DSM-V Paper

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Clinical Project for Concepts of Mental Health
For this project you will use the DSM-V: The Diagnostic and Statistical Manual of Mental Disorders
Please provide double spaced 12 Times New Roman Font to explain the following:
1-Look through the DSM-V, and pick a diagnosis that you find interesting, 1- explain the diagnosis 2- why
you find this diagnosis interesting, and 3-a surprising diagnostic feature of the diagnosis in 800 words.
2- Look at the website AHRQ at (https://www.ahrq.gov/) and determine the best treatment and
outcomes for this diagnosis. Please cite your references in APA format. This must be at least 800 words.
Be concise, no rewording of previous sentences to take up space. Your concern/enthusiasm must come
alive in your paper.
Submit to the assignment drop box by date your instructor gives
There must be at least 2 references in APA format
DSM-V: Major Depressive Disorder
DSM-V: Major Depressive Disorder
Most people do not realize there is more to mental illness than someone being classified
as a “crazy” person. What most individuals fail to understand is how common certain illnesses,
such as severe depression, function within society.
DSM-V Diagnosis
Depression is also known as a mood disorder. Based on the research from the National
Institute of Mental Health, major depressive disorder affects about roughly 300 million adults in
the United States. The major depressive disorder itself consists of multiple disorders including
major depressive disorder, disruptive mood dysregulation disorder, dysthymic disorder,
premenstrual dysphoric disorder, substance-induced depressive disorder and depressive disorder
that is not classified elsewhere. (Halter, 2014, p. 250) One of the major leading causes of
disability in the United States is depressive disorder. The reason this disorder manifests disability
in some individuals is due to the lack of functioning an individual may experience when the
manifestations of this disorder are prevalent. Depression is a chronic disorder that can last
anywhere from intermittent episodes (about 2 weeks at a time) to a longer episode lasting for
months with moderate or severe intensity. Individuals with this disorder find it hard to get
adequate sleep, function properly with the task of decision making, and it even can affect
appetites resulting in significant weight loss and furthermore malnutrition. Like most mental
disorders, depression is usually accompanied by some form of comorbidity disorders including,
anxiety, substance abuse, eating disorders schizoaffective disorders and schizophrenia. (Halter,
2014, p. 251-252)
Diagnosis Interests
I personally find this disorder interesting by how the genetics play a factor into the
disorder. I’ve always thought from personal experiences that depression occurs because of a
traumatic event, terminal illness, or just a person feeling hopelessness. I never once thought that
genetics can tie into mental illness; I never connected that two individuals could feel the same
way just because they are related. The probability (37%) of one twin developing depression
because the other twin has it is undeniably fascinating. Learning how multiple genes can be
involved with depression puts a difference aspect on the disease for me. Sometimes I wonder that
if genetics plays a major role in this disorder, would the manifestations become present with
every little depressive trigger?
To be diagnosed with depression per DSM-V, the individual must have at least one of
these symptoms for more than two weeks including depressed mood and/or anhedonia, and at
least four of these symptoms for at least two weeks including fatigue, sleep disturbances,
excessive guilt, changes in appetite, weight loss, persistent thoughts about death or suicide and
the inability to concentrate or make decisions; indecisiveness.
Areas that are assessed when diagnosing depressive disorder include affect, thought
processes, mood, feelings, physical behavior, communication and religious beliefs. I thought that
a surprising feature of this disorder was the postpartum time period where depression can take
place. It usually happens about 4 weeks after a mother delivers her child. What I did not know is
that the postpartum depression is a highly prevalent disorder among lots of women in childbearing age. There are still a few questions I have about how depression can manifest
postpartum. Research states that there are ways to screen for postpartum depression before it can
actually happen. A “well baby care” screening technique was used in research that showed
promising improvements in the Postnatal Depression Scale. (Angarath, 2017, p. 9) “The
intention of WBC is to monitor the child’s development and health, including the wellbeing of
the parents.” (Angarath, 2017, p. 10) This diagnostic feature can help in so many ways such as,
stress, new mother basic needs and more to ensure that the mother is not so far overwhelmed that
it later turns into depression.
Nursing Assessment/Treatment
During the nursing assessment, anergia, which is the lack of energy, and hypersomnia are
expected findings. Several assessment tools are used to test for depression for various types of
individuals including Beck Depression Scale, Hamilton Depression Scale, Zung Depression
Scale, Geriatric Depression Scale, and Patient Health Questionaire-9 (PQH-9). For depression,
the nurse will always assess for suicidal or homicidal ideation. Approximately 97% of
individuals with depression will have anergia. (Halter, 2014, p. 257) Common feelings for
individuals diagnosed with major depressive disorder will feel worthlessness, hopelessness, guilt,
anger, and helplessness. With the assessment findings, the nurse’s priority would be to focus on
making sure the patient’s strengths and goals are mutually developed—patient centered. Several
therapies are used during the nursing treatment. Those therapies include exercise (30 minutes 3-5
days a week), electroconvulsive therapy (ECT), light therapy, and medication therapy.
Medications used to treat major depressive disorder include SSRIs (Prozac, Zoloft, Paxil, Celexa,
Lexapro, Luvox), TCAs (Elavil, Pamelor, Norpramin, Silenor, Tofranil) and MAOIs (Marplan,
Nardil, Parnate).
Nursing Outcomes
Outcomes for mental illnesses are often tailored to the individual themselves for various reasons.
“Outcomes relating to thought processes, self-esteem, and social interactions are frequently
formulated because these areas are often problematic in people with depression” (Halter, 2014, p.
274) Affect and negative self-perception are the two main manifestations that turn to a positive
outcome when the manifestations of depression subsides. The individual will present positive
self-outlook on life, maintain interpersonal relationships, and demonstrate adequate mood and
function at work, socially, and also within their family household.
Halter, M. J. (2014). Chapter 14. In Varcarolis’ Foundations of Psychiatric Mental Health
Nursing (7th ed., pp. 249-277). St. Louis, Missouri: Elsevier Health Sciences.
Zee-van den Berg, A., Boere-Boonekamp, M., IJzerman, M., Haasnoot-Smallegange, R., &
Reijneveld, S. (2017). Screening for Postpartum Depression in Well-Baby Care Settings:
A Systematic Review. Maternal & Child Health Journal, 21(1), 9-20.

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