Depression is any form of condition that causes a low mood within an individual and affects the person’s behavior, thought, physical appearance as well as feelings. Depression can have various effects to an individual’s brain and can influence how an individual behaves, responds to feelings, thinks or relates with others as well as the environment (Corrigan 2004). There are different causes of depression; hence, different theories incorporate results from different research fields. There three major types of depression; namely major depression, bipolar disorder and dysthymia.
A number of factors such as social, psychological, and mental disturbances can cause depression. Studies link the different types of depression to neurological and genetic causes involving brain pathology. However, environmental and social influences such as history of abuse, poverty, and other serious emotional traumas affect a person’s venerability to depression (Fung 2007).
There are a number of challenges that individuals suffering from depression and their families go through. One of the challenges is that these individuals are denied some of their essential benefits, like being excluded from public schemes, such as insurance covers. They are also exposed to exploitation by credit cards companies, which lend to them with an intention of racking up unmanageable debts (Dickey 2002). Discrimination greatly undermines the ability of the affected person to cope with daily life; moreover, it exacerbates their illness.
People with depressive disorders experience a number of problems such as confusion, anguish and, in some respect, are unable to undertake a normal life. In some situations, depression challenges do not affect the sick individuals only, but also affects their caregivers, family members and friends (Corrigan 2004). The caregivers are affected in terms of safety issues that arise from the patient’s deviant actions that deviate from the expected society norms. Such kinds of behaviors trigger involvement of the mental health workers to intervene by assisting the affected individuals. Family members often suffer from shame and denigration, especially when individuals are affected seriously. If an individual’s actions are seen as a threat to other society members, the obvious consequence is fear.
The depressed person can have extreme loss of energy, which may make every activity arduous. Common tasks like reading become so cumbersome that, understanding and remembering are impossible even if they re-read several times. While driving a car, an intrusive thought of killing one self may occur. Self destructing thoughts gradually become more detailed, frequent and intense with no warning or provocation. These mood symptoms are different from sadness, and they impede personal functioning.
When it comes to work, depressed people are likely to be slow and less productive, unable to decide and uncertain. They are also vulnerable to making mistakes. This is due to the self destructive thoughts that occur to them. This leads to them being less productive and, therefore, cannot find employment. Individuals who suffer from mild depression are likely to be distressed by the symptoms, but with great efforts, they are able to continue with their daily activities. As the symptoms increase, performance of most activities becomes possible with so much effort until the illness becomes severe. Activities, other than the short term maintenance of the soul and body, become impossible at this stage (Townsend, 2000).
Since the people suffering from depression cannot be able to work, it can lead to them and their families suffering financially. This is because; the affected individuals cannot be able to provide for their families. When this happens, the family members are forced to fulfill that on their behalf (Dickey 2002). In this case, the family uses quite a large amount of money on the patient. At home, these people lack interest in their family and are not be able to enjoy the shared activities and company of the family (Skapinakis 2008). They are also not able to participate in family life. They are not able to demonstrate affection to loved ones. This in turn affects the relationship that they have with their family.
Depression patients are unable to demonstrate affection to their spouses and are not interested in love making. This can have an effect in their marriages, to the extent that, it can result into break ups, mostly in situations where the other spouse feels lonely and frustrated. This is a situation that is likely to affect the other spouse, children and the entire family as a whole.
It is worth noting that there are as well physical implications on the depressed person. Most of the patients suffer from chronic fatigue. This fatigue is due to protracted stress in both work and private life, with no possibility of getting better. It leads to a series of both mental and physical symptoms. It usually starts with pain in back of the neck, back shoulders, and chest. It then proceeds with psychological problems, such as anxiety and low moods which can result to severe depression and anxiety which are far more threatening than their symptoms as they can lead to very dangerous consequences because of the negative influence on the person. Fatigue has an influence on the cognitive, behavioral, emotional, and physical function (Dickey, 2002).
Families with affected individuals face the challenge of not knowing the right kind of treatment to give to the patient. They may not know if to be involved in home care, or to put the patient under independent living (Herrman, Saxena and Moodie2005). The members may not conceptualize the issue of having depressed individuals with them, because the sick person may indulge into bewildering conducts that requires the caregivers to make decisions that go beyond each day routine. Many care givers have stated that, their distresses are closely linked to daily management issues concerning the affected behavior.
Anxiety is very common among families of individuals diagnosed with bipolar disorder. This is because such illnesses cause unpredictable violence which is normally directed to the family members (Kessler 2006). Individuals affected by bipolar disorder often have unpredictable behavior that can perplex family members as they struggle to be in terms with their relative without grasping their thought.
Family members, who most of the times are the care givers, find it difficult to understand the sick person, and can be frustrated by the negative effects of depression like withdrawal, anhedonia and apathy. Research reveals that people who live with depressed persons are at a higher risk of being depressed too hence depression can be contagious. The depressed persons overall health may deteriorate due to the condition of the mind. The sick person is not able to feed well because of the anxiety that they have. The sleep of the person may be disrupted either because of delaying to fall asleep or frequently waking up at night or losing sleep very early.
Currently nurses have become increasingly aware on ways on ways of dealing with individuals with depression. Nursing interventions assist in addressing specific challenging symptoms and their often associated diagnoses (Hoge 2004). Skilled professional interventions provide empathy and support which acts as a catharsis opportunity, which is an interpersonal relationship that provides feed back concerning the patient’s behavior, thought and education needed in facilitating change. In cases where the patient undergoes regression, nurses provide directives on approaches of meeting the client’s basic needs (Maurin 2000). In most emergency cases, nurses are concerned with dealing with both short term and immediate goals. Sometimes, clients require emotional and physical attention, assistance and medication in order to mobilize resources or give supervisors directives. Mental health nursing interventions assist depressed persons as well as their family members in managing their condition by reducing their level of stress. They do so by distracting the patient from being involved in destructive behaviors, position of comfort through being present all the time to address the client’s issue. They soothe the patients from having the feeling of venerability and loneliness. At moments of psychiatric emergency, patients sometimes become very anxious, and this can prevent them from being fully involved in participation on treatment intervention. In such instances, nurses come to offer support to patients by creating avenues for the affected individuals to manage themselves. It is very easy to learn such stress reduction approaches if clients are carefully guided through proper nursing intervention.
Electroconvulsive therapy is a possible intervention. This is a procedure in which electric currents are used; they are passed through the brain and they deliberately trigger a brief seizure. Electroconvulsive therapy causes brain change in chemistry that reverses symptoms of mental illnesses including depression.
The nurse can build a trusting relation ship with the patient first. The nurse introduces his or herself to the patient, does some interactions with the patient to expel any fear and to calm the patient. The nurse can then pay attention to the patient’s notice with empathy and patient’s attitude. When doing this the nurse should use non-verbal language, like touch, a nod, speak in a low tone, concise, clear, and simple and be easily understood. She should accept the patient with comparing with other patients. The patient gives a response in accordance with her wishes.
The nurse should make sure that patients use adaptive coping. This can be done by offering encouragement and making the patient understands that nurses understands what patients saw. Activities such as enquiring from the patient on how he or she overcomes pain, sadness among other feelings, conversing with the patient on the best coping strategies, identifying alternative strategies and ensuring that the patient gets to chose the best and correct coping strategy, and also gets to practice it. The nurse can also give instruction to the patient to try other alternatives in solving the problem.
Ensuring that the patient is protected from any violent behavior either to self or others is another nursing intervention. The nurse monitors the risk of suicide or violence by the patient. This can be best attained by completely keeping any instruments that the patient can use to harm others or him/herself away from the patient’s reach. The patient should be placed in a room that is easily monitored.
The nurse should ensure that the patient improves his or her self- esteem. The client needs help to understand that he can overcome despair. The nurses should evaluate and mobilize the various internal resources through which one can gain back good relationships with others, lost hope as well as beliefs. At this point the client can now use social support. The nurse can review and utilize the individual’s external sources like the people who are closest, religion and support groups and health care team. The nurse can then make referrals like counseling as indicated.
The patient can use the prescribed drugs correctly. The nurse should discuss the drug with the patient. The name, how it should be taken that is dosage and frequency, its side effects and effects of taking medication. The patient should be encouraged to talk about the effects and side effects when they are felt and a positive reinforcement should be given when the patient is using drug properly (Schatzberg 2002).
Nurses can assist the clients by teaching those ways of avoiding stress. When a person is in deep stress, one can use the natural impulse technique of holding breath or breathing rapidly (Maurin 2000). Clients are taught deep-breathing techniques that necessitate them to ensure a lot of self-care while at the same times distancing their attention from feelings of helplessness and distressing symptoms. In doing so, nurses train the clients how to take and release very deep breathes. Some occasions may require the clients to place their hand on the abdomen in order to feel differences between deep and swallow breathing. Clients are instructed to take very deep breathes, hold them for sometime and release them out slowly. This is usually done over a number of minutes while instructing the clients to take longer and deeper breathes
Desensitization is another relaxation technique used in assisting affected individuals to recover from different depression forms. In this technique, the situation causing the stress is broken down into fine and small tolerable steps (Fung 2007). This greatly assists the client on focusing manageable steps, which can be completed successfully. It is a very demanding experience to work closely with persons undergoing crises. Staff members should be provided with adequate opportunities of expressing their concerns and frustration in order to prevent them from burning out. Adequate support on mechanisms of dealing with emotional and physiological challenges should be provided to all staff members.
In conclusion, it is worth mentioning that the affected individual together with the caregiver or family members should seek for professional counseling immediately after identifying the first symptoms. Therapy greatly helps the affected individual as well as the family members in recovering from stresses associated with the disorder. Caregivers need to take some time to relax so that they can deal with their loved ones in an understanding and loving manner (Sokal 2004). It is also important for the caregivers to ensure that family members are involved in the treatment process of the patient. The care giver should take time to make the family members understand and be able to deal with the patient and the process of healing.
References
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