Health issue: Major depression
• Patient states she is sad and preoccupied with her thoughts most days.
• Experiences lack of appetite, states that she is “disgusted by the sight of food”.
• Patient suffers from insomnia. She goes to sleep around midnight and wakes up numerous times during the night. She can only fall asleep by taking Ativan.
• Spends most of her days sleeping. She complains of fatigue and muscle aches.
• Patient tends to skip her classes because she lacks motivation and concentration.
• Patient has recurrent thoughts of suicide and a history of suicide attempts.
• Engages in self-mutilation to express her anger and frustration.
• Facial expression conveys sadness and hopelessness. There is a lack of eye contact and patient’s speech is slow with a low tone.
• Patient answers questions using very short responses and answers are delayed.
Nursing Hypotheses
• Risk for suicide related to depression, hopelessness, and poor coping skills as evidenced by previous suicide attempts, suicidal ideations with no plan, and feelings of hopelessness.
The risk for suicide is the biggest concern for this patient because she lacks adaptive coping skills, displays poor problem solving, and her judgment seems to be impaired. For instance, the patient admits that her self-mutilations and suicide attempts were always impulsive decisions. Her actions were never planned or thought through, which makes this patient at high risk for suicide. Also, the patient meets many of the risk
Psych: The patient states that she is depressed due to “falling apart” and anxious about dying. Denies suicidal thoughts, memory loss and confusion.
The National Institute of Mental Health (NIMH) has published a fact sheet of statistics on suicide in the United States. In 2007, it is reported that suicide was the tenth leading cause of death. Furthermore, for every suicide committed, eleven were attempted. A total of 34,598 deaths occurred from suicide with an overall rate of 11.3 suicide deaths per 100,000 people. (NIMH, 2010). Risk factors were also noted on this report and listed “depression and other mental disorders, or a substance abuse disorder (often in combination with other mental disorders). More than ninety percent of people who die by suicide have these risk factors (NIMH, 2010).”
The following essay is a case study of a client named John who is suffering from major depression and was sent to see me for treatment by his concerned wife. I will provide brief background information about John then further discuss interventions and strategies I believe can be applied in each session with my client in order to make John's life more manageable. In the essay, I will be writing as the therapist, and the sessions are based on a ten week period.
The patient is a 40 year old female who presented to the ED with suicidal ideation and a attempted overdose on cocaine the day before. The patient reports increase depression and recently losing her job, house, and car. The patient denies homicidal ideations and symptoms of psychosis.
Major depressive disorder, we all have probably heard of it, but do we really know what is it is ? Major depressive disorder is “a mood disorder that causes a persistent feeling of sadness and loss of interest… major depressive disorder or clinical depression, affects how you feel, think and behave and can lead to a variety of emotional and physical problems”(Mayo Clinic Staff). Having this disorder puts you in a very unstable position because you are constantly feeling depressed so it affects the way you think and feel and that can be very dangerous. Sometimes this happens to a person for one day, but put yourself in the shoes of someone who experiencing this for more than two weeks? When you have major depressive disorder, the signs of depression disorder can last for two weeks or more(myers646). This dis order must be treated immediately because “depression may make you feel as if life isn 't worth living”(Mayo Clinic Staff). Feeling this way can lead you to doing things that you can not take back such as committing suicide and sadly that can happen when you have major depressive disorder. Kiyohara and Yoshimasu conducted a research that showed that 90% of suicides have were dealing with major depressive disorder(qtd. in The World Health Organization). Throughout this paper I will be discussing the causes, symptoms and treatment when dealing with major depressive disorder.
d. A nurse gives a PRN dose of an antipsychotic drug to a patient to prevent violent acting out because
Client “B” has struggled with major depression for over 30 years- unable to work, poor hygiene,
Pt is a 8 y/o white female that was presented at NNBHC by her mother with a dx of ADHD, OCD, and Anxiety D/O. Pt is currently on vacation and reports of have intrusive thoughts of SI with a plan to “get a knife” with a desire to harm self. Pt states that she has been having difficulty of controlling her anger towards family members. Pt describes that she sometimes to get upset and punches herself in the face. Pt also states that she has suicidal thought “at least ten times” where she verbalize that she wanted to harm herself. “I am having a hard time controlling my anger lately”, stated by pt. “Sometimes I want to harm myself when I get so angry” stated the pt.Pt states that she does not have future goals and she forsee plans for tomorrow. Pt denies psychosis and paranoid thinking. Pt utilizes vulgar language when she is upset towards her family, however she states that she apologizes afterwards.
Client was oriented 4x, appropriately groomed and attired, and no evidence of perceptual or thought disturbances was present. Client appeared to be at low probability of suicide/DTS as evidenced by her verbal denial.
Generally, people who are diagnosed with specific psychological disorders are at higher risk of suicide and statistics show that nine out of ten people who commit suicide were suffering with a mental disorder. Psychological risk factors can be associated with an individual’s psychiatric disorders, with their environmental factors, or both. (Larson, Lutes, Orgera, & Suplick Benton). The main suicide risk factors are hostile life events and a lack of mental health care treatment. The American Association of Suicidology states that if depression is left untreated it can lead to comorbid (occurring at the same time) mental disorders, recurrent episodes and higher rates of
Most people often find obstacles in their life to be overwhelming at times and can turn to drastic measures. Suicidal people believe dying is easier then living. Suicide is described as the taking of your own life. Depression and lowered self-esteem can be responsible for most suicides in today’s society. Depression can be caused by a number of things, and can also be triggered by low self-esteem. The way hope is described on Merriam-Webster Dictionary is to cherish a desire with anticipation. Meaning wishing for a desired outcome to happen. Most people experience hopelessness after a tragedy or incident such as depression. Strategies for coping with hopelessness can be by talking to someone about the situation.
De Munck, Portzky, & Van Heeringen, (2009) define suicide as an individual deliberately acts in self-harming or destructive behavior. Bremberg (2015) states that when an individual experiences stress that is greater than they can handle is when they are at a higher risk of committing suicide. Borges et al. (2008) states that there are three specific behaviors that lead to suicide-related outcomes: suicide ideation, suicide plan, and suicide attempts. The presence of psychiatric disorders increases the possibility of suicidality. Borges et al. (2008) defines suicide attempt as “self-destructive behaviors not leading to death.” Shirav & Levy (2013) found that suicide rates are higher in more economically advanced countries. The world’s highest
It is widespread with patients having mood disorders. Numerous suicide attempts have been associated with mental disorders specially depression and schizophrenia and many these association has been under estimated. With a number of studies done have proved to be true thus depression has been mostly been associated with high risk suicide. Leading to major risk factor for suicidal attempts, ideas, or completions.
Risk factors, such as, conditions, personal characteristics, and traumatic life events greatly affect the risk of suicidal ideation, planning of a suicide, or the act of committing suicide. In most cases, one or more of these signs have been present in someone who is at risk for suicide:
Other factors that lead to suicidal tendencies like poverty, hopelessness, feeling of insecurity, relationship problems and work stress are also mentioned.