Nursing Care Plans for Depression – Best Nursing Care Plans(2022)

This article discusses Nursing Care Plans for Depression plus its causes, symptoms, preventions, treatments and interventions.

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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.


Depression is a mood illness characterized by a continuous sense of melancholy and a loss of interest. It affects how you feel, think, and behave and can lead to several mental and physical difficulties. It’s also known as major depressive disorder or clinical depression. A depressed person may find it challenging to carry out day-to-day tasks and feel like life isn’t worth living. A person suffering from depression may feel unhappy all of the time.

Bereavement or the loss of a job are examples of significant life events that can contribute to depression. On the other hand, doctors only consider grieving to be an element of depression if it persists.

Depression is a long-term issue, not a blip on the radar. It comprises episodes with symptoms that last at least two weeks. Depression can endure weeks, months, or even years.

Symptoms and signs of Depression

The following are some of the signs and symptoms of depression:

  1. A depressed mood
  2. Decreased interest or pleasure in previously enjoyed activities
  3. Changes in appetite
  4. Unintentional weight loss or gain
  5. Restlessness  and pacing up and down,
  6. Slowed movement and speech
  7. Fatigue or loss of energy
  8. Feelings of worthlessness or guilt
  9. Difficulty thinking, concentrating or making decisions.
  10. Recurrent thoughts of death or suicide, or an attempt at suicide recurrent thoughts of death or suicide, or an attempt at suicide

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Depression in Female

According to the Centers for Disease Control and Prevention, depression is about twice as common in women as it is in men (CDC).

Sources of depression that are more common in females include:

  • Irritability \sanxiety
  • Fluctuations in mood
  • Ruminating on weariness (dwelling on negative thoughts)

In addition, several kinds of depression are exclusive to women, such as:

  • Depression after childbirth
  • Premenstrual dysphoric disorder

Depression in men

According to the American Psychological Association, approximately 9% of males in the United States experience depression or anxiety.

Males with depression are more prone than females to drink excessively, be angry, and take risks due to t their illness.

Other signs and symptoms of depression in men include:

  • Avoiding social situations and families
  • Working without taking a break having.
  • Trouble balancing work and family duties.
  • Exhibiting harsh or dominating behaviour in relationships

Depression in Students at college

College can be stressful since students are exposed to new lives, cultures, and experiences for the first time. Some students struggle to cope with these changes, and as a result, they may develop sadness, anxiety, or both.

The following are some of the signs and symptoms of depression in college students:

  • Difficulty concentrating on schoolwork
  • Sleeplessness
  • Excessive napping
  • A decrease or increase in appetite
  • Avoiding social situations and activities that they previously enjoyed

Depression in Adolescents

According to CDC, physical changes, peer pressure, and other factors can all contribute to depression in teenagers.

They may exhibit the following signs and symptoms:

  • Withdrawing from friends and family
  • Difficulty concentrating on schoolwork
  • Feeling guilty, helpless, or worthless
  • Restlessness, such as an inability to sit still

Risk factors of Depression

Depression most commonly strikes people in their teens, twenties, and thirties, although it can strike anyone at any age. Women are diagnosed with depression at a higher rate than men, which may be attributable to women being more prone to seek therapy.

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The following factors appear to enhance the chance of acquiring or triggering depression:

Personality traits- low self-esteem, being overly reliant, self-critical, or pessimistic.

Traumatic or stressful experiences – physical or sexual abuse, the death or loss of a loved one, a strained relationship, or financial difficulties.

Family members who have struggled with depression, bipolar disorder, alcoholism, or suicide.

In an unsupportive situation, when one is lesbian, gay, bisexual, or transgender or has differences in the development of genital organs that aren’t unmistakably male or female (intersex).

Mental health disorders- anxiety disorder, eating disorders, or post-traumatic stress disorders.

Alcohol or recreational drug abuse

Cancer, stroke, chronic pain, or heart disease are examples of severe or chronic illnesses.

Certain medications, such as antihypertensive drugs and sleeping pills

Complications Resulting from Depression

Depression is a severe illness that can have devastating consequences for you and your family. If depression isn’t treated, it can lead to emotional, behavioural, and physiological issues that influence every aspect of your life.

The following are some examples of depression-related complications:

Obesity, or excess weight, can contribute to heart disease and diabetes.

Physical ailment or pain

Misuse of alcohol or drugs

Anxiety, panic disorder, or social phobia are all examples of anxiety disorders.

Workplace or school issues, as well as family conflicts and relationship issues

Isolation from others

Suicidal thoughts, attempts, or thoughts of suicide

Self-mutilation, such as cutting.

Premature death as a result of medical issues

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Nursing care plans for depression
Nursing Care Plans for Depression

Prevention of Depression

There is no surefire strategy to keep depression at bay. These tactics, on the other hand, maybe beneficial. They include:

Take actions to manage stress, build resilience, and improve your self-esteem.

To assist you in getting through difficult times, reaching out to family and friends, especially during times of crisis.

To prevent depression from escalating, seek treatment as soon as you see a problem.

To assist prevent a return of symptoms, consider obtaining long-term maintenance treatment.

Medical Management for Depression

Depressive symptoms can be relieved with just medication and brief psychotherapy (cognitive-behavioural therapy, interpersonal therapy). Additionally, combination therapy has been linked to significantly greater rates of depressed symptom improvement, improved quality of life, and better treatment adherence. CBT’s potential to prevent relapse is also supported by research.

Patients who are not responding well to drugs or who are suicidal may benefit from electroconvulsive therapy.


Selective serotonin reuptake inhibitors (SSRIs). SSRIs have the benefit of being easy to dose and having minimal toxicity in overdose. They are also the first-line treatments for depression that has developed late in life. SSRIs include the following: Citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, vilazodone, and vortioxetine are the medications used to treat depression.

SNRIs (serotonin/norepinephrine reuptake inhibitors): SNRIs, such as venlafaxine, desvenlafaxine, duloxetine, and levomilnacipran, can be utilized as first-line medicines in patients who have considerable tiredness or pain syndromes associated with a depressive episode. In individuals who have not responded to SSRIs, SNRIs can be used as a second-line treatment.

Antidepressants. Bupropion, mirtazapine, nefazodone, and trazodone are some examples of atypical antidepressants. They’ve all been shown to be successful in treating major depressive disorder when administered alone, and they can also be used in combination therapy for more difficult-to-treat depression.

Tricyclic antidepressants (TCAs)

Electroconvulsive Therapy (ECT)

ECT is an extremely successful depression treatment. The onset of action may be faster than with medication treatments, with benefits frequently visible within a week of starting treatment. Patients who do not react to medication therapy, are psychotic, or are suicidal or harmful to themselves should consider an ECT course (typically up to 12 sessions). As a result, the following are some of the indications for using ECT:

A fast antidepressant reaction is required—drug therapy failure.

Patient inclination

Suicide risk is high.

Medical morbidity and mortality are at high risk.


Evidence-based psychotherapies such as Cognitive Behavior Therapy and Interpersonal Therapy have been demonstrated to be beneficial in the treatment of depression.

CBT (cognitive-behavioural therapy)

CBT is a systematic and didactic kind of treatment that focuses on assisting people in identifying and changing harmful thinking and behaviour patterns. It is predicated on the idea that depressed people display the “cognitive triad” of sadness, which involves a negative perception of themselves, the world, and the future. Patients with depression have cognitive distortions that aid in the maintenance of their negative views. CBT for depression usually consists of behavioural methods (such as activity scheduling), as well as cognitive restructuring to shift automatic negative thinking and address maladaptive schemas.

There is evidence that CBT can be used with people of various ages. It is also thought to be effective in the prevention of recurrence. It’s especially useful for senior individuals, who are more likely to have issues or negative effects from drugs.

The goal of mindfulness-based cognitive therapy (MBCT) is to decrease relapse in people who have had successful treatment for recurrent major depressive disorder. Mindfulness training is the main therapeutic component. The MBCT program focuses on ruminative mental processes as a relapse risk factor. MBCT appears to be helpful in reducing the likelihood of relapse in patients with recurrent depression, particularly in those with the most severe remaining symptoms, according to research. Interpersonal counselling (IPT)

Interpersonal Therapy (IT) is a type of psychotherapy (IPT)

Interpersonal therapy (IPT) is a treatment for major depressive illness that is time-limited.IPT is based on attachment theory and emphasizes the importance of interpersonal connections, with a particular focus on contemporary interpersonal issues. Grief, interpersonal conflicts, role shifts, and interpersonal deficiencies are all topics of focus.

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Nursing care plans for depression
Nursing Care Plans for Depression

Nursing Management for Depression

When caring for a depressed person, the nurse should focus her treatments on correcting the problems revealed by the nursing diagnoses. The patient’s safety is a top focus, which includes reducing the danger of suicide. The following is a list of depressed person interventions:

  1. Keep an eye out for suicidal tendencies.
  2. Remove sharp objects and items that could be used to hurt oneself from the area.
  3. Encourage the patient to do as much for himself as possible. If the patient’s depression is severe, they may require extra guidance with daily activities.
  4. To promote sleep, practice good sleep hygiene.
  5. Establish a therapeutic relationship with the patient.
  6. When communicating with the patient, show empathy.
  7. Reinforce therapeutic elements include addressing negative self-, world-, and future-related ideas.
  8. Encourage the patient to join in on activities.
  9. Make a list of the patient’s favourable features.
  10. Have the patient develop a realistic objective for the day and go through it with them.
  11. Examine and assess the patient’s coping mechanisms and support systems.
  12. Keep an eye on the patient’s eating habits and make sure the patient’s is getting enough nutrients.
  13. Keep an eye on the patient’s drugs to see if they’re working and if they’re having any negative effect.
  14. If the patient so desires include family members in their treatment.

Nursing Diagnosis for Depression

  1. Chronic Low Self-Esteem
  2. Spiritual Distress
  3. Risk for Self-Directed Violence
  4. Impaired Social Interaction

Nursing Care Plans for Depression Based on the Diagnosis

Nursing Care Plan 1: Chronic Low Self-Esteem

It may be related to:

  • Unbalances in biochemistry and neurology.
  • Shame and guilt feelings.
  • Cognitive self-appraisal is impaired.
  • Failure in the past.
  • Self-expectations that are unrealistic.

Possibly evidenced by:

  • Self-assessment: unable to deal with circumstances.
  • Inability to appreciate one’s own accomplishments.
  • A negative perception of oneself and one’s talents.
  • Repeated expressions of insignificance.
  • Positive feedback is turned down.
  • Verbalizations that are self-defeating.

Desired Outcomes

  1. The patient will express self-assurance.
  2. The patient’s self-esteem will be preserved.
  3. The patient will show a zest for life and the ability to enjoy the present moment.
  4. By the end of the day, the patient will have identified one or two strengths.
  5. By the end of the day, the patient will have identified two unrealistic self-expectations and will have reformulated more realistic life goals with the nurse.
  6. The patient will identify three judgmental terms that the client uses to describe self (e.g., “I am lazy”) and replace them with objective terms (e.g., “I do not feel motivated to”).
  7. The patient will keep a daily load and rate feelings of guilt, shame, and self-hatred on a scale of 1 to 10 (1 being the lowest, 10 being the highest).
  8. On a scale of 1 to 10, the patient will report decreased feelings of guilt, shame, and self-hatred (1 being the lowest, 10 being the highest).
  9. The patient will show that they can change unrealistic self-expectations.
  10. The patient will describe four positive qualities in a factual and nonjudgmental manner, as well as two areas in which they wish to improve.
Nursing InterventionsRationale
Nursing Assessment
Assess the self-esteem level of the patient.Signs of low self-esteem include withdrawal from social relationships, feeling of inadequacy, neglect of personal hygiene and dress, and rejecting self which all may indicate a negative thought pattern.
Therapeutic Interventions
Allow the patient to perform personal care activities.Paying attention to grooming serves as a first step towards achieving a positive self-image.
Give positive feedback after a task is achieved.Positive reinforcement plays a big part in building self-esteem.
Allow the patient to engage in simple recreational activities, advancing to more complex activities in a group environment.The patient may feel overwhelmed at the start when participating in a group setting.
Teach visualization techniques that can help the client replace negative self-images with more positive images and thought.To promote a healthier and more realistic self-image by helping the client choose more positive thoughts and actions.
Encourage the client to participate in group therapy where the members share the same situations/feelings that they have.To minimize the feelings of isolation and provide an atmosphere where positive feedback and a more realistic appraisal of self are available.
Evaluate the client’s need for assertiveness training tools to pursue things they want or need in life. Arrange for training through community-based programs, personal counselling, literature etc.Low self-esteem individuals often have feelings of unworthiness and have difficulty determining their needs and wants.
Role model assertiveness.Clients can follow examples/role models.
Involve the client in activities that they want to improve by using problem-solving skills. Assess and evaluate the need for more teaching in this area.Feelings of low self-esteem can interfere with usual problem-solving abilities.
Work with the client to identify cognitive distortions that encourage negative self-appraisal. For example: Discounting positive attributes.Mind reading.Overgeneralizations.Self-blame.Cognitive distortions reinforce a negative, inaccurate perception of self and the world. Focus on negative qualities.Assuming others “do not like me”. For example, without any real evidence that assumptions are correct.Taking one fact or event and making a general rule out of it. (“He always”, I never”).Consistent self-blame for everything perceived as negative.

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Nursing care plans for depression
Nursing Care Plans for Depression

Nursing Care Plan 2: Spiritual Distress

  • It may be related to:
  • Self- or other-inflicted chronic illness.
  • Self-death or death of others.
  • There is a lack of meaning in life.
  • Life evolves.
  • Pain.
  • Self-alienation.
  • Deprivation on a sociocultural level.

Possibly evidenced by:

  • Expresses intense feelings of guilt.
  • Feelings of hopelessness and helplessness are expressed.
  • Expresses feelings of abandonment or resentment toward God.
  • Concerned about the meaning of life and death, as well as religious systems.
  • Lack of hope, meaning, or purpose in life, self-forgiveness, peace, serenity, and acceptance are all expressed.
  • Lack of ability to pray.
  • Inability to articulate prior creative states (e.g., writing, drawing, singing).
  • Unable to take part in religious activities
  • There is a lack of enthusiasm for art.
  • The meaning of one’s own existence is questioned.
  • Refuses to interact with members of his family, friends, or religious authorities.
  • I’m on the lookout for a spiritual source of power.

Desired Outcomes

  1. The patient will feel a sense of belonging as they share their thoughts, feelings, and beliefs with others.
  2. The patient will experience a sense of inner self-connection.
  3. The patient will take part in spiritual rites and rites of passage.
  4. Within three days, the patient will share with the nurse two items that have given meaning to his or her life in the past.
  5. Within three days, the patient will speak with a nurse or a spiritual leader about spiritual problems and concerns.
  6. For one week, the patient will keep a journal of his or her thoughts and feelings.
  7. The patient will express that he or she feels forgiven.
  8. The patient will express a desire to return to previous creative endeavours.
Nursing InterventionsRationale
Nursing Assessment
Assess what spiritual practices have offered comfort and meaning to the client’s life when not ill.Evaluates neglected areas in the person’s life that, if reactivated, might add comfort and meaning during a painful depression.
Therapeutic Interventions
Encourage the client to write a journal expressing thoughts and reflections daily.This will help in identifying important personal issues and one’s thoughts and feelings surrounding spiritual issues. Writing a journal is a good way to explore deeper meanings in life.
If the client is unable to write, provide a tape recorder.Often speaking aloud helps a person clarify thinking and explore issues.
Discuss with the client what has given comfort and meaning to the person in the past.When depressed, clients usually have a hard time searching for meaning in life and reasons to go on when feeling hopeless and despondent.
Suggest that the spiritual leader affiliated with the facility contact the client.Spiritual leaders are familiar with dealing with spiritual distress and can offer comfort to the client.
Provide information on referrals, when needed, for religious or spiritual information (e.g., readings, programs, tapes, community resources).When hospitalized, spiritual tapes and readings can be useful; when the client is in the community, the client might express other needs.

Nursing Care Plan 3: Impaired Social Interaction

Possibly evidenced by:

  • Attempts at violence in the past
  • Suicidal idea (clear, specific, lethal method and available means).
  • Suicidal tendencies (attempts, ideation, plan and available means).
  • Clients may have the energy to carry out a suicidal plot once their despair begins to dissipate.

Desired Outcomes

  1. When a patient has self-destructive tendencies, he or she will seek help.
  2. A behavioural manifestation of absent depression will be present in the patient.
  3. The patient will be content with his or her social situation and the accomplishment of his or her life goals.
  4. Before discharge, the patient will select at least two-three people to whom he or she can turn for support and emotional direction if he or she is feeling self-destructive.
  5. The patient will not do harm to himself or others.
  6. Within one month, the patient will find support and support groups with whom he or she can communicate.
  7. The patient will express his or her desire to live.
  8. The patient will begin making positive plans for the future.
  9. Within the next two weeks, the patient will demonstrate compliance with any drug or treatment plan.
  10. The patient will demonstrate several approaches to dealing with unpleasant emotions and stress.
Nursing InterventionsRationale
Nursing Assessment
Identify the level of suicide precautions needed. If there is a high risk, does a hospitalization requires? Or, if there is a low risk, will the client be safe to go home with supervision from a family member or a friend? For example, does client: Admit previous suicide attempts. Abuse any substances. Have no peers/friends. Have any suicide plans.A client with a high risk will require constant supervision and a safe environment.
Check for the availability of the required supply of medications needed.Normally, a suicidal client’s medical supply should be limited to 3-5 days.
Therapeutic Interventions
Encourage clients to express feelings (anger, sadness, guilt) and come up with alternative ways to handle feelings of anger and frustration.Clients can learn alternative ways of dealing with overwhelming emotions and gain a sense of control over his/her life.
Contact the family, arrange for crisis counselling. Activate links to self-help groups.Clients need a network of resources to help diminish personal feelings of helplessness, worthlessness, and isolation.
If hospitalized, follow unit protocols. There are different measures for the suicidal client in either the hospital, clinic, or community.
Implement a written no-suicide contract.Reinforces action the client can take when feeling suicidal.

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Nursing care plans for depression
Nursing Care Plans for Depression

Nursing Care Plan 4: Risk for Self-Directed Violence

It may be related to:

  • Changes in mental processes.
  • Anxiety (lack of energy and motivation).
  • Feelings of inadequacy.
  • Fear of being rejected.
  • There is no support system in place.
  • Disturbance in one’s self-perception.

Possibly evidenced by:

  • Interactions with family, peers, and/or others that are dysfunctional.
  • A change in style or interaction patterns has been reported by the family.
  • In social contexts, expressed dissatisfaction.
  • Feels alone, avoids touch with people, and doesn’t make eye contact.

Desired Outcomes

  1. The patient will be able to recognize the emotions that lead to bad social interactions.
  2. The patient will interact with his or her family, friends, and peers.
  3. The patient will take part in certain social events in the community (e.g., leisure activity, church member).
  4. By the end of the day, the patient will have completed one activity.
  5. When the patient feels the urge to withdraw, he or she will discuss two to three different options.
  6. Two to three personal behaviours will be identified by the patient that may prevent others from seeking contact.
  7. Within a therapeutic environment, the patient will eventually voluntarily attend individual/group therapeutic meetings (community or hospital).
  8. The patient will express that he or she enjoys connecting with others in activities and one-on-one encounters to the same amount as he or she enjoyed prior to becoming sad.
  9. Within one month, the patient will assert and demonstrate improvement in resuming and maintaining relationships with friends and family members.
Nursing InterventionsRationale
Initially, provide activities that require minimal concentration (e.g., drawing, playing simple board games).Depressed people lack concentration and memory. Activities that have no “right or wrong” or “winner or loser” minimize opportunities for the client to put themselves down.
Involve the client in gross motor activities that call for very little concentration (e.g., walking).Such activities will aid in relieving tensions and might help in elevating the mood.
When the client is in the most depressed state, Involve the client in one-to-one activity.Maximizes the potential for interactions while minimizing anxiety levels.
Eventually, involve the client in group activities (e.g., group discussions, art therapy, dance therapy).Socialization minimizes feelings of isolation. Genuine regard for others can increase feelings of self-worth.
Eventually, maximize the client’s contacts with others (first one other, then two others, etc.).Contact with others distracts the client from self-preoccupation.
Refer the client and family to self-help groups in the community.The client and the family can gain tremendous support and insight from people sharing their experiences.

Related FAQs

1. What are the 4 main causes of depression?

The four major causes of depression are:

  • Family history. Though there are no specific genes that we can look at and trace to depression, if your family members have had depression, you are more likely also to experience depression.
  • Illness and health issues.
  • Medication, drugs, and alcohol.
  • Personality.

2. What exactly is depression?

Overview. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.

3. What are the five main symptoms of depression?

5 characteristics of depression

  • Low mood/low interest in activities enjoyed previously: Low interest or feeling depressed for more than two weeks is an alarming sign to seek immediate help.
  • Trouble concentrating
  • Changes in appetite or sleep
  • Feeling hopeless/worthless
  • Thoughts of suicide

4. What is an example of depression?

The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being “depressed.”

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