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1. 5

2. INTRODUCATION
• The word ‘Depression’ was introduced by
Hippocrates.
• It is derived from the latin word ‘Deprimere’
Pressure down

3. DEFINITION
“ Affective mood disorder charectrized by
sadness of mood, poverty of ideas,
Psychomotor retardation.”
“ If the mood is sad without any cause or it
remains sad for a long time we call it as
depression.”

4. CLASSIFICATION (ICD 10)
• F 32 Depressive episode
• F 32.O Mild depression
• F 32.1 Moderate depression
• F 32.2 Severe depressive episode without psychotic symptoms
• F 32.3 Severe depression with psychotic symptoms
• F32.8 Other depressive episodes Atypical depression.
• F32.9 Unspecified
• F 33 Recurrent depressive disorder.

5. ETIOLOGICAL FACTORS
• Biological factors
- Neurochemical changes(serotonin level decres)
- dopamine
- Nor-epineprin
• Biochemical Influence
• Neuroendocrine distrubance
• Medication side effects
• Electrolyte distrubance
• Hormonal distrubance
• Nutritional deficiencies
• Socio economic therory & Cognitive theory

6. CLINICAL MANIFESTATION
 Deprressed mood
 Sucidal thoghts
 Poverty of idea
 Guilt
 Insomia
 Tieardness
 Difficulties in thinking and concentartion
 Poor memory
 Menstrural or sexual distrubance
 Fatigue

7. DIAGNOSIS
 History collection
 Mental status examination
 Psychological Test
 Toxicology “Screening suggesting drug
induce depression”
 ICD 10 CRITERIA

8. TREATMENT
 PHARMACOLOGY:
- Tricylic Antidepressants(TCAs)
Imipramin
Amtiptyline
Clomipramin
- Dopaminegic antideppressants
Fluvoxamine
- Atypical Antidepressants
Amineptine

9. PHYSICAL THERAPY
• 1. Electroconvulsive therapy- severe
depression with suicidal risk is the most
important indication for E.C.T.
• 2. light therapy- involves exposing the
patient to artificial light source during
winter months to relieve seasonal
depression.

10. PSYCHOSOCIAL TREATMENT
• Cognitive therapy
• Psycho therapy
• Supportive therapy
• Familiy therapy

11. NURSING DIAGNOSIS
• Nursing diagnosis 1/
• Dysfunctional grieving related to real or perceived
loss, bereavement, evidenced by denial of loss,
inappropriate expression of ,anger, inability to carry
out activities with grieving.
• OBJECTIVE - Patient will be able to verbalize normal
behaviours associated with grieving.

12. • Nursing diagnosis – powerlessness related to
dysfunctional grieving process, life –style of
helplessness, evidenced by feeling of lack of
control over the situation, over dependence
on others to fulfill needs .
• Objective : the patient will be able to take
control of life situation.

13. • Nursing diagnosis -3/
• self esteem disturbance related to learned
helplessness, impaired cognition, negative view of
self, evidenced by expression of worthlessness
,sensitivity to criticism, negative and pessimistic
outlook.
• OBJECTIVE patient will be able to verbalize positive
aspects, self and attempt new activities without ear
of failure

14. • Nursing diagnosis 4/
• Altered communication process related to
depressive cognition, evidence by being
unable to interact with other, withdrawn,
expressing fear failure or rejection.
• OBJECTIVE - patient will communicate or
interact with staff or other patients in the
unit.

15. • NURSING DIAGNOSIS-- 5
• Altered sleep nd rest, related to depressed mood
and depressive cognition evidenced by difficulty in
falling asleep, early morning awakening, verbal
complaints of not feeling well rested.
•
• OBJECTIVE – Patient will sleep adequately during
the night

16. • NURSING DIAGNOSIS --6/
• Altered nutrition ,less than body requirements
related to depressed mood, lack of appetite or lack
of interest in food,evidenced by weight loss, poor
muscle tone, pale conjunctiva,poor skin turgor.
• OBJECTIVE – Patient’s nutritional status will
improve.

17. NURSING DIAGNOSIS – 7 /
Self care deficit related to depressed mood, feeling of
worthlessness, evidenced by poor personal hygiene.
OBJECTIVE – patient will maintain adequate personal hygiene
NURSING DIAGNOSIS – 8/
high risk of self directed violence related to depressed mood,
feeling of worthlessness and anger directed inward on the self.
OBJECTIVE - Patient will not harm self.