The document discusses depression as a mental disorder. It defines depression and lists its objectives which are to define depression, identify its etiology, describe types of depression, and explain its diagnostic features. It discusses the biological, psychological, and social theories of depression's etiology. It describes the main types of depression - major depressive disorder, persistent depressive disorder (dysthymia), and premenstrual dysphoric disorder - and provides their diagnostic criteria.

1. DEPRESSION
Group 9

2. GROUP MEMBERS
Sallome Nyauti
Cecelia Bulaimu
Zawadi Lungu
Maria Mwanyali
Tabitha Nkhoma
Malizani P. Pangani
Joseph Wyson
Fortune Kazembe

3. Broad objective
To equip fellow students with the knowledge about depression
as a mental disorder

4. OBJECTIVES
By the end of this presentation, students should be able to:
 Define depression
 Identify the etiology of depression
 Describe the types of depression
 Explain the diagnostic features of depression

5. INTRODUCTION
- Depression is a common mental state characterized by sadness,
loss of interest or pleasure, feelings of guilt or low self-worth,
disturbed sleep or appetite, low energy, and poor concentration
(World Health Organization [WHO],2010).
- Depression is one of the mood disorders also known as unipolar.
- It is characterized by severe and debilitating depressive episodes. It
is associated with high levels of impairment in occupational, social
and physical functioning and can cause much disability and distress
to patients as chronic disorders.

7. ETIOLOGY OF DEPRESSION
The etiology is described in theories which include;
1. Biological theories
2. Psychological theories
3. Social theories

8. BIOLOGICAL THEORIES
Genetics: Mostly first- degree biologic relatives.
Neurobiological: deficiency or dysregulation in concentration of
neurotransmitters such as dopamine.
Neuroendocrine: elevated levels of serum cortisol and decreased
levels of thyroid stimulating hormone have been associated with
depression in some individuals.

9. PSYCHOLOGICAL THEORIES
Psychodynamic factors: early lack of love, care, warmth, and protection and
resultant anger, guilt, helplessness, and fear regarding loss of love.
Behavior factors: severe reduction in rewarding activities or an increase in
unpleasant events in ones life.
Cognitive factors: irrational believes and negative distortions of thought
about the self, environment and the future engender and perpetuate
depressive effects.
Developmental factors: loss of parents through death or separation or lack of
emotionally adequate parenting leading to delay or prohibition from
realization of appropriate developmental milestones.

10. SOCIAL THEORIES
Family factors: maladaptive patterns in family interactions such
as ambivalent, abusive, rejecting, or highly dependent family
relationships.
Social factors: social isolation, and financial deprivation.

11. SIGNS AND SYMPTOMS OF DEPRESSION
• Lack of sleep
• Disturbance in elimination, digestion, breathing
• Loss of appetite
• Decreased self esteem
• Social withdrawal
• Feelings of worthlessness
• Fatigue
• Unintentional weight loss
• Lack of interest in life

12. TYPES OF DEPRESSION
Depressive disorders are the same but the difference lies in the
duration and the severity of the symptoms .
1. MAJOR DEPRESSIVE DISORDER
- It is characterized by depressed mood or loss of interest or pleasure
in usual activities.
- Impaired social and occupational functioning that has existed for at
least 2 weeks, no history of manic behavior, and symptoms that can
not be attributed to the use of substances or general medical
condition.
- The presence of anxiety and severity of suicide risk.

13. Cont…
NB:The diagnosis of major depressive disorder(MDD) is specified
whether it is a single episode (individuals first encounter to
major depressive disorder) or recurrent episode (individuals has
history of previous major depressive disorder).
- The diagnosis will also identify the degree of severity of
symptoms (mild ,moderate ,severe) .

14. 2. PERSISTENT DEPRESSIVE DISORDER
(DYSTHYMIA)
- Characterized by chronic depressive syndrome that is usually
present for most of the day ,more days for at least 2 years (APA
2000)
- The depressive mood disturbance because of its nature cannot
be distinguished from the persons usual pattern of functioning
(APA 2000)
- The diagnosis is identified as early onset before the age of 21
years or late onset at the age of 21 years or older.

15. DIAGNOSITIC CRITERIA FOR PERSISTENCE
DEPRESSIVE DISORDER
• Fatigue or loss of energy
• Low self esteem
• Difficulty making decisions or poor concentration
• Hopelessness feelings
• Depressed mood for most of the day as indicated by either
subjective account or observation by others for at least 2 years
• Poor appetite or overeating
• Insomnia or hypersomnia

16. 3. PREMENSTRUAL DYSPHORIC
DISORDER
- The essential features of premenstrual disorder include
markedly depressed mood, excessive anxiety, mood swings and
decreased interest in activities during the week prior to menses,
improving shortly after the onset of menstruation, and
becoming minimal on absent in week post menses (APA,2013).

17. DIAGNOSTIC CRITERIA FOR
PREMENSTUAL DISORDER
- In the majority of menstrual cycles, at least five symptoms must be
present in the final week before the onset of menses.
one or more of the following symptoms must be present:
• Marked affective liability (e.g. mood swings; feeling suddenly sad or
tearful or increased sensitivity to injection).
• Marked irritability or anger or increased interpersonal conflicts.
• Marked depressed mood, feeling of hopelessness or self-
deprecating thoughts
.

19. REFERENCES
Mary, T. C. (2011). Nursing diagnosis in psychiatric Nursing (8
ed.). Philadelphia: F.A. Davis Company.
Mary, T. C. (2015). Psychiatric Nursing Assessment, Care Plans
and Medications (9 ed.). Philadelphia: F. A. Davis Company.
Sheila, V. L. (2011). Psychiatric-Mental health Nursing (5 ed.).
Philadelphia: Wolters Kluwer Health| Lippincott Williams &
Wilkins.
https://www.who.int/mental_health/management/depression/
who_paper_depression_wfmh_2010.pdf
https://www.apa.org/topics/depression