Introduction
Major Depressive Disorder defined by DSM-IV-TR (2000) “is characterised by one or more Major Depressive Episodes (i.e., at least 2 weeks of depressed mood or loss of interest accompanied by at least four additional symptoms of depression)”. Major Depressive Disorder affects twice as many women as men and for both genders it is most common in those who are 25-44 years of age (All About Depression.com 2011). In the case of 65 year old Mrs Adele Harper who was diagnosed at age 43, has been suffering with this disorder for many years and has now been admitted to the Acute Psychiatric ward from the Emergency Department after her daughter had found her dishevelled and extremely seated in her home after an attempt to take her own life. A care plan was devised by a nurse in order to care for this patient by identifying nursing diagnosis, possible goals, potential interventions and expected outcomes.
Pathophysiology of Major Depressive Disorder
There are several areas of the brain that are involved in the emotional and physical changes that are seen in depression (Shives 2005). Shives (2005) says while the brain of a depressed individual is generally underactive, certain areas display overactivity. The thalamus is associated with changes in emotion and is known to stimulate the amygdala. This area displays increased levels of activity in a depressed person (Shives 2005). The amygdala is responsible for negative feelings; there are displays of overactivity in this area in depressed people (Shives 2005). In depressed people there is increased activity in the cingulate gyrus. This area helps associate smells and sights with pleasant memories of past emotions. It also takes part in the emotional reaction to pain and the regul...
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This paper introduces a 35-year-old female who is exhibiting signs of sadness, lack of interest in daily activities and suicidal tendencies. She has no interest in hobbies, which have been very important to her in the past. Her lack of ambition and her suicidal tendencies are causing great concern for her family members. She is also exhibiting signs of hypersomnia, which will put her in dangerous situations if left untreated. The family has great concern about her leaving the hospital at this time, fearing that she may be a danger to herself. A treatment plan and ethical considerations will be discussed.
Evidence shows that Major Depression Disorder has been around four thousands of years. In the fourth century BC, Hippocrates referred to a group of symptoms including loss of appetite, insomnia, flat affect, and irritability as melancholia (Jackson). Taking accountability of melancholia appeared in ancient Mesopotamian texts in the second millennium B.C. At this time, any mental illness had something to do with the demons. It had to be checked by the priests. The first time that there was an understanding of depression it was truly considered more of a spiritual illness caused by demons rather than a physical illness. Ancient Greeks and Romans put taught about the causes of melancholia. For example in the 5th century B.C., Herodotus wrote about a king who was driven mad by evil spirits. Even early Babylonian, Chinese, and Egyptian civilizations point of view also related to mental illness, and used exorcism techniques (such as beatings, restraint, and starvation) which was designed to remove the demons. Roman and Greek doctors thought that depression was both a biological and psychological disease. Gymnastics, massage, special diets, music, and baths would help with the disorder.
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The biologic basis of Clinical Depression originates in the brain. Your brain is made up of a complex network of nerve cells, called neurons and of brain chemicals, called neurotransmitters. Neurotransmitters transmit messages from one neuron to another. Two of these neurotransmitters are not produced in sufficient quantities in a depressed person’s brain. Because of this lack, too few messages get transmitted between neurons and the symptoms of depression occur. In Clinical depression the chemicals in the brain are out-of-balance. New technology allows researchers to take pictures of the brain that show activity levels in the brain. These imaging techniques such as f-MRI and PET scan actually create images of how active different parts of the brain are. Some studies with these kinds of techniques have suggested that the patterns of activation in the brains of depressed people are different than those who are not. These tests can help doctors and researchers learn more about depression and other mental illnesses. Since this research is fairly new, it is not yet used to diagnose clinical depression.
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