Question

Depression, or major depressive disorder is the leading cause of disability in patients 15-44. It negatively affects the way you think, the way you feel and the way you act towards society. Some symptoms of depression includes feeling sad, trouble sleeping, changes in appetite, feeling worthless and suicidal thoughts. As nurses, its important understand how depression affects the mind and it's reason for onset. " Distinguishing between grief and depression is important and can assist people in getting the help, support or treatment they need." (Torres, 2020). Although, I've never personally treated someone with depression I understand that there are many ways treatment for these patients can go array. Psychotherapy combined with medication suits most depressed patients best, this allows them to decipher their problems and come up with ways to mediate them. Just providing medication without therapy can be one reason a treatment plan is unsuccessful.

Some nursing interventions that could be helpful are encouraging the client to express their feelings, this allows the nurse to further understand their patient and allows the client to deal with overwhelming emotions. Antidepressant are prescribed to patients to help modify brain chemistry, they include SSRI's, TCA's and MAOI's. Overall, I believe that patients who only receive medication without some sort of therapy are not safe, they are a great risk for harming themselves because the medication may promote energy before affecting the mood. Referring patients to a psychiatrist will be in the best interest for the patient.

Respond to the above post  and explain in 5 paragraph if you agree or disagree with how they would handle a client who was having those symptoms. If you do not agree with the post, please provide how they could have approached the client differently.

Answer 1

MANAGEMENT OF DEPRESSION

DEPRESSION ;

Depression is a mental health disorder characterised by persistently depressed mood or loss of interest in activities , causing significant impairement in daily life . The possible causes of depression include a combination of biological , psychological and social sources of distress .

I agree with the given post . I believe that patients who only receive medication without some sort of therapy are not safe . Referring the patients to psychiatrist , providing various kinds of therapies along with some nursing interventions are the best way to treat depressive patients .

COGNITIVE - BEHAVIOURAL THERAPY .

Cognitive therapy and behavioural therapy work well together to help depression and anxiety disorders , the two are often combined in an approach called cognitive - behavioural therapy ( CBT ) . It focuses on addressing both the negative thought patterns and the behaviours that contribute to depression .CBT sessions are often accompanied by homework , which include ; keeping a journal ,practicing relaxation activities and complete reading .

PSYCHODYNAMIC THERAPY

It is also known as psychoanalytic therapy .This therapy assumes that depression can occur because of unresolved - usually unconscious- conflicts , often originating from childhood . The main goal of the therapy is ;  to make the patient more aware of their full range of emotions , including contradictory and troubled ones , and help the patient more effectively bear these feelings and put them in a more useful perspective .

INTERPERSONAL THERAPY

Poor social support and Interpersonal conflict are also contribute to depression . It is a type of therapy which focuses on these issues by addressing past and present social roles and interpersonal interactions . This therapy involves examining social relationships with important people in your life .This can include parents , relationship with partners ,friends , family and co-workers . The therapist will ask you to role - play different scenarios inorder to practice and improve communication . By doing this , the patient will be able to implement these strategies in the relationships and build a stronger social support system .

PSYCHOTHERAPY

It can be delivered in a number of different ways

• Individual therapy
• Family therapy
• Group therapy
• Couple therapy   

DIALECTICAL BEHAVIOUR THERAPY

It is a type of cognitive behaviour therapy . The goal is to teach people with depression the skills to cope with stress , regulate emotions , and improve relationships with others . This therapy incorporates mindfullness practices and the use of crisis coaching , in which the individual can call the therapist to receive guidance on how to handle difficult situations .

NURSING INTERVENTIONS FOR DEPRESSION .

1. Assess the client for physical symptoms of depression

• Clients appearance may show disheveled hair and clothes in low tone colors .
• Posture may be stooped and facial expression may be dull .
• Note how the patient respond verbally .
• Observe for any physical complaints like constipation , anorexia , headache , sleep disturbances.

​​​​​​​2 . Conceptualize your goals with the client

• Acceptance and awareness of self - promoting positive concept of self.
• Personal hygiene .
• Verbal expression of feelings .
• Realistic resolution of problems

3 . Maintain a therapeutic distance , exhibiting open posture .

4 . Do not hurry the patient when interacting , instead be patient and show a sense of empathy .

5 . Depression can disrupt sleeping patterns .Some points to restore a regular sleep pattern ;

• Try to go to sleep and get up at the same time each day .
• Avoid drinking caffeine after 4pm
• Avoid using alcohol to help you sleep .
• Give your mind a break from online activity such as social media for an hour before bedtime

6 . Tips to control worry and reduce negative thinking

• try not to focus on the things you cannot change .
• Focus on the present . Accept your thoughts without actively engaging with them .
• Avoid making major decisions about your life at this time.

7 . Prevent suicide by helping the patient feel that life is worth living . Make yourself available for him to confide and listen for cues of suicidal tendencies . Explain to him that a person with suicidal thoughts is not a bad person instead it is just part of the  illness .

In connection , depression nursing inteventions should be planned accordingly which must go hand in hand with psychotherapy and medical treatments . Since in depression , the person may react to perceive loss with intense feelings of reduced self- esteem or cofidence , and the client views himself negatively , various consderations should be made .