Mood and Affect, and Mood Episodes (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 Let's take a look at mood disorders.

    00:03 We're going to be looking at bipolar disorder, as well as depressive disorder.

    00:08 So what is a mood disorder and what is affect? Oftentimes, we're talking about moods and affects, as though they're the same thing.

    00:17 But they're not.

    00:18 A mood is an emotional state.

    00:21 It is one that a patient experiences.

    00:24 And we see it in an emotional attitude.

    00:30 We learn of it the state of this mood because the patient tells us.

    00:36 They report on their feelings.

    00:40 Now, the patient might say to us, "I feel like there's no hope.

    00:45 I haven't had any good feelings or hope for a very long time." And so we hear that in the person's voice.

    00:57 Now, an affect, on the other hand, is how the patient is going to show us what that mood is.

    01:05 So for example, if that patient is going to say, "I feel like there is no hope." The effect might be that they are a little collapsed.

    01:22 And their movement might be slow.

    01:26 And their eyes might look quite sad.

    01:29 It's more about how the patient is responding in the environment that conveys what their mood is to us.

    01:39 That's the affect.

    01:42 So before we even look at this next slide, I want you to think about mood and affect and the word congruent, meaning are they the same? If a person comes into you, and they say, "I have no hope." "I just don't see anything good ever happening." Well we're going to say their mood and their affect is congruent.

    02:12 As opposed to someone going, "Hi, I have no hope." There's like, there's nothing to look forward to.

    02:22 That's going to make us a little bit worried about this patient because it's incongruent.

    02:28 And we would write that down, mood and affect incongruent.

    02:33 What they are reporting, the sadness is not being demonstrated by their behaviors.

    02:40 So now let's look at a client case.

    02:42 So JJ Banter is coming into our clinic.

    02:47 And you notice that JJ is walking really slowly.

    02:51 And he's looking down at the ground, almost speaking in a whisper.

    02:59 "I'm not feeling like myself these days." You actually have to lean in, in order to hear what JJ wants to say.

    03:09 "Usually, I'm so happy-go-lucky." "But lately, I've been feeling really down." So what is JJ's mood? Would you say it's elated? Would you say it's sad? It sounds like it's sad. How do we know? We know what his mood is because JJ is reporting that JJ feel sad, down.

    03:43 But what about the affect? Did you notice? When I said what JJ was saying, I had an affect.

    03:55 There was a little collapse, the little sad, a little heavy, not getting eye contact, my voice kind of fell down.

    04:07 I started speaking more slowly.

    04:11 So JJ's affect was also sad, because we saw and heard...

    04:20 how JJ was feeling.

    04:24 Now if we have somebody who is really, really sad, who says they have no hope.

    04:31 What do you think might be the most important question to ask JJ? If you are thinking that maybe because he has no hope that maybe there are thoughts of self-harm, or even thoughts of killing oneself.

    04:54 You are correct.

    04:56 I hear what you're saying.

    04:59 I hear you say you have no hope, tell me JJ.

    05:05 Are you thinking about hurting yourself? Are you thinking about killing yourself? So those would be the most important things that you would ask.

    05:16 Now, we're going to be talking a little bit about mood episodes.

    05:22 Mood episodes are time sensitive.

    05:25 It's really important to understand that before we're going ahead and saying someone with a mood disorder, they are probably having episodes, sort of showing us some of a hint of something that might be coming in the future.

    05:45 So we see them sort of as building blocks of mood disorders.

    05:52 We don't diagnose a mood episode.

    05:55 It is something that is when we have people come in, we say, "Has this ever happened before?" And quite frequently, they will say, "Oh, when I was a teenager, I'd go into a little sad period, you know, a couple of weeks at a time, but I always snapped out." It's not something that gets diagnosed by a clinician.

    06:18 Also, it helps us to understand what is going on, and how sometimes you have a mood episode, you have a period of sadness or a period of elation.

    06:33 But it's self corrects or you do something that helps it go away and get back into a balanced life.

    About the Lecture

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

    Included Quiz Questions

    1. Mood is an emotional state with a sustained emotional attitude while affect is the way the client conveys an emotional state.
    2. Mood refers to how the client describes how they are feeling, while affect refers to how the client is responding in their environment.
    3. Affect is an emotional state with a sustained emotional attitude while mood is the way the client conveys an emotional state.
    4. Affect refers to how the client describes how they are feeling, while mood refers to how the client is responding in their environment.
    1. The client who is tearful and covering their face in their hands while telling the nurse how much they miss their spouse
    2. The client who is smiling brightly and clapping their hands together while telling the nurse how excited they are to be discharged today
    3. The client who is staring vacantly at the wall, wringing their hands together while telling the nurse how much they enjoyed having their parents visit them today
    4. The client who is laughing to themselves and smiling while telling the nurse how they have been feeling hopeless recently
    1. “I hear what you’re saying. Are you having any thoughts of wanting to hurt or kill yourself?”
    2. “I am so sorry you feel like that. I will ask the doctor to increase your medication so you feel better.”
    3. “You are not worthless! There is hope!”
    4. “You need to think about all the good things you have in your life, then you won’t feel worthless or hopeless anymore.”

    Author of lecture Mood and Affect, and Mood Episodes (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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