Electroconvulsive therapy (ECT) n is used at a hight risk of suecide. ECT is believed to affect neurotransmitters like the medications do. Patients are anesthetized and given muscle relaxants to minimize discomfort. Then low-level electric current is passed through the brain to cause a brief convulsion. The most common side effect of ECT is mild, short-term memory loss.

Alternative treatment n There are many alternative therapies that may help in the treatment of mood disorders, including acupuncture, botanical medicine, homeopathy, aromatherapy, constitutional hydrotherapy, and light therapy. The therapy used is an individual choice. Short-term clinical studies have shown that the herb St. John's wort

Prevention of mood disorders: n Preventive measures to reduce the incidence of mood disorders are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the individual's normal growth and development, and improve the quality of life experienced by persons with mood disorders.

Conclusions: n 1.Mood disorders- the disorders,which are characterized by a disturbance in mood. n 2.Ethiology includes:chemical imbalanse in brain and risk factors n 3.Mood disorders types 4.Everyone can be affected by mood disorders 4.Everyone can be affected by mood disorders

n 5.Main symptoms of mood disorders: persistent feelings of sadness persistent feelings of sadness feeling hopeless or helpless feeling hopeless or helpless having low self-esteem having low self-esteem feeling inadequate feeling inadequate excessive guilt excessive guilt feelings of wanting to die,so on feelings of wanting to die,so on n 6. Treatment of mood disorders n 7. Prevention of mood disorde

Conclusions 6. Treatment of mood disorders include: antidepressant medications;psychotherapy; 6. Treatment of mood disorders include: antidepressant medications;psychotherapy; family therapy. family therapy. n 7. Prevention of mood disorde