Rasmussen Mental Health Exam 2

Rasmussen Mental Health Exam 2 DEPRESSION - ANS DEPRESSION DEPRESSION Define Common Symptoms - ANS Mood of sadness Negative Pessimistic Thinking Emotional sensitivity Insomnia Suicidal Ideation Excessive guilt DEPRESSION Becks Triad - ANS Three automatic negative thoughts that are responsible for the development of depression: 1. A negative, self-deprecating view of self: "I really never do anything well; everyone else seems smarter." 2. A pessimistic view of the world: "Once you're down, you can't get up. Look around, poverty, homelessness, sickness, war, and despair are every place you look." 3. The belief that negative reinforcement (or no validation for the self) will continue: "It doesn't matter what you do; nothing ever gets better. I'll be in this stupid job the rest of my life." The phrase automatic negative thoughts refers to thoughts that are repetitive, unintended, and not readily controllable. This cognitive triad seems to be consistent in all types of depression, regardless of clinical subtype. DEPRESSION Risk for Suicide (High vs Low) - ANS "You have said you are depressed. Tell me what that is like for you." • "When you feel depressed, what thoughts go through your mind?" • "Have you ever thought about taking your own life in the past? Now? Do you have a plan? Do you have the means to carry out your plan? Is there anything that would prevent you from carrying out your plan?" High: A patient that HAS a plan AND a weapon Older, single, lonely individuals with multiple health problems are more likely to commit suicide than individuals with a great family support system and always in the midst of people. Males are more commonly committing suicide than females. DEPRESSION - ANS 1. Help the patient question underlying assumptions and beliefs and consider alternate explanations to problems. 2. Work with the patient to identify cognitive distortions that encourage negative self-appraisal. For example: a. Overgeneralizations b. Self-blame c. Mind reading d. Discounting of positive attributes 3. Encourage activities that can raise self-esteem. Identify need for a. problem-solving skills b. coping skills c. assertiveness skills. 4. Discuss physical activities the patient enjoys (e.g., running, weightlifting). Explain that initially 10 to 15 minutes a day 3 or 4 times a week has short-term benefits. 5. Encourage formation of supportive relationships, such as through support groups, therapy, and peer support. 6. Provide information referrals, when needed, for spiritual/religious information (e.g., readings, programs, tapes, community resources). DEPRESSION Nursing Diagnosis - ANS Risk for suicide Risk for self-mutilation Ineffective coping Interrupted family processes Risk for impaired parent/infant/child attachment Ineffective role performance Hopelessness