Nursing Management of Depressive Disorder or Depression
What is Depression or Depressive Disorder?
A mental or physical condition characterized by insomnia, anorexia, irritability, emotionalization, impaired concentration and suicidal tendency is termed as depression. It is an affective disorder which is characterized by feelings of overwhelming sadness or lack of enjoyment, sometimes with anxiety and irritability with change in eating habit, sleep and sexual function.
Nursing Management of Depression or Depressive Disorder:
It includes the following:
1. Promote sleep and food intake-give the prescribed drugs in time and monitor food intake and, if necessary, administer IV fluids.
2. Assess if there is any suicidal tendency. Take safety measures and keep vigil if patient has suicidal ideas. The patient’s safety is a nursing priority.
3. Diminish feelings of loneliness. Build trust by a one-to-one relationship.
4. Improve interaction with the patient.
5. The interaction should focus on the present, not the past or far into the future. Reassure the patient that the present depressed mood state is temporary and that he will be protected and helped. Use a kind, firm and warm attitude. The presence of a rusted individual provides emotional security for the patient.
You can read: Different Types and Causes of Hypertension (HTN)
6. Postpone to your patients decision making and resumption of duties.
7. Provide non-intellectual activities. For example, cleaning and physical exercise provide safe and effective methods for discharging pent-up tension.
8. Encourage expression of emotions, denial, hopelessness, helplessness, guilt, etc. Provide the patient the opportunity to cry out and ventilate his anger.
9. Keep strict records of sleeping patterns. Discourage sleep during the day to promote more restful sleep at night. At night use measures that may promote sleep, such as warm drinks (milk), warm baths, soft music, etc.
10. Limit intake of drinks like coffee, tea and colas. Assist patient in getting to sleep until normal sleep pattern is restored.
11. Indicate that success is possible and not to be hopeless.
12. Health Education:
Regarding the disease: Educate your depressive patients with the following guidelines:
- Depression is far more common than you might think.
- Depression can occur without any obvious external cause, due to biochemical imbalance.
- Sometimes the process of getting better takes time and one must wait.
13. You are not alone; there are many people around you who care about your well-being like your family, your friends and your doctor and his team.
14. Regarding drugs:
- Take your medicines carefully and regularly. Never take less or more than the prescribed dose. Never skip a dose.
- Do not expect miracles. It could be at least two weeks before you feel better.
- There may be some side effects due to the antidepressants, like dry mouth, constipation, giddiness; do not worry about them.
- Some medicines can make you sleep initially and it is good for you to sleep well. Avoid driving or performing any activity which might need a lot of concentration after taking these drugs.
- Avoid taking alcohol when you are on medication. They may interact and produce harm
- Do not stop treatment without the doctor’s advice
15. Advice to family members:
Educate the family members in the following ways:
- Understand that the patient’s problems are due to depression, a disease like any other physical disease and needs active treatment.
- Give correct history to the doctor.
- Give the medication regularly as prescribed by the doctor.
- Give adequate support and encouragement, so that patient may feel, more secure and the recovery will be faster.
- Watch for any suicidal ideas or gestures and inform your doctor.
- Accept him as he is, and give him care and hope.
