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16.1 Depressive Disorders

The etiology of mood disorders involves genetic, biological, environmental, and psychological factors. These disorders are often now looked at as a spectrum of symptoms rather than as discrete categories of symptoms. Diagnosis is based on detailed clinical evaluation and symptomatology, guided by criteria from diagnostic manuals, such as the DSM-5. Managing mood disorders typically involves a combination of pharmacological and psychotherapeutic interventions. Antidepressants and mood stabilizers are considered the gold standards of medication treatment, while cognitive behavioral, interpersonal, dialectical, and family-focused therapies are common forms of psychotherapy. Early detection and appropriate management are critical to improving outcomes and enhancing the quality of life for individuals with mood disorders (Sekhon & Gupta, 2020).

16.2 The Spectrum of Mood Disorders

Depressive disorders, a category of mood disorders, are characterized by persistent feelings of sadness, loss of interest or pleasure in activities, and various physical and cognitive symptoms that cause significant distress or impairment in daily life. Major depressive disorder, the most severe form, and dysthymia, a chronic but milder form, are the primary types. These disorders result from a complex interplay of genetic, biological, environmental, and psychosocial factors. Accurate diagnosis is crucial and involves a thorough clinical evaluation, often using diagnostic criteria from the DSM-5.

Management typically involves a combination of pharmacological and psychotherapeutic interventions. Nurses play a pivotal role in managing care for individuals with depressive disorders. They protect the safety of the client, monitor clients’ responses to treatment, manage medication side effects, provide client and family education, and offer emotional support.

16.3 Self-Harm and Suicide

Understanding and effectively managing suicide and NSSI is critical for nursing professionals. Early identification of signs is pivotal, and this is where clinical judgment comes into play. Recognize that suicide and NSSI are distinct phenomena, requiring different intervention approaches. For suicide, risk assessment tools like the SAD PERSONS scale can be valuable, but should be supplemented with clinical insights. Clients at high risk for suicide may require continuous monitoring and potentially immediate intervention. In the case of NSSI, the role of the family, ethical dilemmas, resource allocation, and cultural considerations all require nuanced clinical judgment. Health-care providers must synthesize clinical data and contextual factors to make informed decisions regarding risk assessment, intervention strategies, and long-term care plans for both conditions. By integrating evidence-based practice with individual client needs, nurses can contribute significantly to improving client outcomes (National Action Alliance for Suicide Prevention, 2018).

16.4 Bipolar Disorders

Bipolar disorders are chronic mental health conditions characterized by severe mood swings that include episodes of depression and mania. Bipolar disorders are categorized into bipolar I, bipolar II, and cyclothymic disorder, each varying in the intensity and frequency of these mood episodes. Symptoms of these disorders fluctuate based on the phase of the disorder: manic episodes may involve high energy, euphoria, and hyperactivity, while depressive episodes may result in feelings of sadness, hopelessness, and lethargy.

The treatment approach for bipolar disorder typically comprises a combination of medication and psychotherapy. Common medications include mood stabilizers, such as lithium, antidepressants, and atypical antipsychotics. In addition, CBT, family-focused therapy, interpersonal and social rhythm therapy, and psychoeducation have proven effective in managing the disorder and preventing relapses.


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