Developing a Nursing Diagnosis for Depression

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1. Signs and Symptoms of Depression
2. How to Create a Nursing Care Plan for Depression
3. Nursing Interventions for Depression

Depression is a common mood disorder affecting people worldwide. Unlike brief episodes of sadness or hopelessness, depression is persistent and can affect daily activities like self-care, work performance, and enthusiasm for previously enjoyed hobbies.

Understanding nursing interventions for depression is vital to developing a plan of care based on intervention strategies for each patient’s unique needs. 

Let’s dive into how you can learn more about the signs and symptoms of depression, complete a mental health assessment, and develop a nursing care plan that meets your patient’s needs.

Signs and Symptoms of Depression

Depression, also termed clinical depression or major depressive disorder, can cause many physical and emotional issues impacting the quality of life.

People who suffer from depression may display signs like:

• Feelings of worthlessness
• Feelings of sadness
• Loss of interest in activities
• Social isolation
• Substance abuse
• Sleep disturbances
• Low self-esteem
• Self-care deficit
• Powerlessness
• Depressed mood
• Suicidal thoughts
• Suicidal behavior
• Insomnia or hypersomnia

Depression can affect all areas of life, potentially leading to more serious illnesses like substance use, self-harm, and suicidal thoughts or tendencies. The incidence of this mental health disorder is high and can impact men, women, adults, teens, and children.

While not all patients may show all the symptoms listed above, the frequency and duration of these symptoms can significantly limit an individual’s daily functioning and feelings of self-worth. 

Patients suffering from these symptoms can likely benefit from a combination of psychotherapy, a designated support system or group, and antidepressant medication management.

The causes of depression are vast and can include several factors, including:

• Inherited genetics
• Traumatic events
• Living environment
• Postpartum hormonal imbalance
• Major biological differences
• Psychological influences (e.g., a pessimistic or low self-esteem personality trait)

Depression is not something someone can just “snap out of.” This mental health illness can be difficult for patients to verbalize and even feel debilitating. As the first point of contact, nurses like you can learn to recognize this mental illness and create a nursing care plan.

The health care provider (HCP) involved in patient care will follow a series of steps for diagnosing depression.

These steps include:

• A physical examination to determine the baseline of physical health.
• Blood tests to rule out other health conditions that can mimic the symptoms of depression, such as thyroid issues, hormone imbalance, or heart disease.
• A psychiatric nursing evaluation by a specialist to determine the psychological baseline of the patient.
• Diagnose the mental illness using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) if none of the previous steps pose a potential reason behind the symptoms of depression.

How to Create a Nursing Care Plan for Depression

A nursing care plan for depression is a set of goals designed to help your patient reach optimum health and wellness. With an assessment of your patient’s level of impairment, stressors, and present coping abilities, you can apply individualized outcomes and appropriate interventions in your nursing profession.

Some priority things to consider when creating a nursing care plan for a person with depression symptoms include any previous suicide attempts, suicidal behavior, or a suicide plan. Suicidal tendencies can play a significant role when your patient lacks friends or a support system. 

A patient with a high risk of suicide may require hospital supervision, while a low-risk patient may be safe at home with friends or family members.

The nursing care plan you create for your patients’’ depression treatment should include several things, including:

• Testing and evaluation completed prior to diagnosis
• The diagnosis
• Symptoms leading to the diagnosis (including frequency and duration)
• Any related diagnoses that coincide with the symptoms of depression
• The desired patient outcome
• The plan of action for your patient to achieve this outcome

Check out our example below for details on creating a nursing care plan for a patient battling depression.

Depression Nursing Care Plan Example

The following is an example of a psychiatric nursing care plan for a fictional patient who shows symptoms of major depression and disordered eating. This plan documents and provides the patient with a list of goals related to their diagnosis.

Name: John Doe

DOB: 01/22/1991

Testing & Evaluation

• Complete physical examination
• Blood work on thyroid, hormones, and heart
• A psychiatric nursing evaluation
• A psychiatrist’s DSM-5 diagnosis

Diagnosis

• Major Depressive Disorder
• Eating Disorder

Assessment Evidence

• Apathy
• Anhedonia
• Food restriction (based on mood)
• Body dysmorphia (3+years)
• Poor eye contact
• Suicide attempts (2 attempts in 4 years)
• Fear of gaining weight
• Limited social support (ongoing)
• Impaired interpersonal relationships
• Impaired problem-solving skills
• Disturbed sleep patterns (intermittent; currently going on three months)

Related Diagnoses 

• Impaired social interaction
• Body dysmorphic disorder
• Internal or situational loneliness

Desired Patient Outcomes

• Consistently able to experience joy
• Motivation to participate in hobbies and activities
• Experience feelings of self-love and self-worth
• Having a healthy appetite and wanting to consume nutrients
• Feeling good about the body
• Confidence in social relationships and support system
• Ability to sleep through the night

Action Plan

• Participate in routine therapy.
• Communicate symptoms with support system.
• Communicate medication compliance with health care team.
• Communicate eating habits with support system.
• Plan self-care measures.
• Establish a daily routine.
• Interact with family, friends, and colleagues.
• Identify withdrawal behaviors to work through.
• Identify self-destructive thoughts or behaviors.
• Participate in new activities and old hobbies.
• Sustain relationships with family members and friends.

Nursing Interventions for Depression

Nursing care plans provide effective interventions and the rationale for each diagnosis in the care plan. These interventions offer suggestions and choices tailored to the patient’s mental illness and personal needs. 

The rationale portion is rarely included in the patient’s physical copy of the care plan. Still, it’s a valuable component of mental health nursing and shows future health care providers (HCP) how the interventions are based on the rationale principles.

Nursing interventions for a patient with depression symptoms may appear as the following (rationales for each intervention appear in parentheses):

• Limit complex words (poor memory and concentration affect understanding and retaining information)
• Identify suicide risk and supervision needs (previous suicide attempts or self-harm can indicate the patient needs a safe environment and round-the-clock supervision)
• Initiate one-to-one activities (one-to-one interaction can build trust and minimize anxiety)
• Initiate group activities (social settings can help minimize isolation and enhance self-worth)
• Create a no-suicide agreement (strengthens alternative choices during times of suicidal ideation)
• Referral to local support groups (group involvement with others who share similar experiences can offer support)
• Encourage alternative, healthy ways of expressing feelings (healthy expression of feelings can help deal with strong emotions and bring a sense of control to the situation)

Studying Mental Illness in Nursing School? 

Working in mental health can be a rewarding experience for nurses. The American Psychiatric Association notes the increasing demand for mental health services will soon outnumber practicing psychiatrists, and the demand for qualified nurses will increase with this shortage.

At SimpleNursing, we help nursing students pass school exams. We have thousands of videos, creative cheat sheets, test-prep questions and their corresponding rationales, and much more.

Join the most trusted global resource for nursing students here.