Manic Depressive Episode (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 So let's think about now, when we have a manic depressive episode.

    00:08 So, in other words, we have elation and depression.

    00:13 And it is usually over a period of 2 weeks where a person is feeling elated.

    00:23 And then they go into that depression.

    00:28 What happens is that they have a loss of pleasure after this very elated sense.

    00:37 And then they are having their sleep disturbances.

    00:42 So it could be that they can't sleep or could be hypersomnia, where they are sleeping too much.

    00:51 They have an appetite disturbance, so they don't eat or they're eating too much.

    00:59 You may have fatigue with the depression symptoms that come along.

    01:04 You might also have, instead of that psychomotor activity, that's the agitation, you suddenly have a slowing down or retardation of psychomotor movements.

    01:19 We also have issues with concentration.

    01:23 But unlike those flight of ideas, sometimes with that depressive episode coming in, it's difficult, it's like a foggy brain, it's hard to concentrate on anything.

    01:37 There is an overwhelming sense of worthlessness that the person might feel, and guilt.

    01:45 Guilt, shame, worthlessness.

    01:49 This gives in to this idea of killing oneself or suicidal ideation, it's very, very important.

    02:00 That's a 911 call.

    02:02 It doesn't matter if it is a depressive episode, if a person states that they are sad, that they don't see any hope going on, and that they have thoughts of killing themselves, it is important to get immediate help for them.

    02:21 They also may have that irritable mood.

    02:26 So when you have someone who's having this manic depressive episode, we're seeing the alternating between that sadness and elation, between someone who is able to be very happy and then suddenly extremely sad.

    02:48 And it is one that actually the manic depressive episodes, they alternate.

    02:56 And they last each of them last for about a week.

    03:02 So let's take a look at a client case.

    03:06 If we have JJ coming into our office, and you notice JJ is walking really slowly and looking down.

    03:18 And again, JJ is whispering, you have the question that needs to be asked.

    03:25 Now, when we look at this slide, once again, I'm going to say, you asked JJ to sit down, then you sit down yourself.

    03:35 You find out how is the distance for JJ.

    03:38 If he's whispering, it may be really difficult to be able to hear JJ.

    03:45 So you might want to say, "Is this a good distance for you?" And then you want to ask JJ, "How long have you been feeling this way?" If you remember, these episodes are time sensitive.

    03:59 And so when we find out that someone's only been feeling this way for 4 days or a week, we want to start thinking that maybe it is one of those building blocks.

    04:10 Maybe it is an episode.

    04:13 And JJ says, "I have taken some medications for a bit but I, you know, I can't remember what it was." We want to know if the person has had a past history.

    04:29 We want to know after the last time whether or not it helped and what went on.

    04:40 JJ says he began to feel a little bit better.

    04:44 But he stopped.

    04:47 This happens a lot with medications.

    04:49 Medications have some side effects that people don't particularly like.

    04:54 For example, weight gain is one of them.

    04:58 Impotence is another for young men, loss of sex drive is another for young women.

    05:05 And after they start feeling a little bit better to have given up these other things or to have gained weight, actually hasn't decided that this may not be a good trade off.

    05:19 So we need to be thinking about the patient and if the patient has any way that they have been able to cope before.

    05:31 So JJ says, I have been very happy for a long time over a year, with some periods where maybe it was a little up and down, right.

    05:45 But for the past 5 weeks, it's not been very good for him, right.

    05:52 He goes on each day and he worries about what's going to happen with the next day.

    About the Lecture

    The lecture Manic Depressive Episode (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Mood Disorders: Major Depressive and Bipolar Disorders (Nursing).

    Included Quiz Questions

    1. Around two weeks
    2. Around one week
    3. Around two months
    4. Around one to two days
    1. “How long have you been feeling like this?”
    2. “You should try to exercise every day to help with your energy level.”
    3. “What medications are you on?”
    4. “Why do you feel like this?”

    Author of lecture Manic Depressive Episode (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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