Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions...
-
Upload
cathleen-harrington -
Category
Documents
-
view
215 -
download
1
Transcript of Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions...
![Page 1: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/1.jpg)
Mood Disorders
![Page 2: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/2.jpg)
Video – Out of the Shadows
• Handout with questions – – Descriptions
– Contributing factors
– Treatments
– Your curiosity
![Page 3: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/3.jpg)
Recognizing signs of depression and mania
• Consider various domains-handout
• Varying degrees of severity
![Page 4: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/4.jpg)
Mood Episodes
• Major Depressive Episode• Manic Episode• Mixed Episode• Hypomanic Episode
Episodes describe sets of sx The pattern of the episodes defines the
disorder
![Page 5: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/5.jpg)
Depressive Disorders
1. Major Depressive Disorder• Major depressive episode• Not better accounted for…• No history of manic, mixed or hypomanic
episode• Specifiers
![Page 6: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/6.jpg)
2. Dysthymic Disorder• Two year duration (one year in kids)• Depressed most of the time• At least 2 specific sx• <2 months free of sx during 2 or 1 year period• No major depressive episode during first 2 or 1 year period• No evidence of manic, mixed, hypomanic episodes or
cyclothymic d/o• Doesn’t occur exclusively during a psychotic d/o• Not better accounted for by substance or medical condition• Clinically significant distress and/or impairment in functioning• Specifier-atypical
3. Depressive Disorder NOS
![Page 7: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/7.jpg)
Bipolar Disorders
1. Bipolar I• Presence of a manic episode• Not better explained by schizoaffective d/o or a part
of another psychotic disorder.• A variety of specifiers
2. Bipolar II• Major depressive episode• Hypomanic episode• No manic or mixed episode• Not better accounted for by…
![Page 8: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/8.jpg)
3. Cyclothymic• 2 years of numerous periods with
hypomanic sx. and depressive sx, but no major depressive episode.
• Sx-free no more than two months.• No major dep., manic or mixed episode
during first two years.• Not better accounted for…• Not due to substance or medical condition.
![Page 9: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/9.jpg)
Others
4. Bipolar Disorder NOS
5. Mood Disorder due to general medical condition.
6. Substance-induced Mood Disorder
7. Mood Disorder NOS
![Page 10: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/10.jpg)
Etiology
1. Exogenous
2. Endogenous
3. Vulnerability-Stress model• Biological vulnerability• Cognitive vulnerability
• Hopelessness theory• Beck’s cognitive distortions• Learned helplessness
![Page 11: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/11.jpg)
Treatment for depression and s-r d/o-Cognitive-Behavioral Therapy
1. Typically used in tx for depressive disorders and substance use disorders alone.
2. Match the tx to the stage of change or treatment stage:
• CBT is most useful during active treatment and relapse prevention.
![Page 12: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/12.jpg)
3. Analyze and work with the ABCs of problem behavior.
• Antecedent-(thoughts, events, people, places, etc.)
• Behavior• Consequence
![Page 13: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/13.jpg)
4. Event to behavior sequence model-• Identify the sequence• Evaluate thoughts• Challenge rationality of thoughts• Identify positive alternative thoughts
![Page 14: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/14.jpg)
Role playing with “Jim,” pg. 379
• Identify cognitive distortions and their consequent feelings.
• Explain event to behavior sequence model to client.
• Challenge the thoughts.
• Help cx develop constructive thoughts.
![Page 15: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/15.jpg)
Issues Specific to Mood Disorders
• Distinguishing mood d/o from substance, medication or medical induced sx is tricky.
• Assessment includes self-report, along with observation and collateral information.
• Recognize how common sx of depression are as a consequence of substance use.
• Suicide risk should be assessed.
![Page 16: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/16.jpg)
Bipolar and suicidality
• Most likely during transition for cx with bipolar
• S/I=80%
• S/A=25%
• S/C=7-19%
• Intoxication increases impulsivity and impairs judgment, putting person at greater risk.
![Page 17: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/17.jpg)
A mnemonic: IS PATH WARM
ideationsubstance abuse purposelessnessanxietytrappedhopelessness withdrawalangerrecklessnessmood changes
![Page 18: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/18.jpg)
Your role
1. Recognize risk factors and respond appropriately
2. Assess seriousness of risk-Fig. D-1, pg 330• What is wrong?• Why now?• How?• Where and when?• When and with what in the past?• Who is involved?• Why not now?
![Page 19: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/19.jpg)
3. Consider appropriate responses-low level of risk
• Talking about it• Address particular triggers• Contracting• Obtaining support from friends/family• Identify and plan use of crisis services• Explore reasons for not killing self• Refer to medication provider-ARNP or psychiatrist
![Page 20: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/20.jpg)
4. Responses with higher level of risk• Schedule additional sessions• Eliminate potential methods, e.g. weapons,
meds, etc.• Explore option of voluntary hospitalization• Contact CDMHPs for involuntary outpatient
or commitment evaluation-206-461-3222• 72 hours, 14 days, 90 days inpatient• 90 (adult) or 180 (youth) days of outpatient
![Page 21: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/21.jpg)
A scenario
1. Read the scenario.
2. Identify problem behavior.
3. What are probable antecedents to the bx?
4. What are the consequences to the bx?
5. How might you and Melody work with the antecedents or consequences to help her resolve the problem behavior?
![Page 22: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/22.jpg)
1. Identify problem behavior.2. Explore the likely feelings that occur prior
to the behavior.3. Explore the likely thoughts that occur
prior to the feelings.4. Challenge these thoughts: are they
rational? Accurate? Constructive? Destructive?
5. Identify positive alternative thoughts.
![Page 23: Mood Disorders. Video – Out of the Shadows Handout with questions – –Descriptions –Contributing factors –Treatments –Your curiosity.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649e575503460f94b4f4aa/html5/thumbnails/23.jpg)
Test Review
• Stages of change• Substance-related disorders:
– know the difference between use and induced disorders – be able to describe abuse and dependence
• Medications:– Important terms– Stepwise treatment– Your role re: meds– Reasons why clients discontinue meds
• Mood Disorders– Mood episodes– Depressive disorders and Bipolar disorders– Cognitive-behavioral theory – event to behavior sequence model
and cognitive distortions