Module ThreeMood Disorders

Lesson 1:What is disorder and how it is manifested (3 training hours)

Lesson 2: What are the causes of Depression (2 training hours) Lesson 3: Which is the treatment of Depression

(2 training hours)

Lesson 4: What is Bipolar Disorder (2 training hours) Lesson 5: Which is the therapeutical treatment of Bipolar

Disorder (2 training hours)

TOTAL TIME 11 TRAINING HOURS OF 45 MINUTES

Lesson 1

WHAT IS DEPRESSION AND HOW IT IS MANIFESTED

TIME:

135 minutes (3 training hours of 45 minutes)

Step 1: Introduction (10΄) The emotion of sadness is a common experience

of all people. Depression is mental disorder, where the normal

emotion of sadness has over passed the usual limits of sadness.

This disorder is extremely common. One in ten people is attacked by it in any time of his life and one in five will experience it some time during his life.

Women are more prone to suffer Depression than men.

It can often lead to suicide.

Step 2: Brainstorming (15΄)

How does it feel and what is the behavior of a person that suffers from Depression?

Step 3: Slide Projection (20΄)Slide 3.1.1: Symptoms of Depression Emotion of intense sadness that does not subside Lack of pleasure Tendency to avoid other people. uneasiness and anxiety Irritability Difficulties to sleep (insomnia) Very early waking up Anorexia and weight loss (some times the opposite) Decrease of sexual desire Sense of fatigue and lack of energy.

Step 3 (continued) Difficulty to accomplish his everyday tasks. Difficulty to take major or minor decisions Loss of interest Thoughts of committing suicide Guilt Difficulties in paying attention and in

concentration Loss of self – esteem Psychotic symptoms (aberrant depressive ideas,

delusions) Physical disturbances

Step 4: Exercise (45΄)

Paper and pen

Describe in brief a personal experience that field you sadness or disappointment.

Step 5: Exercise and discussion (25΄)

Many times bad mood and sadness cannot be expressed through words to others, but through no verbal ways.

Find a way to express your sadness to others without using words.

Step 6: Theory Presentation (10΄)Verbal and no verbal communication Communication between people is usually made

through exchange of verbal messages. This requires:

Listening and paying attention, Understanding of the content, Knowledge of the language structure (grammar

and syntaxes), Creating new sentences, Using common vocabulary with others, Remembering, Thinking, Putting his thoughts in words, Following social rules, as for example when to

answer and in what way so that the answer responds to the question.

Step 6 (continued)Verbal messages are either completed, or replaced by

no verbal. These include: Body posture Physical distance from the interlocutor Face expression Eye threat or its absence Various gestures Other elements of the persons behaviorPeople with serious mental disorders some times have

difficulties in verbal expression.

Step 7: Questions and comments (5΄)

Step 8: Lesson’s evaluation (5΄)

Lesson 2

WHICH ARE THE CAUSES OF DEPRESSION

TIME :90 minutes (2 training hours of 45

minutes) 

Step 1: Role play (45΄)

Leaflet 3.2.1: Role play

Try to play the role of the father, the mother, the son and the daughter.

Step 2: Brainstorming (10΄)

What do you think that are the causes of Depression ?

Step 3: Slide projection (15΄)Slide 3.2.1: Factors related to the causes of

Depression Genetic Neurochemical Traumatic experiences Hard social situations Stressful situations Physical diseases Substance use especially alcohol and cocaine Perperium (after birth recovery)

Step 4: Slide Projection (10΄)Slide 3.2.2: Clinical course (progress) of

Depression

1 Case: long , gentle and insidious start

  

 

Step 4 (continued)

2nd case: long gentle and insidious start, plus acute symptoms for a period of time.

Step 4 (continued)

3rd Case: Sudden start and total subsiding of symptoms after a period of time.

Step 4 (continued)

4th Case: Sudden start, partial subsiding, relapses.

Step 4 (continued)

5th Case: Sudden or insidious start and chronic duration.

Step 5: Questions and comments (5΄)

Step 6: Lesson’s evaluation (5΄)

Lesson 3WHAT IS THE THERAPEUTICAL

TREATMENT OF DEPRESSION

TIME :

90 minutes (2 training hours of 45 minutes)

 

Step 1: Exercise (15΄)

Leaflet 3.3.1: Clinical Case

Which needs of X require therapeutical treatment?

Step 2: Slide Projection (15΄)Slide 3.3.1: Therapeutic interventions to

depressive patient Antidepressants Therapy with Lithium Psychotherapy Electrospasmic therapy Social interventions

Step 3: Exercise (15΄)

Leaflet 3.3.2: Therapeutical interventions for Depression.

Mark the letter (s) of the alphabet that correspond to the appropriate intervention.

Step 4: Slide Projection (15΄)

Do you know any antidepressants?

Give examples.

Step 4 (continued)Slide 3.3.2: Common antidepressantsTricycles Imipramine (Tofranil) Amitriptyline (Saroten) Clomipramine (Anafranil) New Fluoxetine (Ladose) Paroxetine (Seroxat) Fluvoxamine (Dumyrox) Venlafaxine (Efexor) Nefazodone (Nefirel)

Step 5: Slide Projection (20΄)Slide 3.3.3: Antidepressants’ side effects Παρενέργειες

αντικαταθλιπτικών φαρμάκων dry mouth, constipation, blurred vision drowsiness and fatigue Standing hypotension (low blood pressure) rapid heart rate excessive sedation or uncoordinated

movements while taking this medicationΤαχυκαρδίες, αρρυθμίες και αίσθημα παλμών

Sexual dysfunction Weight gain From newer antidepressants: nausea, migraine

headaches and insomnia.

Step 6: Questions and comments (5΄)

Step 7: Lesson’s Evaluation (5΄)

Lesson 4

WHAT IS BIPOLAR DISORDER

TIME :

90 minutes (2 training hours of 45 minutes)

 

Step 1: Introduction (10΄) Depression might appear in combination with

an opposite emotional state, euphoria which characterizes Mania. It is then called “Manio-Depressive Disorder” or “Bipolar Disorder” as it is named nowadays.

Bipolar Disorder, like Schizophrenia, is considered as a psychotic disorder with long and serious course

Patients with this disorder appear Depressive episodes as well as manic episodes. Either one might appear first.

Step 1 (continued)

It is possible that some patients appear severe episodes of Depression only, while the characteristics of euphoric behavior and hyperactivity are really mild and do not cause any problem. Other might appear only manic episodes, but it is not very common.

The time in between the episodes the person might feel perfectly well.

In some patients episodes alternate in high rate.

Step 1 (continued) Some times at the beginning of the disease, if there are

intense psychotic characteristics, it is difficult to distinguish a manic from a schizophrenic episode.

The depressive episodes manifested in Bipolar Disorder are usually serious.

Bipolar Disorder affects about 1 every 100 persons, men as well as women.

Depends on genetic background. Difficult social situations and stressful every-day situations

worsen the development (progress) of this disorder.

Step 2: Brainstorming (10΄)

What is the behavior of a manic patient?

Step 3: Slide projection and Discussion (15΄)

Slide 3.4.1: Manic SymptomsSymptoms related to mood : Assiduous euphoric mood Irritability Temporary depressionSymptoms related to concentration, speech and thinking: Easy distraction of attention Pressurized talking, loss of ideas High self esteem

Step 3 (continued)

Somatic/ Biological/ Behavior symptoms: High mobility and activity (physical,

social, working, sexual) Dangerous or socially improper behavior Insomnia with no feeling of fatigue Good appetite, but loss of weight because

of hyperactivity.

Step 4: Exercise (10΄)

Express on your face successively the following emotions: joy, sadness, anger, anxiety, despair, hopelessness, hope, tension, fear, panic, enthusiasm, guilt, disgust, blank.

Step 5: Exercise (10΄)

Think up a plot of a specific situation and imitate your feelings using, apart from face expression, any other non verbal way of communication you wish.

Step 6: Role play (25΄)

Imitate a person whose behavior is characterized by euphoria, non- stop talking and high ideas of himself as well as for his friends.

Step 7: Questions and comments (5΄)

Step 8: Lesson’s evaluation(5΄)

Lesson 5

WHICH IS THE THERAPEUTICAL TREATMENT OF BIPOLAR DISORDER

TIME :90 minutes (2 training hours of 45 minutes) 

Step 1: Introduction (5΄)

Bipolar Disorder, without therapeutical treatment, has the tendency to manifest successive manic and depression episodes, which as the time pass become more often and more severe, while the intermediate free of symptoms periods become shorter.

Step 2: Slide Projection (5΄)Slide 3.5.1: Development of Bipolar Disorder with and

without treatment. one yearς Many years

Θεραπεία συντήρησης

therapy of acute phase

 

ΣυνεχιζόμενηΘεραπεία

Step 3: Brainstorming (10΄)

Leaflet 3.5.1: Clinical case

What are the needs of X that should be attended and in what way during his/ her treatment ?

Step 4: Slide projection (10΄)Slide 3.5.2: Therapeutical treatment for Bipolar DisorderEpisode treatmentDepression episode: Antidepressants medication Other psychosocial interventions. Manic episode: Hospitalisation Medical treatment (with antipsychotic and

tranquilizers) Limitation of manic behavior.  

Step 4 (continued)

Continued therapy from preventing relapses Continuation of the medication Ψυχοεκπαίδευση Supporting psychotherapy Other psychosocial interventions

 Preservation therapy Administration of lithium or other drugs that

stabilize mood Psychosocial interventions

Step 5: Theory presentation (15΄)Lithium Λίθιο Lithium is a chemical substance like sodium

and potassium it is used as a simple salt. It is useful for the treatment and the

prevention of manic episodes. Common Lithium drugs are: Milithin,

Priadel, Lithiofor. Before the patient starts the lithium

treatment he undergoes urine, blood tests and an electrocardiograph. With these tests the function of the kidneys, liver, thyroid are checked out.

Step 5 (continued) measuring the lithium levels in the blood (at first

very often and later onevery1-2 months) is essential as the level at which the drug is efficient is not far from the toxicity level.

Person in lithium medication should have a low in salt diet.

It needs extra care when a person on lithium medication shows vomiting, diarrhea or dehydration.

It shouldn’t be administered in pregnant women or in people with kidney failure.

Step 5 (continued)Slide 3.5.3: Lithium side effectsEarly signs Nausea, vomiting, diarrhea Fear at voluntary movements Dry mouth, thirst Fatigue blocked nose, metallic taste Later signs hypothyroid Weight gain ataxia, joint dysfunction Arrhythmias Kidney disease

Step 5 (continued)

Lithium poisoning Terror (phobias) Ataxia Uncoordinated movements Rushed speech Confusion Loss of orientation Spasms (convulsion) Coma

Step 6: Exercise (35΄)

Paper and pen

Describe briefly a personal experience that made you full of joy, enthusiasm and optimism.

Step 7: Questions and comments (5΄)

Step 8: Lesson’s evaluation (5΄)