Here is information from the sources that comprehensively addresses the learning objectives
concerning individuals experiencing mood and affect fluctuations:
● Relating to individuals with mood and affect fluctuations
● When communicating with a withdrawn patient, making observations can be useful. For
example, commenting on new pictures or articles of clothing can draw the patient into
and reinforce reality.
● It is important to show a genuine interest in learning about patients with depression.
● Feelings of frustration, hopelessness or annoyance can arise for nurses; discussing
these feelings with peers and supervisors can help separate personal feelings from
those of the patient.
● Factors that contribute to mood/affect fluctuations and mental health illnesses
● Genetic, biological, psychological, and cultural factors can contribute to mood and affect
fluctuations.
● Risk factors for depression: Female gender, early childhood trauma, stressful life
events, family history of depression (especially in first-degree relatives), high levels of
neuroticism, other disorders like substance use, anxiety and personality disorders, and
chronic or disabling medical conditions.
● Etiology of depression: Biological, genetic, and biochemical factors, stressful life
events (especially losses), hormonal influences, hypothalamic-pituitary-adrenal axis,
inflammation, and the diathesis-stress model all play a role.
● Biochemical factors: Neurotransmitter abnormalities, which may result from genetic or
environmental factors or other medical conditions, may cause clinical depression.
● The Diathesis-stress model considers the interplay of biology and life events in the
development of depressive disorders and that psychosocial stressors and interpersonal
events may trigger neurophysical and neurochemical changes in the brain.
● Mood as subjective and affect as objective:
● Mood is defined as the way a person feels. It is the patient’s subjective experience of
sustained emotions or feelings.
● Affect is defined as the observable response a person has to their own feelings. It is
reported as an objective finding based on a nurse’s assessment.
● Evaluation of mood is often done in terms of affect.
● Assessing behaviors in a patient with depression
● Areas to assess include affect, thought processes, feelings, physical behavior, and
communication.
● Affect: Affect may not be congruent with mood, as individuals may laugh and cry
simultaneously. Affective instability may present as agitation, sadness, elation, or
blunting.
● Thought processes: Depression can negatively affect a person’s ability to solve
problems and think clearly. During a depressive episode, a person's ability to solve
problems and think clearly is negatively affected.
● Feelings: Feelings frequently reported by those with depression include worthlessness,
guilt, helplessness, hopelessness, and anger.
