What are the two psychosocial treatments for PDD?
- Cognitive Behavioral Analysis System of Psychotherapy (CBASP) - integrative therapy with components of cognitive, behavioral, interpersonal, and psychodynamic therapy
- Chronically depressed patients: experience disconnectedness from their environment leading to decreased access to important feedback on problematic interpersonal patterns and relationships
The therapeutic relationship helps generate empathic behavior, identify and change interpersonal patterns related to depression, and heal interpersonal trauma
What are the three techniques of CBASP? Cognitive Behavioral Analysis System of Psychotherapy
- Situational analysis - helps the patient focus on a specific stress event
- what happened?
- Their interpretation of events
- how did they want it to turn out?
- how could they have achieved the desired outcome in this situation? - Interpersonal Discrimination Exercises - Examine traumatic interactions with others and differentiation of those from healthier interactions and relationships
- Behavioral Skills Training - assertiveness to help depressed person modify maladaptive behavior
What is bipolar disorder?
A mood disorder that goes beyond what is typically described as “moodiness”. Patients experience extreme moods of mania and depression
What is needed to be considered Bipolar 1?
- Mania or manic episode must last at least one week and be present for most of the day nearly every day.
- This may or may not come before or follow a depressive or hypomanic episode
- In most cases, patients do have a depressive episode
What is needed for it to be considered Bipolar 2?
- The patient must meet the criteria for a current or past hypomanic episode and for a current or past major depressive episode or MDE
- The hypomania doesn’t cause impairment the MDE does
What is a manic episode?
- A mood characterized by unrestrained emotional expression, often accompanied by an overvaluation of one’s importance or significance to others; sometimes merely another name for elevated mood.
- an cause a variety of problems, ranging from interpersonal to monetary and legal
Someone who is in an expansive mood may be behaving grandly or lavishly, assuming a superior or grandiose attitude, dressing and behaving flamboyantly.
What is mania?
- The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
- The episode is not attributable to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or another medical condition.
- Note: A full manic episode that emerges during antidepressant treatment (e.g., medication, electroconvulsive therapy) but persists at fully syndrome level beyond the physiological effect of that treatment is sufficient evidence for a manic episode and therefore a bipolar I diagnosis.
What is a hypomanic episode?
- Hypomania is a less severe version of mania. The same symptoms scaled down a bit.
How do you differentiate between Bipolar 1 and 2
- Manic Episode + Typical Depressive or hypomanic episode = Bipolar 1
- Depressive Episode + Hypomanic = Bipolar 2
What is DIGFAST?
- Distractible
- Increased activity/psychomotor agitation
- Grandiosity/Super-hero mentality
- Flight of ideas or racing thoughts
- Activities that are dangerous or hypersexual
- Sleep decreased
- Talkative or pressured speech
What are some treatments for Bipolar Disorder?
- Mood stabilizers- to control manic or hypomanic episodes. Examples of mood stabilizers include Lithium Depakote, Tegretol, Lamictal
- Antipsychotics. If symptoms of psychosis are present
- Antidepressants-an antidepressant to help manage depression. Because an antidepressant can sometimes
trigger a manic episode, it’s usually prescribed along with a mood stabilizer or antipsychotic. - Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer.
- Psychotherapy is helpful for handling the anxiety that many patients experience and to help patients monitor their symptoms to identify if they are beginning to feel manic or depressed.
What is Situational Analysis?
It helps the patient focus on a specific stress event
- what happened?
- Their interpretation of events
- how did they want it to turn out?
- how could they have achieved the desired outcome in this situation?
What are Interpersonal Discrimination Exercises
They examine traumatic interactions with others and differentiation of those for healthier interactions and relationships
What is Behavioral Skills Training?
Assertiveness to help depressed person modify maladaptive behavior
