Mental & Behavioral Health

A serious mood disorder — not sadness that lingers — where the nurse’s first assessment is always safety, and the riskiest weeks are the ones when treatment starts working.

When chronic drinking stops abruptly, a brain rebalanced around alcohol swings into hyperexcitation — a timeline that runs from tremor to seizures to delirium tremens.

A disorder of the brain’s salience system that makes irrelevant things feel urgently meaningful — and the one psychiatric diagnosis where the treatment itself can kill the patient if nobody recognizes the movement disorder.

One manic episode in a lifetime rewrites the diagnosis, the drug list and the prognosis — and the drug that treats it best is cleared by the same tubule that handles sodium, which is why a stomach bug can become a neurologic emergency.

One survival circuit firing at the wrong threat, or at a threat that ended years ago — and as the perceptual field narrows, the patient loses the ability to learn, decide or problem-solve, which changes everything the nurse can usefully do.

The same dose that was tolerated last month can kill today — and the two toxidromes a nurse must tell apart point their pupils in opposite directions.

Three disorders that look nothing alike from the doorway — a visibly starved teenager, a normal-weight student with swollen cheeks, an adult with obesity — share one psychology, and the most dangerous moment in the first one is the week feeding starts again.

Agitation is an emergency that usually resolves with words in under five minutes — and when it does not, federal regulation dictates exactly how, for how long, and by whose order a person may be restrained.

A long-lasting disorder of intrusive, unwanted thoughts (obsessions) and repetitive acts done to relieve them (compulsions), taking more than an hour a day or causing real distress. Most adults know the thoughts are irrational but feel powerless to stop. Exposure and response prevention (a form of CBT) and SSRIs — often at higher doses and for 8–12 weeks before they work — are first-line; clomipramine is an alternative with more risks. Suicide risk is raised, so thoughts of suicide need 988 or 911.

Long-standing, inflexible patterns of thinking, feeling and behaving that cause distress and trouble with relationships, usually emerging by adolescence or early adulthood. Borderline personality disorder brings intense, unstable moods and relationships, impulsivity, self-harm and a high suicide risk; psychotherapy such as DBT is first-line and no medicine is FDA-approved. Antisocial personality disorder involves disregard for others’ rights, often after childhood conduct disorder. Nursing centers on safety, clear consistent limits and a united team.

A neurodevelopmental disorder of inattention and/or hyperactivity-impulsivity that begins in childhood and often persists into adulthood, where inattention, disorganization and impulsivity usually outlast hyperactivity. Stimulants are the mainstay of treatment and carry a boxed warning for abuse, misuse and addiction; they are Schedule II, raise blood pressure and heart rate, and commonly cause poor appetite and insomnia. Atomoxetine is a non-controlled alternative. Psychotherapy, coaching and treating co-occurring conditions round out care.