9 Major Depression Nursing Care Plans

Updated on November 4, 2019

Included in this nursing care plan guide are nine (9) nursing diagnosis for major depression. Get to know the nursing assessment, interventions, goals, and related factors to the different nursing diagnosis for major depression.

What is Major Depression?

Major depression (or major depressive disorder) is classified under mood disorders which are characterized by disturbances in the regulation of mood, behavior, and affect that go beyond the normal fluctuations that most people experience.

You can learn more about major depression in our study guide here.

Nursing Care Plans for Major Depression

Nursing care plan goals for patients with major depression includes determining a degree of impairment, assessing the client’s coping abilities, assisting the client to deal with the current situation, providing for meeting psychological needs, and promote health and wellness.

Here are nine (9) nursing care plans (NCP) and nursing diagnosis for major depression:

Risk For Self-Directed Violence

Nursing Diagnosis

Risk for self-directed violence: At risk for behaviors in which an individual demonstrates that he/she can be physically, emotionally, and/or sexually harmful to self.

Risk factors

Anhedonia, helplessness, hopelessness
Loneliness
Social isolation
Severe personality disorder/ depression/ psychosis, substance abuse

Possibly evidenced by

Previous attempts of violence.
Suicidal plan (clear, specific, lethal method and available means).
Suicidal behavior (attempts, ideation, plan and available means).
When depression begins to lift, clients may have energy to carry out suicidal plan.

Desired Outcomes

Patient will seek help when experiencing self-destructive impulses.
Patient will have a behavioral manifestation of absent depression.
Patient will have satisfaction with social circumstances and achievements of life goals.
Patient will identify at least two-three people he/she can seek out for support and emotional guidance when he/she is feeling self-destructive before discharge.
Patient will not inflict any harm to self or others.
Patient will identify support and support groups with he/she is in contact within one month.
Patient will state that he/she wants to live.
Patient will start working on constructive plans for the future.
Patient will demonstrate compliance with any medication or treatment plan within the next two weeks.
Patient will demonstrate alternative ways of dealing with negative feelings and emotional stress.

Nursing Interventions	Rationale
Nursing Assessment
Identify the level of suicide precautions needed. If there is a high-risk, does a hospitalization requires? Or if there is a low risk, will the client be safe to go home with supervision from a family member or a friend? For example, does client: Admit previous suicide attempts. Abuse any substances. Have no peers/friends. Have any suicide plan.	A client with a high-risk will require a constant supervision and a safe environment.
Check for the availability of required supply of medications needed.	Normally, a suicidal client’s medical supply should be limited to 3-5 days.
Therapeutic Interventions
Encourage clients to express feelings (anger, sadness, guilt) and come up with alternative ways to handle feelings of anger and frustration.	Clients can learn alternative ways of dealing with overwhelming emotions and gain a sense of control over his/her life.
Contact the family, arrange for crisis counseling. Activate links to self-help groups.	Clients need a network of resources to help diminish personal feelings of helplessness, worthlessness, and isolation.
If, hospitalized, follow unit protocols.	There are different measures for the suicidal client in either the hospital, clinic, and community.
Implement a written no-suicide contract.	Reinforces action the client can take when feeling suicidal.

References and Sources

References and recommended sources for this care plan guide for major depressive disorder:

Boyd, M. A. (Ed.). (2008). Psychiatric nursing: Contemporary practice. lippincott Williams & wilkins.
Keltner, N. L. (2013). Psychiatric nursing. Elsevier Health Sciences.
Videbeck, S. L. (2010). Psychiatric-mental health nursing. Lippincott Williams & Wilkins.
Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]