Submitted By: GROUP 1

Members:
Madrio, Stephanne S.
STUDENT

Uy, Jesamae
STUDENT

Garcia, Nheriza
STUDENT

Sarip, Ahmad M.
STUDENT

Submitted To:
Mr. Sherwin L. Cabanlet
CLASSROOM INSTRUCTOR
I. DEFINITION
 is the oldest and most frequently described
psychiatric illness.
 An illness that involves the body, mood, and
thoughts, that affects the way a person eats
and sleeps, the way one feels about oneself,
and the way one thinks about things.

II. SYMPTOMS
1. Common
a. apathy
b. sadness
c. sleep disturbances
d. hopelessness
e. helplessness
f. worthlessness
g. guilt
h. anger

2. Other
a. Fatigue
b. Thoughts of death
c. Decreased libido
d. Psychomotor agitation
e. Private verbal berating of self
f. Spontaneous crying without apparent cause
g. Dependency
h. Passiveness

III. CATEGORIES
1. Major Depressive Disorder (MDD)
a. Key Features
 at least a 2-week period of maladaptive
functioning that is a clear change from previous
levels of functioning and at least 5 of the following
symptoms must be present during that 2-week
period, 1 of which must be either no. 1 or no. 2.
1. depressed mood
2. anhedonia
3. appetite disturbance with weight change – 5% up
or down
4. sleep disturbance
5. psychomotor disturbance
6. psychomotor disturbance
7. worthlessness or excessive and inappropriate
guilt
8. diminished ability to concentrate or
indecisiveness
9. recurrent thought of death or suicidal ideation

b. Categories
 Atypical Depression
- a mood disturbance of depression that
generally occurs in younger populations and is
expressed by increased appetite or weight
gain, hypersomnia, leaden paralysis, and
extreme sensitivity to interpersonal rejection.
 Melancholic Depression
- a disturbance of depression occurring most
often in elderly persons and may be
misdiagnosed as dementia.
 Postpartum Depression
-a mood disturbance that occurs in the first
30 days after giving birth.
 Psychotic Depression
- a person has delusions and hallucinations in
conjunction with the mood disturbance.
 Seasonal Affective Disorder
- a depression occurring in conjunction with a
seasonal change most often beginning in fall
or winter and remitting in spring.
c. Predisposing Factors
 loss of parents through divorce, separation, or
death
 death of other persons close to the child such
as siblings, grandparents, relatives, or friends
 death of a pet
  move to another neighborhood or town
 academic problems or failure
 physical illness or injury that might require
hospitalization and/ or prolonged treatment.

Note: The occurrence of depression in children

and adolescents can be even more devastating
than in adults. The onset of childhood
depression predisposes a child to develop
recurrent adult depression.

2. Dysthymic Disorder
 is diagnosed when a person has a depressed
mood for at least 2 years and when 3 other criteria
for depression are met.
a. Objective Signs
 Alteration in activity
 Altered social interactions
b. Subjective Symptoms
 Alteration of affect
a. anger
b. anxiety
c. apathy
d. bitterness
e. dejection
f. denial of feelings
g. despondency
h. guilt
i. hopelessness
j. helplessness
k. uselessness
l. loneliness
m. low self-esteem
n. sadness
o. sense of worthlessness

 Alteration of cognition
a. ambivalence and indecision
 b. inability to concentrate
c. confusion
d. loss of interest and motivation
e. pessimism
f. self-blame
g. self-depreciation
h. self-destructive thoughts
i. thoughts of death and dying
j. uncertainty

 Alterations of a physical nature

a.abdominal pain
b. anorexia
c. chest pain
d. constipation
e. dizziness
f. fatigue
g. headache
h. indigestion
i. insomnia
j. menstrual changes
k. nausea and vomiting
l. sexual dysfunction

3. Depressive Disorder Not Otherwise Specified

IV. ETIOLOGY
1. Biological Theories
 attributed to alterations in neurochemical, genetic,
endocrine, and circadian rhythm functions.
a. depression may be genetic based and the
heredity may predispose persons to develop
depression
b. circadian rhythm functions may be caused by
medications, nutritional deficiencies, physical or
psychological illnesses, hormonal fluctuations
associated with women’s reproductive system,
and / or aging

2. Psychological Theories
 a. psychoanalytic theorists have contended that
depression occurs as a result of a person’s ego
loss in relationship to early life occurrences.
b. Cognitive theorists have contended that
depression results when a person perceives all
stressful situations as being negative
c. Some researchers have indicated that when a
person has interpersonal difficulties coping with
individuals, life event, and life changes, it can be
inordinately stressful and can lead to depression.
Categories:
d. Debilitating Early Life Experience
e. Intrapsychic Conflicts
f. Reaction to Life Events
3. Sociological Theories
a. Medical Model – supports the idea that
depression is a disease that can be treated
through medical interventions such as
medications, nutritional therapy, and
electroconvulsive shock treatment.
b. Social Learning Model – indicates that depression
occurs when a person learns, through repetitive
experiences, to cope with stress in a negative
manner.
c. Stress Model – contended that the development
of depression is related to the interactions of a
person’s experiences, perceptions, social
support, biopsychosocial weaknesses, and
occurrences of stress.
d. Antipsychiatric Model – supports the premise that
depression is a person’s normal adaptive
response to cope with aversive socioeconomic
and political situations.

V. PSYCHOTHERAPEUTIC MANAGEMENT
1. Nurse-Patient Relationship
a. accepts clients as they are is the most effective
approach to bolster self-esteem and help them
focus on the positive accomplishments and good
points.
b. Build trust
 c. Be sincere and empathetic
d. Point out even small visible accomplishments and
strength
e. Recognize but not resent the tendency in
depressed persons to become dependent and
reward even small decisions and independent
actions.
f. Do not attempt to “embarrass” clients out of
being depressed because this could only add to
the patient’s guilt
g. Never reinforce hallucinations, delusions, or
irrational beliefs
h. Encourage verbal expression of anger to release
client’s tension
i. Spend time with withdrawn clients even without
speaking
j. Provide decision-making opportunities as clients
are able to comply

2. Millieu Management
• For clients with low self-esteem
a. encourage client to participate in activities in
which he will be able to experience
accomplishment and receive positive feedback.
b. Provide assertiveness training
c. Help patient to avoid embarrassing himself
through socially unacceptable appearance or
behavior

• For patients who are withdrawn

a. keep frequent but brief contacts with
withdrawn clients
b. just sit with the patient in silence for a
short while

• For anorectic patients

a. encourage the patient to eat and may spoon-feed
if required
b. allow patient to participate in selecting preferred
foods from the menu
 c. provide small frequent meals and record intake
d. provide adequate fiber content diet and monitor
and record bowel elimination to prevent
constipation, a side-effect of antidepressants and
depression
e. allow patient to eat foods brought from home

• For patients with sleep disturbance

d. record the amount and quality of patient’s actual
sleep
e. give TCA in a single bedtime dose to decrease
daytime sedation
f. eliminate daytime napping and drinking
stimulants such as coffee and cola to increase the
likelihood of nighttime sleep
g. restrict access to their rooms and provide them
with adequate rest for at least 6-8 hours per
night.

VI. PROGNOSIS
In the vast majority of cases, the prognosis for
depression is good. Of course, this is true only when someone
is in treatment for depression. Untreated depression usually
doesn't go away by itself, and often gets worse with time. And
remember, untreated depression can be terminal, since it is
the leading cause, by far, of suicide. Depression is a very
serious illness which demands treatment--but those who take
the difficult step of getting treated for it, will usually recover.