Depressive disorder

Depression
Stress/ Anxiety/Fear
Mental illness
Psychological Problems
Mentally Disturb
Psychiatric Nursing

1. DEPRESSIVE DISORDER Dr. Rahul Sharma Associate Professor H.O.D. of Mental Health Nursing Ph. D Coordinator Seedling School of Nursing, Jaipur National University, Jaipur

2. INTRODUCTION It is a widespread mental health problem affecting many people . The lifetime risk of depression in male is 08-12% and in female it is 20-26%. Depression occur twice in female in comparison to male. The highest incidence of depressive symptoms has been indicated in individual without close interpersonal relationship and in person who are divorced or separated or widow. Prevalence of suicide show large peak in spring season and less in October. Major depressive disorder often co-occur with other psychiatric disorder and alcoholic or substance related disorder.

3. ETIOLOGY Biological factors 1. NEUROTRANSMITTER -: Decreased norepinephrine and serotonin level -: Deregulation of Acetylcholine and GABA 2. GENETIC -: When 1 twin is diagnosed with major depression, the other twin has a greater than 70% chances of developing it. 3. ENDOCRINAL FACTORS -: Pituitary of adrenal system malfunction and hormonal abnormalities .

4. Psychosocial factors Loss of loved one or any valuable objects. BEHAVIORAL FACTOR Experience of uncontrollable events Example - a fight COGNITIVE FACTORS Self negative thoughts. Depression due to negative cognition Negative exceptions of environment ( Example - flood,fights,stealing) Negative expectations of self Negative expectations of future.

5. SOCIOLOGICAL FACTOR Stressful life events Example- death, marriage

6. CLINICAL MANIFESTATION Sadness of mood Loss of interest Loss of pleasure Hopelessness Worthlessness A feeling of inferiority Suicidal thought Anxiety Restlessness Spiritual thinking , walk and eat slowly Feeling of uneasiness

7. Diagnostic evaluation Psychological test for depression to access severity of depression Family history according to ICD 10 Criteria

8. TREATMENT Pharmacotherapy Major category of depressant are 1. Selective serotonin re-take inhibitions 2. Citalopram 3. Serialize 4. Tricyclic ANTIDEPRESSANTS Amitriptyline Clomipramine Imipramine Doxepine

9. Mono amino oxidase inhibitors Isocarboxazid Phenelzine Other anti depressant are:- Buproprin Maprotiline

10. PSYCHOSOCIAL THEORIES Cognitive therapy Supportive theory Family therapy Group theory Behavioral therapy