Depression

What causes Depression?

Family History

Having a family members who has
depression may increase a persons risk
Imbalances of certain chemicals in the brain
may lead to depression
Major Life Changes

Positive or negative events can trigger
depression. Examples include the death
of a loved one or a promotion.
Major Illnesses such as heart attack,
stroke or cancer may trigger depression.
Certain medications used alone or in
combination can cause side effects much
like the symptoms of depression.
Use of Alcohol or other Drugs can lead to
or worsen depression.
Depression can also occur for no apparent
reason!
Symptoms of Depression
Vary from person to person

2 key signs are loss of interest in things
you like to do and sadness or irritability
Additional Signs include:
Changes in feelings which may include:
Feeling empty
Inability to enjoy anything
Hopelessness
Loss of sexual desire
Loss of warm feelings for family or friends
Feelings of self blame or guilt
Loss of self esteem
Inexplicable crying spells, sadness or irritability
Changes in behavior and attitude
These may include:
General slowing down
Neglect of responsibilities and appearance
Poor memory
Inability to concentrate
Suicidal thoughts, feelings or behaviors
Difficulty making decisions

Physical Complaints
These may include:
Sleep disturbances such as early morning
waking, sleeping too much or insomnia
Lack of energy
Loss of appetite
Weight loss or gain
Unexplained headaches or backaches
Stomachaches, indigestion or changes in bowl
habits
Different Types of Depression


1- Major Depression: A Major Problem

you may feel and see symptoms of extreme sadness, hopelessness,
lack of energy, irritability, trouble concentrating, changes in sleep
or eating habits, feelings of guilt, physical pain, and thoughts of
death or suicide







2- Dysthymia

is a type of depression that causes a low mood over a long
period of time perhaps for a year or more,. Symptoms include
sadness, trouble concentrating, fatigue, and changes in sleep
habits and appetite.
3- Postpartum Depression:

is characterized by feelings of extreme sadness, fatigue,
loneliness, hopelessness, suicidal thoughts, fears about
hurting the baby, and feelings of disconnect from the child.
It can occur anywhere from weeks to months after
childbirth
4- Atypical Depression: A Misunderstood Form of Depression

This type of depression is less well understood than major depression Unlike major
depression, a common sign of atypical depression is a sense of heaviness in the
arms and legs like a form of paralysis.


5- Seasonal Affective Disorder: Extreme Winter Weariness

you could be one of 4 to 6 percent of people in the United States
estimated to have seasonal affective disorder, or SAD. Though
many people find themselves in winter funks, SAD is
characterized by symptoms of anxiety, increased irritability,
daytime fatigue, and weight gain. This form of depression
typically occurs in winter climates, likely due to the lessening of
natural sunlight. "We don't really know why some people are
more sensitive to this reduction in light


6- Psychotic Depression: Losing Touch With Reality

Psychosis a mental state characterize by false beliefs, known
as delusions, or false sights or sounds, known as hallucinations
doesnt typically get associated with depression. But about 10
to 15 percent of people with depression have episodes so
severe that they see or hear things that are not really there.
"People with this psychotic depression may become catatonic,
not speak, or not leave their bed,




7- Bipolar Disorder: From High to Low (and Back to High
Again)
If your periods of extreme lows are followed by periods of
extreme highs, you could have bipolar disorder(which is also
sometimes called manic depressive disorder, as symptoms can
alternate between depression and mania).
8- Premenstrual Dysphoric Disorder: When
Depression Strikes Once a Month
Premenstrual dysphoric disorder, or PMDD, is a type
of depression that affects women during the second
half of their menstrual cycles. Symptoms include
depression, anxiety, and mood swings. Unlike
premenstrual syndrome (PMS)



9- Situational Depression: When Life Gets You
Down
Also called adjustment disorder ,situational
depression is triggered by a stressful or life-
changing event, such as job loss, the death of a
loved one, trauma even a bad breakup.

Nursing Care Plan
for Depression

Scenario
A 50 year old female in admitted to your floor with suicide attempt. The
patient was found trying to jump off her 50 foot balcony outside her
apartment. The patients neighbor was able to prevent her from doing
this and EMS was called immediately. According to the patients history,
the patient lost her husband, two sons, and dog in a car accident 6
months ago while they were coming back from a hunting trip. The
patient was apparently unable to go with her family on this hunting
trip because she was sick with the flu. On assessment, the patient
reports inability to sleep at night and constant episodes of crying spells.
She states that her whole family is gone and that she is not able to cope
with this tragedy. She states she has also lost her job because she
couldnt drag herself out of bed. She report feelings of social isolation,
inability to deal with stress and think clearly. She reports that she wants
to get out of this dark place of her life and have things go back to the
way they were but feels like this will never happen without help. The
patient agrees with you to a verbal contract of safety and that she will
not try to hurt herself again. She states that it was her first suicide
attempt ever.
Nursing Diagnosis:
Ineffective individual coping related to situational crisis as evidence by
verbalization of inability to cope, reported life stress, and alteration in social
participation.
Goal to prevent crisis or suicide
Subjective Data
On assessment, the patient reports inability to sleep at night and constant
episodes of crying spells. She states that her whole family is gone and that
she is not able to cope with this tragedy. She states she has also lost her job
because she couldnt drag herself out of bed. She report feelings of social
isolation, inability to deal with stress and think clearly. She reports that she
wants to get out of this dark place of her life and have things go back to the
way they were but feels like this will never happen without help. She states
that it was her first suicide attempt ever.
Objective Data
A 50 year old female in admitted to your floor with suicide attempt. The
patient was found trying to jump off her 50 foot balcony outside her
apartment. The patients neighbor was able to prevent her from doing this and
EMS was called immediately. According to the patients history, the patient
lost her husband, two sons, and dog in a car accident 6 months ago while they
were coming back from a hunting trip. The patient agrees with you to a verbal
contract of safety and that she will not try to hurt herself again.
Nursing Outcomes

Pt will remain safe without any self harm during
hospitalization.-By discharge the patient will report an
increase in sense of control over her current situation.
-Pt will verbalize 2 people she can talk to when she needs
emotional assistance.
-The patient will report decrease crying spells and ability
to sleep better at night.
-The patient will verbalize 3 coping techinques to help her
get her life back on track
.

Nursing Interventions:
The nurses will assess every shift the patients mental status regarding suicidal
thoughts.
-The nurse will give the patient opportunities to make decisions about
her hospitalization and treatment plan.
-The nurse will discuss with the patient about how set-up a network of people
she can talk to during emotional times.
-The nurse will encourage the patient to verbalize feelings, perceptions, and
fears of her current situation.
-The nurse will discuss with the patient 3 coping techniques she can use to help
her feel more control over her current situation.

The therapy for patients with
depression
( antiderpressed drug)
possibly
electroconvulsive
therapy

communication with
patients with
depression

Professional treatment is
necessary for all these types of
depression.
Treatment for Depression
Medication
Antidepressants can help ease the symptoms of
depression and return a person to normal
functioning. Antidepressants are not habit
forming.

Psychotherapy
This can help many depressed people
understand themselves and cope with their
problems. For example:
Interpersonal therapy works to change
relationships that affect depression
Cognitive-behavioral therapy helps people
change negative thinking and behavior
patterns
If you or someone you know has
symptoms of depression


Take Action!
See a doctor for a complete check up.

Go to the counseling center and talk to a
counselor.
Talk things over with a friend, family
member or a residential life staff member.

Dont expect too much of yourself
Take a break
Get some exercise
Avoid extra stress and big changes
Things to do
Reduce or eliminate the use of alcohol or
drugs
Exercise or engage in some form of physical
activity
Eat a proper, well-balanced diet
Obtain an adequate amount of sleep
Seek emotional support from family and
friends
Focus on positive aspects of your life
Pace yourself, modify your schedule, and
set realistic goals
Things to Avoid
Dont make long-term commitments or important
decisions unless necessary
Dont assume things are hopeless
Dont engage in emotional reasoning (i.e.: because
I feel awful, my life is terrible)
Dont assume responsibility for events which are
outside of your control
Dont avoid treatment as a way of coping
Intervening with a depressed friend
Be empathetic and understanding
Dont try to cheer up a depressed person
Avoid critical or shaming statements
Challenge expressions of hopelessness
Empathize with feelings of sadness, grief,
anger and frustration

Dont argue about how bad things are
Dont insist that depression or sadness are the
wrong feelings to be experiencing
Dont become angry even though your efforts
may be resisted or rejected

Helping a depressed friend
Helping a depressed friend

Advocate for their recovery from
depression
Emphasize that depression is treatable
Seek consultation
Encourage them to seek help, go with them
to the counseling center
Be supportive of counselor or doctor
suggestions