In recent decades, depression has ceased to be only a psychiatric problem. More people are talking and writing about depression in patients with somatic pathology. The relevance of depression is primarily determined by its growing prevalence. Today, depression is a phenomenon with a frequency of occurrence in the population of up to 20% (Strain & Blumenfield, 2018). The level of modern treatment of patients suffering from depression remains unsatisfactory. Moreover, according to Patten et al. (2016), the number of patients with depression has increased in Canada over the years. This is why I am particularly interested in this topic. I believe that quality treatment of depression will help people live more meaningful and happy lives. I am sure that as a nurse I can contribute to helping people with depression live better lives.
During the course, I found out that diagnosing depression is simple and requires knowing its main symptoms. The main ones are a sad mood, loss of previous interests, the inability to enjoy the usual activities, decreased physical activity, energy, and depletion of movements (Halter et al., 2018, p. 583). Additional signs of depression are a low ability to concentrate, low self-esteem, lack of self-confidence, the emergence of a consciousness of worthlessness, pessimism in assessing personality and the world, and suicidal thoughts. According to Patten et al. (2016), the presence of two primary and two additional symptoms is usually sufficient to make a diagnosis. Thus, as a nurse, I will be able to work with the patients according to the symptoms diagnosed by a doctor.
Another important fact that I learned is that the systemic effect of depression on the body is multifaceted. According to Patten et al. (2016), at the initial stages, the behavioral aspect is of decisive importance, when persistently low mood, pessimism, and focus on painful well-being lead to hypochondriac self-observation and stress. A person has weak communicative capabilities, and compliance with treatment decreases. Eating disorders associated with depression can affect a patient’s appetite and body weight fluctuations both upward and downward (Halter et al., 2018, p. 506). Another aspect of depressive behavior is that patients are prone to alcohol and tobacco use. It must also be remembered that depression directly affects a number of organs and systems, particularly on the autonomic nervous system, systemic and cerebral blood flow (Halter et al., 2018, p. 509).
Nurses assist doctors in treatment of patients diagnosed with depressive disorders. This requires knowledge of the initial symptoms, the nurse’s interest in the diagnostic process, and the conviction that early treatment will significantly improve the patient’s quality of life. Constant communication with the patient and their relatives, purposeful questioning of the patient, special scales and tests, active observation of the patient’s appearance and behavior are the steps in the nursing diagnosis of depression (Lam, 2018). In the diagnosis of masked depression, detailed questions can be helpful about whether the patient can experience the joy of life as before, whether they want to leave previously pleasant communication, whether they are burdened by the performance of household and work duties, and whether they have a feeling of hopelessness (Patten et al., 2016).
During all periods of observation of patients with other diseases, doctors and nurses should be aware of the initial signs of depression to prevent suicide, which can even be carried out in patients with a favorable outcome of the disease (Strain & Blumenfield, 2018). These signs include sleep disorder, increased withdrawal, and increased apathy. The most likely symptoms of suicide are the presence of mental disorders, depression, and alcohol abuse. Suicidal tendencies are urgent conditions. Nurses should be highly wary of patients’ statements about the unwillingness to live or the desire to die. A patient with suicidal thoughts needs the urgent help of a psychiatrist, while the patient must be under the supervision of medical personnel, relatives, and other people at all times (Lam, 2018). In the conversation, it is essential to create confidence in the patient that they can receive significant help from the doctor. Knowing this, in my future practice, I will be able to successfully encourage the patient to find a more positive way out of the situation than suicide.
Another crucial fact is that necessary nursing interventions for depression include establishing confidential contact with the patient (Strain & Blumenfield, 2018). I will try to create such relations with patients to make them feel safe. This is an essential condition for the prevention of suicidal thoughts and actions. It is crucial to organize the constant presence of relatives, nurses, medical personnel, which will allow them to maintain communication with the patient, help avoid suicidal behavior, and improve the patient’s mood (Lam, 2018). Treatment with the involvement of various specialists is a mandatory requirement since only a psychiatrist can competently treat depression.
At the beginning of pharmacotherapy, the patient must be informed that the onset of antidepressant action will occur at least two weeks later, and the drug must be used daily (Strain & Blumenfield, 2018). Improvement can be combined with periods of deterioration. The patient should be aware of this to avoid disappointment. Treatment should be continued until all symptoms disappear, at least four months after the condition improves, but the doctor may increase the course of treatment (Halter et al., 2018, p. 583). If a person abruptly quits taking medications, they may experience withdrawal symptoms: anxiety, diarrhea, vivid dreams, and even nightmares. To avoid this, the dose must be reduced gradually (Halter et al., 2018. P. 504).
It is essential for the nurse to regularly remind the patient and their loved ones that pharmacotherapy is an addition to lifestyle modification, relaxation techniques, and psychotherapy or other non-drug methods. Doctors and nurses should review the list of side effects each time they prescribe an antidepressant and anxiolytic. Patients and their families should be informed about the possible side effects of the medication. Returning to the necessary nursing interventions, attention should be paid to the normalization of the patient’s sleep. It is important to treat the organization of healthy sleep of the patient informally, creatively, to demonstrate an interest in improving the quality of sleep.
Proper nutrition for the patient is another essential condition for the prevention and treatment of depression. Therefore, it is necessary to work with relatives and explain the need for a varied food rich in proteins, vitamins, aesthetics of dishes, and a good accompaniment to meals (Halter et al., 2018, p. 560). Another good remedy for depression is being busy at work. The use of all possible methods to realize a person in the family and at work to increase his self-esteem is possible with a nurse’s participation. It is possible to switch the patient to socially meaningful goals (transfer of life experience to loved ones, communication with children, grandchildren, painting, needlework, writing poetry, etc.). The way to reach it is to give the patient complete information about these processes’ benefits and then give the positive experience related to them. In addition, it is necessary to maintain an optimistic mood in the patient. Talking to the nurse about a painful experience can prevent depression. Learning to react differently to life’s circumstances, the patient will cope well with depression. With the right treatment and support from friends and relatives, this psychological problem will become surmountable sooner or later.
Depression threatens with suicidal thoughts and actions and significantly worsens the quality of life of patients. Early diagnosis can improve treatment success and enable people to feel better and have more strength to pursue their plans (Strain & Blumenfield, 2018). It is necessary to develop educational programs for patients and relatives, create information stands, brochures, memos containing information about diseases, methods of treatment, forms of psychological support to avoid depression and other mental disorders. All this will allow the patient to move away from a pessimistic outlook on life, give them more strength and patience, help prevent depressive disorders, and support worried relatives of patients.
References
Halter, M. J., Pollard, C. L., & Jakubec, S. L. (2018). Varcarolis’s Canadian psychiatric mental health nursing. Elsevier Health Sciences.
Lam, R. W. (2018). Depression. Oxford University Press.
Patten, S. B., Williams, J. V. A., Lavorato, D. H., Wang, J. L., McDonald, K., & Bulloch, A. G. M. (2016). Major Depression in Canada: What Has Changed over the Past 10 Years? The Canadian Journal of Psychiatry, 61(2), 80–85.
Strain, J. J., & Blumenfield, M. (2018). Depression as a systemic illness. Oxford University Press.