When you're expressing your own feelings, the phrases you use may seem clear and to the point from your perspective, but the person with depression who is on the receiving end may feel attacked, misunderstood, or deeply hurt.

1. MENTAL HEALTH NURSING
• NAME-Mr.Pawas Netawat
• DESIGNATION-Assistant professor
• QULIFICATION-Msc.Nursing
• SPECILIZATION-Medical surgical nursing
(cardio)
• TOPIC- Depression

2. INTRODUCTION
• During the common era, many barbaric and primitive treatments for
depression continued to be the norm. Cornelius Celsus (25 BCE to 50 CE)
reportedly recommended the very harsh treatments of starvation, shackles,
and beating in cases of mental illness. A Persian doctor named Rhazes
(865–925 CE), however, did see mental illness as arising from the brain and
recommended such treatments as baths and a very early form of behavior
therapy which involved positive rewards for appropriate behavior.

3. DEFINITION
• DEPRESSION Common mental disorder that presents with
depressed mood, loss of interest or pleasure, feelings of guilt or
low self- worth, disturbed sleep or appetite, low energy, and poor
concentration.

4. TYPES OF DEPRESSION
• Major depressive disorder : recurrence of long episodes of low
moods or one extended episode that seems to be ‘never-ending.
• Atypical depression –
• Post partum depression –
• Catatonic depression –
• Seasonal affective disorder - Melancholic depression

5. CON…..
• Manic depression (bipolar disorder) Four ‘Episodes’ of Bipolar
Disorder - depressive episode - manic episodes - hypomanic
episode - mixed-mood states
• Dysthymic depression - lasts a long time but involves less severe
symptoms. - lead a normal life, but we may not be functioning well
or feeling good
• Situational depression
• Psychotic depression
• Endogenous depression

6. ETIOLOGY
• Genetic cause
• Environmental factors
• Biochemical factors :Biochemical theory of depression postulates
a deficiency of neurotransmitters in certain areas of the brain
(noradrenaline, serotonin, and dopamine) Dopaminergic activity :
reduced in case of depression, over activity in mania.
• Endocrine factors - hypothyroidism, cushing’s syndrome etc

7. CONT…
• Abuse of Drugs or Alcohol
• Hormone Level Changes
• Physical illness and side effects of medications DRUGS -
Analgesics Antidepressants Antihypertensives • Anticonvulsants •
Benzodiazipine withdrawal • Antipsychotics

8. CONT…
• Viral illness
• Carcinoma
• Neurological disorders
• Thyroid disease
• Multiple sclerosis
• Pernicious anaemia
• Diabetes
• Systemic lupus erythematosus
• Addison’s disease

9. PSYCHOPATHOLOGY
DUE TO ETIOLOGICAL FACTORS
The stress response starts with a signal from the part of your brain known as the
hypothalamus. The hypothalamus joins the pituitary gland and the adrenal
glands to form a trio known as the hypothalamic-pituitary-adrenal (HPA) axis,
which governs a multitude of hormonal activities in the body.
When a physical or emotional threat looms, the hypothalamus secretes
corticotropin-releasing hormone (CRH), which has the job of rousing your body
Hormones are complex chemicals that carry messages to organs or groups of
cells throughout the body and trigger certain responses. CRH follows a
pathway to your pituitary gland

10. CONT….
• where it stimulates the secretion of adrenocorticotropic hormone (ACTH), which
pulses into your bloodstream. When ACTH reaches your adrenal glands, it
prompts the release of cortisol.
• it influences the concentration of neurotransmitters throughout the brain.
Disturbances in hormonal systems, therefore, may well affect neurotransmitters.
• DEPRESSION

11. CLINICAL MANIFESTATIONS
• Thinking is pessimistic and in some cases suicidal.
• In severe cases psychotic symptoms such as hallucinations or delusions
• may be present.
• Insomnia or hypersomnia
• libido
• weight loss,
• loss of appetite.
• Intellectual or cognitive symptoms include a decreased ability to
• concentrate, slowed thinking, & a poor memory for recent events.

12. DIAGNOSTIC EVALUATION
• HISTORY OF PATIENT
• PHYSICAL EXAMINATION
• MSE
• CBC
• URINE TEST
• CT SCAN
• MRI,
• X-RAY

13. MEDICAL MANAGEMENT
• Ephedrine, Reserpine. • Moclobemide (Rimarex) : 150 mg BDS-TDS Max : 600
mg/day • Less ADR as compared to irreversible MAOI.
• Imipramine (depsonil) : 50- 200 mg/day - antidepressant action starts after few
weeks, whereas blockade starts immediately • Amitryptyline (tryptomer) : 50- 200
mg/day.

14. NURSING DIAGNOSIS
• Risk for injury related to accelerated motor activity
• Disturbed thought process related to impaired judgement associated with manic
behaviour
• Self-care deficit (unkempt appearance) related to hyperactivity
• Impaired verbal communication –flight of ideas related to accelerated thinking
• Ineffective coping related to elated expressive mood
• Disturbed thought process –grandiosity related to elevated mood

15. THANKYOU