Nursing Assignment on Depression

This nursing assignment discusses the mental health and mental illness, relation of mental and physical illness, Mary’s recovery issue from depression and implication for the practice of health care giver.

Running head: NURSING ASSIGNMENT ON DEPRESSION
Nursing Assignment on Depression
Name of the Student
Name of the University
Author Note

1NURSING ASSIGNMENT ON DEPRESSION
In recent years, mental health deterioration is one of the major concern of health care
professional and nursing personnel. In relation to this, issue of issue of mental illness is also
increasing day by day. This mental illness is also directly associated with the problem of physical
health as well(Kemp and Quintana, 2013). Depression is one of the most common mental illness
worldwide in recent years. Severe depression can result in physical health issue in the patients
with depression. The onset of depression or other mental illness is dependent on various
biological, psychological and as well as social factors (Jeste and Palmer, 2013). In this case
study, it is seen that Mary is a 41 years old woman living with her husband and three children.
Mary is a working lady and currently she is in seek leave due to her mental illness that is
depression. Recently she is complaining about her lack of motivation and do not get any
confidence even in her activities of daily life. According to her husband, Mary often thought that
she was worthless and described herself as the burden for her family. Although, she did not think
she had have any problem related to her health. Moreover, she had a history of hospitalization
due to her depression issue. In this essay, the mental health and mental illness , relation of mental
and physical illness, Mary’s recovery issue from depression and implication for the practice of
health care giver are discussed.
Mental health and mental illness is closely associated with each other. The term mental
health refers to the emotional , social and as well as the psychological factors of a person. Mental
health can alter the way of thinking, behavior and as well as can introduce stress to the people.
Stress also acts as one of the major causative factor for altering the mental health (Jorm, 2015).
Altered mental health can cause changes in the health condition of the individual. This changed
health condition is referred to as mental illness (Graham, 2013). Mental illness is closely
associated with disturbed social, family life that is the personal life and also the working life of

2NURSING ASSIGNMENT ON DEPRESSION
that individual ( Rogers and Pilgrim,2014.). Mental health is involved in effective performance
of activities of daily life like caregiving, work, and maintaining relationship. On the other hand,
the diagnosable health conditions like mood swings, emotional changes are under the mental
illness section. However, mental illness is like other disease of human being and it is totally
treatable. In this case study, it is seen that Mary is a patient of depression and had hospitalized at
the age of 39. She also had have antidepressant medicines named citalopram in past. In this
disease development, biological factor plays a vital role (Lewis et al., 2014). From the case
study, it is seen that Mary’s mother is patient of severe depression and that genetical factor had
inherited to Mary. Recently, Mary thought herself as a burden to her family and also she thought
that she was worthless in nature. This lowered mood and feeling of worthlessness also push the
person towards her depressive condition (Brewin, 2013). However, she had no past medical
history and as well as psychological trauma history. She lived with her husband and children. So
it can be said that there is no other severe psychological factor that can be responsible for
development of depression. However, withdrawal of the antidepressant drug might be a
promotional factor for the onset of depression for second time (Fava et al., 2015).
Often it is seen that, the mental and physical health are discriminated and as well as
neglected. However it is seen that, they are closely related to each other in direct and as well as
in indirect way. In a study, it is seen that, the mental and physical health are strongly
interconnected. Altered mental health can affect the working life of the individual and ultimately
this negative income effect will hamper the physical health and as well as the quality of
life(World Health Organization, 2014). In this case, It is seen that ,due to Mary’s depression she
was not able to maintain her working life. In addition to this, Mary’s husband complained about
Mary’s insomnia and this lack of sleep can also affect Mary’s physical health. Secondly, a bad

3NURSING ASSIGNMENT ON DEPRESSION
mental health condition can affect the persons’ decision making power and as a result he or she
cannot take right decision regarding to his or her heath ( Mani et al., 2013). In this case, Mary
had stopped her medicines of depression as she thought that she had no problem at all. This
decision hamper her health condition and again the depression issue occurred. Another major
health problem that is associated with the mental health is that consumption of alcohol and also
the smoking activity(Choi and Jeong, 2015). However, from the case study it is observed that,
Mary had no habit of alcohol consumption and also no habit of smoking. Several studies said
that, depression can affect the physical health by ceasing the physical activity and results in poor
physical condition (Lindwall et al., 2014). In this case, Mary felt that, she had no energy and she
even did not want to move from her bed. She also had lack of motivation even in dressing and
eating. Previously she was very much concerned about her health and dressing and now due to
lack of motivation she had no concern about her own health and hygiene. Lack of social
interaction is another factor that links between the mental and physical health. Social isolation
can cause adverse effect on physical health condition (Teo, Choi and Valenstein, 2013). In this
case study, Mary is socially isolated from other people as she was not able to perform as a
accounts manager in her organization. Although she had a supportive husband, the social
isolation can seriously affect her mental and physical health. Another health problem that is
associated with depression is chronic pain and people with depression and it can cause sudden
unexplained pain in head and lower back portion. It is seen that, people who are suffering from
depression along with chronic pain often have the symptoms of reduced energy level,
unwillingness in movement, feeling of despair (Smith, 2018). Heart disease is also closely
related with the heart disease. The nervous system and hormonal balance of the depressed person
is changed and that can induce cardiac arrhythmia. Persons with depression generally have sticky

4NURSING ASSIGNMENT ON DEPRESSION
platelets, which is responsible for the clotting of the blood. This can cause atherosclerosis and
increases the chances of heart attack (Gan et al., 2014). Depression can also induce fatigue in the
patient with depression (Snekkevik et al., 2014).
Mary had admitted to the hospital and she had no intention to be admitted in the hospital.
To help Mary, in her recovery at first doctor should start the treatment with medicines as she
previously had antidepressant medicine previously. In next process, to address the mental health,
psychological treatment should be done. There are various type of psychological treatment like
cognitive behavior therapy (CBT) can be done . CBT is mainly done to treat the patients who
have depression and altered thinking pattern (Cuijpers et al., 2013). Mary was in a severe
depressed condition and she started to felt very down and thought herself as a worthless person.
In this scenario, CBT will be very much helpful to reduce the negative thinking pattern of Mary.
During this days , Mary had less concerned about her clothes and she became very inactive. To
treat this problem the activities of Mary’s daily life should be increased and there should be at
least one such activity in everyday life of Mary. Mary also had the problem of insomnia and to
address this problem the disrupt sleep pattern should be recovered at first. To restore the regular
sleep pattern some measures can be followed and they are a particular sleep time should be fixed
and that time should be followed every day. Mary should be closely monitored whether she was
going to the window or not. As it is seen that, often Mary woke up and stared outside through the
window. In addition to this, to reduce her negative thinking and feeling of worthlessness, she
should always be encouraged and motivated. She also should be encouraged to back to her
working life as soon as possible. This type of positive thinking and supportive behavior will help
the patient in her recovery process (Schrank et al., 2014).

5NURSING ASSIGNMENT ON DEPRESSION
In treatment of depression patients, a person centered need model is very much effective
as it mainly emphasizes on the patient’s health improvements. This method is an approach of
thinking that treats all the people in the society as equal and all the people are the part of the
planning, monitoring and developing care to ensure their own needs regarding to the health care.
In addition to this, the family of the patient should also be involved in the care plan of the patient
as well. Although, giving priority to the patient in decision making, does not mean that the
patient will get whatever they want. It is only meant that the patient and his/ her family will be
given priority during the decisison making process related to the patient care (Joseph and
Murphy, 2013). There are few principles that should be followed during the application of a
person centered care plan and they are- patients should be in the center of the care plan, patient’s
need should be considered and importance should be given to the patient’s wish. In addition to
this ,family and friends of the patients should be included in the medication procedures, patients’
security should also be addressed in priority basis(Gillick ,2013). In this case study, it is seen
that Mary described her moment of hopelessness and became tearful. In this condition, she
should be given support and try to make her calm down. In patient centered care, the patient’s
desire should be the first priority. In this case ,Mary did not want to get admitted in the hospital.
Although, the principle of giving priority to patient’s wish cannot be maintained here as Mary
was not so well to take decision about her own medication due to her depression. She also
thought that she was absolutely fine and stopped her medicines in her own choice. Moreover, she
should be given proper medicines in against her wishes. In this scenario, the person-centered
model cannot be followed. Moreover, it is quite possible to include Mary and her family that is
her husband and three children in the treatment procedure so that they also can help Mary in her
recovery. Involvement of Mary’s family in the treatment procedure will give Mary an additional

6NURSING ASSIGNMENT ON DEPRESSION
psychological support and that can encourage Mary to think positive about her life. From the
case study, it was seen that, Mary thought herself as burden. Involvement of family will
encourage Mary to rethink on that matter.
To implement the proper recovery plan for Mary, the health care professionals of the
hospital in which Mary had been admitted, should follow the process of the person centered care
model and it should be to that level that would not hamper Mary’s health. They can talk more to
patient in order to know more about her personality and it would help in the treatment process
(Fortinash and Worret, 2014). In addition to this, in order to make Mary comfortable in the
whole medication process they should listen Mary’s words very carefully. However, during the
conversation, they should take a holistic approach and that will help in assessing Mary. In each
step of medication process, Mary’s husband and her children should be included if possible. As
Mary was very much hopeless about her life and thought herself as worthless, the nurses and
other health care professionals should motivate Mary all the time so that she can get rid of this
condition (Fortinash and Worret, 2014). Moreover, during the CBT therapy, motivational
sessions can be increased. In order to give priority to Mary, the positive outcomes of the
treatment procedure should be conveyed to Mary so that she can feel motivated about her own
life. Along with this, after involvement of the family in the treatment process, the role of Mary’s
family should also be depicted to Mary so that she can realize that she was not a burden to them
and her family also love her very much. Along with this, an overall healthy and safe environment
should be maintained in that hospital so that Mary can feel very much comfortable and her
unwillingness to stay in the hospital will reduce gradually. A proper healthy and safe
environment provided by the health care professionals can do the change in the patient
(Spielmans et al., 2013).

7NURSING ASSIGNMENT ON DEPRESSION
In conclusion , it can be said that, depression can seriously alter mental health
condition. An altered mental health is associated with person’s decision making. A wrong
decision about own life can create serious issues like Mary. Mary’s decision to stop her
antidepressant had hampered her personal and as well as her healthy working life. This would
ultimately reduce the Mary’s quality of life. A proper medication and proper care from hospital
and also from her family will help Mary to recover soon from this condition.

8NURSING ASSIGNMENT ON DEPRESSION
References
Brewin, C.R., 2013. Cognitive Foundations of Clinical Psychology (Psychology Revivals).
Psychology Press.
Choi, B.Y. and Jeong, H.C., 2015. Relationship between alcohol dependence and depression of
alcohol dependent inpatients. International Journal of Bio-Science and Bio-Technology, 7(5),
pp.375-382.
Cuijpers, P., Sijbrandij, M., Koole, S.L., Andersson, G., Beekman, A.T. and Reynolds III, C.F.,
2013. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety
disorders: a meta‐analysis of direct comparisons. World Psychiatry, 12(2), pp.137-148.
Fava, G.A., Gatti, A., Belaise, C., Guidi, J. and Offidani, E., 2015. Withdrawal symptoms after
selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychotherapy and
psychosomatics, 84(2), pp.72-81.
Fortinash, K.M. and Worret, P.A.H., 2014. Psychiatric Mental Health Nursing-E-Book. Elsevier
Health Sciences.
Gan, Y., Gong, Y., Tong, X., Sun, H., Cong, Y., Dong, X., Wang, Y., Xu, X., Yin, X., Deng, J.
and Li, L., 2014. Depression and the risk of coronary heart disease: a meta-analysis of
prospective cohort studies. BMC psychiatry, 14(1), p.371.
Gillick, M.R., 2013. The critical role of caregivers in achieving patient-centered
care. Jama, 310(6), pp.575-576.
Graham, G., 2013. The disordered mind: An introduction to philosophy of mind and mental
illness. Routledge.
Jeste, D.V. and Palmer, B.W., 2013. A call for a new positive psychiatry of ageing. The British
Journal of Psychiatry, 202(2), pp.81-83.
Jorm, A.F., 2015. Why we need the concept of “mental health literacy”. Health
communication, 30(12), pp.1166-1168.
Joseph, S. and Murphy, D., 2013. Person-centered approach, positive psychology, and relational
helping: Building bridges. Journal of Humanistic Psychology, 53(1), pp.26-51.
Kemp, A.H. and Quintana, D.S., 2013. The relationship between mental and physical health:
insights from the study of heart rate variability. International Journal of
Psychophysiology, 89(3), pp.288-296.
Lewis, G., Collishaw, S., Thapar, A. and Harold, G.T., 2014. Parent–child hostility and child and
adolescent depression symptoms: the direction of effects, role of genetic factors and
gender. European child & adolescent psychiatry, 23(5), pp.317-327.

9NURSING ASSIGNMENT ON DEPRESSION
Lindwall, M., Gerber, M., Jonsdottir, I.H., Börjesson, M. and Ahlborg Jr, G., 2014. The
relationships of change in physical activity with change in depression, anxiety, and burnout: A
longitudinal study of Swedish healthcare workers. Health Psychology, 33(11), p.1309.
Mani A., Mullainnathan S., Shafir E. and Zhao J., 2013. . Poverty impedes cognitive function
Rogers, A. and Pilgrim, D., 2014. A sociology of mental health and illness. McGraw-Hill
Education (UK).
Schrank, B., Brownell, T., Tylee, A. and Slade, M., 2014. Positive psychology: An approach to
supporting recovery in mental illness. East Asian Archives of Psychiatry, 24(3), p.95.
Science, 341 (6149) (2013), pp. 976-980
Smith, K. (2018). Chronic Pain and Depression: Patients with pain have a high-risk of
Depression.. [online] PsyCom.net - Mental Health Treatment Resource Since 1986. Available at:
https://www.psycom.net/depression.central.chronic.pain.html [Accessed 4 Oct. 2018].
Snekkevik, H., Eriksen, H.R., Tangen, T., Chalder, T. and Reme, S.E., 2014. Fatigue and
depression in sick-listed chronic low back pain patients. Pain Medicine, 15(7), pp.1163-1170.
Spielmans, G.I., Berman, M.I., Linardatos, E., Rosenlicht, N.Z., Perry, A. and Tsai, A.C., 2013.
Adjunctive atypical antipsychotic treatment for major depressive disorder: a meta-analysis of
depression, quality of life, and safety outcomes. PLoS medicine, 10(3), p.e1001403.
Teo, A.R., Choi, H. and Valenstein, M., 2013. Social relationships and depression: ten-year
follow-up from a nationally representative study. PloS one, 8(4), p.e62396.
World Health Organization, 2014. Social determinants of mental health. World Health
Organization.