Depressive Disorders Across the Life Span

• Mild to moderate depression – characterized by depression and moderate functional impairment. Some people recover from the short

term, but 50 percent have recurrent symptoms.

• Severe depression – characterized by agitation or psychomotor retardation with profound neurovegetative (biological) symptoms (sleep,

concentration, appetite, and energy disturbances).

• Psychotic depression – characterized by depression or delusions and hallucinations.

Adulthood

Major depressive disorders include: a period of 2 weeks during which there is depressed mood or loss of interest in things that were

once pleasurable (anhedonia) and the following:

• Alterations in appetite and weight

• Sleep disturbances, usually insomnia

• Psychomotor retardation or agitation

• Fatigue

• Concentration disturbances – forgetfulness, memory difficulties, difficulty making decisions

• Feelings of worthlessness, inadequacy, guilt

• Recurrent thoughts of death or suicidal ideations, plans or attempts.

Anhedonia, or a loss of interest or pleasure, is usually present and the client feels apathetic or has little interest in hobbies or other

pleasant activities. Family

Members often report that the client is socially isolative and shows less interest in sexual activity or desire. All in all, the level of impairment

produced by MDD varies. Some clients may experience significant impairment and have difficulty performing normal daily responsibilities, whereas

others may not. Atypical depressive symptoms are more common in adults and may include increased appetite, weight gain, or increased sleep and

cravings for high carbohydrate foods.

The depressed client may feel worthless and question the nurse’s interest in knowing about present symptoms, preferences, and other

assessment data. Nurses need to use empathy and patience to establish a therapeutic relationship. In addition, a thorough examination must be

performed to rule out medical and mental conditions. Gathering information about the mood changes during the woman’s menstrual cycle and

postpartum and menopause offer important information about hormonal influences.