depression

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Understanding Depression
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What causes Depression?

• Family History
• Having family members who have depression may
  increase a persons risk
• Deficiencies of certain chemicals in the brain
  may lead to depression

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Predisposing Factors R/T Depression

• Biological theories
• Genetics Hereditary factor may be involved
• Biochemical influencesDeficiency of
  norepinephrine, serotonin, and dopamine has
  been implicated

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Predisposing Factors (Depression)

• Physiological influences
• Medication side effects
• Neurological disorders
• Electrolyte disturbances
• Hormonal disorders
• Nutritional deficiencies

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Electrolytes

• low levels of sodium, potassium and magnesium,
  and high levels of calcium, are linked to
  depressive episodes.

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Nutritional

• A notable feature of the diets of patients
  suffering from mental disorders is the severity
  of deficiency in essential vitamins, minerals,
  and omega-3 fatty acids.
• Studies have indicated that daily supplements of
  vital nutrients are often effective in reducing
  patients' symptoms

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• Major Life Changes
• Negative or particularly stressful events can
  trigger depression. Examples include the death of
  a loved one or a job change.
• Major Illnesses such as heart attack, stroke or
  cancer may trigger depression.

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• Certain medications used alone or in combination
  can cause side effects much like the symptoms of
  depression.
• Use of Alcohol or other Drugs can lead to or
  worsen depression.
• Depression can also occur for no apparent reason
  at all!

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Symptoms of Depression

• Vary from person to person
• 2 key signs are loss of interest in things you
  like to do, and pervasive sadness or irritability

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Additional Signs include

• Changes in feelings such as
• Feeling empty
• Inability to enjoy anything
• Hopelessness
• Loss of sexual desire
• Loss of warm feelings for family or friends
• Feelings of self blame or guilt
• Loss of self esteem
• Inexplicable crying spells, sadness or
  irritability

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Changes in behavior and attitude

• These may include
• General slowing down
• Neglect of responsibilities and appearance
• Poor memory
• Inability to concentrate
• Suicidal thoughts and feelings
• Difficulty making decisions

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Physical Complaints

• These may include
• Sleep disturbances such as insomnia, early
  morning waking, or sleeping too much
• Lack of energy
• Loss of appetite
• Weight loss or gain
• Unexplained headaches or backaches
• Stomachaches, indigestion or changes in bowl
  habits

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Common Types of Depression

• Major Depression
• Dysthymia
• Bipolar Disorder
• Seasonal Affective Disorder (SAD)

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Major Depression

• This type causes symptoms that may
• Begin suddenly, possibly triggered by a loss,
  crisis or stressful change
• Interfere with normal functioning
• Continue for months or years
• It is possible for a person to have only one
  episode of major depression. However, It is more
  common for episodes to be long lasting or to
  recur several times during a persons life

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Dysthymia

• People with this illness may be consistently and
  mildly depressed for years. They function fairly
  well on a daily basis, but their relationships
  and self esteem suffer over time.

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Bipolar Disorder (A.K.A. Manic-Depression)

• People with this type of illness change back and
  forth between periods of depression and periods
  of mania (an extreme high, sometimes with
  agitation or irritability).
• Symptoms of mania may include
• Less need for sleep
• Overconfidence
• Racing thoughts
• Reckless behavior
• Increased energy
• Mood changes are often gradual, but can be sudden

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Season Affective Disorder

• This is depression that coincides with changes in
  the season. Most cases begin in the fall or
  winter, when there is a decrease in sunlight
• (more common in regions
• farther north)
• Less often, depression
• can occur in late Spring
• or summer

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• Professional treatment is helpful for all these
  types of depression.

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Psychotherapy

• Counseling can help many depressed people
  understand, accept and feel better about
  themselves. People also learn more effective
  ways of coping with lifes adversities and
  difficulties. For example
• Interpersonal therapy works to change how people
  how to accept self and relate to others that
  affects mood and self-worth.
• Cognitive Behavior therapy helps people change
  negative thinking, behavior patterns and
  attitudes that affect self esteem and overall
  sense of well being.

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Medical Treatment for Depression

• Medication
• Antidepressants are an option (most often for
  more severe cases) that can help ease the
  symptoms of depression and return a person to a
  better level of functioning. Medication is often
  crucial for cases of bipolar (typically a mood
  stabilizer).
• Antidepressants are
• not habit forming and
• generally have minimal
• side effects.

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• See a medical doctor for a complete check up.
  Some medical problems, such as an
  under-functioning thyroid,
• can cause depression.
• Go to the counseling center and talk with a
  professional counselor.
• Talk things over with an under-
• standing friend, family member
• or student services staff.

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• Dont expect too much of yourself until your
  energy and mood improve
• Take a break
• Get some exercise
• Avoid extra stress and big changes

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Things to do

• Reduce or eliminate the use of alcohol or drugs
• Exercise or engage in some form of physical
  activity
• Eat a proper, well-balanced diet
• Establish a regular sleep
• pattern

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• Obtain an adequate and consistent amount of
  sleepnot too much, nor too little
• Seek emotional support from family and friends
• Focus on meaningful, positive aspects of your
  life
• Pace yourself, modify your schedule, and set
  small, realistic goals
• Remember, depression is
• a temporary difficulty, not
• a reflection of your whole
• life or self worth.

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Things to Avoid

• Dont make long-term commitments or important
  decisions unless necessary while you are feeling
  down
• Dont assume things are hopeless
• Dont engage in emotional reasoning (i.e.
  because I feel awful, my life is terrible)
• Dont assume responsibility for events which are
  outside of your control
• Dont avoid treatment-take some action to cope
• Dont be critical of yourself avoid critical
  others

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Dealing with a depressed friend

• Be empathic and understanding
• Dont try to cheer up a depressed personit can
  feel minimizing. Simply ask if there is anything
  you can do to helpthe answer will often be no,
  but the support will be felt.
• Avoid critical or shaming statements
• Challenge expressions of hopelessness
• Empathize with feelings of sadness, grief, anger
  and frustration (other feelings will come in time)

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Helping a depressed friend

• Dont argue about how bad things are or are not
• Dont insist that depression or sadness is not
  warranted for their situation
• Dont react with anger even though your efforts
  to help may be resisted or rejected

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Helping a depressed friend

• Advocate for their recovery
• convey hope
• Emphasize that depression is very treatable
• Seek consultation (professional counselors from
  the counseling center are always glad to
  consultby phone or in person).
• Encourage your friend to seek help offer to go
  with them to the counseling center
• Be supportive of counselor or other doctor
  suggestions

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Diagnosis

• Risk for suicide related to
• Depressed mood
• Feelings of worthlessness
• Anger turned inward on the self
• Misinterpretations of reality

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Outcomes/Goals

• The client will
• Sets realistic goals for self within 2 weeks past
  admission
• no longer be afraid to attempt new activities
  within 2 weeks past admission
• Be able to identify aspects of self control over
  life situation within 2 weeks past admission

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Planning/Implementation

• Nursing Interventions are aimed at
• Maintaining client safety
• Assisting client through grief process
• Promoting increase in self-esteem
• Encouraging client self-control and control over
  life situation
• Helping client to reach out for spiritual
  support of choice

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Treatment Modalities

• Individual Psychotherapy
• Group Therapy
• Family Therapy
• Cognitive Behavior Therapy
• Electroconvulsive Therapy
• Psychopharmacology