Question

2)   Describe the symptoms associated with mild depression. What interventions would the nurse implement when evaluating/caring for a client with mild depression. List interventions in priority order (highest priority to lowest).

Answer 1

According to the American Psychiatric Association (APA), the symptoms of mild or moderate depression are similar to those of severe depression but less intense.

A person with mild depression may experience:

• feelings of sadness
• a loss of appetite
• sleeping problems
• reduced energy levels
• difficulties concentrating.

Other common symptoms include:

• irritability and agitation
• feeling unusually tired
• feeling hopeless
• feeling guilty or worthless
• feeling unmotivated
• wanting to be left alone
• having unexplained, minor aches and pains
• losing empathy with others
• moving or talking slowly
• changes in the use of tobacco, alcohol, or drugs
• changes relating to work or study
• daytime sleepiness and fatigue

Many people with mild depression can manage these distressing symptoms, but they may have a minor effect on their social and work life. Mild symptoms can also occur between relapses or as warning signs of more severe depression.

Early intervention can help prevent more serious complications from arising.

Goals for nursing a person experiencing mild depression:

• Develop a relationship with the person based on empathy and trust.
• Promote the person’s sense of positive self-regard.
• Promote effective coping and problem solving skills in a way that is empowering to the person.
• Promote positive health behaviours, including medication compliance and healthy lifestyle choices (for example diet, exercise, not smoking, limit consumption of alcohol and other substances).
• Promote the person’s engagement with their social and support network.
• Ensure effective collaboration with other relevant service providers through development of effective working relationships and communication.
• Support and promote self care activities for families and carers of the person with depression.

.Intervenions:

• Arrange for a review of the person’s medication for depression and an initial or follow-up psychiatric assessment if their care plan needs reviewing. A mental health assessment may be appropriate to undertake
• Assess whether the person’s helplessness or hopelessness are indicators of suicidal thinking.
• A person’s cultural background can influence the way symptoms of mental illness are expressed or understood. It is essential to take this into account when formulating diagnosis and care plans.
• Encourage the person to talk about how he or she feels and respond with respect. Do not make or agree with any negative comments or behaviours that are self-defeating and gently challenge the person’s negative assumptions by providing alternative perspectives.
• Avoid statements such as ‘Things can’t be that bad’ and ‘Everything will be okay’, as the person might feel that you do not really understand his or her problems. This may make the person unwilling to share other feelings.
• Show empathy and support. However, avoid being overly sympathetic, as the person may feel that you are being condescending
• Encourage the person to carry out self-care, even though it may be easier for a nurse to do these things.
• Encourage the person to participate in purposeful activity and daily routine. Assure the person that the extra effort will be worth it in the long run.
• Point out any improvements in the person’s condition (for example, sleeping and eating patterns), as he or she may be unable to recognise these.
• Reinforce the person’s strengths and positive attributes by encouraging the person to value his or her achievements, relationships and health.
• Encourage the person to increase self-esteem by being more compassionate towards himself or herself (for example, help them to identify small but important goals and ways of celebrating when they are reached).
• Help the person to identify and develop a range of contacts for support and socialisation. This may include helping the person to write a list of friends who could be contacted when extra support is needed or identifying interests that could be expanded upon by joining a group of like minded people (for example, arts groups, sports groups).
• Monitor recovery, compliance with medication and general physical health (including nutrition, weight, blood pressure etc.). Provide education on possible side effects to any medication (if appropriate) and work with the person to develop appropriate actions to address any issues.
• Provide family members and carers with information about the illness, if appropriate, as well as reassure and validate experiences with the person. Encourage family members and carers to look after themselves and seek support if required.