Depression

1. Define Depression.

2. Outline the causes and predisposing factors to depression

3. Outline 5 clinical features of major depression

4. Discuss the difference between endogenous depression and exogenous depression

5. Discuss the medical management of a patient with major depression using the following headings

   1. aims

   2. Investigations

   3. Drug therapy

      1. state the name, dose and route, Mechanism of action, side effects, and Nursing implications.

6. Discuss the nursing management under the following headings

   1. Environment

   2. Maintaining safety

   3. Building a therapeutic relationship

   4. Psychotherapy

   5. Cognitive behavioral Therapy

   6. Social Therapy

   7. Assertiveness training

   8. Group therapy

   9. Family therapy

   10. IEC

7. Identify 5 nursing problems and using a table format discuss the care of a patient

8. Outline 5 complications of MDD.

Definition of Depression:

Depression is a common and serious mood disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in daily activities. It affects how a person feels, thinks, and behaves, and can lead to various emotional and physical problems. Depression interferes with one’s ability to function in day-to-day life.

Causes and Predisposing Factors to Depression:

1. Biological Causes:

   • Genetic factors: Family history of depression increases the likelihood of developing the disorder.

   • Neurotransmitter imbalance: Reduced levels of neurotransmitters like serotonin, dopamine, and norepinephrine.

   • Hormonal changes: Conditions such as pregnancy, menopause, thyroid problems, or other hormonal shifts can contribute.

   • Medical conditions: Chronic illnesses like diabetes, cancer, and cardiovascular diseases are associated with depression.

2. Psychological Causes:

   • Trauma and stress: Life events like the loss of a loved one, financial difficulties, or relationship problems.

   • Childhood experiences: Abuse, neglect, or unresolved conflicts from childhood can predispose individuals to depression.

   • Negative thinking patterns: Constant negative or critical self-talk can lead to low self-esteem and depression.

3. Environmental and Social Causes:

   • Substance abuse: Prolonged use of alcohol or drugs can contribute to depressive symptoms.

   • Social isolation: Loneliness or lack of social support may trigger depression.

   • Economic hardship: Financial difficulties or unemployment can increase the risk of depression.

5 Clinical Features of Major Depression:

1. Depressed Mood: Persistent sadness, emptiness, or hopelessness that is present most of the day, nearly every day.

2. Anhedonia: Loss of interest or pleasure in most, if not all, activities, even those once enjoyed.

3. Fatigue or Loss of Energy: Constant feelings of tiredness and reduced energy, making daily tasks overwhelming.

4. Sleep Disturbances: Insomnia or hypersomnia (excessive sleeping), often without feeling rested.

5. Impaired Concentration: Difficulty focusing, thinking clearly, or making decisions.

Difference Between Endogenous Depression and Exogenous Depression:

• • The cause of Endogenous depression is Primarily biological or internal While Exogenous Depression is Triggered by external life events or environmental factors, such as the death of a loved one, financial issues, or a traumatic experience.

  • The onset of Endogenous depression is without an identifiable external trigger while that of Exogenous depression follows a specific external event or stressor.

  • the signs and symptoms for endogenous depresion are Persistent feelings of sadness and despair without clear cause while that of exogenous depression Symptoms are often related to or follow a stressful life event.

  • Endogenous depression is more responsive to medication, particularly antidepressants while Exogenous depression May respond better to psychotherapy or counselling, alongside medication. 

  •  In Endogenous Depression Mood disturbances are typically consistent and less tied to external circumstances while in Exogenous Depression Mood fluctuations are often tied to ongoing stress or life events.