Depression: Biopsychosocial Factors, Treatment Interventions, and Ethical Implications

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Depression: Biopsychosocial Factors, Treatment Interventions, and Ethical Implications
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Depression: Biopsychosocial Factors, Treatment Interventions, and Ethical Implications
Introduction
According to the American Psychiatric Association (2018), depression is a critical health
condition that severely impairs how people feel, thinks and acts. It is responsible for causing
feelings of prolonged sadness as well as loss of interest in the things one used to enjoy doing.
Aziz and Steffens, (2013, pp. 497-516) observe that late-life depression is caused by different
biopsychosocial factors which often combine to exacerbate the condition. To this end, elderly
patients diagnosed with depression need to be subjected to treatment and management
approaches that promise to suppress symptoms rapidly to prevent emergence or curtail other old
age complications such as hypertension and diabetes. In doing so and for purposes of
administering comprehensive patient-centered care, nurses ought to take into consideration the
ethical implications of managing such patients. Drawing from the case study of Amy (75-year
old woman suffering from depression), the focus of this paper will be on identifying and
discussing the biopsychosocial factors contributing to the development of depression and nursing
management approaches used in the treatment of same under the guidance of ethical
implications.
Biopsychosocial Factors Related To Depression
Like is the case for Amy, patients suffering from depression exhibit symptoms such as
depressed mood, sadness, loss of appetite leading loss of weight, sleep disturbance, restlessness,
increased fatigue, feelings of guilt and worthlessness, having difficulties in thinking and having
constant thoughts of death. These symptoms come by patients undergo through touching
incidences and painful moments in their life subjecting them to stressful and grieving situations
that by extension exacerbate to more serious mental disorders such as depression. While there is

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no single known cause of depression, factors leading to depression are quite numerous and
interact to lead to complex relationships that work to compound the condition. The
biopsychosocial model is one model that can be used by mental health professionals to easily
identify and diagnose a patient as suffering from depression (Beck & Alford, 2009).
First, advanced by cardiologist Dr. George Engel, the biopsychosocial model is widely
used in the management of individuals with mental health illnesses. The model advances that
biological, psychological and social factors are interlinked contributors in the development of ill
health of patients and especially for those suffering from mental disorders. The model promotes
that idea that the mind and the body are connected and interdependent and that what affects the
body also affects the mind and vice versa. Health is not only a matter of the physical body status
but it is also greatly influenced by a patient’s psychological and social status too (Bruce, 2008,
pp.175-184).
In using the biopsychosocial model to identify and describe mental health phenomena
such as depression, psychiatric nurses are obliged to examine critical biological, psychological,
and social factors. Concerning biological factors and drawing from Amy’s case, some patients’
depressed condition may emanate from family lineage gene s implications leading to such
individuals inheriting their depressed conditions from their fore parents. Amy is reported to be a
quiet but caring person who likes her own company. These same traits were exhibited by her
mother who also had been diagnosed with depression and died some fifteen long ago. This
implies that possibly Amy’s depressed condition could have been partly instigated by genes
transmission that contributes to depression. Moreover, being an elderly woman, Amy could be
suffering from hormonal imbalances or having an impaired neurotransmitter system. Women
have a higher likelihood developing depression than men given that they have a greater

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likelihood of “internalizing stress”. Amy is also suffering from diabetes and hypertension which
are health conditions that play a critical role in exacerbating depression in older persons (Katon
et al., 2010, pp. 423-429).
The psychological factors contributing to depression include possession of negative
personality behaviors such as perfectionism, low self-esteem and self-criticism. Amy has been
labeled as having low-self-esteem and is quick to self-criticize herself. Despite being a caring
person, she keeps to herself which could have triggered feelings of worthlessness, hopelessness,
and helplessness. At one point in time she is heard saying “If I were gone, things would be easier
for my daughters”. Such negative thought patterns and judgments coupled with the absence of
coping mechanisms helps promote depression. Furthermore, Williams and Tappen (2008, pp.72-
80) assert that long-term stress emanating from ongoing issues is another factor that may dearly
contribute to depression over time. It is reported that Amy started to feel depressed some ten
years ago after being diagnosed with diabetes and hypertension. These chronic health conditions
are not only a constant source of worry for Amy but also important triggers of the same.
Lastly, social factors contributing to depression include being severely affected by recent
negative events such as losing a loved one. In this case, after the death of Amy’ husband some
three years ago, Amy was unable to eat and sleep and since she felt she had no one to talk to
since her children lived in another city, she relocated to a retirement village. Moreover, after
lacking social support, Amy decided to relocate to a retirement village. Amy's children would
only visit her only once a month. Social stressors such as traumatic situations like losing a loved
one can trigger other physical causes of depression (Mitchell, Vaze & Rao, 2009, pp.609-619).
Scientific evidence has confirmed that biopsychosocial factors are by and large
interdependent and work to influence each other in promoting depression. Depression can