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Major Depressive Disorder 8-20-20 - Coggle Diagram
Major Depressive Disorder 8-20-20
Pathophysiology
Major depressive disorder is the same as clinical depression with symptoms of persistent feelings of sadness and loss of interest. Major depressive disorder affects feelings and thinking process that can lead to a variety of emotional and physical problems.
o Biological differences. People with depression appear to have physical changes in their brains.
o Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression.
o Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.
o Inherited traits. Depression is more common in people whose blood relatives also have this condition.
Nursing Interventions:
o Provide and assist patient with self-care and personal hygiene. Teach and encourage patient on the importance of maintaining a balanced nutrition.
o Plan activities for times when the patient’s energy level peaks.
o Establish open and active listening communication with the patient.
o Provide patient education about signs, symptoms, interventions, and the effects of depression in daily activities.
o Help patient recognize distorted perceptions and link them to depression.
o Ask patient whether they think about death or suicide and recommend immediate need for consultation if suicide risk is present.
o Recommend community resources, family and support groups.
o Educate the patient on the different type of medications and the effectiveness for depression.
Medication:
• Selective serotonin reuptake inhibitors (SSRIs) are drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd).
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima).
• Atypical antidepressants include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone and vortioxetine (Trintellix).
• Tricyclic antidepressants (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil)
• Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan
• Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects.
Important Assessment:
Physical exam-your doctor may do a physical exam and ask questions about your health.
Lab tests- complete blood test count or test your thyroid to make sure it's functioning properly.
Psychiatric evaluation- a mental health professional asks about your symptoms, thoughts, feelings and behavior patterns, and a questionnaire to help answer these questions.
DSM-5- a mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Behavioral Interventions:
Simplify your life. Cut back on obligations when possible and set reasonable goals for yourself.
Write in a journal. Journaling, as part of your treatment, may improve mood by allowing you to express pain, anger, fear, or other emotions.
Read reputable self-help books and websites
Locate helpful groups. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance, offer education, support groups, counseling, and other resources to help with depression
Do not become isolated. Try to participate in social activities and get together with family or friends regularly.
Learn ways to relax and manage your stress. Include meditation, progressive muscle relaxation, yoga, and tai chi.
Structure your time. Plan your day.
Do not make important decisions when you're down. Avoid decision-making when you are feeling depressed, because of thinking impairments.
Patient Education:
Stick to your treatment plan
Learn about depression.
Pay attention to warning signs.
Avoid alcohol and recreational drugs.