PSYCHIATRIC TEACHING
DEPRESSION
Depression I
SN instructed patient/caregiver about Depression that is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living. Depression may require long-term treatment. But don’t get discouraged. Most people with depression feel better with medication, psychotherapy or both.
Depression II
SN instructed patient/caregiver that depression is an abnormal and persistent mood state. Although depression may occur only once during your life, people typically have multiple episodes. It is characterized by sadness, melancholy, slowed mental processes and changes in physical patterns such as eating and sleeping. Depression is more frequent in people with chronic or severe medical illness and also with substance abuse.
Depression Causes
SN instructed patient/caregiver on the causes of depression, such as, substance abuse, deficiencies in cerebral neurotransmitters, family history of depressive disorders, hormonal imbalances, lack of social support, prior episodes of depression, significant medical problems, and stressful life events.
Depression Symptoms
SN instructed patient/caregiver in the depression’s symptoms such as constant feelings of sadness, irritability or tension, decreased interest or pleasure in usual activities or hobbies, loss of energy, feeling tired despite lack of activity, a change in appetite with significant weight loss or weight gain, difficulty sleeping, early morning awakening or sleeping too much, restlessness or feeling slowed down decreased ability to make decisions or concentrate, feelings of worthlessness, hopelessness or guilt, thoughts of suicide or death.
Depression & Closure
SN instructed patient/caregiver in ways underlining manifestations of depression that at times, depression can present as both anger towards one’s self as well as anger towards others. Discomfort, pain and hurt feelings can arise from unresolved issues with others. This occurs from never having the closure necessary to let go.
Depression Older Adults
SN instructed patient/caregiver Depression that is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as: memory difficulties or personality changes; physical aches or pain; fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication; often wanting to stay at home, rather than going out to socialize or doing new things; suicidal thinking or feelings, especially in older men.
Depression Preventions
SN instructed patient/caregiver about Depression. There’s no sure way to prevent depression. However, these strategies may help. Take steps to control stress, to increase your resilience and boost your self-esteem. Reach out to family and friends, especially in times of crisis, to help you weather rough spells. Get treatment at the earliest sign of a problem to help prevent depression from worsening. Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.
Depression Suicide Risk
SN instructed patient/caregiver about depression risk factors for suicide. Women are 3 times more likely than men to attempt suicide, but men are 3 times more likely to complete suicide. Suicide is more frequent among white or native Americans, older than 60 years, lacking social support and/or having financial difficulties. Depression is more frequent in people with chronic or severe medical illness and also with substance abuse.
ANXIETY
Anxiety I
SN instructed patient/caregiver about Anxiety. This disorder is a feeling of fear, dread, and uneasiness. It might cause you to sweat, feel restless and tense, and have a rapid heartbeat. It can be a normal reaction to stress. For example, you might feel anxious when faced with a difficult problem at work, before taking a test, or before making an important decision. It can help you to cope. The anxiety may give you a boost of energy or help you focus. But for people with anxiety disorders, the fear is not temporary and can be overwhelming. Anxiety disorders are conditions in which you have anxiety that does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships.
Anxiety II
SN instructed patient/caregiver about Anxiety. There are several types of anxiety disorders, including. Generalized anxiety disorder (GAD). People with GAD worry about ordinary issues such as health, money, work, and family. But their worries are excessive, and they have them almost every day for at least 6 months. Panic disorder. People with panic disorder have panic attacks. These are sudden, repeated periods of intense fear when there is no danger. The attacks come on quickly and can last several minutes or more.
Phobias. People with phobias have an intense fear of something that poses little or no actual danger. Their fear may be about spiders, flying, going to crowded places, or being in social situations (known as social anxiety).
Anxiety Signs and Symptoms
SN instructed patient/caregiver about Anxiety. Generalized anxiety disorder symptoms can vary. They may include: persistent worrying or anxiety about a number of areas that are out of proportion to the impact of the events; overthinking plans and solutions to all possible worst-case outcomes; perceiving situations and events as threatening, even when they aren’t; difficulty handling uncertainty. Physical signs and symptoms may include: fatigue; trouble sleeping; muscle tension or muscle; aches; trembling, feeling twitchy; nervousness or being easily startled; sweating; nausea, diarrhea or irritable bowel syndrome; irritability.
Anxiety Management and Control
SN instructed patient/caregiver on some ways to cope with stress and anxiety. explained to the patient that anxiety can be a normal part of life when faced with stressors such as changes in relationships, presenting in front of a crowd, or making decisions. There is no one right answer to eliminate anxiety. It is important to find healthy coping skills that will work for you. Consult with your primary care physician when anxiety becomes persistent or unmanageable. SN Instructed patient about some coping skills to consider when struggling with anxiety include: Reaching out to support system (i.e. family/friends, counselors, psychiatrists, or support groups). Deep breathing Meditation, Yoga, Avoiding caffeinated beverages, Healthy diet, and Calming music.
Anxiety to Report
SN instructed patient/caregiver to report any symptoms of anxiety such as feeling apprehensive, feeling powerless, having a sense of impending danger, panic or doom, having an increased heart rate, breathing rapidly (hyperventilation), sweating, trembling, and or feeling weak or tired to SN or MD immediately to help prevent further complications.
DEMENTIA
Dementia I
SN instructed patient/caregiver about Dementia that is a term used to describe a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. It isn’t a specific disease, but several diseases can cause dementia. Though dementia generally involves memory loss, memory loss has different causes. Alzheimer’s disease is the most common cause of a progressive dementia in older adults, but there are a number of other causes of dementia. Depending on the cause, some dementia symptoms might be reversible.
Dementia Signs and Symptoms I
SN instructed patient/caregiver about Dementia. Symptoms vary depending on the cause, but common signs and symptoms. Cognitive changes: memory loss, which is usually noticed by someone else; difficulty communicating or finding words; difficulty with visual and spatial abilities, such as getting lost while driving; difficulty reasoning or problem-solving; difficulty handling complex tasks, planning and organizing; confusion and disorientation. Psychological changes: personality changes; depression; anxiety; inappropriate behavior; paranoia; agitation; hallucinations.
Dementia Signs and Symptoms II
SN instructed patient/caregiver that the dementia symptoms vary depending on the cause, but common signs and symptoms include: Cognitive changes: Memory loss, difficulty communicating or finding words, difficulty with complex tasks, difficulty with planning and organizing, difficulty with coordination and motor functions, problems with disorientation, such as getting lost. Psychological changes like personality changes, inability to reason, inappropriate behavior, paranoia, agitation, hallucinations.
Alzheimer’s Disease I
SN instructed patient/caregiver Alzheimer’s disease (a type of dementia) that is a progressive disease that destroys memory and other important mental functions. At first, someone with Alzheimer’s disease may notice mild confusion and difficulty remembering. Eventually, people with the disease may even forget important people in their lives and undergo dramatic personality changes. Alzheimer’s disease is the most common cause of dementia — a group of brain disorders that cause the loss of intellectual and social skills. In Alzheimer’s disease, the brain cells degenerate and die, causing a steady decline in memory and mental function. At first, increasing forgetfulness or mild confusion may be the only symptoms of Alzheimer’s disease that you notice. But over time, the disease robs you of more of your memory, especially recent memories. The rate at which symptoms worsen varies from person to person.
Alzheimer’s Disease Management and Control I
SN instructed patient/caregiver on Alzheimer’s disease and other disorders that cause dementia. Heart-healthy lifestyle choices that may reduce the risk of Alzheimer’s include the following: exercise regularly, eat a diet of fresh produce, healthy oils and foods low in saturated fat, follow treatment guidelines to manage high blood pressure, diabetes and high cholesterol, if you smoke, ask your doctor for help to quit smoking.
Alzheimer’s Disease Management and Control II
SN instructed patient/caregiver managing behavioral symptoms Behavioral and psychological symptoms of dementia (BPSD), especially agitation, aggression, depression and psychosis, are the leading causes for assisted living or nursing facility placement. Early recognition and treatment can reduce the costs of caring for these patients and improve the quality of life of the patient and caregiver.
PSYCHOSIS
Psychosis
SN instructed patient/caregiver about Psychosis that is an abnormal condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.
Psychosis Etiology
SN instructed patient/caregiver about Psychosis. This disorder occurs when a person loses contact with reality. The person may: Have false beliefs about what is taking place, or who one is (delusions). See or hear things that are not there (hallucinations). Medical problems that can cause psychosis include: alcohol and certain illegal drugs, both during use and during withdrawal; brain diseases, such as Parkinson disease, Huntington disease; brain tumors or cysts; dementia (including Alzheimer disease); HIV and other infections that affect the brain; some prescription drugs, such as steroids and stimulants; some types of epilepsy; Stroke.
Schizophrenia I
SN instructed patient/caregiver about Schizophrenia that is a mental disorder that makes it hard to tell the difference between what is real and not real. It also makes it hard to think clearly, have normal emotional responses, and act normally in social situations. People with schizophrenia require lifelong treatment. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.
Schizophrenia II
SN instructed patient/caregiver about Schizophrenia. This disorder is a complex illness. Mental health experts are not sure what causes it. Genes may play a role. Schizophrenia occurs in just as many men as women. It usually begins in the teen or young adult years, but it may begin later in life. In women, it tends to begin slightly later. Schizophrenia in children usually begins after age 5. Childhood schizophrenia is rare and can be hard to tell apart from other developmental problems.
Schizophrenia Symptoms
SN instructed patient/caregiver about Schizophrenia. Symptoms of schizophrenia usually start between ages 16 and 30. Men often develop symptoms at a younger age than women. People usually do not get schizophrenia after age 45. There are three types of symptoms: Psychotic symptoms distort a person’s thinking. These include hallucinations (hearing or seeing things that are not there), delusions (beliefs that are not true), trouble organizing thoughts, and strange movements. “Negative” symptoms make it difficult to show emotions and to function normally. A person may seem depressed and withdrawn. Cognitive symptoms affect the thought process. These include trouble using information, making decisions, and paying attention. No one is sure what causes schizophrenia. Your genes, environment, and brain chemistry may play a role.
Bipolar Disorder
SN instructed patient/caregiver on Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. Episodes of mood swings may occur rarely or multiple times a year. Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).
Bipolar Disorder National Suicide Prevention Lifeline
SN instructed patient/caregiver on Bipolar disorder. Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
STRESS
Stress I
SN instructed patient/caregiver on stress. There are at least three different types of stress: Routine stress related to the pressures of work, family, and other daily responsibilities. Stress brought about by a sudden negative change, such as losing a job, divorce, or illness. Traumatic stress, which happens when you are in danger of being seriously hurt or killed. Examples include a major accident, war, assault, or a natural disaster. This type of stress can cause post-traumatic stress disorder (PTSD).
Stress II
SN instructed patient/caregiver on Stress that is an automatic physical, mental and emotional response to a challenging event. It’s a normal part of everyone’s life. When used positively, stress can lead to growth, action and change. But negative, long-term stress can lessen your quality of life. Different people may feel stress in different ways. Some people experience digestive symptoms. Others may have headaches, sleeplessness, depressed mood, anger, and irritability. People under chronic stress get more frequent and severe viral infections, such as the flu or common cold. Vaccines, such as the flu shot, are less effective for them.
Stress & Blood Sugar
SN instructed patient/caregiver on how stress can affect blood sugar. One-way stress affect blood sugar and having a direct effect on it, is as with the stress of a physical illness, prolonged or excessive stress can cause the body to produce hormones that prevent insulin from working properly. That, in turn, increases the blood sugar levels.
Stress Management and Control I
SN instructed patient/caregiver on stress avoidance techniques such as: listening to relaxing music, meditation, distracting oneself from the stressor/s, and to engage in immersive yet relaxing activities.
Stress Management and Control II
SN instructed patient/caregiver on Stress. Management approaches include: Learning skills such as problem-solving, prioritizing tasks and time management. Enhancing your ability to cope with adversity. For example, you may learn how to improve your emotional awareness and reactions, increase your sense of control, find greater meaning and purpose in life, and cultivate gratitude and optimism. Practicing relaxation techniques such as deep breathing, yoga, meditation, tai chi, exercise and prayer. Improving your personal relationships.
MISCELLANEOUS
Psych Educate Acting Out
SN instructed patient/caregiver on appropriate behaviors; pt shows with difficulty with verbalized needs and thoughts due to psych disorder. Pt gets frustrated easily and acts out verbally with screaming.
Psych Effective Communication
SN instructed patient/caregiver on effective communication verses screaming when caregivers are nearby. Caregiver instructed to check with patient every few hours to see if Pt needs anything as a means to help decrease disruptive behavioral outburst. Caregiver demonstrated understanding.
Psych Goals
SN instructed patient/caregiver in plans and goals for psych intervention, instructions and teachings in s/s of disease process, benefits of medication, and s/e. instruct re-motivation/ re-socialization therapy to decrease isolation. Reality therapy to increase knowledge into psychosis. Relaxation therapy to decease agitation/nervousness.
Psych Reorientation
SN instructed patient/caregiver on reality reorientation when needed by reconfirming areas of disorientation as date place time and clarification of inaccuracy in conversation, to provide social interactions with other by having participate in group activities…ie bingo etc.
Psych/Disease Process
SN instructed patient/caregiver in s/s of Pt’s disease process to increase insight into Pt’s thoughts and actions that precipitate feelings of depression, agitation and psychosis.
