Major depressive disorder

Pathophysiology

Medication

Nursing interventions

Medical interventions

Pertinent assessment findings

Nursing considerations

Patient education

When major depressive episodes repeat themselves for more than 2 years, depressive disorder is diagnosed. They can occur in response to situations, events, and developmental tasks. They are often seen in combination with other mental health problems. Severe, prolonged depression results in many physical changes and increase's ones risk for illness.

Patient finds no pleasure in any activity or social interaction

Suffers form suicidal ideations

Decline in mental or physical health

Psychotherapies- Cognitive behavioral therapy is used to help clients identify and correct self-defeating thoughts that may lead to depression. Interpersonal therapy assists clients with relationships and interactions.

Electroconvulsive therapy- Introduction of a controlled grand mal seizure by passing an electrical current through the brain. Works by raising the levels of norepinephrine.

Reduce symptoms and inappropriate behaviors

To prevent relapses into depressing emotional states

To prevent recurrences

To provide patient safety

Pharmacological treatment

Tricyclic antidepressants

Transcranial direct current stimulation- Uses a mild electrical current to stimulate the brain. Studies have shown encouraging results with improvement in depression, attention, and memory.

MAO inhibitors

SSRI's

SNRI's

Mood stabilizing drugs

Institute suicide precautions

Encourage frequent oral car

Monitor food and fluid intake

Teach relaxation techniques

Encourage patient to discuss thoughts and feeling

Teach patient to report eye pain immediately

Teach importance of adequate food and fluid intake

Encourage a high fiber diet to combat constipation

Teach client to rise and chage position slowly

Monitor vitals

Monitor for psychosis, seizures, and hypoactivity