Depression or depressive disorder is a mental health condition that results in depressive episodes, feeling of guilt, lack of self-worth, and a loss of interest. Some other symptoms commonly associated with the disease include low energy, disturbed sleep, poor appetite, and difficulty in concentration. Many people confuse depression with the normal feeling of sadness. However, an individual battling depression has an intense feeling of anxiety, negativity, helplessness, and hopelessness that stays for an extended period. Depression can affect anyone irrespective of their background. According to data the World Health Organization (WHO) data, approximately 300 million around the globe have depression. In the United States, depression is one of the most common mental illnesses. As of 2016, about 7.4% of American adults had depression. In 2017, the number of adults diagnosed with the mental health condition was at 20%. The age group with the highest prevalence of depression as of 2016 was between 40 and 59 years (McIntyre et al. 2013). According to information from the National Institute of Health Management (NIHM), major depression is also significant mental health condition in the country. Approximately 16.2% of the adults in the US had to contend with at least one major depressive episode in a year. The prevalence of major depressive episodes was markedly higher in females than in males at 8.5% and 4.8% respectively (McIntyre et al. 2013).
The Healthy People 2020 draws a close association between mental health and physical health. In its model for understanding mental health, it stresses the significance of social, genetic, and environmental factors throughout the life of an individual. Some of the common risk factors associated with depression include the family history and the presence of a chronic physical or mental illness. Psychological factors such as low esteem and sensitivity to loss could also predispose an individual to the mental disorder. Social issues such as lack of social support and stressful events can also lead to depression. Other than the risk, the Health People 2020 further emphasizes the protective measures against mental disorders such as depression. However, depression does not have a single specific method of prevention, but people can limit some of the practices leading to the illnesses including controlling stress and maintaining healthy relationships with family members and friends. Any individual showing a sign of depression should seek prompt treatment to prevent the progression of the disease to severe stages. Those on treatment plans must ensure that they adhere to their regimen to prevent chances of relapse. The discussion aims at providing a rationale for the prevention and management of depression and its risk factors by outlining the health care promotion guidelines, management, and the use of nursing interventions to address the disease.
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Review of Literature
Vital to understanding is the risk factors associated with depression. According to research, biological factors are a common cause of the disease and are due to the imbalances in the brain chemicals. Family genetics also play a significant role as studies have shown that 10-15% of the cases of depression have been witnessed in children whose parents have a history of the mental health illness (Ripke et al. 2013). With regards to gender, women have a higher prevalence of the disorder in comparison to men. Some of the psychological factors that can lead to depression include unresolved grief and low self-esteem. Environmental factors include stress and lack of social support. Medically, patients with terminal or chronic illnesses and people under substance abuse are prone to the depression more than the general population (Kupfer, Frank, & Phillips, 2012). Depression is usually classified as a mood disorder with three significant subtypes that include major depression, atypical depression, and dysthymia. Depression that begins immediately after pregnancy is known as postpartum depression. Some of the core symptoms of depression include an intense feeling of sadness, despair, isolation, and hopelessness that spans for an extended period. Depression can also be manifested when a person shows an increased disinterest in the things they would normally do such as working, hanging out, or making friends. They also indicate problems with their ability to concentrate and tend to feel restless for extended amounts of time. The American Psychiatric Association (APA) utilizes the DSM-5 released in 2013 as a standard way of diagnosing mental illnesses such as depression.
According to the WHO, health promotion is a process where people are enabled to improve and increase control over the health (Kupfer, Frank, & Phillips, 2012). It not only focuses on the individual behavior but also incorporates a wide range of issues that include environmental and social interventions. Mental health promotion primarily seeks to maximize the ability of patients to realize their abilities, cope with the normal stresses, and integrate meaningfully in the social setting. It also aims at enhancing awareness, appreciating the mental health conditions, reducing discrimination and stigma, and encouraging the patients to seek help whenever possible. At a personal level, health promotion in depression cases will focus on reducing vulnerability and heightening the emotional resilience. Kupfer, Frank, and Phillips (2012) noted that some of the strategies towards achieving this include developing self-esteem and other interpersonal skills which increases an individual’s ability to cope with life stresses. At the community level, health promotion targeting depression will seek to create healthy environments at workplaces or schools and further ensure that supportive and inclusive social networks exist. At the structural level, entities will ensure that public policies aimed at addressing depression are implemented. Examples of such policies would include advocating for equality, reducing discrimination, and responsible media coverage of people with depression amongst many others.
In treating depression, it is critical to appreciate that depression will not likely go away on its own. If left untreated for a while, it is likely to continue for months and years leading to more adverse effects on an individual. Therefore, treatment must be tailored to meet the demands of an individual. Mild symptoms of depression could be treated through lifestyle changes and psychological therapy provided by professionals in mental health. Moderate to severe conditions require medical treatments. Ripke et al. (2013) asserted that psychological therapies that individuals can utilize include cognitive behavior therapy, interpersonal therapy, behavior therapy, and mindful-based cognitive therapy. In medical treatment, the best form of medication is provided by prescribing antidepressant medication. Apart from treatment, management is an essential part of the recovery. The mental health professional will advise the patient to remain active, have enough and regular sleep patterns, avoid negative thoughts, stay positive, and to develop a mechanism of coping with irritability.
Nurses have an essential duty in ensuring that the best possible outcome is achieved during the treatment of mental health. Depression is a mental illness that can have debilitating consequences on the client including the development of suicidal ideation. Therefore, when dealing with a depression patient, the nurse must ensure that he or she contact the family members and make arrangements for crisis counseling. Furthermore, they have a duty to create links to the various self-help groups. Townsend and Morgan (2017) asserted that the importance of this strategy is that clients need a wide array of resources to assist them in getting rid of feelings of isolation, worthlessness, and helplessness. Secondly, the nurse will assess the availability of required medication for the patient. The rationale behind this strategy is that medication is essential therapy for depression and enables an individual to recovery when combining with other forms of treatment. The third nursing intervention that a nurse will look into is whether there are precautions for suicide required. The reason behind this practice is that the clients with a high-risk for suicide require continuous supervision and a safe environment.
The implication for Nursing Practice
Research has shown that the depressive disorders are amongst the most prevalent mental health problems affecting people especially in America and other parts of the Westernized world. However, the data shows that less than a third of the patients with depression acquire appropriate medical intervention. One of the reasons attributed to the under-treatment of depression is the systemic and systematic under-recognition of the condition by health care professions including the nurses (Townsend, & Morgan, 2017). Therefore, nurses must play a significant role in not only the treatment process but also recognition, failure to which the prevalence of the disease will continue to exist in the population. Nurses, especially those working amongst people in the community, must appreciate the value of prompt diagnosis. Furthermore, the must show adequate understanding of the mental health problem and further appreciate their unique role in the diagnosis and treatment of depression. Failure will only result in more adverse depression conditions.
In conclusion, depression is a common mental health disorder characterized by prolonged depressive thoughts and lack of self-worth amongst other negative feelings. The WHO asserts that over 300 million people suffer from the illness worldwide. Health promotion advocates for a holistic view in the treatment and prevention of depression that involves the individual, the community, and the structural frameworks. Treatment strategies include various forms of therapy and medication with antidepressants. Management requires a change in lifestyle and developing coping skills. Nurses have an essential role to play in the recognition, diagnosis, treatment, and prevention of adverse outcomes. Without their proper intervention, the disease will likely continue to remain highly prevalent and most fundamentally implicate on the Health People 2020 objectives.
References
Kupfer, D. J., Frank, E., & Phillips, M. L. (2012). Major depressive disorder: new clinical, neurobiological, and treatment perspectives. The Lancet , 379 (9820), 1045-1055.
McIntyre, R. S., Cha, D. S., Soczynska, J. K., Woldeyohannes, H. O., Gallaugher, L. A., Kudlow, P., ... & Baskaran, A. (2013). Cognitive deficits and functional outcomes in major depressive disorder: determinants, substrates, and treatment interventions. Depression and anxiety , 30 (6), 515-527.
Ripke, S., Wray, N. R., Lewis, C. M., Hamilton, S. P., Weissman, M. M., Breen, G. ... & Heath, A. C. (2013). A meta-analysis of genome-wide association studies for a major depressive disorder. Molecular Psychiatry , 18 (4), 497.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice . FA Davis.
