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DEPRESSION.pptx
1.
DEPRESSION Owondo Thomas Bwindi Community
Hospital © 2018 Thomas Owondo. All rights reserved.
2.
What Is Depression?
Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a mood disorder characterized by persistent low mood. Depression © 2018 Thomas Owondo. All rights reserved.
3.
Many people with
a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression. • There are several forms of depressive disorders. Depression © 2018 Thomas Owondo. All rights reserved.
4.
Major depression;
Severe symptoms that interfere with your ability to work, sleep, study, eat, and enjoy life. An episode can occur only once in a person’s lifetime, but more often, a person has several episodes. For one to be diagnosed with Major depression, the symptoms must be present for 2 weeks and interfere with the individual’s social. Education, work and general functioning. Depression © 2018 Thomas Owondo. All rights reserved.
5.
Persistent depressive
disorder (Dysthymia); Depressed mood that lasts for at least 2 years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years. Depression © 2018 Thomas Owondo. All rights reserved.
6.
Some forms
of depression are slightly different, or they may develop under unique circumstances. They include: 1. Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations). Depression © 2018 Thomas Owondo. All rights reserved.
7.
2. Postpartum depression,
which is mood changes that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth. Depression © 2018 Thomas Owondo. All rights reserved.
8.
3. Seasonal affective
disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy. Depression © 2018 Thomas Owondo. All rights reserved.
9.
4. Bipolar disorder,
also called manic-depressive illness. Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression). Depression © 2018 Thomas Owondo. All rights reserved.
10.
Causes Most likely,
depression is caused by a combination of genetic, biological, environmental, and psychological factors. Hope you still recall them ↑↑↑ Depression © 2018 Thomas Owondo. All rights reserved.
11.
Depressive illnesses
are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression. Depression © 2018 Thomas Owondo. All rights reserved.
12.
Some types
of depression tend to run in families. However, depression can occur in people without family histories of depression too. Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors. Depression © 2018 Thomas Owondo. All rights reserved.
13.
In addition,
trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Other depressive episodes may occur with or without an obvious trigger. Depression © 2018 Thomas Owondo. All rights reserved.
14.
Common statements in
Depression "It was really hard to get out of bed in the morning. I just wanted to hide under the covers and not talk to anyone. I didn't feel much like eating and I lost a lot of weight. Nothing seemed fun anymore. I was tired all the time, and I wasn't sleeping well at night. But I knew I had to keep going because I've got kids and a job. It just felt so impossible, like nothing was going to change or get better." Depression © 2018 Thomas Owondo. All rights reserved.
15.
People with
depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness. Depression © 2018 Thomas Owondo. All rights reserved.
16.
Signs and
symptoms include: Persistent sad, anxious, or "empty" feelings Feelings of hopelessness or pessimism Feelings of guilt, worthlessness, or helplessness Irritability, restlessness Loss of interest in activities or hobbies once pleasurable, including sex Depression © 2018 Thomas Owondo. All rights reserved.
17.
Fatigue and
decreased energy Difficulty concentrating, remembering details, and making decisions Insomnia, early-morning wakefulness, or excessive sleeping Overeating, or appetite loss Thoughts of suicide, suicide attempts Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment. Depression © 2018 Thomas Owondo. All rights reserved.
18.
SIGECAPS - Changes in
sleep pattern - Changes in interests or activity - Feelings of guilt or increased worry - Changes in energy - Changes in concentration - Changes in appetite - Psychomotor disturbances - Suicidal ideation S I G E C A P S Sleep Interest Guilt Energy Concentration Appetite Psychomotor Suicide © 2018 Thomas Owondo. All rights reserved.
19.
Depression, even
the most severe cases, can be effectively treated. The earlier that treatment can begin, the more effective it is. The first step to getting appropriate treatment is to visit a doctor or mental health specialist. Certain medications, and some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor can rule out these possibilities by doing a physical exam, interview, and lab tests. If the doctor can find no medical condition that may be causing the depression, the next step is a psychological evaluation. Depression © 2018 Thomas Owondo. All rights reserved.
20.
Other illnesses
may come on before depression, cause it, or be a consequence of it. But depression and other illnesses interact differently in different people. In any case, co-occurring illnesses need to be diagnosed and treated. Depression © 2018 Thomas Owondo. All rights reserved.
21.
Other disorders
like post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, panic disorder, social phobia, and generalized anxiety disorder, often accompany depression. PTSD can occur after a person experiences a terrifying event or ordeal, such as a violent assault, a natural disaster, an accident, terrorism or military combat. People experiencing PTSD are especially prone to having co- existing depression. Depression © 2018 Thomas Owondo. All rights reserved.
22.
Alcohol and
other substance abuse or dependence may also co- exist with depression. Research shows that mood disorders and substance abuse commonly occur together. Depression also may occur with other serious medical illnesses such as heart disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinson's disease. Depression © 2018 Thomas Owondo. All rights reserved.
23.
Depression People who have
depression along with another medical illness tend to have more severe symptoms of both depression and the medical illness, more difficulty adapting to their medical condition, and more medical costs than those who do not have co-existing depression. Treating the depression can also help improve the outcome of treating the co-occurring illness. © 2018 Thomas Owondo. All rights reserved.
24.
© 2018 Thomas
Owondo. All rights reserved.
25.
© 2018 Thomas
Owondo. All rights reserved.
26.
Treatments Once diagnosed,
a person with depression can be treated in several ways. The most common treatments are medication, psychotherapy and ECT. Depression © 2018 Thomas Owondo. All rights reserved.
27.
How should I
take medication? All antidepressants must be taken for at least 4 to 6 weeks before they have a full effect. You should continue to take the medication, even if you are feeling better, to prevent the depression from returning. Depression © 2018 Thomas Owondo. All rights reserved.
28.
Medication should
be stopped only under a doctor's supervision. Some medications need to be gradually stopped to give the body time to adjust. Although antidepressants are not habit-forming or addictive, suddenly ending an antidepressant can cause withdrawal symptoms or lead to a relapse of the depression. Some individuals, such as those with chronic or recurrent depression, may need to stay on the medication indefinitely. Depression © 2018 Thomas Owondo. All rights reserved.
29.
In addition, if
one medication does not work, you should consider trying another. Research has shown that people who did not get well after taking a first medication increased their chances of beating the depression after they switched to a different medication or added another medication to their existing one. Depression © 2018 Thomas Owondo. All rights reserved.
30.
Sometimes stimulants,
anti-anxiety medications, or other medications are used together with an antidepressant, especially if a person has a co-existing illness. However, neither anti-anxiety medications nor stimulants are effective against depression when taken alone, and both should be taken only under a doctor's close supervision. Report any unusual side effects to a doctor immediately. Depression © 2018 Thomas Owondo. All rights reserved.
31.
Antidepressants primarily work
on brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways that they work. Depression © 2018 Thomas Owondo. All rights reserved.
32.
Popular newer antidepressants
Some of the newest and most popular antidepressants are called selective serotonin reuptake inhibitors (SSRIs). Fluoxetine (Prozac), sertraline (Zoloft), Escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa) are some of the most commonly prescribed SSRIs for depression. Most are available in generic versions. Serotonin and norepinephrine reuptake inhibitors (SNRIs) are similar to SSRIs and include venlafaxine (Effexor) and duloxetine (Cymbalta). Depression © 2018 Thomas Owondo. All rights reserved.
33.
SSRIs and
SNRIs tend to have fewer side effects than older antidepressants, but they sometimes produce headaches, nausea, jitters, or insomnia when people first start to take them. These symptoms tend to fade with time. Some people also experience sexual problems with SSRIs or SNRIs, which may be helped by adjusting the dosage or switching to another medication. Depression © 2018 Thomas Owondo. All rights reserved.
34.
One popular
antidepressant that works on dopamine is bupropion (Wellbutrin). Bupropion tends to have similar side effects as SSRIs and SNRIs, but it is less likely to cause sexual side effects. However, it can increase a person's risk for seizures. Depression © 2018 Thomas Owondo. All rights reserved.
35.
Tricyclic Antidepressants
(TCAs) • Tricyclics are older antidepressants. Tricyclics are powerful, but they are not used as much today because their potential side effects are more serious. They may affect the heart in people with heart conditions. They sometimes cause dizziness, especially in older adults. They also may cause drowsiness, dry mouth, and weight gain. These side effects can usually be corrected by changing the dosage or switching to another medication. However, tricyclics may be especially dangerous if taken in overdose. Tricyclics include Imipramine, Amitriptyline and nortriptyline. Depression © 2018 Thomas Owondo. All rights reserved.
36.
MAOIs Monoamine oxidase
inhibitors (MAOIs) are the oldest class of antidepressant medications. They can be especially effective in cases of "atypical" depression, such as when a person experiences increased appetite and the need for more sleep rather than decreased appetite and sleep. They also may help with anxious feelings or panic and other specific symptoms. Depression © 2018 Thomas Owondo. All rights reserved.
37.
• However, people
who take MAOIs must avoid certain foods and beverages (including cheese and red wine) that contain a substance called tyramine. Certain medications, including some types of birth control pills, prescription pain relievers, cold and allergy medications, and herbal supplements, also should be avoided while taking an MAOI. These substances can interact with MAOIs to cause dangerous increases in blood pressure. Depression © 2018 Thomas Owondo. All rights reserved.
38.
The development of
a new MAOI skin patch may help reduce these risks. If you are taking an MAOI, your doctor should give you a complete list of foods, medicines, and substances to avoid. • MAOIs can also react with SSRIs to produce a serious condition called "serotonin syndrome," which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm, and other potentially life- threatening conditions. MAOIs should not be taken with SSRIs. Depression © 2018 Thomas Owondo. All rights reserved.
39.
Note: In case
of life threatening depression and/ or depression that does not respond to the anti depressants mentioned above, Electro Convulsive Therapy (ECT) is also indicated: Given on alternate days With a total dose of between 6 -12 doses. Depression © 2018 Thomas Owondo. All rights reserved.
40.
ECT administration. The usual
dose of electricity is 70–150 volts for 0.1–0.5 seconds. In the first stage of the seizure (tonic phase), the muscles in the body that have not been paralyzed by medication contract for a period of 5–15 seconds. Depression © 2018 Thomas Owondo. All rights reserved.
41.
ECT administration. These are
caused by alternating contraction and relaxation of these same muscles. This stage lasts approximately 10– 60 seconds. The physician in charge will try to induce a seizure that lasts between one-half and two minutes. This is followed by the second stage of the seizure (clonic phase) that is characterized by twitching movements, usually visible only in the toes or in a nonparalyzed arm or leg. Depression © 2018 Thomas Owondo. All rights reserved.
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ECT administration. If the
first application of electricity fails to produce a seizure lasting at least 25 seconds, another attempt is made 60 seconds later. The session is stopped if the patient has no seizures after three attempts. The entire procedure, from beginning to end, lasts about 30 minutes. Depression © 2018 Thomas Owondo. All rights reserved.
43.
NURSING CARE PLAN •
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44.
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