What is Depression- Classification & Nursing Management

What is Depression- Classification & Nursing Management


Depression Introduction

  • 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

  1. Sadness of mood
  2. Decreased psychomotor activity
  3. Poverty of ideas
  1. 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
  • Divorce
  • 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

  1. 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.
  1. 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.
  1. Stupor depression

  • 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.
What is Depression- Classification & Nursing Management
What is Depression- Classification & Nursing Management

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

Depression Drugs:-

    • Antipsychotic drugs
    • Anti-depressant
  • Selective serotonin reuptake inhibitors (SSRIs) – Fluoxetine, Citalopram
  • Tricyclic antidepressants (TCAs)
      • Imipramine
      • Clomipramine
      • Amitriptyline
  • 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.

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