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Signs and Symptoms of Severe Depressive Episodes

   

Added on  2020-04-07

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Running head: NURSINGNursingName of the student:Name of the University:Author’s note

1NURSINGAnswer 1a)Signs and symptoms of severe depressive episodes: David Wilson, a 38 year old manworking as a mechanical fitter for mining company has been diagnosed with MajorDepression (ICD10 diagnosis F32.2 severe depressive episode without psychoticsymptoms). In the category of depressive episodes, his condition comes under F32.2. Asevere depressive episode without psychotic symptoms is one where symptoms likefatigue, tiredness, lowering of mood, decreased concentration, low capacity forenjoyment, decreased appetite and sleep disturbance are present at extreme level andpatient develop distressing experiences in life. In patients with F32.2 severe depressiveepisodes, the continuous presence of such symptoms results in loss of self-esteem andfeeling of worthlessness (ICD-10 Version: 2016, 2017). This was also seen in case ofDavid, as his performance at workplace decreased due to poor concentration and he keptruminating over negative events resulting in poor self-esteem. Such patients generallyhave suicidal feelings and somatic symptoms like unusual waking hours, weight loss, lossof appetite, psychomotor and loss of libido. As majority of these symptoms were presentin Mr. David Wilson, he has been diagnosed with Major Depression.b)Pathophysiology of depression: The difficulty faced by Mr. David Wilson is clearly anindication of severe depression. Major depressive disorder is medical condition in whichfeeling, thinking and activities of a person is negatively affected. This leads to feelings ofsadness, loss of interest in activities, guilty feeling, loss of energy, change in appetite andsleeping patterns and difficulty in concentration. People may experience single ormultiple episodes of depression. The examination of neurobiological theories elucidatingthe pathophysiology of depression suggest that depletion of neurotransmitters like

2NURSINGdopamine and serotonin in the central nervous system results is the underlying factorbehind the pathophysiology of depression (Hasler, 2010).While considering the pathophysiology behind the condition, it can be said thatneurotransmitters, the brain chemicals plays a major role in depression. Sperner-Unterweger,Kohl, & Fuchs, (2014) has shown that changes in function of neurotransmitters affect theirinteraction with neurocircuits and this in turns results in development of depression asneurocircuits are mainly involved in maintaining mood stability. Hence, mood stability isseverely affected by the biological changes in neurotransmitters. Links has been foundbetween inflammatory pathways and neurocircuits in the brain as the mechanism ofinteractions of the immune system with the neurotransmitters and neurocircuits affects therisk for depression. The activation of inflammasome results in release of stress inducedinflammatory signals such as increased expression of pro-inflammatory cytokines. Theinflammatory cytokines consequently has an impact on monoamines, noradrenaline anddopamine.Neurotransmission plays a role in mood regulation and through severalmechanism, inflammatory cytokines reduces the availability of monoamines whichcontributes to the pathophysiology of depression. In case of dopamine, they play a role inmotivation and motor activity and cytokines decreases the release of dopamine leading topoor mood and depression (Miller & Raison, 2016). Hence, activation of inflammasomeleads to release of inflammatory cytokines and this affects the function of neurotransmittersand neurocircuits resulting to unsuitable behavior in affected person. c)There is ambiguous evidence on the specific causes of depression. However, acombination of biological factors as well as environmental stressors might play a role inthe onset and diagnosis of depression (Uher, 2014).. While reviewing the case of David

3NURSINGWilson, it has been found that his mother, Michelle, 69 years old had a history ofdepression and currently she was also suffering from early onset of Alzheimer’sdementia. This is an indication that David may have hereditary links to depression asblood relatives with history of depression are known to increase the risk of developingdepression. Research has shown that genetics has a role in the development of depressionand as it mainly runs in families, it is highly regarded as hereditary (Flint & Kendler,2014). In case of David, his mother has been found to have a history of depression and insuch case he is 1.5 to three times more likely to suffer from the condition. Hence,hereditary factors may have contributed to David’s depression. Other biological factors that might be the cause of depression in David include theabnormal brain structure and brain chemistry. For instance, the parts of brain involved inregulating mood, thinking and behavior might be affected and the imbalance inneurotransmitters leads to the progression of depression (Kemp, Lickel & Deacon, 2014).Due to such imbalance, David might be suffering from low moods and other symptomsof depression. As David has been working as a mechanical fitter on the Pilmara mines since thelast 7 years, it is also possible that his work environment might have increased the risk ofdepression in him. This is said because research has pointed out that mining industryworkers often develops mental health problems like depression and anxiety. Thelifestyles, work characteristics and attitudes influences the mental and psychologicalhealth and well-being of workers (Liu,Wang, & Chen, 2014). Hence, work environmentand occupational factors might be cause of depression in David.

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