Mood and Affect Student Notes
Mood and Affect (Concepts Page 301)
Definition
The term mood is defined as the way a person feels. The term affect is defined as the observable response a
person has to his or her own feelings.
The mood spectrum is a continuum, or spectrum, of all possible moods that any person may experience. Mood
disturbances disrupt an individual’s ability to function normally.
Key Terms
Affective instability
Functional status
Depression
Melancholy: don’t feel low or high just feels “nothing”
Mania: very high
Perceptual disturbance: what they perceive: in bipolar
(everyone is out to get them)
Scope of Mood and Affect
Ranges from low or depressive, normal range, and elevated
range
Normal range itself is a range of cycles -happy
o Normal happiness
o Normal sadness
Normal Physiological Process
Reduced blood flow and abnormal phosphorus metabolism in
the prefrontal aspect of the cerebral cortex
Disturbed activity in neurotransmitters of the brain
o Dopamine
o Norepinephrine
o Serotonin
Variations and Context
Depressive spectrum
o Overwhelming sadness and despair
o May lead to suicidal ideation
o No energy they may feel sad and empty and suicidal thought
Mania spectrum the very high state.
o Euphoric or agitated affective states
o Varying degrees of perceptual disturbances
o They have difficulty concentrating: Bipolar Pt have a tendency of reckless activities
Consequences: Mood Spectrum Disorders
Change in interpersonal relationships
Limited productivity
Reduced functional ability
Higher use and need for medical care
Increased potential for suicide
Risk Factors for Mood Disturbances
Populations at greatest risk
o Females
o Individuals in the second and sixth decades of life
o Abusive households,
o Family Hx
o Hx of suicide in family
o Adolescents, (bully)
, Mood and Affect Student Notes
o PTSD
o Childhood trauma
Individual risk factors
o Stress, early trauma, neglect, abuse, family history, comorbid medical and psychiatric disorders,
personality disorders, substance dependence
Identifying Mood Spectrum Disturbances
Affective instability may present as any combination of the following behaviors:
o Agitation
o Sadness
o Elation
o Blunting
Speech may be in a monotone during blunting, and responses may be unusually brief
Nurses should know the common indicators of these key findings
o Persistent mood disturbance: sadness, melancholy, irritability. lack of interest in normal activities,
euphoria, rage, or lack of feeling anything at all
o Melancholy 2 weeks
o Mnic 4 weeks persistently feels low or high patient is unstable
o Functional impairment (mood should not fluctuate so rapidly or extreme that functional ability is
disruptive)
o Disturbed vegetative functioning
o Very Low -you’ll see increase sleep, low libido decrease energy, decreases appetite
Diagnostic Test
o There are no specific tests to confirm the diagnosis of mood spectrum disorders
o Mental Status Assessment
o Tools to quantifiably measure mental status
Mini-Mental State Exam:
Neecham Confusion Scale: test to see if you are confused
Confusion Assessment Method Instrument
Clinical management
Primary Prevention
o Prevention efforts focus on societal egalitarian interventions
o Programs that target prevention tend to be early interventions
o Don’t abuse children
o Try to help patients in poverty
o Help with Stress
Secondary Prevention (screening)
o Aimed at early detection
o Questions
“Over the past 2 weeks, have you ever felt down, depressed, or hopeless?”
“Have you felt little interest or pleasure in doing things?”
o Questionnaire will help see S/Sx and referral may be needed
Collaborative Care
o Motivational interviewing : help them get out of certain situation emotionally
o Psychotherapy
o Pharmacotherapy
o Brain stimulation therapy
o Management of emergent situations (potential for suicide and/or violence to others)
o Cognitive: help change thought and believes for a healthy lifestyle
o Family therapy
o Play therapy
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