Major Depressive Disorder (MDD)

● Depression, otherwise known as major depressive disorder or clinical depression, is a

common and serious mood disorder

● Those who suffer from depression experience persistent feelings of sadness and hopelessness
and lose interest in activities they once enjoyed. Aside from the emotional problems caused by
depression, individuals can also present with a physical symptom such as chronic pain or
digestive issues. To be diagnosed with depression, symptoms must be present for at least two
weeks.
The specific DSM-5 criteria for major depressive disorder

● Depressed mood: For children and adolescents, this can also be an irritable mood
● Diminished interest or loss of pleasure in almost all activities (anhedonia)
● Significant weight change or appetite disturbance: For children, this can be failure to
achieve expected weight gain
● Sleep disturbance (insomnia or hypersomnia)
● Psychomotor agitation or retardation
● Fatigue or loss of energy
● Feelings of worthlessness
● Diminished ability to think or concentrate; indecisiveness
● Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a
suicide attempt or specific plan for committing suicide

At least 5 of the following symptoms have to have been present during the same 2-week period
(and at least 1 of the symptoms must be diminished interest/pleasure or depressed mood)
TREATMENT : PHAMRACOLOGICAL

SSRIs are the initial antidepressants of choice for uncomplicated

depression because of their minimal anticholinergic effects.

● Zoloft (sertraline)
● Citalopram (celexa)
● Fluoxetine (Prozac)
● Paroxetine (Paxil, Pexeva)
● Vilazodone (vybriid)
● Escitalopram (Lexapro)
Nursing Interventions :

●Interact with the client in a slow-paced, low, and firm tone.

●Encourage him to verbalize his feelings, thinking, worries etc. using broad, leading statements
or open-ended questions.
●Maintain a therapeutic distance, exhibiting open posture.
●Do not hurry the client when interacting, instead be patient and show a sense of empathy.
●When the client is able to regain his energy to do tasks, encourage him to do personal hygiene,
and encourage him that feeling good often starts when you also care about oneself.
●Be calm and supportive when the client shows irritability or expresses anger. Clarify for
statements of blame and help him understand that being irate sometimes makes other people
shun away; thus you may also encourage the need for re-establishing relationships with loved
ones.
More nursing interventions :

● Listen to physical complaints and reinstall some behavior modification techniques.

●Appraise his strengths and recognize an activity accomplished, this way you could help him
improve his feelings about himself.
●Attend to his spiritual needs, too. If needed, ask the assistance of a clergyman or priest.
●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.
Citations :
● Jerry L Halverson. Depression Clinical Presentation: History, Physical
Examination, Major Depressive Disorder, Medscape, 7 Sept. 2020,
emedicine.medscape.com/article/286759-clinical#b4.

● “Depression Medications: Antidepressants Drugs for

Depression Treatment.” WebMD, WebMD,
www.webmd.com/depression/guide/depression-medication
s-antidepressants.

● https://rnspeak.com/depression-
nursing-interventions/