You are a nurse at an outpatient clinic and are presented with a 68-year-old female client. She is experiencing the following symptoms: decreased appetite, disturbed sleep pattern, fatigue, difficulty concentrating, disordered thought process, anhedonia, guilt, and low self-esteem. The doctor diagnoses the client with major depressive disorder. Answer the following questions: Purchase the answer to view it
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), major depressive disorder (MDD) is characterized by the presence of several key symptoms for a minimum duration of two weeks. These symptoms include persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in previously enjoyed activities (anhedonia). In the case of the 68-year-old female client presented, it is evident that she meets the criteria for a diagnosis of major depressive disorder due to her presenting symptoms of decreased appetite, disturbed sleep pattern, fatigue, difficulty concentrating, disordered thought process, anhedonia, guilt, and low self-esteem.
One of the primary symptoms mentioned is decreased appetite. This is a common feature of major depressive disorder and can lead to weight loss and malnutrition if not addressed. Studies have shown that alterations in appetite regulation, such as decreased levels of the neurotransmitter serotonin, are involved in the pathophysiology of depression and may contribute to the development of decreased appetite. Additionally, individuals with depression often experience changes in taste perceptions, leading to a reduced desire for food.
Disturbed sleep pattern is another symptom commonly seen in individuals with major depressive disorder. Sleep disturbances can manifest in various ways, including difficulty falling asleep, waking up frequently throughout the night, or early morning awakening. The underlying mechanism of sleep disturbances in depression is not fully understood, but it is thought to involve dysregulation of neurotransmitters, such as serotonin and norepinephrine, as well as disturbances in the circadian rhythm. Sleep disruptions can further exacerbate depressive symptoms and impair overall functioning.
Fatigue is a hallmark symptom of major depressive disorder and can significantly impact a person’s daily life. The exact cause of fatigue in depression is not well understood, but it is believed to be multi-factorial. Biological factors, such as dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and alterations in neurotransmitter levels, may contribute to fatigue. Additionally, behavioral factors, such as decreased physical activity and disturbed sleep patterns, can contribute to feelings of fatigue in individuals with depression.
Difficulty concentrating and a disordered thought process are cognitive symptoms commonly associated with major depressive disorder. These symptoms can manifest as problems with attention, memory, decision-making, and executive functioning. Cognitive deficits in depression may be due to alterations in neurotransmitter functioning, such as decreased levels of norepinephrine and dopamine. Additionally, psychological factors like rumination and negative thought patterns can further impair cognitive functioning in individuals with depression.
Anhedonia, the loss of interest or pleasure in previously enjoyed activities, is considered a cardinal feature of major depressive disorder. It can significantly impact a person’s quality of life as they may no longer find joy in activities that once brought them happiness. The exact neurobiological mechanisms underlying anhedonia are not fully understood but are thought to involve dysregulation of dopamine and other neurotransmitters involved in the brain’s reward pathways.
Feelings of guilt and low self-esteem are common psychological symptoms of major depressive disorder. Individuals with depression often experience excessive self-blame and feelings of worthlessness. These negative self-perceptions may be influenced by distorted thinking patterns and a negative cognitive bias, which are characteristic cognitive aspects of depression. Negative life events, such as loss or failure, can also contribute to feelings of guilt and low self-esteem in individuals with depression.
In conclusion, the 68-year-old female client presented with multiple symptoms that meet the diagnostic criteria for major depressive disorder. These symptoms include decreased appetite, disturbed sleep pattern, fatigue, difficulty concentrating, disordered thought process, anhedonia, guilt, and low self-esteem. It is important for the nurse to collaborate closely with the doctor and mental health professionals to develop an appropriate treatment plan that addresses the client’s physical, emotional, and cognitive symptoms. Effective treatment strategies for major depressive disorder often involve a combination of medication, psychotherapy, and lifestyle modifications to improve overall well-being and functioning.