Pharmacological Management of Emotional, Mood, and Behavioral Disorders

Drugs for Emotional, Mood, and Behavioral Disorders

Introduction

This chapter provides an overview of the pharmacological approaches to treating emotional, mood, and behavioral disorders, with a focus on depression and related conditions. Understanding the symptoms, diagnosis, and treatment options is essential for effective nursing and psychological care.

Depression

Definition and Symptoms

• Depression is characterized by a sad or despondent mood.

• Associated symptoms include:

  • Lack of energy

  • Sleep disturbances

  • Abnormal eating patterns

  • Feelings of despair, guilt, and hopelessness

• It is the most common mental health disorder among older adults.

Major Depressive Disorder (MDD)

Diagnosis and Clinical Features

• Also called clinical depression.

• Diagnosis: A depressed affect plus five or more of the following symptoms for at least two weeks:

  • Difficulty sleeping or sleeping too much

  • Extreme fatigue; lack of energy

  • Abnormal eating patterns

  • Vague physical symptoms

  • Obsession with death

  • Avoidance of psychosocial and interpersonal interactions

  • Lack of interest in personal appearance or sex

  • Delusions or hallucinations

  • Inability to concentrate or make decisions

  • Feelings of despair, guilt, misery, and lack of self-worth

Other Forms of Depression

Types and Characteristics

• Postpartum depression: Intense mood changes associated with hormonal changes after childbirth.

• Seasonal Affective Disorder (SAD): Enhanced release of melatonin due to lower natural light levels.

• Psychotic depression: Intense mood shifts and unusual behaviors.

Antidepressants

Nursing Considerations and Monitoring

• Monitor vital signs.

• Monitor for dizziness, headache, tremor, nausea/vomiting.

• Monitor for anxiety, disorientation, agitation, diaphoresis, and fever.

• Monitor neurologic and cardiovascular status.

• Monitor mental and emotional status.

• Monitor for underlying psychoses.

• Monitor sleep-wake cycle.

• Monitor renal, gastrointestinal, liver, and hematologic status.

• Monitor visual acuity.

• Ensure patient safety.

Treatment Approaches

Comprehensive Management

• Severe depressive illness generally requires both medication and psychotherapy.

• Types of psychotherapy include:

  • Interpersonal therapy

  • Cognitive-behavioral therapy (CBT)

  • Psychodynamic therapy

• Electroconvulsive therapy (ECT) may be used in patients unresponsive to pharmacotherapy.

Key Terms

• Depression: A mood disorder with persistent feelings of sadness and loss of interest.

• Major Depressive Disorder (MDD): A severe form of depression meeting specific diagnostic criteria.

• Postpartum Depression: Depression occurring after childbirth.

• Seasonal Affective Disorder (SAD): Depression related to seasonal changes in light exposure.

• Psychotic Depression: Depression accompanied by psychotic symptoms such as delusions or hallucinations.

Example

• A patient presenting with persistent sadness, lack of energy, sleep disturbances, and feelings of hopelessness for more than two weeks may be diagnosed with major depressive disorder if additional symptoms are present.

Additional info: These notes are based on textbook slides and are suitable for psychology and nursing students studying the pharmacological management of mood disorders.