Mood Disorders: Depression and Bipolar Disorder - Concept Map
Mood (Affective) Disorders
Related concepts
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
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
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
Pharmacological Management
Sub concepts
- SSRIs
- Tricyclic Antidepressants
- MAOIs
- Mood Stabilizers
- Lithium Carbonate
- Anticonvulsants
- Atypical Antipsychotics
Relationship to central
Primary treatment modality for mood disorders
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
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
Concept connections
- Major Depressive DisorderSuicide Risk AssessmentSuicidal ideation is a core criterion and the highest priority nursing concern in MDD
- Suicidal IdeationOne-to-One ObservationHigh-risk suicidal clients require continuous one-to-one observation for safety
- SSRIsSuicide Risk MonitoringEarly suicidal ideation may emerge as energy returns before mood improves in early treatment
- Tricyclic AntidepressantsSuicide Risk in Suicidal ClientsTCAs are cardiotoxic in overdose; contraindicated in actively suicidal clients due to lethality in overdose
- SSRIsMAOIsCannot combine due to serotonin syndrome risk; requires 2-5 week washout period between medications
- Serotonin SyndromeImmediate Drug DiscontinuationSerotonin syndrome is a medical emergency requiring immediate cessation of serotonergic agents
- Lithium CarbonateSodium-Fluid BalanceLithium is handled like sodium by kidneys; sodium depletion or dehydration causes lithium accumulation and toxicity
- Lithium LevelsRegular MonitoringBlood levels must be drawn 12 hours post-dose and monitored regularly due to narrow therapeutic index
- Bipolar I DisorderManic EpisodeBipolar I is defined by the presence of at least one full manic episode with severe functional impairment
- Bipolar II DisorderHypomanic EpisodeBipolar II is characterized by hypomanic episodes (milder, shorter elevation) plus major depression, never full mania
- Manic EpisodeEnvironmental De-escalationReducing stimulation is the primary nursing intervention to manage escalating manic behavior
- Manic EpisodePhysiologic NeedsManic clients will not stop to eat, drink, or rest; high-calorie finger foods and fluids are essential
- Severe DepressionElectroconvulsive TherapyECT is indicated for treatment-resistant depression, psychotic features, or high suicide risk requiring rapid response
- ECTTransient Cognitive EffectsTemporary confusion and memory loss are expected side effects that usually resolve; client and family education is essential
- MAOITyramine-Restricted DietTyramine combined with MAOI causes hypertensive crisis; dietary restriction is mandatory for safety
- Major Depressive DisorderTherapeutic RelationshipNon-judgmental, consistent presence and validation of feelings are core nursing interventions for depression
- DepressionBasic Needs ManagementDepressed clients lack energy and motivation for self-care; nurses must ensure nutrition, hygiene, and elimination needs are met
- Mental Health Act (RA 11036)Involuntary TreatmentRA 11036 permits involuntary treatment for imminent risk of harm with appropriate safeguards and documentation
- Antidepressants2-4 Week OnsetAll major antidepressant classes (SSRIs, TCAs) require 2-4 weeks for therapeutic effect; client adherence teaching is critical
- Bipolar DisorderMood StabilizersLithium and anticonvulsants are primary agents for managing bipolar disorder across depressive and manic episodes
Diagrams
Mood Disorders: Comprehensive Concept Hierarchy
Comprehensive mind map showing all major concepts in mood disorders including major depressive disorder, bipolar disorder, suicide prevention, pharmacological treatments, and non-pharmacological interventions organized hierarchically.
Suicide Risk Assessment and Management Algorithm
Detailed flowchart depicting the nursing process for suicide risk assessment, from initial screening through management of high-risk clients, including RA 11036 compliance points and critical danger periods.
Antidepressant Selection and Drug Interaction Management
Decision tree for antidepressant selection based on client presentation and safety considerations, including SSRI first-line approach, TCA safety concerns in suicidal clients, MAOI precautions, and serotonin syndrome management.
Lithium Therapy: Monitoring and Toxicity Management
Comprehensive lithium management algorithm including therapeutic range, monitoring schedule, sodium-fluid balance education, drug interactions, and toxicity assessment with corresponding interventions at each severity level.
Manic Episode: Assessment and Nursing Interventions
Detailed assessment and intervention flowchart for manic episodes in Bipolar I disorder, emphasizing environmental de-escalation, physiologic needs management, behavioral limits, activity channeling, and protection from poor judgment consequences.
Electroconvulsive Therapy (ECT): Pre-, Intra-, and Post-Procedure Nursing Care
Comprehensive ECT protocol detailing pre-procedure consent and preparation, intra-procedure anesthesia and monitoring, and post-procedure airway management, vital sign monitoring, reorientation, and management of expected transient side effects.
Major Depressive Episode: Clinical Progression and Treatment Response
State diagram showing the clinical progression of major depression from prodromal phase through treatment response, highlighting the critical early treatment period when suicide risk increases, and the maintenance-discontinuation pathway.
Antidepressant Distribution in First-Line Treatment
Pie chart illustrating that SSRIs represent the predominant first-line choice for major depression treatment due to safety and tolerability profile, while other agents are reserved for specific clinical scenarios or treatment resistance.
Lithium Management: Comprehensive Clinical Guide
Detailed mind map of lithium therapy focusing on therapeutic and toxic ranges, precise toxicity signs by severity, critical sodium-fluid interactions, drug interactions, monitoring requirements, and comprehensive client education points.