Depression disorder

post has two assignments

Marguerite Duras’s The Lover.

Order Description

How does the narrator form her identity, as a European in Asia? How does her special perspective as an expatriate allow her to see Europeans? Does psychoanalytic theory illuminate her inner life?

2: Depression disorder

Order Description

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act.” (“What Is Depression?”, 2017). “Depression comes from the late Latin word depressare and the classical Latin word deprimere. Deprimere literally means “press down”; de translates into “down” and premere translates into “to press.”” (Kanter, Busch, Weeks, & Landes, 2008). Depression is very common and can occur at any age. Having a family history of depression places the person at a higher risk of developing or having depression.
Signs and symptoms of depression:
• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite — weight loss or gain unrelated to dieting
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide (“What Is Depression?”, 2017).
Assessment:
A thorough evaluation of the patient should be done to include family history and medical history. Mental health screening tools are used to assess depression. Questions are asked and answered relating to the last 2 weeks of the patients’ life. There are many different types of screening tools available.
• Patient Health Questionnaire (PHQ-9) is the most common screening tool to identify depression. It is available in Spanish, as well as in a modified version for adolescents.
• The MacArthur Foundation Initiative on Depression and Primary Care has created a Depression Tool kit is intended to help primary care clinicians recognize and manage depression.
• The Medicare Learning Network “Screening for Depression” Booklet is now available in hard copy format. This booklet is designed to provide education on screening for depression. It includes coverage, coding, billing, and payment information. To access a new or revised product available for order in hard copy format, go to MLN Products and click on “MLN Product Ordering Page” under “Related Links” at the bottom of the web page. (https://www.integration.samhsa.gov/clinical-practice/screening-tools#depression (Links to an external site.)Links to an external site.).
Nursing Interventions:
1. Strengthen coping by exploring with the patient what is causing the feelings of depression
2. Maintain safety by assessing current suicide risk
3. Facilitate sleep by determining the patients past and present sleep patterns

Post 2:
1. WHAT IS DEPRESSION?
The exact pathophysiology of depression is unknown, but there are many theories. It is likely caused by a combination of factors: biochemical factors, genetics, psychological factors and environmental factors. There is a disturbance that occurs in the neurotransmitters and chemicals in the nervous system, especially with the serotonin, norepinephrine and dopamine receptors. Evidence also shows that there is a link with genetics and family history of depression. Stressors, losses, traumas can be triggers of the environmental factor involve. (NCBI, 2012)
2. WHAT ARE THE SIGNS AND SYMPTOMS OF DEPRESSION?
The following symptoms needs to be present continuously for a minimum of 2-week period: Depressed mood, loss of interest or pleasure, significant weight or appetite alteration, insomnia or hyposomnia, psychomotor agitation or retardation, fatigue, loss of energy, feelings of worthlessness, diminished ability to think or concentrate or indecisiveness and suicidal ideation. Depression is more evident in females than males with ratio of 5:2.
3. WHAT CAN YOU AS A NURSE USE TO ASSESS IF YOUR PATIENT IS EXPERIENCING DEPRESSION?
Subjective cues:
1. Verbalization of inability to cope even with day to day activities of daily living.
2. Sleep disturbance
3. Fatigue
4. Abuse of chemical agents: drugs, alcohol.
5. Reports of muscular, emotional tensions.
6. Lack of appetite.
Objective cues:
1. Lack of goal- oriented resolution of behavior or problems.
2. Decrease use of social support.
3. Inability to meet expectations or basic needs.
4. Destructive behavior towards self: Overeating, smoking, drinking, use of illicit drugs, overuse of prescribed/OTC medications. (Nurse-labs, 2017)
Screening test for Depression:
Beck Depression Scale – measures severity of depression. Composed of 21 questions and score of above 11 is likelihood of depression.
Mood Disorder Questionnaire (MDQ) – 5- minute questionnaire that screen for presence of bipolar disease.
Geriatric Depression Scale – Use for geriatric patients.
Cornell Depression Scale – Use with older adults with Dementia. A score above 18 is highly suggestive of depression. A score of 10-17 indicates probable depression and 1 or below 6 indicates absence of depression.
Patient Health Questionnaire (PHQ) – Composed of questions: “In the last weeks have you felt down or depressed? “In the last 2 weeks have you had little interest or pleasure in doing things?”.
4. GIVE 3 NURSING INTERVENTIONS FOR THE PATIENT WITH DEPRESSION.
1. Identify the level of suicide precautions needed. Rationale: A patient with high-risk will require a constant supervision and a safe environment.
2. Identify the patient’s negative thinking thoughts and teach the patient to reframe/or refute negative thinking thoughts. Rationale: Negative thinking thoughts add to feelings of hopelessness and are a part of a depressed person’s faulty thought process. Intervening in this process helps in healthier and more useful outlook in life.
3. Encourage the use of soap, water, toothbrush, shaving equipment, make-up, etc. Rationale: Being clean and well-groomed can temporarily increase self-esteem.

post 3:
Mood Disorder: Depression
Alterations in mood and affect may be seen at any point across the life span. What most Americans think of as depression is major depressive disorder (MDD), also called unipolar depression. MDD is diagnosed when the client experiences either depressed mood or loss of interest most of the day, almost every day, for at least 2 weeks. (Pearson, 2015). It’s not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:
• Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.
• Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.
• Hormones. Changes in the body’s balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or many other conditions.
• Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression. (Mayo,2017)
Depressed mood or dysphoria is the primary feature of major depressive disorder (MDD). Depression may occur only once during your life, but typically people have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:
• Feelings of sadness, tearfulness, emptiness or hopelessness
• Angry outbursts, irritability or frustration
• Loss of interest or pleasure in most or all normal activities
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation or restlessness
• Slowed thinking, speaking or body movements
• Feelings of worthlessness or guilt, fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions and remembering things
• Suicidal ideation
• Unexplained physical problems, such as back pain or headaches
Some Clinical assessment tools are:
• Hamilton Depression Rating Scale (HDRS): is the most widely used interview scale
• Beck Depression Inventory (BDI): is a self-rating scale that is used to screen for depression
• Patient Health Questionnaire (PHQ): is a self-administered tool of 2 (PHQ2) or 9 (PHQ9) items, establishes the clinical diagnosis of depression and can additionally be used over time to track the severity of symptoms over time
• Major Depression Inventory (MDI): is a self-rating scale used for the diagnosis or measurement of depression, according to both DSM-IV major depression and ICD-10 moderate to severe depression criteria
• Center for Epidemiologic Studies Depression Scale (CES-D): is a 20-item self-rating scale that asks people to rate how often during the past week they experienced symptoms associated with depression. A score of 16 or above indicates depression. This scale is useful for a wide age range of populations including older adults
• Zung Self-Rating Depression Scale (SDS): is a 20-item self-administered test published in 1965 with the goal of developing a quick and inclusive self-administered tool. Half of the 20 items are positively worded, and half are negatively worded. This scale has been used in clinical research to monitor treatment or as a screening tool in general practice
• Geriatric Depression Scale (GDS): was specifically developed for use in geriatric populations. The questions elicit only “yes” or “no” responses, making comprehension easier compared with multiple-choice answers
• Cornell Scale for Depression in Dementia (CSDD): is designed for use in elderly patients with underlying cognitive deficits. Because this patient population may give unreliable answers, the CSDD additionally uses information from a patient informant, someone who knows and has frequent contact with the patient, and can include family members or care staff.
As a nurse the first and most important aspect in conducting an assessment is to establish a therapeutic relationship based on mutual trust. Open-ended questions should be asked, and we need to allow adequate time for their response. It is important that we remain nonjudgmental and validate the client’s feelings. Weneed to encourage them to discuss all their feelings.
Some interventions to help a patient suffering from depression are:
Maintaining a therapeutic distance, exhibiting open posture.
Prevent suicide by helping them feel that life is worth living. Listen for cues of suicidal tendencies. Explain to them that a person with suicidal thoughts is not a bad person instead it is just part of the illness. Expressing their thoughts is helpful and that you could do something about it.
Listen to physical complaints and reinstall some behavior modification techniques. Help them find healthy ways to express how they are feeling. Exercising is beneficial to both the mind and can help with the physical pain they are experiencing.

What are some alternative therapies other then antidepressants that can be used to treat depression?

depression