MAJOR DEPRESSION

FLASHCARD FRIDAY

An astounding 14.5 million Americans have been diagnosed with major depression in the past 12 months. And I'll bet all the money in my wallet that that number is low, mostly because so many people never get diagnosed at all. Oh, and that's just the adult population. Count in the teenagers and that number zooms up to nearly 20 million.  The prevelance over people's entire lifetimes goes into the stratosphere--an astounding 105 million Americans. The chances are pretty high that if you are reading this, you or someone in your family has experienced major depression. So you know suffering from this is no joke.

I can count myself among those multi-millions of souls who have been, at one point or another, crippled with major depression. Childhood PTSD was probably the first domino to fall for me on that front (I grew up in a rough neighborhood where teenagers assaulted younger kids on a regular basis. Starting at age 7, I was regularly terrorized and assaulted by these roaming groups of teens looking to exert their power,) but clearly I had a genetic predisposition to it regardless. In childhood, it presented mostly as terrible anxiety--a common way for it to express itself, rather than depressed mood. But my first bonafide depressive episode came out of nowhere in high school my sophomore year. It came, I suffered (as did my grades), it went. No treatment, or even diagnosis. It was the first of several I would have in my lifetime.

Fifteen years later, having dropped into a suffocating post-partal depression, I started on medication for the first time, and within 10 short days, I was magically lifted out of terrible darkness and back into the light. A miracle.

So for those of you who have not experienced it or seen it in someone you love, here are the bare basics:

• Depressed mood most of the day, nearly every day (e.g., feeling sad, empty, hopeless; in children/adolescents this can be irritable mood or anxiety)

• Markedly diminished interest or pleasure in almost all activities (anhedonia)

• Significant change in weight ot appetite

• Significant change in amount of sleep

• Significant change in psychomotor activity (observable restlessness or slowed movements/thinking)

• Fatigue or loss of energy

• Feelings of worthlessness or excessive/inappropriate guilt

• Diminished ability to think or concentrate, or indecisiveness

• Recurrent thoughts of death, suicidal ideation, or suicide attempt/plan**

  (Author's Note: Combat veterans are often plagued with ongoing thoughts of death because of the massive amount of exposure to death they've experienced. Be especially careful to assess for all other possible symptoms of MD in this patient population, because this one symptom may be more due to PTSD and working through trauma than MD.)

ANCC PMH-BC exam questions will focus on the nurse's ability to assess for symptoms of major depression or understand what someone with major depression might say, feel or do.

Next up: TEST TIDBIT TUESDAY! "Like" my Facbook page so that you can be notified of my twice weekly exam prep notes.

Want even more help getting ready for ANCC's Psychiatric-Mental Health Nurse Board Certification Exam? Check out our exam prep materials at pmhrn.com.