NLE Psychiatric Disorders — Mood Disorders: Depression and Bipolar DisorderConcept Map

Concept

Major Depressive Disorder (MDD)

Sub Concepts

• Depressed Mood or Anhedonia
• Sleep Disturbances
• Energy Loss and Fatigue
• Psychomotor Changes
• Concentration Impairment
• Appetite Changes
• Feelings of Worthlessness or Guilt
• Suicidal Ideation

Relationship To Central

Primary mood disorder characterized by persistent depressed mood and anhedonia lasting ≥2 weeks

Concept

Bipolar Disorder

Sub Concepts

• Bipolar I Disorder
• Bipolar II Disorder
• Manic Episode Features
• Hypomanic Episode Features
• Major Depressive Episodes

Relationship To Central

Mood disorder with alternating episodes of depression and elevated/expansive mood

Concept

Suicide Risk Assessment and Prevention

Sub Concepts

• Direct Assessment
• Plan, Method, and Means
• Warning Signs
• Risk Factors
• One-to-One Observation
• Environmental Safety
• Therapeutic Relationship

Relationship To Central

Highest priority nursing concern across all mood disorders

Concept

Pharmacological Management

Sub Concepts

• SSRIs
• Tricyclic Antidepressants
• MAOIs
• Mood Stabilizers
• Lithium Carbonate
• Anticonvulsants
• Atypical Antipsychotics

Relationship To Central

Primary treatment modality for mood disorders

Concept

Non-Pharmacological Interventions

Sub Concepts

• Environmental Modification
• Therapeutic Relationship
• Activity Structuring
• Meeting Basic Needs
• Electroconvulsive Therapy
• Psychotherapy

Relationship To Central

Complementary therapeutic approaches supporting medication management

Concept

Legal and Ethical Framework

Sub Concepts

• Mental Health Act (RA 11036)
• Informed Consent
• Involuntary Treatment Criteria
• Rights Protection
• Humane Treatment Standards

Relationship To Central

Guides psychiatric nursing practice in Philippine context

To

Suicide Risk Assessment

From

Major Depressive Disorder

Strength

strong

Relationship

Suicidal ideation is a core criterion and the highest priority nursing concern in MDD

To

One-to-One Observation

From

Suicidal Ideation

Strength

strong

Relationship

High-risk suicidal clients require continuous one-to-one observation for safety

To

Suicide Risk Monitoring

From

SSRIs

Strength

strong

Relationship

Early suicidal ideation may emerge as energy returns before mood improves in early treatment

To

Suicide Risk in Suicidal Clients

From

Tricyclic Antidepressants

Strength

strong

Relationship

TCAs are cardiotoxic in overdose; contraindicated in actively suicidal clients due to lethality in overdose

To

MAOIs

From

SSRIs

Strength

strong

Relationship

Cannot combine due to serotonin syndrome risk; requires 2-5 week washout period between medications

To

Immediate Drug Discontinuation

From

Serotonin Syndrome

Strength

strong

Relationship

Serotonin syndrome is a medical emergency requiring immediate cessation of serotonergic agents

To

Sodium-Fluid Balance

From

Lithium Carbonate

Strength

strong

Relationship

Lithium is handled like sodium by kidneys; sodium depletion or dehydration causes lithium accumulation and toxicity

To

Regular Monitoring

From

Lithium Levels

Strength

strong

Relationship

Blood levels must be drawn 12 hours post-dose and monitored regularly due to narrow therapeutic index

To

Manic Episode

From

Bipolar I Disorder

Strength

strong

Relationship

Bipolar I is defined by the presence of at least one full manic episode with severe functional impairment

To

Hypomanic Episode

From

Bipolar II Disorder

Strength

strong

Relationship

Bipolar II is characterized by hypomanic episodes (milder, shorter elevation) plus major depression, never full mania

To

Environmental De-escalation

From

Manic Episode

Strength

strong

Relationship

Reducing stimulation is the primary nursing intervention to manage escalating manic behavior

To

Physiologic Needs

From

Manic Episode

Strength

strong

Relationship

Manic clients will not stop to eat, drink, or rest; high-calorie finger foods and fluids are essential

To

Electroconvulsive Therapy

From

Severe Depression

Strength

strong

Relationship

ECT is indicated for treatment-resistant depression, psychotic features, or high suicide risk requiring rapid response

To

Transient Cognitive Effects

From

ECT

Strength

moderate

Relationship

Temporary confusion and memory loss are expected side effects that usually resolve; client and family education is essential

To

Tyramine-Restricted Diet

From

MAOI

Strength

strong

Relationship

Tyramine combined with MAOI causes hypertensive crisis; dietary restriction is mandatory for safety

To

Therapeutic Relationship

From

Major Depressive Disorder

Strength

strong

Relationship

Non-judgmental, consistent presence and validation of feelings are core nursing interventions for depression

To

Basic Needs Management

From

Depression

Strength

strong

Relationship

Depressed clients lack energy and motivation for self-care; nurses must ensure nutrition, hygiene, and elimination needs are met

To

Involuntary Treatment

From

Mental Health Act (RA 11036)

Strength

strong

Relationship

RA 11036 permits involuntary treatment for imminent risk of harm with appropriate safeguards and documentation

To

2-4 Week Onset

From

Antidepressants

Strength

strong

Relationship

All major antidepressant classes (SSRIs, TCAs) require 2-4 weeks for therapeutic effect; client adherence teaching is critical

To

Mood Stabilizers

From

Bipolar Disorder

Strength

strong

Relationship

Lithium and anticonvulsants are primary agents for managing bipolar disorder across depressive and manic episodes