- Depression is the most common and widespread mental health problem affecting people.
- Depression is an affective mental health disorder characterized by the sadness of mood, Poverty of ideas, and psychomotor retardation.
- Depression is among the leading cause of disability worldwide.
- Rapid cyclic depression onset more than 4 episodes in a year.
- Chronic depression is also known as Dysthymia.
Incidence of Depression
- Depression is higher in females than males (2:1)
- Depression is commonly occurred in middle age group after 35 years.
Tried feature of depression
- Sadness of mood
- Decreased psychomotor activity
- Poverty of ideas
- Depression is associated with a variety of medical conditions
Classification of depression
- F32 – Depressive episode
- F32.0 – Mild depression episode
- F32.1 – Moderate depression episode
- F32.2 – Severe depression episode without psychotic symptoms
- F32.3 – Severe depression episode with psychotic symptoms
- F32.8 – Other depression episodes.
- F32.9 – Depression episodes unspecific.
Causes of depression
Biological cause Of Depression–
Decrease serotonin and epinephrine neurotransmitter level. Increased the cortisol level.
Psychological Cause Of Depression
- Death of loving one
- Unable to achieve desired goal
- Failure in exam
- Failure in love and breakup.
- Loss of love.
Social cause Of Depression
- Family disputes and broken family
- Social status.
Endocrine Cause Of Depression
- Thyroid and hormonal abnormalities
- System malfunction.
Behavioral cause Of Depression
- Losses in the past
- Extra thinking abnormality.
- Genetic cause
- Change in brain anatomy
Stages and clinical features of depression
Mild depression –
Mild depression is also known as chronic, Persistent depression
Mild Depression Symptoms-
- Apathy (Absence of emotion)
- Patient helpless and lack of confidence
- The sadness of mood (Despair)
- Loss of interest and social withdrawal.
- Highly sensitive criticism by other
- Reduce energy level.
Severe depression (Acute onset)
Severe Depression Symptoms
- A vermouth sign – is a physical sign in which a triangular shape is formed at the corner of nose, near upper eyelid.
- Omega sign – Omega sign on the forehead of the patient.
- SWAG sign
- S –Suicidal tendency
- W – Weight loss
- A – Anhedonia
- G – Guilt
- Delusion of worthless.
- Hopelessness and suicidal ideas
- Death of thoughts.
- The decreased minimum level of activity
- Waxy flexibility
- Auditory hallucination
- Delusion of nihilism
- Loss of appetite and insomnia
- Reduced sexual desire
- Delusion of Nihilism – Patient false believe nothing is existence in world like power, money, beauty.
Diagnosis of Depression
- History collection
- Hamilton rating scale – Used in depression, Assess severity and prognosis of depression
- Identify depression based on sign and symptoms
- Based on ICD-10 criteria
- Dexamethasone suppression test.
Management Of Depression
- Electroconvulsive therapy (ECT) is the effective management in severe depression.
- Cognitive behavior therapy is 1st Priority in all therapy.
- Other therapy
- Light therapy,
- Repetitive transcranial magnetic stimulation and vagus nerve stimulation.
- Group therapy
- Family therapy
- Supportive psychotherapy and behavior
- Antipsychotic drugs
- Selective serotonin reuptake inhibitors (SSRIs) – Fluoxetine, Citalopram
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors – Phenelzine
- Close observation
Nursing management of Depression
- Nurse should maintain the nurse-patient relationship.
- Nurse encourage the patient to identify social support and develop relationship.
- Nurse encourage to patient for share the thinking with trusting relationship.
- Nurse asses for homicidal and suicidal ideation.
- Nurse should provide the safety from suicidal action.
- Nurse encourage them to patient to participate in activities of daily living.
- Nurse provide the stimulating environment.
- Begin one to one activity with the client.
- Maintain the routine bathing, dressing, grooming and personal hygine.
- Nurse do not allow patient to sleep for long periods.
- Help the patient identify positive aspects about himself.
- Identify the patient like and dislike related to food.
- Administer the medication as prescribed.
- Spend time with the client to convey the client’s worth and value.
QnA of Depression
Most common severe psychiatric disorder in the world – Depression
A most common symptom of psychiatric disorder – Anxiety
Chronic depression is known as Dysthymia
Which age group peoples are commonly affected with depression – Middle age group (35 -50 Years)
Biological cause of depression – Decreased serotonin and increased cortisol level.
Chronic, Persistent depression is seen at – Forehead
Most common symptom in severe depression – Suicidal tendency.
Which hallucination occur in depression patient – Auditory hallucination.
Most common treatment of a severe depressive patient – ECT Therapy
Nurse should use which therapy in a priority in depression patients – CBT
A Depressive patient response is MY WIFE BECOME HAPPY AFTER ME nursing priority is – Close observation to patient.