IntroductionMajor Depressive Disorder defined by the DSM-IV-TR (2000) “is characterized by one or more Major Depressive Episodes (i.e., at least 2 weeks of depressed mood or loss of interest accompanied by at least four additional symptoms of depression)”. Major depressive disorder affects twice as many women as men and for both sexes is most common among those aged 25 to 44 (All About Depression.com 2011). In the case of Mrs Adele Harper, 65, who was diagnosed with the disorder at the age of 43, has been suffering from this disorder for many years and has now been admitted to the acute psychiatry ward from the emergency department after her daughter found disheveled and extremely sitting in her home after attempting to take her own life. A nurse has designed a plan of care to care for this patient by identifying the nursing diagnosis, possible goals, potential interventions, and expected outcomes. Pathophysiology of major depressive disorder There are several areas of the brain involved in the emotional and physical changes that are observed in depression (Shives 2005). Shives (2005) states that while the brain of a depressed individual is generally underactive, some areas show hyperactivity. The thalamus is associated with emotional changes and is known to stimulate the amygdala. This area shows increased activity levels in a depressed person (Shives 2005). The amygdala is responsible for negative feelings; there are manifestations of hyperactivity in this area in depressed people (Shives 2005). In depressed people there is increased activity in the cingulate gyrus. This area helps you associate smells and sights with pleasant memories of past emotions. It also participates in the emotional reaction to pain and regular...... middle of paper...... T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B , Reid-Searl, D & Stanley, D 2010, Kozier and Erb's Fundamentals of Nursing, 1st edition, vol. 1, Pearson Australia, NSW.Berman, A, Snyder, S, Levett-Jones, Dwyer, T, Hales, M, Harvey, N, Luxford, Y, Moxham, L, Park, T, Parker, B, Reid-Searl , D & Stanley, D 2010, Fundamentals of Nursing by Kozier and Erb, 1st edition, vol. 3, Pearson Australia, NSW.Fontaine, KL 2009, Mental Health Nursing, 6th edition, Pearson Education, New Jersey.Keleher, H, MacDougal, C, & Murphy, B 2007, Understanding Health Promotion, Oxford Community Press, South Melbourne, Vic.Shives, L 2005, Basic concepts of psychiatric and mental health nursing, Lippincott Williams & Wilkins, Philadelphia.Smith, M & Segal J 2011, 'Coping with Grief and Loss', viewed 10 September 2011, .