“Globally, an estimated 350 million people of all ages suffer from depression” (WHO, 2016). Major depressive disorder (MDD) is defined as “having a depressed mood or loss of interest in usual activities which have persisted for longer than 2 weeks and is not a result of medication side effects or substance abuse. There is also no history of manic behavior” (Townsend, 2014, p. 381). The Diagnostic and Statistical Manual of Mental Disorders (2013) describes a person must have at least five of the following symptoms to be diagnosed with MDD: • Depressed mood almost all day, everyday • Markedly diminished interest in all or almost all activities most of the day, everyday • Significant weight loss or gain (5% body weight change in a month) • Insomnia or hypersomnia nearly every day • Psychomotor agitation or retardation nearly everyday • Fatigue or loss of energy nearly every day • Feelings of worthlessness or excessive or inappropriate guilt nearly every day • Diminished ability to think or concentrate nearly every day • Recurrent thoughts of death or suicidal ideation …show more content…
Although depression has been related to genetic and environmental factors, research has yet to understand the exact cause.
More specifically, the Centers for Disease Control and Prevention (2016) reports that “49% of those residing in nursing homes have been diagnosed with this mental illness”. Unfortunately, the presence of depression in these facilities has been greatly under-recognized despite the fact almost half of nursing home residents have a diagnosis of depression. Nursing staff have the opportunity to improve those patients’ outcomes which is significant because “the association between depression and quality of life highlights the importance of identifying and treating depression in nursing home residents with and those without dementia” (Gerritsen et al.,
2011). Diagnostic Tools As stated by Prado-Jean et al. (2011) “Depression is often overlooked in elderly nursing home residents because symptoms may be masked or dismissed as an inevitable consequence of aging”. To help identify those clients who may be suffering from depression, it was found that “the use of a diagnostic instrument increased the rate of recognition by 55%” and that “there are several tools with which we can detect depression in an institutional setting to include the Geriatric Depression Scale, the Cornell Scale for Depression in Dementia, and the Dementia Mood Assessment Scale, all of which have been validated in this population” (Prado-Jean et al., 2011). According to Townsend (2014) the Hamilton Depression Rating Scale is commonly used to assess a clients presence and level of depression with certain care considerations to keep in mind including “providing a calm and safe environment for the client, establishing trust between the nurse and client, initiating a one-to-one for risk of suicide if appropriate, evaluating support systems, evaluating medications, obtaining referrals for psych evaluation and counseling, assessing whether the client feels safe in their home (if they have a home), and assessing whether the client has a history of mental illness or substance abuse”. In addition to implementing these interventions, therapeutic communication must also be implemented. The use of therapeutic communication means asking the client to elaborate on specific concerns without asking why questions, but not forcing the client to talk about topics if discomfort to the client is noticeable. Offering to sit with the client, making eye contact, sitting at eye level, and paraphrasing what the client has shared helps show a genuine concern for the client. The clients’ religious or spiritual needs and their perceived level of threat need to be respected and accepted so the client feels safe sharing information (Townsend, 2014). Risk Factors and Prevalence Tiong, Yap, Huat Koh, Phoon Fong, & Luo (2013) explain “The institutionalized elderly people are often at increased risk of developing depressive symptoms that are associated with factors such as old age, poor or lack of social support from family and society, as well as the presence of chronic medical conditions or other debilitating illnesses that limit their functional abilities”. It is important to note the prevalence of depression in the elderly varies depending on living arrangements. Tiong et al. (2013) found, “depression rates are higher among elderly who live in nursing homes as compared to those who stay in community settings”. Elderly persons residing in a nursing home more specifically are at risk for depression related to “pain, functional limitations, visual impairment, stroke, loneliness, lack of social support, negative life events and perceived inadequacy of care” (Tiong et al., 2013) in contrast to risk factors for the elderly in general according to Khouzam (2012) which include: •Female gender. •Social isolation. •Being single, widowed, divorced, or going through marital separation. •Lower socioeconomic status. •Co-occurring psychiatric and or substance abuse disorder. •Co-occurring medical conditions such as coronary heart disease, stroke, and cancer. •The development of uncontrolled or inadequately managed pain. •Insomnia. •Functional impairment due to neurodegenerative disease of the brain such as Parkinson disease or cerebrovascular diseases. •Cognitive impairment due to Alzheimer disease, vascular dementia, and other dementias. •Medications that cause depression. •Ongoing stressful financial, occupational, or interpersonal life events. During their study, Tiong et al. (2013) had discovered there were specific risk factors which were shown to be significant precursors to depression: (1) having a length of stay in the nursing home for more than 2 years; (2) known history of depression prior to admission to the nursing home; (3) pain; and (4) no or lack of social contact. Pain is an especially significant factor according to Tse, Leung, & Ho (2011) because “Pain is often under-treated and is also a neglected problem in long-term care settings, which contributes to the development of depression among the elderly nursing home residents”. Uncontrolled pain has a direct correlation to social isolation from being unable to physically participate in group or solo activities.
Major Depressive Disorder, which is also referred to as Clinical Depression, is a disorder caused when low serotonin levels, that suppress pain perception and are often found in the pineal gland at the center of the brain, promote low levels of norepinephrine, a monoamine neurotransmitter that controls cognitive ability. This disabling disorder interferes with a person’s daily life as it prevents one from performing normal functions, such as eating, sleeping, interacting, or enjoying once pleasurable activities. According to the National Institute of Mental Health, the common symptoms of Major Depressive Disorder are continued feelings of anxiety, worthlessne...
A 38-year-old single woman, Gracie, was referred for treatment of depressed mood. She spoke of being stressed out due to conflicts at work, and took a bunch of unknown pills. She reported feeling a little depressed prior to this event following having ovarian surgery and other glandular medical problems. She appeared mildly anxious and agitated. She is frequently tearful, but says she does not have any significant sleep or appetite disturbance. She does, however, endorse occasional suicidal ideation, but no perceptual disturbances and her thoughts are logical and goal-directed.
Major depressive disorder is a mood disorder characterized by the DSM-5 of depressed mood and markedly diminished interest or pleasure in nearly all activities occurring nearly every day, for most of the day, as indicated by a subjective self-report or an observational report from others. Individuals who have depression also tend to experience significant weight loss, insomnia or hypersomnia, psychomotor agitation, fatigue and loss of energy, feelings of worthlessness or excessive guilt, diminished ability to concentrate, and recurrent thoughts of death. Most people who suffer from depression usually experience major depressive episodes in unipolar major depression, while some others experience both depressive and manic episodes in bipolar
Depression is a serious medical illness that negatively affects how a person conducts him/herself, and the way he/she think. Depression may include anxiety disorders, post-traumatic stress disorders, manic depressions. People with a depressive illness cannot merely ‘pull themselves together’ and get better. About 5% of the population will have some form of a mental illness at some point in their lives. Half of these people will also have a substance abuse
According to the DSM5 major depressive describes a person who is in a depressed mood for most of the day, nearly everyday. The person also has a diminished interest or pleasure in all, or almost all, activities most of the time. There may be significant weight loss or gain as a result of decrease or increase of appetite, respectively. The person may also experience insomnia or hyper insomnia nearly everyday. There may also be a consistent feeling of fatigue or loss of energy. Usually in major depression, there are feelings of worthlessness or inappropriate guilt. It is also common to have a diminished ability to think, concentrate, or experience indecisiveness. All of these symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. (DSM 5, 160-161)
A hospital was encouraged strongly by a husband that his wife mental status warren assessment. Therefore, the woman was hospitalized voluntarily for depression. The husband provided information to the hospital on the women’s current state because the woman has failed to display coherent behavior and effectively communicate with personnel at the time of admission.
Darby, S. Marr, J. Crump, A Scurfield, M (1999) Older People, Nursing & Mental Health. Oxford: Buterworth-Heinemann.
This paper introduces a 35-year-old female who is exhibiting signs of sadness, lack of interest in daily activities and suicidal tendencies. She has no interest in hobbies, which have been very important to her in the past. Her lack of ambition and her suicidal tendencies are causing great concern for her family members. She is also exhibiting signs of hypersomnia, which will put her in dangerous situations if left untreated. The family has great concern about her leaving the hospital at this time, fearing that she may be a danger to herself. A treatment plan and ethical considerations will be discussed.
Depression is an equal opportunity disorder, it can affect any group of people with any background, race, gender, or age. Depression is a sneak thief that slips quietly and gradually into people’s lives - robbing them of their time, and their focus. At first, depression may be undetectable, but in the long run a person could become so weighed down that their life may feel empty and meaningless. Contrary to popular belief, not everyone who commits suicide is depressed, but majority of people who commits suicide do so during a severe depressive episode. There are over 300 million people in the world today who suffer from depression. Depression has affected people for a long as records have been kept. It was first called out by the famous Greek philosopher Hippocrates over 2,400 years ago. Hippocrates called it “melancholia”. Many times we think of depression as one disorder alone, when in fact there are many different types of depression. The different types of depression are major depressive disorder, dysthymic disorder, atypical disorder, adjustment disorder, and depressive personality disorder. All types of depression share at least one common symptom. It is commons from the person who suffers from any form of depression to feel an unshakable sadness, anxious, or empty mood. Major depressive disorder also known as unipolar depression or recurrent depressive disorder is the most severe depressive disorder out of all of the depressive in my estimation. Major depressive disorder is a condition in which affects a person’s family, work or school life, sleeping, eating and general health. It is important to emphasize that we can understand the mechanics of this disorder and how it affects people with major depressive disorder.
Mayo foundation for medical education and research. Depression (major depressive disorder). HONcode, 2014. Web. 1 May 2014. .
Major Depressive Disorder or MDD is a very common clinical condition that affects millions of people every year. According to the Agency for Health Care Policy & Research, “ depression is under diagnosed & untreated by most medical doctors, despite the fact that it can almost always be treated successfully.
The elderly represents a large amount of the population in our society and continues to grow each day. As the population grows, it is important to meet the demands and resolve the challenges that we encounter in regards to the overall quality of health and well-being of the elderly. Mental health of the elderly is a major issue but majority of the time goes unnoticed and untreated by caregivers and loved ones. About 20 percent of adults 55 and older are suffering from some type of mental health disorder, and one in three elderly adults do not receive any type of treatment (The State of Mental Health, 2008). Those suffering from mental illness are hesitant to seek out help or any type of treatment because of the stigma, services and cost for care that then comes with mental health disorders. Mental health issues that affect elderly include dementia, delirium, and psychosis. Some of the most common conditions include anxiety, mood disorders such as depression and bipolar disorder and cognitive impairment such as Alzheimer’s disease. Mental health is essential to the
Acute and chronic alcohol and other drugs (AOD) can provoke, increase, or initiate psychiatric disorders. In some people, psychiatric disorders may not emerge until the abuse of substances. In the brain, there are overlapping areas that are both affected by drug use and mental illnesses. Studies have shown that brain changes stimulating from one may negatively affect another part of the brain or cause susceptibility to something else. In other cases, one part of the brain can be affected by both a psychiatric disorder and AOD. For example: dopamine is a known neurotransmitter that carries messages from one neuron to another. In alcohol/drug abuse, the release of dopamine is disrupted by limiting the brains natural chemical messengers or cause
Mood disorders are the most commonly diagnosed mental illnesses in the United States. Of those, Depression ranks the highest (Bower, n.d.). The rate of depression diagnoses and anti depressant usage amongst American’s, “…has risen nearly 400% since 1988, according to data from the Centers for Disease Control and Prevention (CDC).” (Szalavitz, 2011). One of the principal reasons for this sharp incline is over-diagnosis by physicians. Any general physician can diagnose Major Depressive Disorder (MDD), without the proper psychological training to accurately do so. Lack of proper psychiatric training among primary care physicians is the root cause of over-diagnosis of major depressive disorder.
Mental and behavioural disorders (expressed in disability adjusted life years, or DALY'S) represented 11% of the total disease burden in 1990, and this is likely to rise to 15% by 2020. Five of the 10 leading causes of disability worldwide in 1990 were mental or behavioural disorders. Depression was the fourth largest contributor to the disease burden in 1990 and is expected to rank second after ischaemic heart disease by 2020. It is estimated that one in four people will develop one or more mental or behavioural disorders in their life-time and that one in four families has one member suffering from a mental or behavioural disorder (Murray et al., 1996; WHO,