Introduction Major depressive disorder (MDD) is characterized by the presence of one or more major depressive episodes (MDE) without a history of manic, mixed, or hypomanic episodes. Episodes of substance-induced mood disorder and mood disorder due to a general medical condition do not count toward the diagnosis of major depressive disorder, nor do episodes that might be better explained as schizoaffective disorder, delusional disorder, or psychotic disorder not otherwise specified. An MDE is defined by a period of at least two weeks during which an individual experiences a depressed mood or a loss of interest or pleasure in almost any activity. Additionally, a diagnosis of MDE must involve at least four symptoms derived from a list that includes: changes in appetite or weight, sleep, and psychomotor activity; decreased energy, feelings of worthlessness or guilt; difficulty thinking, concentrating, or making decisions; or recurrent thoughts of death or suicidal ideation, plans, or attempts. Over the course of at least two weeks, symptoms should occur most of the day, almost every day. Finally, MDE must be accompanied by clinically significant distress or impairment in social, occupational, or other functioning (American Psychiatric Association, 2000). Major depressive disorder is one of the most common mental disorders in the United States. It is estimated that nearly 7% of adults suffer from major depressive disorder each year. DCS affects individuals of all ages and has an average age of onset of 32 years. Major depressive disorder affects significantly more women than men: women are 70% more likely to develop it than men (Nation Institute of Mental Health, n.d.). DCS is important to healthcare professionals as it is associated with a number of general medical treatments... focus of the article ......ack, I realize that this simple action would have helped further convey my respect for the patient. Another action I did not take at the beginning of the interaction was to adequately delineate the duration of the therapeutic relationship. I managed to outline the amount of time I hoped to spend conversing with the patient, however I failed to mention that I would only be on the unit for one day a week. I shared this information with the patient at the end of our conversation, however I feel it would have been more appropriate to disclose this information at the beginning of our conversation. Recognizing both my strengths and weaknesses during patient interaction will help me make positive changes in the future and further increase my therapeutic communication skills and therefore help me become a caring and competent nurse.
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