Major Depressive Disorders: Epidemiology and Diagnosis (Nursing)

00:00 Now lifetime prevalence of the major depressive disorders, we see it a 12% in males, 20% in females.

00:11 And when we're thinking about why this might be? It maybe because women are actually reporting more.

00:19 Women go to their physicians more.

00:23 And therefore these things are being monitored a little bit higher.

00:29 When we're thinking about the statistics of depressive disorders with children, we see depression, depressive disorder, major depressive disorder in 2-6% of children.

00:43 In adults, it's between 10-25%.

00:47 But when we look at people who are over the age of 65, it is 25% of those adults who have some sort of major depressive disorder.

01:01 And remember, we were talking about the idea of this alteration, retirement, getting older, losing some of our physical and mental acuity, being something that actually adds to that fear of aging which increases stress, which then in turn makes a change in the way we see ourselves.

01:25 And that might be part of the reason that we are seeing this increased kind of depression in persons who are over 65.

01:35 So let's start thinking a little bit about these major depressive disorders.

01:40 And thinking about that, we want to think about the different types of depressive disorders that there are, that we have major depressive disorder, we also have dysthymic disorder.

01:54 You might also see the depressive disorder that is not otherwise specified as major depressive or dysthymic or even the seasonal affective disorder.

02:08 So when you're thinking about when you look at a patient, these are the kinds of diagnoses that they may have.

02:17 All of them are reflective of a depressive disorder, which is really important for us to understand, because we are going to be dealing with somebody who is not well, and they need our support.

02:33 So let's think about when we think about the globe, a 120 million people are affected by depressive disorders.

02:44 And in the United States alone, there are 30 million people who have depressive disorders.

02:51 So one thing that's really important for us to understand is that 50%-80% go undiagnosed.

03:01 And why is that important for nurses? Because people break their leg.

03:07 People get gallstones.

03:10 People are admitted to hospitals for any number of reasons.

03:14 That doesn't mean that they may not have a depressive disorder.

03:19 And you as the nurse who is admitting them might be the first person who actually is able to identify some of these signs and symptoms, and alert someone, alert the practitioner.

03:32 "I've noticed this about this patient." We also want to remember that only 10%-16% are actually going to be taken care of for that depressive disorder.

03:46 And when we think about that, what does that mean? That means the rest are not being given therapy.

03:53 They are not being given any medication.

03:56 And every day of their life is a struggle.

04:00 If you consider them on that recovery spectrum, on that wellness continuum.

04:07 These are people who are struggling, struggling just to get by everyday.

04:15 Less than 25% of persons with depressive disorders, even has proper access to care.

04:22 They don't even know where to go or how to go to get the help that they need.

04:28 And so unfortunately, even when they start feeling better, 70% of people with depressive disorders go back into their depression, they have a relapse.

04:41 And so each time you go back into a depressive state for that person, it feels like failure.

04:48 And when a person is in a depressive state, it feels as though it will never get better.

04:54 And they are unable to understand that we need to help them to get back to getting better.

05:01 Because it can get better, it can get better with treatment, it can get better with a diagnosis and help.

05:09 So when we think about a depressive disorder and a practitioner is going to go ahead and make that diagnosis that practitioner needs to know that there was at least one single major depressive episode.

05:26 Remember, these episodes are the building blocks.

05:31 And then we think, how long did that episode last? If our patient is saying to us, "Well, when I was a teen, it lasted about a week, but I could come back.

05:42 But now, it's really been going on for over 4months." Now we're starting to think, "Maybe it's not an episode this time, maybe this person now has moved into a disorder." We also want to make sure that we know that it is not some other psychiatric disorder that may be interfering.

06:06 So when we look at this person, we want to make sure that there's no other problem that is coming in like Schizoaffective disorder.

06:16 We want to make sure that the person does not have Schizophrenia, does not have delusion, does not have PTSD.

06:25 Because one of the symptoms of PTSD is also a depression.

06:31 So we also finally want to think about how long it has been going on and find out if there was any kind of manic episode that happened.

06:44 How long have you felt this way? And how did you feel before this happened? And when you were younger, did you ever have moments where you felt so energetic that you didn't even need to sleep and it never even bothered you? So we really want to look for that because that would not be a depressive disorder.

07:06 That would be a diagnosis that would be different.