Maryville NURS663 Exam 2 (SU22)

Phases of Grief · Shock and denial (days-weeks) acute anguish, lost patterns of conduct, resolution (months-year) · Denial, bargaining, depression, anger, acceptance · No real timeline, comes in waves Grief vs. MDD · Grief- Sx may meet syndromal criteria for MDD episode, but survivor rarely has morbid feelings of guilt, worthlessness, SI, or psychomotor retardation o Considers self bereaved o Dysphoria often triggered by thoughts or reminders of the deceased o Onset within 2 months of bereavement o Duration of depressive episode is less than 2 months o Functional impairment is transient and mild o No family or personal hx of depression o Predominant affect is emptiness and loss o Pain of grief accompanied with positive emotions and humor, self-esteem generally preserved MDD vs. Grief MDD o May consider self weak, defective, or bad o Dysphoria is often autonomous and independent of thoughts or reminders of the deceased o Onset at any time o Depression often becomes chronic, episodic, or intermittent o Clinically significant distress or impairment o Family or personal hx of depression o Persistent depressed mood and inability to anticipate happiness or pleasure o Pervasive unhappiness and misery, self-critical and pessimistic ruminations, feelings of worthlessness and self-loathing Persistent Complex Bereavement Disorder o Unshakeable grief that does not follow the general pattern of improvement over time, individuals continue to experience persistent and intense emotions or moods and unusual, severe symptoms that impair major areas of functioning, or that cause extreme distress o Persists for greater than 6 months after bereavement o Patients report loss of self-worth and sense of self, feel emotionally disconnected from others and do not wish to move on from bereavement, sometimes feeling thatto do so would represent a betrayal of the deceased o At least one of the following: Intense and persistent yearning for the deceased -Frequent preoccupation with the deceased -Intense feelings of emptiness or loneliness -Recurrent thoughts that life is meaningless or unfair without the deceased -A frequent urge to join the deceased in death Delirium Vs. Dementia