Depression is a mental health condition that affects millions of people each year. It can be difficult to diagnose and even more difficult to treat. Nurses are often the first line of defence when it comes to helping people who feel like they need assistance with depression. We will discuss what nurses should look for to identify depression, as well as the treatment options available to educate you as a nursing student.
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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students, for learning purposes only, and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.
Depression is a group of conditions that causes your mood to drop, leading you to have difficulty performing day-to-day activities. A depressed person often feels sad, worthless, and anxious. These people lose interest in activities easily and get significant challenges in terms of their mental health.
- Lack of energy
- Decrease in appetite
- Feelings of guilt and worthlessness
- Difficulty concentrating or remembering things, also known as “brain fog.”
- Restless sleep habits that lead to insomnia or oversleeping (hypersomnia) – Thoughts about death or suicide
- Loss of interest in things, also known as “anhedonia” (pleasureless)
People who have this type of mental health challenges often experience all of the symptoms mentioned earlier. Some risk factors are bouts of crying, insomnia or hypersomnia (sleeping for more than average), and loss of appetite.
People suffering from major depression often have at least one episode lasting two weeks or more. It is characterized by low mood, an inability to generate pleasure in usual activities, feelings of worthlessness or excessive guilt, and problems with concentration. Among the risk factors of this is that the patient may become violent.
Individuals with dysthymia are often known as chronic depressives because their symptoms may be present for at least two years without remission. Unlike major depressive disorder, dysthymia does not involve major depressive episodes.
A major depressive disorder will be diagnosed if the individual has had at least one episode of depression during a particular time of year, such as winter for those in the northern hemisphere. Unlike other forms of severe depression, this type is often treated by adjusting to a person’s natural light cycle.
The individual with unipolar depression will experience the symptoms of major depressive disorder, but only during one side of their mood spectrum. In other words, they may be happy and excited on one end or sad and apathetic on the other extreme. This type is more common in individuals who have a genetic predisposition.
A person with postpartum depression will experience mood swings, anxiety, overeating or eating very little (also known as pica), and trouble sleeping. The individual may also have nightmares about the birthing process or flashbacks of it. Postpartum depression happens in new mothers who are breastfeeding, and at times, it leads to social isolation.
This type of depression is a mood disorder that causes the individual to experience depressive episodes during certain times, such as winter. This usually happens in individuals who live far from the equator and does not have much natural light exposure. The symptoms may include feelings of hopelessness or guilt, changes in sleep patterns, and appetite changes.
- Impaired social interaction
- Self-care deficit (inability to care for oneself)
- Disturbed mood/affect, including anhedonia and loss of libido
- Sleep disturbance (insomnia or hypersomnia)
- Grossly impaired cognitive function or inability to concentrate on tasks
- Lack of interest
- Appetite disturbance (overeating or eating very little)
- Anger and irritability
- Fatigue, feeling low in energy level, or difficulty initiating activities.
- Impaired social interaction: This nursing diagnosis is characterized by the inability to interact with others without becoming angry, depressed, withdrawn, or irritable.
- Self-care deficit (inability to care for oneself): This nursing diagnosis is characterized by difficulties functioning at the most basic level, such as dressing or bathing without becoming angry, depressed, withdrawn, or irritable.
- Disturbed mood/affect, including anhedonia and loss of libido: This nursing diagnosis is characterized by a change in mood or undesirable alteration of psychomotor activity.
- Sleep disturbance, insomnia, or hypersomnia: This nursing diagnosis is characterized by an inability to sleep without becoming angry, depressed, withdrawn, or irritable.
- Impaired cognitive function: This nursing diagnosis is characterized as difficulty concentrating on tasks and remembering information due to depression.
- Lack of interest, loss of libido: This nursing diagnosis is characterized by the lack of desire for sexual activity without becoming angry, depressed, withdrawn, or irritable.
- Appetite disturbance: This nursing diagnosis is characterized as overeating and weight gain or a decreased appetite that leads to malnutrition and fluid imbalance.
- Anger/irritability: This nursing diagnosis is characterized as feeling irritable or angry due to depression.
- Fatigue, low energy level, and difficulty initiating activities: This nursing diagnosis is characterized by having a difficult time getting up in the morning, and moving around throughout the day without becoming angry, depressed, withdrawn, or irritable.
Antidepressant medications are used to treat moderate to severe depression. These medications are also prescribed for bipolar disorder, major depression disorders, and people under the influence of substance abuse.
A referral is often a nursing care plan used as an intervention when other interventions have not been successful in alleviating the symptoms of depression or if suicidal behaviors are present. This therapy aims to provide relief from difficult thoughts, feelings, and physical pain caused by depression.
Nurses should encourage patients to use family and friends as a source of support. This is a nursing care plan that helps patients feel better about themselves and give their loved ones the chance to care for someone who needs it most without feeling burdened by feelings of guilt or shame.
Nurses should encourage patients to share their experiences or feelings with someone to get them off their chest and out into the open. This will give relief from feeling trapped by depression symptoms like social isolation while also getting a fresh perspective on what is happening around them.
Encouraging a patient to participate in social activities can be beneficial for patients with depression. This is because it allows them to interact socially and feel like they are contributing something of value. Such activities can include volunteering, going to church, or even watching a movie with friends.
Nurses should always provide patients with positive reinforcement for their efforts and accomplishments. This will help them feel more empowered and less defeated by depression symptoms, leading to feelings of uselessness. In this way, nurses who are actively engaged in the lives of their patients will be able to provide significant assistance.
Encourage patients to consider changing the environment they are living or working in if it is triggering depression symptoms and interfering with daily life. This might not always be an easy task, but nurses should recommend this as an intervention because it can be a positive change in the life of many patients.
Depressed people often want their privacy and need to feel dignified. In this case, nurses should respect the boundaries they set and not ask too many questions.
This nursing intervention ensures the person is not suffering in silence and that they are receiving proper treatment for their condition. All instructions and advice are given to patients as a means of helping them recover from depression.
Nurses should share their own accounts and experiences with the person so that they can feel less alone in dealing with this mental illness. They may also need to hear about other people’s stories, which could help relieve some of their symptoms and let them know they are not alone.
Nurses should refer patients or family members to websites, books, and pamphlet-type information about depression if they are open to it. This will help them understand what they are feeling better and give insight into treatment options for this mental illness.
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The nurse should evaluate the person’s response to this intervention to see if it has been effective. If not, a new strategy may need to be considered before trying again. The common evaluation mechanisms employed include;
Ask the person how they are feeling. This is intentionally done to understand the current situation of the patient.
Providing a visual analog scale with which to measure depression symptoms or using tools like an SF-36. Such tools help nurses to track the progress of their interventions.
Encouraging the person to keep a journal of their thoughts and feelings. The journal will serve as a guide for the nurse to understand how keen the instructions were followed.
Admitting them into a ward or hospital for further evaluation, when appropriate.
Checking the ability of the patient to assess current situations accurately.
Checking the patterns with which the patient can cope with current life situations at home.
The ability of the patient to meet physiological needs. This will be a demonstration to the nurse that the condition of the patient is improving.
Evaluation of strengths and weaknesses in the person’s support system or any other informal networks they may have access to.
A list of people who can be supportive, for instance, family members, friends, clergy members etc; it is through these people that the nurse will confirm what the patient has been going through regarding the treatment.
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