Nursing Diagnosis for Depression (A brief guide)

Nursing Diagnosis for Depression

In this guide, we will discuss nursing diagnosis for depression.

Nursing Diagnosis for Depression: What does it mean?

Nursing diagnosis for depression is a description that indicates potential problems a patient faces where a nurse will provide diagnose and treat their symptoms (or health problems), in this case, related to depression. 

Depression involves or compromises both mental and physical health and this makes the nursing diagnosis for depression is very important in a patient’s life. This is considered the most common mental health condition in this era due to the kind of lifestyle we have. Someone with depression will always be in a constant state of hopelessness and anxiety, with some feelings of restlessness and self-doubt.

Nursing Diagnosis for Depression (A brief guide)

Sometimes, determining the reason why someone is depressed or suffers from depression is very difficult and certainly requires treatment and a proper approach. Some of the most common symptoms and signs include:

  • Social withdrawal, for instance, removing themselves from meetings with friends or family members or simply avoiding going in the first place.
  • Experiencing a long and prolonged feeling of deep sadness and anxiety.
  • Eating habits can change either eating too much or refusing to eat at all. 
  • They seem distracted or inattentive in their day to day activities.  
  • Having suicidal thoughts and/or behaviors. 
  • Having health conditions such as frequent headaches or migraines, frequent presentation of anger outbursts and irritability. 

Depression is considered a very serious condition that if left untreated can end in suicide. Some people get early treatment through psychotherapy in combination with medication so symptoms can be addressed and controlled. In a proper nursing diagnosis for depression, a patient has to be treated with patience and empathy. 

It is considered that depression can be divided into different stages where the first stage is the least dangerous while the fifth is considered the most dangerous since it involves the suicidal attempt or an attempt to hurt themselves. 

Nursing Diagnosis for Depression (A brief guide)

According to nandanursingdiagnosislist.org, “The feeling of forlornness and hopelessness are the ones that push a person in this direction and overall efforts from everyone from family to friends to the doctors must be applied to make sure that person doesn’t succumb to this medical condition deeply.”

Things that are needed to follow in order to overcome depression: 

  • Guidance and counseling from an expert is necessary since professionals in mental health are trained to help overcome this condition. They have the skills to listen and talk to patients helping them change their perspective, in some cases providing new hope and courage to face their condition. 
  • Constant support is needed for people with depression, it is important not to leave them alone and always keep them company (especially by a loved one) so they know they are not alone. 
  • When someone shows signs of depression, it is important not to encourage any negative talk or situation in front of them since it will not help them at all, making them feel even less confident. 
  • Invite them to talk about their feelings without forcing them, also, providing a positive word to encourage them or just making sure they know you are there to support them is immensely appreciated. 

As nandanursingdiagnosislist.org indicates, “The most important thing to keep in mind while nursing diagnosis for depression; is the person must not be considered sick and this condition must not be seen as a kind of disease. In a fast-growing competitive environment, people tend to feel alone, neglected and ignored and all these factors and negative thoughts can result and prosper a frame of mind that can bring down the confidence of the person and make them feel like the victims of the situation.”

What is the target population?

Adult patients admitted to the psychiatric unit with a diagnosis of depression.

Nursing Diagnosis for Depression (A brief guide)
  1. Description of the clinical condition

Here, depression is described as an illness within the mood disorders category that causes a persistent feeling of sadness and a loss of interest in activities that the person used to enjoy. This is considered a state in which in normal ranges within acceptable limits and controllable by the subject. The affectivity, a sense or feel as if balance exceeds these limits, in most cases, passes become evident or objectified in the form of various mental disorders.

Epidemiology

“Mood disorders are the most prevalent psychiatric disorders and disabling. Up to 15% of the population are in some point in their life depressive disorder, about 3% dysthymia, and 1% or cyclothymic bipolar disorders. Pathology depression occurs twice in women as in men, but not in bipolar disorders is parallel. Depression is prevalent among the 4th and 5th decade of life. Depression is involved in two-thirds of suicides committed by the elderly whose rate is the highest of any age group.”

Etiology

It is suggested that depression involves a combination of physical, psychological and environmental factors such as:

Biological factors:

– Genetic.

– Somatic (biochemical, metabolic).

Psychosocial Factors:

– Personality traits (vulnerability)

– Life events stressors/triggers

– Psychological stress.

– Lack of social support.

– Chronic frustration, exhaustion, loss of values, discrimination, job failure.

2. Clinical: Signs, Symptoms and determining process

Depression affects several areas such as emotional, physical, social and intellectual. It can be mild, moderate or severe. When depression is severe, persists longer than 2 weeks it is called a depressive episode. Subsequently, there could be a greater number of previous depressive episodes for more than 2 years. Dysthymia is a disorder where depression is moderate that persists for more than 2 years. 

Some of the behaviors related to depression include:

Emotional symptoms:

  • Anxiety (e.g. restlessness)
  • Apathy
  • Abatement
  • Feeling guilty and discouraged
  • Feeling lonely
  • Low self-esteem
  • A profound feeling of Sadness
  • The feeling of lack of self-worth
Nursing Diagnosis for Depression (A brief guide)

Physical symptoms:

  • Eating disorders, where there are weight changes either gaining or losing. 
  • Constipation, Indigestion, Nausea
  • Feeling Fatigued or drained
  • Difficulties sleeping or staying asleep

Cognitive symptoms:

  • Inability to concentrate
  • Loss of interest and motivation towards activities that were enjoyable before
  • Pessimism
  • self Contempt
  • self-defeating thoughts
  • Feelings of Uncertainty

Behavioral symptoms:

  • Self-aggressiveness (Agitation, Irritability, anger outbursts)
  • Altered level of activity
  • Excessive dependence
  • Loss of interest in keeping personal hygiene
  • Social withdrawal/isolation
  • Emotional liability

3. Medical Complications: Signs and symptoms

Complications:

– Aspiration pneumonia

– Intestinal obstruction

4. Nursing assessment

Here it is determined and described if the patient according to nandanursingdiagnosislist.org:

Need Breathing. No alterations in this need.

Need Food – Hydration. Anorexia is characteristic of depressive episodes may be accompanied by dramatic weight loss.

Need Elimination. The autonomic system is altered frequently, bowel habits. This coupled with the medication side effects we can find an altered bowel movement, altered by decreased peristalsis.

Need Activity – Mobility – Rest. Dependence for self-care due to lack of motivation in grade II (food, hygiene, toilet use, grooming). The patient feels lethargic and unwilling to perform activities of daily living. Dream altered: insomnia, circadian rhythm changes and rarely hypersomnia.

Need Perception – Cognition – Development. Distorted perception of himself and events.

Need Emotional State. Inappropriate affect: overreaction to the stimulus. Anxiety

Need Relationship. Inability to express feelings. Self-destructive attitude. Rejection communication (isolation) Alterations in sexuality.

Need Security. Homing violence can file. The physical discomfort tolerance decreases, so trivial annoyances are expressed by the patient as unbearable.

Health Care Needs. Attitude to the disease can be passive and lack of motivation can lead to a dropout. Lack of motivation to maintain health.

Proper medical procedures must be followed in such situations, only the medicines that are prescribed by the doctors must be followed and no lapses in the appointment with the doctors must be allowed. The feeling of sadness is the worst feeling for any person therefore they must be treated with care and attention to encourage effective nursing diagnosis for depression.

Nursing interventions for depression (Sample 2)

 Assess the patient for symptoms of depression

When assessing the patient, the symptoms should not be caused or explained by a medical condition, difficult circumstances, drug abuse or any medication.

Assessment may involve the following aspects according to rnspeaks.com:

  • Description of their appearance and the color of their clothes may indicate symptoms of depression. Additionally, their posture and facial expressions may be dull, with reddened eyes from crying or furrowed brow or worried frown. The client may also be agitated. Note nonverbal behaviors such as avoiding to make eye contact and consistency of mouth smile.
  • Describe how they respond verbally, their pace, tone of voice, etc. The pace of your interaction may be slow since they may lack the interest in the topic or has low motivation to talk to other people.
  • Assess and observe any physical complaints. It is very common that a patient will complain about other related medical conditions such as, constipation, anorexia, headaches and sleep disturbances (which are often related to the emotional symptoms of the condition)
  • Assess and observe their behaviors. Agitation is one of the most common signs or behavioral symptoms. They may also isolate themselves socially due to low self- esteem, has compulsive overeating, drinking or substance abuse, and some people can even engage in frequent fights.
  • And also assess his feelings. A marked apathy, lack of humor and irritability are common.

Goal setting with the client

Help them identify their strengths and what they would like to achieve once they have recovered from depression, this includes:

  • Helping them accept and be aware of the self-promoting of a positive concept of self.
  • Helping them promote personal hygiene
  • Address, express and manage guilt in an appropriate way
  • Set realistic expectations towards problems
  • Resuming of activities as an outlet of unpleasant mood
  • Express their feelings verbally

Provide depression nursing interventions (rnspeaks.com):

  • Talk to the patient in a slow-paced, low and firm tone.
  • Encourage them to express and verbalize his feelings, thoughts, worries, etc. using broad, leading statements or open-ended questions.
  • Maintain a therapeutic distance, exhibiting open posture.
  • Do not hurry or interrupt them, instead be patient and show empathy.
  • When they feel ready and have regained their energy to perform tasks, encourage them to follow personal hygiene routines and encourage the sense of feeling good when they start by caring about themselves. 
  • Remain calm and supportive when they are feeling irritable or express anger. If they make statements of blame, help them understand by clarifying with them that being angry and exploding at people sometimes makes them stay away or keep their distance, so encouraging the need for re-establishing relationships with loved ones is key. 
  •  Listen to any physical complaints they may have and implement some behavior modification techniques.
  • Value their strengths and reinforce those activities that have been accomplished, no matter how small. This can help them improve their self-esteem and how they perceive themselves in a more positive way. 
  • If they have unfulfilled spiritual needs, you can ask for the assistance of a priest or clergyman. 
  • Identify or ask the client what activities may interest him to do. It should be productive and utilizes his restless energy like drawing, etc. It should be non-stimulating and also limiting in some way that it would not affect the client emotionally.
  • Prevent suicide by helping him feel that life is worth living. Make yourself available for him to confide and listen for cues of suicidal tendencies. Explain to him that a person with suicidal thoughts is not a bad person, instead it is just part of the illness. Expressing his thoughts is helpful and that you could do something about it.

Why is this blog post about the nursing diagnosis for depression important?

Knowing how depression can affect someone’s life and identifying the signs and symptoms is key to understanding the condition, preventing suicidal behavior. In addition, early treatment of the symptoms can help improve the quality of life for the person that is suffering from depression. 

The assessment and intervention are key areas to elaborate on an intervention plan in the nursing diagnosis for depression.

Feel free to comment in the comments section below.

Recommended links

References 

Academy.nrsng.com

Nandanursingdiagnosislist.org

Rnspeak.com

Nursing Diagnosis for Depression (A brief guide)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.