vSim H Williams Part 2 Clinical Packet Latest Update 2025
DESCRIBE DISEASE PROCESS AFFECTING PATIENT (Include Pathophysiology of Disease Process) Etiology and pathophysiology. The causes of major depression have not been established. Possible risk factors are genetic or environmental. Many studies have shown that children of a parent suffering from a major affective disorder have a rate of depression three to six times higher than that in the general population. Cognitive theories attribute the development of depression to feelings of hopelessness and helplessness secondary to an actual or perceived loss. Psychosocial theories point to factors such as disturbance in family dynamics or in the parent-child relationship, a family move, the death of a loved one, divorce, or abuse or maltreatment. Depression is a mood disturbance characterized by exaggerated feelings of sadness, despair, lowered self- esteem, loss of interest in former activities, and pessimistic thoughts. Depression is more than a state of mind; in any given 2-week period, almost 8% of Americans report symptoms of moderate or severe depression (Centers for Disease Control and Prevention [CDC], 2018). Depression is found in all races, ethnic groups, age groups, and socioeconomic levels. Women are affected twice as often as men. Depression can be so severe at times that an affected person contemplates, or succeeds at, committing suicide. Suicide falls in the top 10 leading causes of death in the United States; where the statistic falls in the top 10 depends on the age group (CDC, 2017). Many deaths supposedly caused by accidental overdoses, automobile accidents, and refusal of medical care may be viewed as hidden suicides even though they are not reported as such. Suicide attempts also are not included in the statistics. Although the highest rate of suicide is among the older population, suicide among teenagers is on the rise in this country. Children must be taught effective coping skills. There is great controversy over the terminally ill patient’s right to commit suicide. Some people believe that deliberately ending one’s life is a rational decision in certain circumstances, such as terminal illness, and defend the right to commit suicide. There is growing support for right-to-die legislation, which removes the criminal stigma from suicide. Most people who commit suicide in the hospital setting have received the diagnosis of an incurable or painful illness. It is important to evaluate terminally ill individuals and treat them for depression, as well as for their physical disorders, to ease their pain and enhance their quality of life. To help prevent suicide, recognize warning signs, and learn the kinds of actions that often can avert suicide attempts. Consider as warning signals verbal statements such as “I wish I were dead” or “You won’t see me coming back here again” and questions about specific methods of suicide. Actions such as giving away possessions, refusing medications, or neglecting hygiene are also possible warning signals. Many people have anxiety because of a moral conflict within themselves. Many suicidal individuals manage to leave that anxiety behind by making the decision to commit suicide. Major depression, or persistent depressive disorder, is defined as repeated, severe depressive episodes lasting more than 2 years (National Institute of Mental Health, 2018). Estimates are that up to 15% of people with major depressive disorder die from suicide. Dysthymic disorder is daily moderate depression that lasts more than 2 years. This disorder often ends up as a lifestyle in which the individual can function but not enjoy life.
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