9 Major Depression Nursing Care Plans


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:

  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

Disturbed Thought Processes

Nursing Diagnosis

May be related to

  • Biologic/medical factors.
  • Biochemical/neurophysical imbalances.
  • Persistent feelings of extreme guilt, fear or anxiety.
  • Prolong grief reaction.
  • Overwhelming life circumstances.
  • Severe anxiety or depressed mood.

Possibly evidenced by

  • Decreased problem-solving abilities.
  • Hypovigilance.
  • Impaired ability to grasp ideas or orders thoughts.
  • Impaired attention span/easily distracted.
  • Impaired insight.
  • Impaired judgment, perception, decision making.
  • Inaccurate interpretation of the environment.
  • Memory problems/deficits.
  • Negative ruminations.

Desired Outcomes

  • Patient will process information and makes appropriate decisions.
  • Patient will accurately recall recent and remote information.
  • Patient will exhibit organized thought process.
  • Patient will identify two goals he or she wants to achieve from treatment, with aid of nursing intervention, within 1 to 2 days.
  • Patient will discuss with nurse two irrational thoughts about self and others by the end of the first day.
  • Patient will reframe three irrational thoughts with the nurse.
  • Patient will remember to keep appointments, attend activities, and attend to grooming with minimal reminders from others within 1 to 3 weeks.
  • Patient will identify negative thoughts and rationally counter them and/or reframe them in a positive manner within 2 weeks.
  • Patient will show improved mood as demonstrated by the Beck Depression Inventory.
  • Patient will give examples showing that short-term memory and concentration have improved to usual levels.
  • Patient will demonstrate an increased ability to make appropriate decisions when planning with the nurse.
Nursing InterventionsRationale
Nursing Assessment
Determine the client’s previous level of cognitive functioning (from client, family, past medical records).Establishing a baseline data  allows for evaluation of client’s progress.
Therapeutic Interventions
Use simple, concrete words.Slowed thinking and difficulty concentrating impair comprehension.
Allow the client to have plenty of time to think and frame responses.Slowed thinking necessitates time to formulate a response.
Allow more time than usual for the client to finish usual activities of daily living (ADL) (e.g.,eating, dressing).Usual tasks might take long periods of time; demands that the client hurry only increase anxiety and slow down ability to think clearly.
Help the client to postpone important major life decision making.Making rational major life decision requires optimal psychophysiological functioning.
While the client is severely depressed, minimize client’s responsibility.Decreases feelings of guilt, anxiety and pressure.
Help the client identify negative thinking/thoughts. Teach the client to reframe and/or refute negative thoughts.Negative ruminations add to feelings of hopelessness and are part of a depressed person’s faulty thought processes. Intervening in this process helps in healthier and more useful outlook in life.
Help client and family structure an environment that can help re-establish set schedules and predictable routines during severe depressions.A fairly and non-demanding repetitive routine is easier to both follow and remember.

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]

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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