Major Depressive Disorder

Running Head: MDD 0
major depressive disorder
MARCH 4, 2020

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Contents
Introduction...........................................................................................................................................2
Task one............................................................................................................................................2
Diagnostic criteria..........................................................................................................................3
Treatment.......................................................................................................................................3
Task 2................................................................................................................................................4
Task 3................................................................................................................................................5
Task 4................................................................................................................................................6
Nursing interventions....................................................................................................................7
Conclusion.............................................................................................................................................9
References...........................................................................................................................................10

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Introduction
Sadness is the natural feeling that human experiences in their life. Individuals feel
sadness when their family member passes away or when they are facing a challenging issue
like divorce, or severe health problem. However, sadness is short term, when it is persistent
and develop an intense feeling of sadness, they may have a major depressive disorder.
Depression is recognized as the mood disorder that triggers a persistent feeling of sadness and
the loss of interest in things that were interesting previously (Kupfer et al., 2016). It is also
called depression or clinical depression. It impacts how an individual feel, think and behave.
It can result in a range of emotional and physical issues, the patient may have trouble
performing daily life activities, and sometime he or she might feel as if life is not worth
living. A major depressive disorder is considered as one of the usual mental disorders in the
United States (Otte et al., 2016). It has been reported that around 13.1 per cent of the total
population of America over the age of 18 have at least one episode of Major Depressive
Disorder (MDD) in 2015 (Bogardus, 2017). Particularly in New Zealand around 14.3 per cent
of adults were diagnosed with depression at some point in their life. Rates of affected women
were higher compared to men as 17.9 per cent of females had this mental health issue.
According to a report published by health loss in New Zealand anxiety, a depressive disorder
is identified as the second leading cause of health loss in New Zealand (Atlas et al., 2017). In
this particular paper the etiology, diagnostic criteria symptoms, and treatment will be
discussed. Potential impacts, principles, recent strategy, and nursing interventions will also be
mentioned in this paper.
Task one
The cause of the major depressive disorder is believed to be a collection of hereditary,
environmental and psychological aspects. Neurotransmitters are naturally occurring
chemicals in the brain that mostly play a key role in the development of depression. Changes

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in the normal functioning and effects o these chemical agents and how they communicate
with the neurocircuits take part in maintaining mood stability can cause depression.
Hormonal imbalances are also associated with MDD. Depression is more common in
individuals whose family members also have this health issue. It can also be triggered by
alcohol or drug abuse, a different medical condition like cancer or hypothyroidism, and
specific types of medication such as steroids (Soares, 2017).
Diagnostic criteria
To be diagnosed with major depressive disorder one must have more than 5
symptoms during the same 2-week period that are changed from the previous functioning.
The patient may feel depressed mood most of the days, and almost every day. The patient
feels a lack of interest in all the activities throughout the day and almost every day and
observed by others. Loss of weight or obesity is another major symptom of this mental health
issue which might be caused by reduced or increased appetite. The affected person may
develop insomnia, fatigue, feeling worthless which endures throughout the day and almost
every day (Fakhoury, 2018). Reduced concentration and suicidal thoughts can also be
observed as the diagnosed symptoms of MDD (Kendler & Gardner, 2016).
Treatment
MDD is commonly treated with drugs and psychotherapy. By applying some lifestyle
changes one can also ease the symptoms of this disorder. Primary care providers commonly
start the treatment with antidepressant drugs such as selective serotonin reuptake inhibitors.
These antidepressants work by inhibiting the serotine breakdown in the patient's brain,
leading to an increased amount of these particular neurotransmitters. Tricyclic
antidepressants are used when other prescribed drugs failed to achieve health goals (Pérez et
al., 2017). Psychotherapy can also be effective for people with MDD such as cognitive
behavioral therapy and interpersonal therapy. Some of the lifestyle changes can also help the

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patient to address the symptoms of MDD. For example, eating healthy food that comprises
omega-3 fatty acids, performing exercise, sleeping well, and avoiding alcohol and different
processed foods can ease the symptoms (Gibbons et al., 2016).
Task 2
A major depressive disorder is a complex health condition that has a substantial
impact on the overall health ad wellness of an individual. People diagnosed with this mental
health issue often develop other chronic, behavioral and pain issues across the lifespan.
Children affected with these health issues develop symptoms such as frequent sadness,
tearfulness, a crying spell. They may also feel hopeless, persistent boredom, social isolation,
and poor communication, low self-esteem, increased irritability and anger, difficulty with a
relationship, and low energy (Wang et al., 2019). It has been reported that 5 % of children
and teenagers in the general population develop depression at any stage of life. Teenagers
with this mental health issue often experiences drug abuse which is the major complicating
variable (Schaakxs et al., 2017). When teens are diagnosed with MDD, they may develop a
slightly dissimilar set of symptoms such as aches and pain and social withdrawal. Adults
diagnosed with MDD often develop single or recurrent episodes of depression and dysthymia
adjustment disorder. Older adult suffers from MDD might be going through alterations like
kids moving away, chronic illness, and relocating to an assisted living facility. Some of the
symptoms they may develop include motor restlessness, retardation, social isolation, and
medical morbidity. Pain often plays a key role in depression, particularly in older people. It
has been reported that around 65 per cent of the older people who live line different
communities affected by chronic pain (Sharpe et al., 2017). The presence of pain among
older adult tend to negatively impact the identification and treatment of od depression.
Memory decline is one of the main complaints of older adults with depression. It has been

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also reported that mild cognitive diminishing and dementia are the continuum of major
depressive disorder (Walsh, 2009).
Task 3
Tangata Whaiora is the person who experienced mental health problems and
searching for wellness or mental health recovery of self (Ministry of Health, 2000). For these
individuals, the recovery provision workers deliver an array of retrieval- intensive help
facilities in a range of society-based settings. principles that support the mental health
recovery for these people in Aotearoa New Zealand includes effective involvement, accurate
identification of culture, utilizing important individuals, specific problems impacting on
ratings, different interrelationships between dissimilar items to advance outcome, and
information analysis, clarification and utility (Evans et al., 2016).
Effective involvement of Tangata whaiora/motuhake and their families in the
recovery journey is the groundwork for improving health outcomes (Ministry of Health,
2000). Effective participation, which focusses on recognizing how these people understand
the course of the disease, and on utilizing skills which permit presenting actions and disorder
indications to be exposed within the larger cultural setting and setting of the Tangata whaiora
and their families. The accurate identification of the ethnicity of these individuals is
important when performing measurements of health outcomes. The identification of culture is
an important first step in classifying differences in ethnicity which might influence medical
involvement, assessment, evaluation and retrieval preparation (Bruder et al., 2017).
Additional persons can also support the demonstration of the complex interaction between
social activities, societal circumstances, and community values, principally concerning
recognizing ethnically attentive behaviors, understanding patient's behavior from the
viewpoint of the Maori community and categorizing differing display of symptomology. The
definite difficulties impacting rankings comprise influences of classifying on the outcome

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assessment ratings, culturally attentive habits and the demonstration of the symptoms, and
Maori values concepts of health. It is important to distinguish the scale ratings from the
medicinal interpretation and scale management. There is a substantial alteration from rating
attainment to a retrieval schedule. This makes the understanding of the practical application
of outcome clarification ratings easy. It includes a focus on teamwork and on identifying
problems that must be conversed with Tangata Whaiora and their whanau (Evans et al.,
2020).
Task 4
Strategy support recovery
To reduce the incidence of health loss due to major depressive disorder, an effective
strategy must be implemented that supports the patient's recovery. One of the main strategies
implemented by the government of New Zealand is the suicide prevention strategy 2019-
2029. It has been reported that individuals diagnosed with MDD are at high risk of
developing thoughts of suicide. It has been reported that particularly in the year to mid-2014,
529 people in New Zealand died by suicide, which indicates 11.73 death per 100000
individuals (Coppersmith et al., 2017). It is also recognized that depression is present in a
minimum of 50 per cent of all the suicides. People suffering from depression are 25 times
more likely to commit suicide (Thomson, 2018). This particular strategy recognizes the
specific challenges experienced by every person and their whanau. It aims to confirm the
services are fair and exact and are supporting the population such as Maori. The strategy
involves the use of a whole-of-society approach to preventing suicide. This specific strategy
seeks to decrease the number and rates of suicide cases and other suicidal behaviour in
Aotearoa New Zealand, particularly among the communities with increased numbers and
incidents (Stubbing & Gibson, 2019). Every life matter takes part in improving the wellbeing
of every person by supporting them to achieve a healthy future. One of the other aims of this

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strategy to build a strong system that includes strengthening national leadership, developing a
suicide prevention workforce and using evidence and collaborative knowledge to make a
difference (Shahtahmasebi, 2019). There different types of initiatives supporting the strategy
including The Lowdown, and national depression initiative. The Lowdown is the website to
support the young population of New Zealand to identify and understand the depression and
anxiety problems. It provides ideas and recommendations from individuals who can support
the viewers. National depression initiative is a part of a national public health program and
suicide prevention strategy. It helps individuals to recognize and understand depression and
anxiety and aims to reduce the impacts of these mental health issues (Shahtahmasebi, 2019).
Nursing interventions
Nursing interventions for individuals with the major depressive disorder include
assessing the patient, providing psychological needs and promote health and overall wellness
(De La Cruz et al., 2017). Nursing assessment of inability of an individual to sleep and
fatigue, use of illegal chemical agents, muscular or emotional tensions and disturbed appetite.
The nurse also assesses the patient for lack of goal-oriented approach, improper problem
solving, reduced sue of societal support, and inability to encounter the role expectations. It
will help the patient to identify negative outcomes of these problems and further resolve them
with the help of nurses (Boylan et al., 2019). Nurses can help the patient with performing a
physical, learning self-care and personal hygiene and encouraging them to eat healthy by
educating them. A nurse can educate the patient and explain that major depressive disorder
can be managed by expressing the feelings and involving in some pleasurable activities.
Tangata whaiora and their whanau often require emotional support from a healthcare
provider. Nurses can provide psychological support and can be a link between the patient and
other healthcare professionals (Townsend & Morgan, 2017). Cognitive-behavioral therapy is
a type of therapy that concentrates on adjusting the thoughts and behavioral patterns of a

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person with MDD. An international investigation has reported that CBT can be helpful for a
range of mental health-associated issues, such as depression, substance abuse, anxiety, eating
disorder, and indications of major depressive disorder, bipolar and schizophrenia (Ahern et
al., 2018). Nurses must be able to build a therapeutic relationship (as a part of talk therapy)
with the client as it helps the patient feel being cared and empowered in the treatment
process. The therapeutic relationship is the relationship between healthcare professionals and
patients. For that nurse must be equipped with essential skills such as being empathetic,
active listening, advocacy, cultural knowledge, and leadership (Feo et al., 2017).
Nurses use effective communication skills to develop this association. Showing
empathy can help the client to feel that they being cared for. The Maori people are from
different culture thus nurses must also respect the patients. Knowing diverse cultures allows
the nurses to understand what spiritual things a person needs during their hospital stay
(Kolovos et al., 2017). Nurses who do not usually listen to the patient fails to develop a
therapeutic relationship with them. The patient might feel that the health care professional is
not worried about their health issues and this might affect their belief in the healthcare setting
(Felton et al., 2018). Nurses must also include the patient’s family members in the decision-
making process related to the treatment of the patient (Kupfer et al., 2016).
Conclusion
Major depression disorder also called depression or clinical depression is the mood
disorder that causes a persistent feeling of sadness and the patient has not interested in think
that was very interesting previously. Depression can be caused by multiple factors such as
having a family member with MDD, alterations in neurotransmitters, increased stress and
substance abuse. Diagnostic criteria symptoms for this mental health issue include feeling
depression almost every day, insomnia, fatigue, feeling worthless, and mood changes. There
are several treatments can be provided to the patients such as the use of SSRIs, cognitive

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behavioral therapy, and interpersonal therapy. Eating healthy, and exercising daily can also
help the patient in recovery. MDD can affects patients negatively across the lifespan. the
children affected by this mental health issue often develop sadness, tearfulness, and crying
spells. Adults experience recurrent episodes of depression. Older adults might be observed
with restlessness, retardation, and social withdrawal. Some of the principles that support
recovery in Tangata Whaiora include effective involvement, right identification of the
culture, specific issues affecting rating, using different individuals in the recovery process.
One of the main strategies that can help the client to recover from MDD and associated risks
like suicidal thoughts is a suicide prevention strategy 2019-2029. Two different initiatives
supporting the strategy are The Lowdown and national depression initiative. Several
therapeutic interventions can be provided to the patients such as assessment, medication
administrating, CBT, and touch therapy. The nurse must have some skills to perform their
interventions such as active listening, empathy, and advocacy.

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