Nursing Diagnosis for Depression

Nursing Diagnosis for Depression: Overview and Prognosis of Depression

Overview of Depression | Nursing Diagnosis for Depression

Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and physical well-being.


Depressed people may feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, or restless. They may lose interest in activities that once were pleasurable; experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions; and may contemplate or attempt suicide. Insomnia, excessive sleeping, fatigue, loss of energy, or aches, pains or digestive problems that are resistant to treatment may be present. (Wikipedia.org)

Patients with depression have a persistent sense of sadness, more days than not, often associated with somatic complaints. The medical work-ups for varied physical complaints will be negative. Patients typically have a loss of interest in normal activities and alterations in sleep and eating habits. Up to one-third of patients will seek care from primary care providers. Patients can also present as unkempt, dirty, withdrawn, and unwilling to engage in conversation. They see life as a state of hopelessness. The patient’s depression must be treated seriously, since it can lead to suicide. A patient’s request for help might be his or her last recourse.

Several different theories exist involving the cause of depression. Genetic factors may lead to changes in the normal functioning of neurotransmitters. Neurotransmitters are released from one side of a synapse and land on a specific receptor site on the other side of the synapse. When a balance is maintained between the amount released and the amount needed to fill the receptor sites, normal function continues. When there is an imbalance, the neurotransmission is altered. Developmental factors can often be traced back to childhood. Personality disorders may begin during school age or adolescence. Psychosocial stressors are another factor linked to the development of depression. Major life changes such as the death of a family member, unemployment, or moving away from family and friends may lead to the onset of depression. A sense of sadness or grief is considered a normal response to this type of loss and should resolve as the person progresses through the normal stages of grieving. Depression, however, is not a normal response to loss.

A grieving person will have a sustained sense of self-esteem, whereas a person with depression will have a sense of worthlessness.

Prognosis of Depression | Nursing Diagnosis for Depression

Proper treatment can help control the symptoms of depression. Adequate treatment can cause remission of symptoms. It is not unusual for there to be a recurrence of symptoms at some point in the future, even with appropriate treatment.

Signs and Symptoms of Depression | Nursing Diagnosis for Depression

• Intense feeling of sadness


• Depressed mood


• Anhedonia (loss of interest in usual activities)


• Hopelessness or worthlessness


• Difficulty concentrating


• Indecision


• Changes in sleep (more or less than usual), eating (more or less than usual), and activity (more or less than usual)


• Social withdrawal and isolation


• Decreased libido


• Thoughts of death


• Physical complaints include headache, malaise, decreased libido, and changes in sleep, activity, and eating

Interpreting Test Result of Depression| Nursing Diagnosis for Depression

• Diagnostic testing results normal, unless co-existing disease present.

Nursing Diagnosis for Depression: Treatment of Depression

Treatment of Depression | Nursing Diagnosis for Depression

• Ask patient about suicidal thoughts.


• Ask patient about suicidal plan.


• Psychotherapy.


• Cognitive-behavioral therapy.


• Support groups.


• Antidepressant medications: SSRIs, venlafaxine, nefazodone, bupropion, mirtazapine, tricyclics, monoamine oxidase inhibitors.


• Electroconvulsant therapy (ECT) in refractory cases.

Nursing Diagnosis for Depression and Nursing Interventions

Most Common Nursing Diagnosis for Depression

• Hopelessness


• Risk for suicide


• Dysfunctional grieving


• Impaired social interaction


• Social isolation


• Disturbed self-esteem

Nursing Interventions for Depression

• Monitor patient frequently when first admitted.


• One-to-one observation if patient is a suicidal risk.


• Develop a level of sensitivity and trust with the patient.


• Ask patient about suicidal ideation; do they have a plan, have they attempted to carry out a plan.


• Monitor medication intake.


• Discuss patient response to therapy.


• Monitor vital signs; watch for elevation in blood pressure with some medications.


• Monitor weight; some medications are associated with changes in weight.


• Monitor sleep; ask patient about restful sleep during the night, and difficulty falling asleep.

Other resources for nursing diagnosis for Depression:

• www.ncbi.nlm.nih.gov

This is a sample of psychiatric nursing diagnosis (nursing diagnosis for Depression).