Hoe om Depressie en Bipolêre Versteuring te ... - Dr. Hans Dreyer
Hoe om Depressie en Bipolêre Versteuring te ... - Dr. Hans Dreyer
Hoe om Depressie en Bipolêre Versteuring te ... - Dr. Hans Dreyer
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>Hoe</strong> <strong>om</strong> <strong>Depressie</strong> <strong>en</strong><br />
<strong>Bipolêre</strong> <strong>Vers<strong>te</strong>uring</strong><br />
<strong>te</strong> oorwin.<br />
Deur: <strong>Dr</strong>. <strong>Hans</strong> <strong>Dr</strong>eyer
Vyf belangrike Simpt<strong>om</strong>e<br />
van <strong>Depressie</strong><br />
Die verandering in gedrag is:<br />
1. Verandering in Werkspatroon<br />
2. Verandering in Sosiale gedrag<br />
Die verandering in liggaamsfunksies is:<br />
3. Verandering in Slaap patroon<br />
4. Verandering in Eet patroon<br />
5. Verandering in Seksuele patroon
Meer werk<br />
Meer sosiaal, (wil m<strong>en</strong>se rond<strong>om</strong> h<strong>om</strong> hê)<br />
Meer slaap (oorslaap)<br />
Meer eet<br />
Meer seksuele dryfkrag<br />
(hoër libido)<br />
OF<br />
Minder werk<br />
Minder sosiaal, (vermy m<strong>en</strong>se)<br />
Minder slaap/kan nie slaap<br />
Minder eet<br />
Minder seksuele dryfkrag<br />
(laer libido)
“The male manifistation<br />
of Depression is anger”
Naam:____________________________ Oud:______ Geslag:______ Daum:____________<br />
1.Ek voel hartseer, bedroef <strong>en</strong> af.<br />
2.Vroeg ogg<strong>en</strong>d voel ek die bes<strong>te</strong><br />
3.Ek is, of voel huilerig<br />
4.Ek slaap moeilik 'n nag deur of oorslaap<br />
5.Ek eet soveel soos gewoonlik<br />
6.Ek g<strong>en</strong>iet dit <strong>om</strong> met "n aantreklike man/vrou <strong>te</strong><br />
gesels, na <strong>te</strong> kyk of by <strong>te</strong> wees<br />
7.Ek k<strong>om</strong> ag<strong>te</strong>r dat ek gewig verloor<br />
8.Ek sukkel met hardlywigheid<br />
9.My hart klop vinniger as gewoonlik<br />
10.Ek raak moeg sonder rede<br />
11.My verstand is so helder soos altyd<br />
12.Ek vind dit maklik <strong>om</strong> my daaglikse take <strong>te</strong> do<strong>en</strong><br />
13.Ek is rus<strong>te</strong>loos <strong>en</strong> kan nie stil sit nie<br />
14.Ek is vol hoop vir die toek<strong>om</strong>s<br />
15.Ek raak makliker geïri<strong>te</strong>erd as gewoonlik<br />
16.Ek vind dit maklik <strong>om</strong> beslui<strong>te</strong> <strong>te</strong> neem<br />
17.Ek voel onmisbaar <strong>en</strong> nodig<br />
18.My lewe is baie besig<br />
19.Dit sal vir ander be<strong>te</strong>r wees as ek dood is<br />
20.Ek g<strong>en</strong>iet nog die dinge wat ek altyd g<strong>en</strong>iet het<br />
© W.W.K. Zung, 1974,1989<br />
ALL RIGHTS RESERVED<br />
Min<br />
tot<br />
nooit<br />
S<strong>om</strong>s<br />
Mees<strong>te</strong><br />
van die<br />
Tyd<br />
SDS Rou <strong>te</strong>lling<br />
SDS Indeks <strong>te</strong>lling<br />
Totaal
20<br />
21<br />
22<br />
23<br />
24<br />
25<br />
26<br />
27<br />
28<br />
29<br />
30<br />
31<br />
32<br />
33<br />
34<br />
35<br />
36<br />
37<br />
38<br />
39<br />
25<br />
26<br />
28<br />
29<br />
30<br />
31<br />
33<br />
34<br />
35<br />
36<br />
38<br />
39<br />
40<br />
41<br />
43<br />
44<br />
45<br />
46<br />
48<br />
49<br />
40<br />
41<br />
42<br />
43<br />
44<br />
45<br />
46<br />
47<br />
48<br />
49<br />
50<br />
51<br />
52<br />
53<br />
54<br />
55<br />
56<br />
57<br />
58<br />
59<br />
60<br />
61<br />
62<br />
63<br />
64<br />
65<br />
66<br />
67<br />
68<br />
69<br />
70<br />
71<br />
72<br />
73<br />
74<br />
75<br />
76<br />
77<br />
78<br />
79<br />
80<br />
75<br />
76<br />
78<br />
79<br />
80<br />
81<br />
83<br />
84<br />
85<br />
86<br />
88<br />
89<br />
90<br />
91<br />
92<br />
94<br />
95<br />
96<br />
98<br />
99<br />
100<br />
50<br />
51<br />
53<br />
54<br />
55<br />
56<br />
58<br />
59<br />
60<br />
61<br />
63<br />
64<br />
65<br />
66<br />
68<br />
69<br />
70<br />
71<br />
73<br />
74<br />
Rou<br />
Telling<br />
SDS<br />
Indeks<br />
Rou<br />
Telling<br />
SDS<br />
Indeks<br />
Rou<br />
Telling<br />
SDS<br />
Indeks
SDS Indeks<br />
Onder 40<br />
40 tot 49<br />
50 tot 59<br />
60 to 69<br />
70 tot 79<br />
80 <strong>en</strong> meer<br />
Die ekwival<strong>en</strong>t “Clinical Global Impressions”<br />
Binne normale gr<strong>en</strong>se - Ge<strong>en</strong> psigopatologie<br />
Distimie<br />
Lig tot matige minor-depressie<br />
Uitgesproke major-depressie<br />
Ernstige major-depressie<br />
Ui<strong>te</strong>rs<strong>te</strong> major-depressie
3.Endog<strong>en</strong>e depressie:<br />
<strong>Depressie</strong> wat veroorsaak word deur 'n<br />
chemiese wanbalans (Serotoni<strong>en</strong> <strong>te</strong>kort)<br />
wat in die depressiewe persoon aan die<br />
gang is <strong>en</strong> waarskynlik oorgeërf is.<br />
Dikwels hou dit ook verband met 'n<br />
familiegeskied<strong>en</strong>is van depressie<br />
(Merck bl. 1592).
4. Reaktiewe depressie:<br />
<strong>Depressie</strong> wat ontstaan het we<strong>en</strong>s<br />
eks<strong>te</strong>rne gebeurt<strong>en</strong>isse soos die verlies<br />
van 'n geliefde, egskeiding, konflik met<br />
ouers <strong>en</strong> nog baie ander faktore, wat<br />
ui<strong>te</strong>indelik ook oorgaan in 'n <strong>te</strong>kort<br />
aan Serotoni<strong>en</strong><br />
(Pug, Louw, Gouws, Meyer P 308)
Gedragspatrone wat verander:<br />
Werkspatroon verander<br />
<strong>en</strong><br />
Sosiale gedrag verander<br />
Liggaamsfunksies wat verander:<br />
Slaappatroon verander<br />
Eet patroon verander<br />
Seksuele dryfkrag verander
Regs<strong>te</strong>lling:<br />
Dit kan klink asof ek met hierdie<br />
simpt<strong>om</strong>e sleg<strong>te</strong> gedrag wil<br />
goedpraat, of sê dat dit maar<br />
so aanvaar moet word.<br />
Dit is glad nie so nie.
Die goue reël waarmee ek werk is:<br />
“NEVER ALLOW A PERSON TO USE<br />
SICKNESS AS AN EXCUSE FOR BAD<br />
OR IRRESPONSIBLE BEHAVIOUR”<br />
J E. Adams Klasaan<strong>te</strong>k<strong>en</strong>inge 1984
D<strong>en</strong>driet<br />
Boodskap<br />
Sinaptiese-op<strong>en</strong>ing<br />
Sinaps<br />
D<strong>en</strong>driet<br />
D<strong>en</strong>driet<br />
D<strong>en</strong>driet<br />
Sinaps<br />
Boodskap
Die probleem is dat die d<strong>en</strong>drie<strong>te</strong> nie<br />
"e<strong>en</strong> aanmekaar stuk s<strong>en</strong>uweebaan” is nie<br />
maar dit is 'n kl<strong>om</strong>p kort stukkies wat<br />
oral met mekaar kontak moet maak.<br />
D<strong>en</strong>driet<br />
Serotoni<strong>en</strong>-molekule<br />
Sinaptiese-op<strong>en</strong>ing<br />
D<strong>en</strong>driet
CHEMIESE PROSESSE<br />
IN DEPRESSIE<br />
As hierdie man<br />
in die verkeer ry <strong>en</strong> sy oog<br />
si<strong>en</strong> 'n rooi lig, dan moet die oog<br />
vir die be<strong>en</strong> laat weet hy moet<br />
die rem trap <strong>om</strong> <strong>te</strong> kan stilhou.
Die boodskap word nou deur die<br />
liggaam gestuur sodat die be<strong>en</strong><br />
die rem kan trap <strong>en</strong> die motor betyds<br />
kan stilhou. Hierdie boodskap word deur die<br />
s<strong>en</strong>uweebane gestuur wat<br />
soos 'n netwerk fyn<br />
kabeltjies deur die<br />
hele liggaam loop.<br />
Die s<strong>en</strong>uweebaan<br />
is nie e<strong>en</strong> aanmekaar<br />
kabel nie, maar kort<br />
D<strong>en</strong>driet<br />
stukkies kabel (d<strong>en</strong>drie<strong>te</strong>) wat aanmekaar las.<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
D<strong>en</strong>driet<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG
D<strong>en</strong>driet<br />
ROOI<br />
LIG<br />
SEROTONIEN-MOLEKULES<br />
IS SOOS 'N KRUIWA<br />
ROOI<br />
LIG<br />
D<strong>en</strong>driet<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG
IN SY MEES VEREENVOUDIGDE<br />
D<strong>en</strong>driet<br />
VORM BETEKEN DEPRESSIE<br />
DAT DAAR TE MIN<br />
SEROTONIEN-MOLEKULES IS<br />
Boodskap<br />
word nie<br />
oorgedra<br />
D<strong>en</strong>driet
D<strong>en</strong>driet<br />
Sirkel<br />
D<strong>en</strong>ke<br />
D<strong>en</strong>driet
SSRI "proppies" verhoed die serotoni<strong>en</strong>molekule<br />
<strong>om</strong> na volg<strong>en</strong>de d<strong>en</strong>driet <strong>te</strong> gaan,<br />
maar laat boodskap (rooilig) deur.<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
SSRI is 'n afkorting:<br />
· Selective<br />
· Serotonin<br />
· Re-uptake<br />
· Inhibitor<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
ROOI<br />
LIG<br />
Serotoni<strong>en</strong>-kruiwa kan 'n<br />
volg<strong>en</strong>de impuls gaan haal
Oorsake van <strong>Depressie</strong> <strong>en</strong> Behandeling<br />
1Chemiese wanbalans<br />
Die groots<strong>te</strong> oorsaak van<br />
depressie is 'n<br />
chemiese wanbalans.<br />
Negatiewe D<strong>en</strong>ke<br />
2 2<br />
3<br />
'n Groot oorsaak van<br />
depressie is negatiewe<br />
d<strong>en</strong>kpatrone.<br />
Eks<strong>te</strong>rne faktore<br />
Daar is s<strong>om</strong>s ook eks<strong>te</strong>rne<br />
sake wat die spanning<br />
verhoog <strong>en</strong> die depressie<br />
aanhelp:<br />
1<br />
3<br />
Medikasie<br />
Antidepressan<strong>te</strong> keer<br />
dat die serotoni<strong>en</strong>molekule<br />
nie vernietig<br />
word nie.<br />
Vernuwing van d<strong>en</strong>ke<br />
Die persoon moet geleer<br />
word <strong>om</strong> anders <strong>te</strong> dink.<br />
Vernuwing van d<strong>en</strong>ke.<br />
R<strong>om</strong> 12:2<br />
Eks<strong>te</strong>rne faktore<br />
Hierdie probleme moet<br />
ook regges<strong>te</strong>l word<br />
sover moontlik.
NORMALE BEVOLKING<br />
DISTIMIE<br />
LIG TOT MATIGE DEPRESSIE<br />
UITGESPROKE DEPRESSIE<br />
ERNSTIGE DEPRESSIE<br />
UITERSTE DEPRESSIE<br />
BEHANDELINGSFASES<br />
Reaksie<br />
Aku<strong>te</strong><br />
(6-12 weke)<br />
Remissie Hers<strong>te</strong>l<br />
TYD<br />
Terugval<br />
Terugval<br />
Verloop<br />
Met Medikasie<br />
Simpto<strong>om</strong> Vry<br />
(4-9 maande)<br />
Herhaling<br />
Instandhouding<br />
(1 of meer jaar)
MANIESE STADIUM<br />
HIPOMANIESE STADIUM<br />
SUPERIEURE STADIUM<br />
NORMALE BEVOLKING<br />
DISTIMIE<br />
LIG TOT MATIGE DEPRESSIE<br />
UITGESPROKE DEPRESSIE<br />
ERNSTIGE DEPRESSIE<br />
UITERSTE DEPRESSIE<br />
180-200km/h<br />
160-180km/h<br />
120-160km/h<br />
100-120km/h<br />
80-100km/h<br />
60-80km/h<br />
40-60km/h<br />
20-40km/h<br />
0-20 km/h
MANIESE STADIUM<br />
HIPOMANIESE STADIUM<br />
SUPERIEURE STADIUM<br />
NORMALE BEVOLKING<br />
DISTIMIE<br />
LIG TOT MATIGE DEPRESSIE<br />
UITGESPROKE DEPRESSIE<br />
ERNSTIGE DEPRESSIE<br />
UITERSTE DEPRESSIE<br />
180-200km/h<br />
160-180km/h<br />
120-160km/h<br />
100-120km/h<br />
80-100km/h<br />
60-80km/h<br />
40-60km/h<br />
20-40km/h<br />
0-20 km/h
MANIESE STADIUM<br />
HIPOMANIESE STADIUM<br />
SUPERIEURE STADIUM<br />
NORMALE BEVOLKING<br />
DISTIMIE<br />
LIG TOT MATIGE DEPRESSIE<br />
UITGESPROKE DEPRESSIE<br />
ERNSTIGE DEPRESSIE<br />
UITERSTE DEPRESSIE<br />
180-200km/h<br />
160-180km/h<br />
120-160km/h<br />
100-120km/h<br />
80-100km/h<br />
60-80km/h<br />
40-60km/h<br />
20-40km/h<br />
0-20 km/h
PHASES PHASES OF OF UNIPOLAR UNIPOLAR AND AND BIPOLAR BIPOLAR DEPRESSION<br />
DEPRESSION<br />
180KM/H<br />
160KM/H<br />
120KM/H<br />
100KM/H<br />
80KM/H<br />
60KM/H<br />
40KM/H<br />
Severe Eleva<strong>te</strong>d<br />
Mania<br />
Modera<strong>te</strong> Eleva<strong>te</strong>d<br />
Hipo-Mania<br />
Mild Eleva<strong>te</strong>d<br />
Normal population<br />
Dis<strong>te</strong>mic disorder<br />
Mild Depression<br />
Modera<strong>te</strong> Depression<br />
20KM/H Severe Depression<br />
Unipolar mood disorder Bipolar mood disorder<br />
Uninhibi<strong>te</strong>d Behaviour<br />
Significant impairm<strong>en</strong>t<br />
Not able to work<br />
Agita<strong>te</strong>d Performance<br />
Significant impairm<strong>en</strong>t<br />
Able to work<br />
Super Performance<br />
without significant impairm<strong>en</strong>t<br />
Able to work<br />
SDS score = -25 to -40<br />
Poor Performance<br />
SDS score = -41 to -50<br />
Bad(No) Performance<br />
SDS score = -51 to -60<br />
Significant impairm<strong>en</strong>t<br />
able to work<br />
SDS score = -61 to -70<br />
Significant impairm<strong>en</strong>t<br />
Not able to work<br />
SDS score = -71 to -80<br />
less than -80 is Extreme Depression
180KM/H<br />
160KM/H<br />
120KM/H<br />
100KM/H<br />
80KM/H<br />
60KM/H<br />
40KM/H<br />
PHASES PHASES OF OF UNIPOLAR UNIPOLAR DEPRESSION<br />
DEPRESSION<br />
Severe Eleva<strong>te</strong>d<br />
Mania<br />
Modera<strong>te</strong> Eleva<strong>te</strong>d<br />
Hipo-Mania<br />
Mild Eleva<strong>te</strong>d<br />
Normal population<br />
Dis<strong>te</strong>mic disorder<br />
Mild Depression<br />
Modera<strong>te</strong> Depression<br />
20KM/H Severe Depression<br />
Unipolar mood disorder Bipolar mood disorder<br />
Uninhibi<strong>te</strong>d Behaviour<br />
Significant impairm<strong>en</strong>t<br />
Not able to work<br />
Agita<strong>te</strong>d Performance<br />
Significant impairm<strong>en</strong>t<br />
Able to work<br />
Super Performance<br />
without significant impairm<strong>en</strong>t<br />
Able to work<br />
SDS score = -25 to -40<br />
Poor Performance<br />
SDS score = -41 to -50<br />
Bad(No) Performance<br />
SDS score = -51 to -60<br />
Significant impairm<strong>en</strong>t<br />
able to work<br />
SDS score = -61 to -70<br />
Significant impairm<strong>en</strong>t<br />
Not able to work<br />
SDS score = -71 to -80<br />
less than -80 is Extreme Depression
180KM/H<br />
160KM/H<br />
120KM/H<br />
100KM/H<br />
80KM/H<br />
60KM/H<br />
40KM/H<br />
PHASES PHASES OF OF BIPOLAR BIPOLAR DEPRESSION<br />
DEPRESSION<br />
Severe Eleva<strong>te</strong>d<br />
Mania<br />
Modera<strong>te</strong> Eleva<strong>te</strong>d<br />
Hipo-Mania<br />
Mild Eleva<strong>te</strong>d<br />
Normal population<br />
Dis<strong>te</strong>mic disorder<br />
Mild Depression<br />
Modera<strong>te</strong> Depression<br />
20KM/H Severe Depression<br />
Unipolar mood disorder Bipolar mood disorder<br />
Uninhibi<strong>te</strong>d Behaviour<br />
Significant impairm<strong>en</strong>t<br />
Not able to work<br />
Agita<strong>te</strong>d Performance<br />
Significant impairm<strong>en</strong>t<br />
Able to work<br />
Super Performance<br />
without significant impairm<strong>en</strong>t<br />
Able to work<br />
SDS score = -25 to -40<br />
Poor Performance<br />
SDS score = -41 to -50<br />
Bad(No) Performance<br />
SDS score = -51 to -60<br />
Significant impairm<strong>en</strong>t<br />
able to work<br />
SDS score = -61 to -70<br />
Significant impairm<strong>en</strong>t<br />
Not able to work<br />
SDS score = -71 to -80<br />
less than -80 is Extreme Depression
DOPAMIEN<br />
LOMERIG<br />
VREESAGTIG EN ANGSTIG<br />
BEWEGINGS WORD STADIG<br />
ERVAAR GEEN PLESIER NIE<br />
HUMEURIG<br />
SEROTONIEN<br />
DEPRESSIEF<br />
ANGSTIG<br />
PANIEKERIG<br />
FOBIES<br />
OBSESSIEF<br />
KOMPULSIEF<br />
EETERIG<br />
ONOPLETTEND<br />
SWAK KONSENTRASIE<br />
VERWERK INLIGTING STADIG<br />
NORADRINALIEN<br />
BEWEGINGS WORD STADIG<br />
VERGEETAGTIG<br />
DEPRESSIEF
DOPAMIEN<br />
LOMERIG<br />
VREESAGTIG EN ANGSTIG<br />
BEWEGINGS WORD STADIG<br />
ERVAAR GEEN PLESIER NIE<br />
HUMEURIG<br />
Moegheid<br />
Lae <strong>en</strong>ergie<br />
Tekort aan<br />
motiveering<br />
Mood<br />
DEPRESSIEF<br />
ANGSTIG<br />
PANIEKERIG<br />
FOBIES<br />
OBSESSIEF<br />
KOMPULSIEF<br />
EETERIG<br />
SEROTONIEN<br />
NORADRINALIEN<br />
ONOPLETTEND<br />
SWAK KONSENTRASIE<br />
VERWERK INLIGTING STADIG<br />
BEWEGINGS WORD STADIG<br />
VERGEETAGTIG<br />
DEPRESSIEF
DOPAMIEN<br />
LOMERIG<br />
VREESAGTIG EN ANGSTIG<br />
BEWEGINGS WORD STADIG<br />
ERVAAR GEEN PLESIER NIE<br />
HUMEURIG<br />
SR 1<br />
Moegheid 2<br />
Lae <strong>en</strong>ergie<br />
Tekort aan<br />
motiveering<br />
(NDRI )<br />
Mood<br />
MAOIs<br />
SSRIs<br />
1<br />
SNRIs<br />
†1<br />
DEPRESSIEF<br />
ANGSTIG<br />
PANIEKERIG<br />
FOBIES<br />
OBSESSIEF<br />
KOMPULSIEF<br />
EETERIG<br />
3<br />
TCAs<br />
SEROTONIEN<br />
NORADRINALIEN<br />
ONOPLETTEND<br />
SWAK KONSENTRASIE<br />
VERWERK INLIGTING STADIG<br />
BEWEGINGS WORD STADIG<br />
VERGEETAGTIG<br />
DEPRESSIEF<br />
1
The Pharmacology behind<br />
depression and antidepressants<br />
DOPAMINE<br />
4<br />
inability to experi<strong>en</strong>ce<br />
pleasure<br />
psych<strong>om</strong>otor slowing<br />
failure to seek reward<br />
1<br />
SR<br />
2 fatigue<br />
low <strong>en</strong>ergy<br />
lack of<br />
motivation<br />
(NDRI )<br />
MAOIs<br />
SNRIs<br />
†1<br />
SSRIs<br />
3<br />
depression<br />
anxiety<br />
panic<br />
phobias<br />
obsessions<br />
c<strong>om</strong>pulsions<br />
food cravings<br />
SEROTONIN<br />
NORADRINALNE<br />
1<br />
impaired att<strong>en</strong>tion<br />
problems conc<strong>en</strong>trating<br />
defici<strong>en</strong>cies in working<br />
memory<br />
slowness of information<br />
processing<br />
depressed mood<br />
psych<strong>om</strong>otor retardation<br />
TCAs<br />
1<br />
123 4<br />
Adap<strong>te</strong>d fr<strong>om</strong> Stahl and Schmidt et al<br />
Noradr<strong>en</strong>aline dopamine re-uptake inhibitor<br />
Tricyclic antidepressants<br />
† Selective serotonin re-uptake inhibitors<br />
Serotonin-noradr<strong>en</strong>aline re-uptakers<br />
Monoamine oxidase inhibitors
MANIESE STADIUM<br />
HIPOMANIESE STADIUM<br />
SUPERIEURE STADIUM<br />
NORMALE BEVOLKING<br />
DISTIMIE<br />
LIG TOT MATIGE DEPRESSIE<br />
ANTIDEPRESANT<br />
ANTIDEPRESANT<br />
ANTIPSIGOTIESE ANTIPSIGOTIESE MIDDEL MIDDEL<br />
GEMOEDSTABILISEERDER<br />
GEMOEDSTABILISEERDER<br />
180-200km/h<br />
160-180km/h<br />
120-160km/h<br />
100-120km/h<br />
80-100km/h<br />
60-80km/h
My Grafiek <strong>om</strong> ‘ups and downs’ <strong>te</strong> plot<br />
SDS<br />
0<br />
10<br />
20<br />
30<br />
40<br />
50<br />
60<br />
70<br />
80<br />
Datums:<br />
180-200km/h<br />
160-180km/h<br />
120-160km/h<br />
100-120km/h<br />
80-100km/h<br />
60-80km/h<br />
40-60km/h<br />
20-40km/h<br />
0-20 km/h
0<br />
10<br />
20<br />
30<br />
40<br />
50<br />
60<br />
70<br />
80<br />
MANIESE STADIUM<br />
HIPOMANIESE STADIUM<br />
SUPERIEURE STADIUM<br />
NORMALE BEVOLKING<br />
DISTIMIE<br />
LIG TOT MATIGE DEPRESSIE<br />
UITGESPROKE DEPRESSIE<br />
ERNSTIGE DEPRESSIE<br />
UITERSTE DEPRESSIE<br />
WEEK 1 2 3 4 5 6 7 8 9<br />
TYDSDUUR
MANIES<br />
HIPOMANIES<br />
SUPERIEUR<br />
0<br />
10<br />
20<br />
30<br />
40<br />
50<br />
60<br />
70<br />
80<br />
WEEK 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15<br />
TYDSDUUR
Fil<strong>te</strong>r<br />
funksioneer<br />
normaal<br />
Blokeer onnodige<br />
eks<strong>te</strong>rne stimuli<br />
FILTER<br />
Fil<strong>te</strong>r<br />
funksioneer<br />
nie<br />
behoorlik nie<br />
S<strong>en</strong>soriese<br />
oorbelading
WHO NEEDS<br />
MAINTENANCE THERAPY?<br />
· Pati<strong>en</strong>ts with 3 Prior Episodes<br />
· Pati<strong>en</strong>ts with 2 Risk Factors for Recurr<strong>en</strong>ce:<br />
- Family Hx of Affective Disorder<br />
- Hx of Frequ<strong>en</strong>t Episodes<br />
- Long Duration of Individual episodes<br />
- Poor Sx Control During Continuation<br />
- Onset Af<strong>te</strong>r age 60<br />
- Double Depression<br />
- C<strong>om</strong>orbid Anxiety Disorder or Substance Abuse<br />
Keller and Boland, Biol Psychiatry. 1998; 44;348
Change language