Depression Stress/ Anxiety/Fear Mental illness Psychological Problems Mentally Disturb Psychiatric Nursing

1. DEPRESSIVE DISORDER
DR. RAHUL SHARMA
ASSOCIATE PROFESSOR
H.O.D. OF MENTAL HEALTH NURSING
PH. D COORDINATOR
SEEDLING SCHOOL OF NURSING,
JAIPUR NATIONAL UNIVERSITY, JAIPUR

3. INTRODUCTION
 It is a widespread mental health problem affecting many people .
 The lifetime risk of depression in male is 08-12% and in female it is 20-26%.
 Depression occur twice in female in comparison to male.
 The highest incidence of depressive symptoms has been indicated in individual without close
interpersonal relationship and in person who are divorced or separated or widow.
 Prevalence of suicide show large peak in spring season and less in October.
 Major depressive disorder often co-occur with other psychiatric disorder and alcoholic or
substance related disorder.

4. ETIOLOGY
 Biological factors
1. NEUROTRANSMITTER
-: Decreased norepinephrine and serotonin level
-: Deregulation of Acetylcholine and GABA
2. GENETIC
-: When 1 twin is diagnosed with major depression, the other twin has
a greater than 70% chances of developing it.
3. ENDOCRINAL FACTORS
-: Pituitary of adrenal system malfunction and hormonal
abnormalities.

5. Psychosocial factors
 Loss of loved one or any valuable objects.
BEHAVIORAL FACTOR
Experience of uncontrollable events
Example - a fight
COGNITIVE FACTORS
Self negative thoughts.
Depression due to negative cognition
Negative exceptions of environment ( Example - flood,fights,stealing)
Negative expectations of self
Negative expectations of future.

6. SOCIOLOGICAL FACTOR
Stressful life events
Example- death, marriage

7. CLINICAL MANIFESTATION
 Sadness of mood
 Loss of interest
 Loss of pleasure
 Hopelessness
 Worthlessness
 A feeling of inferiority
 Suicidal thought
 Anxiety
 Restlessness
 Spiritual thinking, walk and eat slowly
 Feeling of uneasiness

9. Diagnostic evaluation
 Psychological test for depression to access
severity of depression
 Family history
 according to ICD 10 Criteria

10. TREATMENT
 Pharmacotherapy
Major category of depressant are
1. Selective serotonin re-take inhibitions
2. Citalopram
3. Serialize
4. Tricyclic
ANTIDEPRESSANTS
 Amitriptyline
 Clomipramine
 Imipramine
 Doxepine

11. Mono amino oxidase inhibitors
 Isocarboxazid
 Phenelzine
 Other anti depressant are:-
 Buproprin
 Maprotiline

12. PSYCHOSOCIAL THEORIES
 Cognitive therapy
 Supportive theory
 Family therapy
 Group theory
 Behavioral therapy