Depression is leading to suicidal tendencies

Depressed people may lose interest in activities that once were pleasurable; experience
loss of appetite or overeating; have problems concentrating, remembering details, or
making decisions; and may contemplate or attempt suicide. Insomnia, excessive sleeping,
fatigue, loss of energy, or aches, pains or digestive problems that are resistant to
treatment may be present. They may feel sad, anxious, empty, hopeless, worried,
helpless, worthless, guilty, irritable, hurt, or restless.

Depression is a loaded word in our culture. Many associate it, however wrongly, with a sign
of weakness and excessive emotion. This is especially true with men. Depressed men are
less likely than women to acknowledge feelings of self-loathing and hopelessness. Instead,
they tend to complain about fatigue, irritability, sleep problems, and loss of interest in
work and hobbies. Other signs and symptoms of depression in men include anger,
aggression, violence, reckless behavior, and substance abuse. Even though depression
rates for women are twice as high as those in men, men are a higher suicide risk,
especially older men.

9 Nanda Nursing Diagnosis for Depression

1. Risk for self-directed violence / Risk for Suicide
2. Ineffective coping
3. Hopelessness
4. Social isolation
5. Imbalanced Nutrition, Less Than Body Requirements
6. Self-care deficit
7. Low self-esteem
8. Ineffective sexuality patterns
9. Spiritual distress

Implement measures to reduce fear and anxiety:

A. orient client to environment, equipment, and routines; explain the purpose
for and operation of a kinetic bed if indicated
B. introduce client to staff who will be participating in care; if possible,
maintain consistency in staff assigned to his/her care
C. assure client that staff members are nearby; respond to call signal as soon
as possible
D. keep door and curtains open as much as possible to reduce feeling of
confinement
E. maintain a calm, supportive, confident manner when interacting with client
F. encourage verbalization of fear and anxiety; provide feedback

G. reinforce physician's explanations and clarify misconceptions client has

about the diagnosis, treatment plan, and prognosis
H. explain all diagnostic tests
I.

provide a calm, restful environment

J. instruct client in relaxation techniques and encourage participation in

diversional activities
K. assist client to identify specific stressors and ways to cope with them
L. initiate social service referral and/or assist client to identify and contact
appropriate community resources if indicated
M. provide information based on current needs of client at a level he/she can
understand; encourage questions and clarification of information provided
N. encourage significant others to project a caring, concerned attitude
without obvious anxiousness
O. include significant others in orientation and teaching sessions and
encourage their continued support of the client
P. administer prescribed antianxiety agents if indicated.

Major depressive disorder is not the occasional down day people ordinarily
experience. Neither is it the chronic depression of persistent depressive
disorder. It is a noticeable change in a persons usual pattern of functioning
that lasts two weeks or more. It is a terrible state of darkness, despair, and
gloom, a debilitating condition in which people feel empty, hopeless, joyless,
enervated, and believe that life is not worth living. When sufferers regain just a
bit of strength, they may use that energy to commit suicide.
With major depressive disorder there is no history of manic behaviors, and the
symptoms cannot be attributed to substance use or a general medical
condition. It is now evident that bereavement and major depression are not
always completely separate. Grief following a loss is a considerable
psychological stressor and may generate a major depressive episode in some
persons.
Gradually, without treatment, episodes of major depression recede and
sufferers return to their former cognitive, emotional, and physical state.
Regrettably, recurrence is high, as is the rate of suicide. In one study, those at

five years in remission were at a 13.2% increased risk for relapse; those 10
years in remission had a 23.2% chance; and those who had gone beyond 10
years were at a 42% greater risk of another episode (Hardeveld, 2013).
Of persons afflicted with major depression, 15% eventually commit suicide. In
the United States, 32,000 persons die by suicide every year, and the lethality
of depression can be elucidated by the fact that suicide is the eighth leading
cause of death (Andrew, 2012).
With appropriate treatment, however, 70%80% of persons with major
depressive disorder can experience a significant reduction in
symptoms (Halverson, 2013).

o clarify the course of diagnoses of depressive disorders, extensions known

as specifiers may be added. These can describe the severity, onset, and
special features of a disorder. The following specifiers apply to both persistent
depressive disorder and major depressive disorder.
Anxious distress includes feeling keyed up or tense, feeling unusually

restless, having difficulty concentrating due to worrying, dreading that

something awful is going to happen, and feeling the possible loss of
control. To have this specified in the diagnosis, at least two of these
symptoms must be present most days.
Mixed features include elevated or expansive mood, inflated self-

esteem or grandiosity, being more talkative or feeling pressure to keep

talking, flight of ideas and racing thoughts, increased energy, increased
or excessive involvement in activities that have high risk for painful
consequences, and a decreased need for sleep.
Melancholic features are lack of pleasure in almost anything, marked

retardation or agitation, greater depression worse in the morning,

excessive or inappropriate guilt, significant weight loss, and early
morning awakening.
Atypical features are unusual symptoms such as hypersomnia,
leaden paralysis (heavy feelings in legs or arms), appetite changes,
significant weight gain, or extreme sensitivity to perceived interpersonal
rejection.