S.No TIME SPECIFIC OBJECTIVE CONTENT MATTER TEACHING LEARNING A.

V EVALUATION
ACTIVITY ACTIVITY AIDS

1. 2. min To introduce Introduction :-Depression is a state Lecture Learning LCD Students got an
depression associated with the affect (mood) of a introduction
person. It is a pathological mood regarding
disturbance characterised by feeling, depression?
attitudes & belief; the person has about
self and his environment.

2. 2 min. To define Definition:-An illness that involves the Explaining Learning LCD Students learnt
depression body, mood and thoughts that affects definition of
the way a person eats, and sleeps, the depression?
way one feels about oneself and the way
one thinks about things.

Depression is a melancholy or sadness

which could last more a half month and
make a significant impact on the normal
activity of a person. It is the loss of
feeling or interest or may be the
inability to do regular activities.

 Hereditary
3. 2 mins To state the  Temperament- cyclothymic Discussion Discussion LCD Students have
etiological factors temperament. (swing of mood elation & an idea
responsible e for dejection) regarding the
depression  Personality – melancholic, etiological
anxious & obsessional personalities factors..
 Season – high in summer
 Age – 25-30 yrs (onset)
40-60 yrs (peak)
 Sex – both sexes
 Precipitation – history of
stressful environmental factors
immediately preceding the onset
 Endocrine, metabolic,
biochemical & electrolyte disturbances
are postulated
  Disturbances of seratonergic and
adrenergic neurotransmitter
 Severe stress
 Socio cultural factors

Explaining Learning LCD Students learnt

To describe the Anxiety in a person the
4. 3 mins psychopathology of psychopatholog
depression y of depression.

Experience severe loss at a early stage of

development

Loss is perceived as rejection

Precipitates anger

Feelings are repressed

Repressed feelings makes the person

guilty, worthlessness & depressed

Stress

Feelings are reactivated and

 manifested as various symptoms of
depression

 Mild depression Lecture Learning Black Students learnt

5. 5 mins To describe the  Moderate depression board the
classification of  Severe depression classification of
depression  Severe with psychotic depression
symptoms

MILD DEPRESSION – symptoms at

mild level of depression are identified
by those associated with normal
grieving.
Affective – denial of feelings, anger and
anxiety, guilt, sadness, hopelessness,
helplessness
Behavioral – tearfulness, withdrawal,
regression, restlessness, agitation
Cognitive – preoccupation with the
loss, self blame, ambivalence and
blaming others
Physiological – anorexia or over eating,
insomnia or hypersomnia, headache,
backache, chest pain.

MODERATE DEPRESSION - represents

more problematic disturbances
Affective – feelings of sadness,
dejection, powerlessness, gloomy,
pessimistic outlook, difficulty in
experiencing pleasure in activities. Lecture Learning LCD
Behavioral – slowed movements,
slumped posture, slowed speech, social
isolation, decreased interest.
Cognitive – retarded thinking process,
difficulty in concentration and
attention, negativism, behaviour
reflecting suicidal ideation.
Physiological – anorexia, over eating,
 insomnia, fatigue, abdominal pain, low
energy. Feeling best in early morning &
continually worse as day progresses

SEVERE DEPRESSION - characterised

by an intensification of the symptom
described for moderate depression.
Affective – feeling of total despair,
emptiness and loneliness
Behavioral – purposeless movements,
sitting in a curled position, no personal
hygiene and grooming.
Cognitive – confusion, indeciveness,
inability to concentrate, self game and
thoughts of suicide
Physiological – sluggish digestion,
constipation, urinary retention,
impotence, weight loss, anorexia.

SEVERE DEPRESSION WITH

PSYCHOTIC SYMPTOMS – patients
have delusions and hallucination along
with other symptoms.

TREATMENT
6. 5 min To discuss the 1. Pharmacotherapy
treatment Anti depressants Discussion Learning LCD Students learnt
- Tricyclic antidepressants (TCAs) the treatment
- Imipramine 75-300 mg/day for depression
- Monoamino reuptake inhibitors
- Amitriptyline 75-300 mg/day
- Fluoxetine 10-80 mg/day
- Seratraline 50-200 mg/day
- Monoamino oxidase inhibitors
( MAO)
- Isocarbonxazed 10-30 mg/day
- Bupropion 150-450 mg/day

MECHANISM OF ACTION
 - TCAs block the reuptake of
norepinephrine or serotonin at the
nerve terminal and increase its
level at the receptor site. 2-3 weeks
will be taken to decrease the
depressive symptoms.
- MAOs degrade the catecholamine
after reuptake and increases brain
amine level. 5-10 days will take to
bring down the symptoms.
- SSRIs act by inhibiting the reuptake
of serotonin and increase s its level
at receptor site.

2. Electro convulsive therapy

3. Psychosocial treatment –
Cognitive therapy- aims at correcting
negative conditions like hopelessness
with new cognitive and behavioral
response.

4. Supportive psycho therapy –

reassurance, occupational therapy,
relaxation

5. Group therapy- negative feeling like

anger are improved through
expression of their feelings.

6. Family therapy

7. Behaviour therapy - social skill

training

To explain nursing NURSING MANAGEMENT

7. 5 min management for Assessment Students learn
depression - Demographic information Explaining Learning LCD the
management of
- Socio economic history depression
- Past medical history
- Present medical history

NURSING DIAGNOSIS
- High risk for violence related to
suicidal tendency
- Alteration in mood pattern related
to reduced self esteem, self concept,
guilty feelings
- Altered attention and concentration
due to thought disturbances
- Altered nutrition, weightloss, due to
irregular eating pattern and
disturbed behaviour pattern
- Alteration in sleep pattern due to
emotional upset, inadequate
adaptation process. Explaining Learning LCD

INTERVENTION
- Provide safe environment
- Remove all potentially harmful
objects
- Administer medication as
prescribed
- Encourage patient to ventilate the
feeling
- Emphasize positive attitude
- Counsel the client, show concern
- Spend more time leisurely with the
patient
- Motivate to perform activities
- Involve family members to provide
support
- Permit the patient to take decision
and perform activities
- Identify the areas of interest
- Clarify the doubts
- Permit the patient to perform
purposeful activities
 - Approach the patient in active
friendly manner
- Be brief in conversation
- Educate the importance of nutrition
- Serve small and frequent feeds
- Never allow the patient to stay
alone
- Accept the patient’s feelings and
make him understand the situation

2 min To summarize Depression is a mood disorder. It may Discussion Discussion LCD Students gained
8. depression be a temporary human emotional knowledge
response to a loss of disappointment regarding
or failure. depression
Depression affects person for months
or even years and involve the body,
mood and thoughts.

Bibliography

1. Basavanthappa. B.T. Psychiatric mental health nursing. 1 st ed. New Delhi: Jaypee publication.2007.p.500-510

2. Dr. Shah.L.P & Mrs.Shah Hema. Anand book of psychiatry. 1 st ed. Mumbai: Vora medical publication.p.60

3. Kapoor Bimla.Textbook of Psychiatry nursing. Vol.2. New Delhi: Kumar publishers. 1994.p.267-268

4. Neeraja K.P.Essentials of mental health and psychiatric nursing.1 st ed. New Delhi:vol 2.JaypeePublication.2008.p.392-

400

5. Prema T.P and Graicy K.F.Principles and practice of psychiatric nuring.1 st ed. New Delhi:2006.Jaypee publication.

p.155-156

6. Sreevani R. A Guide to mental Health & psychiatric nursing .2 nd ed. New Delhi:2007.Jaypee publication.p.95-98
7. Townstend Mary. Psychiatric mental health nursing. 5 th ed. New Delhi: Jaypee Publication. p.835- 837

8. http://:www.depression.com

9. http://:www.typesofdepression.com

Practice TEACHING
Topic – DEPRESSION

SUBJECT – MENTAL HEALTH NURSING

SUMITTED TO:
MR. ABHISHEK. JACOB SIR
HOD (PSYCHIATRY NURSING)
S.C.O.N SUBMITTED
BY:
TINA C
ABRAHAM
MSC NURSING
1ST YEAR
PSYCHIATRIC
NURSING
S.C.O.N