9 Major Depression Nursing Care Plans

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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:

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  1. Risk For Self-Directed Violence
  2. Impaired Social Interaction
  3. Spiritual Distress
  4. Chronic Low Self-Esteem
  5. Disturbed Thought Processes
  6. Self-Care Deficit
  7. Grieving
  8. Hopelessness
  9. Deficient Knowledge
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Chronic Low Self-Esteem

Nursing Diagnosis

  • Chronic Low Self-Esteem

May be related to

  • Biochemical/neurophysiological imbalances.
  • Feelings of shame and guilt.
  • Impaired cognitive self-appraisal.
  • Repeated past failure.
  • Unrealistic expectation of self.

Possibly evidenced by

  • Evaluates self as unable to deal with events.
  • Inability to recognize own achievement.
  • Negative view of self and abilities.
  • Repeated expression of worthlessness.
  • Rejection of a positive feedback.
  • Self-negating verbalizations.

Desired Outcomes

  • Patient will express belief in self.
  • Patient will maintain self-esteem.
  • Patient will demonstrate a zest for life and ability to enjoy the present.
  • Patient will identify one or two strengths by the end of the day.
  • Patient will identify two unrealistic self-expectations and reformulate more realistic life goals with nurse by the end of the day.
  • Patient will identify three judgemental terms (e.g., “I am lazy”) client uses to describe self and identify objective terms to replace them (e.g., ” I do not feel motivated to).
  • Patient will keep a daily load and identify on a scale of 1 to 10 (1 being the lowest, 10 being the highest) feelings of guilt, shame, self-hate.
  • Patient will report decreased feelings of guilt, shame and self-hate by using a scale of 1 to 10 (1 being the lowest, 10 being the highest).
  • Patient will demonstrate the ability to modify unrealistic self-expectations.
  • Patient will give an accurate and nonjudgmental account of four positive qualities as well as identify two areas he or she wishes to improve.
Nursing InterventionsRationale
Nursing Assessment
Assess the self-esteem level of the patient.Signs of a low self-esteem includes withdrawal from social relationships, feeling of inadequacy, neglect of personal hygiene and dress, and rejecting self which all may indicate a negative thought pattern.
Therapeutic Interventions
Allow the patient to perform personal care activities.Paying attention to grooming serves as a first step towards achieving positive self-image.
Give positive feedback after a task is achieved.Positive reinforcement has a big part in building self-esteem.
Allow the patient to engage in simple recreational activities, advancing to a more complex activities in a group environment.Patient may feel overwhelmed at the start when participating in a group setting.
Teach visualization techniques that can help the client replace negative self-images with more positive images and thought.To promote a healthier and more realistic self-image by helping the client choose more positive thoughts and actions.
Encourage the client to participate in a group therapy where the members share the same situations/feelings that they have.To minimize the feelings of isolation and provide an atmosphere where positive feedback and a more realistic appraisal of self are available.
Evaluate client’s need for assertiveness training tools to pursue things he or she wants or needs in life. Arrange for training through community-based programs, personal counseling, literature etc.Low self-esteem individuals often have feelings of unworthiness and have difficulty determining their needs and wants.
Role model assertiveness.Clients can follow examples/role models.
Involve the client in activities that he or she wants to improve by using problem-solving skills. Assess and evaluate the need for more teaching in this area.Feelings of low self-esteem can interfere with usual problem-solving abilities.
Work with the client to identify cognitive distortions that encourage negative self-appraisal. For example:

 

  1. Discounting positive attributes.
  2. Mind reading.
  3. Overgeneralizations.
  4. Self-blame.
Cognitive distortions reinforce negative, inaccurate perception of self and the world.

 

  1. Focus on negative qualities.
  2. Assuming others “do not like me”. for example, without any real evidence that assumptions are correct.
  3. Taking one fact or event and making a general rule out of it. (“He always”, I never”).
  4. Consistent self-blame for everything perceived as negative.
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Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans for mental health and psychiatric nursing:

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]
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Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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