No matter what patient population you work with, knowing how to care for a patient with depression is crucial. It is easy to think that understanding depression symptoms and nursing intervention is only essential if you are a psychiatric nurse, but the truth is that anyone can experience depression, and in your nursing career, you will likely care for a patient whose depression is impacting both their mental and physical health.
- What are the clinical symptoms of depression?
- What symptoms should nurses look for?
- Considerations for different patient populations
- Depression symptoms in children and adolescents
- Depression symptoms in women
- Depression symptoms in older adults
- What are the causes of depression?
- How is depression diagnosed?
- How is depression treated?
- Applying the nursing process to depression
- Nursing Intervention
- Frequently Asked Questions
- What are the interventions for depression patients?
- What are the 5 R’s of depression?
- What are the three basic approaches to treating depression?
- The essential role of the nurse in caring for patients with depression
- References
According to Mental Health America, about 22.5 million adults in the United States experience major depression. That’s 8.8% of the population. Many factors may worsen or contribute to depressive episodes, including admission into a long-term care facility, an exacerbation of a chronic illness, or a stressful health situation. Because of this, nurses working in hospitals, nursing homes, or home care (regardless of specialty) should understand how to care for a patient with depression.
Below, we take a closer look at major depression and what nurses should consider when caring for someone with this condition.
What are the clinical symptoms of depression?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies major depression as a mood disorder. It lists nine symptoms of depression. For a diagnosis, at least five of the following nine symptoms must be present:
- Sleep disturbances
- Interest/pleasure reduction
- Guilt feelings or thoughts of worthlessness
- Energy changes/fatigue
- Concentration/attention impairment
- Appetite/weight changes
- Psychomotor disturbances
- Suicidal ideation or thoughts
- Depressed mood
What symptoms should nurses look for?
Major depression can cause several symptoms that nurses should be aware of, including emotional, behavioral, and somatic symptoms.
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Emotional symptoms |
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Behavioral symptoms |
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Physical symptoms |
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Many people with major depression may first seek help from their doctor for physical symptoms, so understanding the many ways that depression can present can be particularly beneficial for nurses who work in primary care.
Considerations for different patient populations
The symptoms mentioned above are common in all people with major depression, but children, adolescents, women, and older adults may present differently.
Depression symptoms in children and adolescents
Occasional sadness is a regular part of growing up, but children and adolescents can also experience major depressive disorder, and they can have unique symptoms. People in this age group who are experiencing depression may spend less time with friends or in after-school activities, care less about school, or experience falling grades.
Children with depression may have more physical complaints, like stomachaches or headaches. Depressed teens may use drugs or alcohol to try to help themselves feel better.
Depression symptoms in women
Certain types of depression are unique to women, and each has its own symptoms. These include:
- Premenstrual dysphoric disorder, an intense form of premenstrual syndrome that causes depressed mood, irritability, suicidal thoughts, bloating, and joint or muscle pain
- Perinatal or postnatal depression, a form of depression that occurs during pregnancy or after childbirth, causing symptoms like anxiety, sadness, and fatigue that can make it difficult to function in daily life
- Perimenopausal depression, which affects some women during the transition to menopause and causes extreme feelings of sadness, anxiety, irritability, and loss of enjoyment
Depression symptoms in older adults
It can be difficult to identify symptoms of depression in older adults. Some factors that can contribute to depression in this population are somewhat unique, like having to move into a retirement facility, managing chronic illness, having children who move away, experiencing the loss of a spouse or close friend, or experiencing physical limitations that impact independence.
Symptoms of depression in older adults can be the same as in any other age group, but they can be more challenging to detect and misunderstand. In severe cases, depression can resemble dementia. Other symptoms, like loss of appetite or sleeping difficulties, can be mistaken for typical signs of aging or another physical illness, causing early signs of depression to fly under the radar.
See Also
What are the causes of depression?
Experts don’t know exactly what causes depression, but a number of factors may be involved, including:
- Genetics, with those who have a first-degree relative with depression being about three times as likely to develop it
- Other conditions, including neurodegenerative diseases like Alzheimer’s disease and Parkinson’s disease, as well as stroke, cancer, multiple sclerosis, substance abuse, and chronic pain
- Environmental factors, like trauma, grief, loneliness, financial problems, and caregiver burnout
- Brain chemistry
- Physical changes in the brain
- Hormones
There are also a number of physical conditions that can mimic depression and should be ruled out before someone is given a definitive diagnosis. These include thyroid disorders, vitamin deficiencies, diabetes, dementia, and medication side effects.
How is depression diagnosed?
While there is no lab test to confirm depression, doctors may use bloodwork to rule out other conditions. These labs may include a CBD with differential, CMP, TSH, lipid panel, vitamin D, or a toxicology screening. MRIs or CT scans of the brain may be done to rule out serious illnesses, like brain tumors or dementia.
Several screening tools can be used to assess for depression, including the following:
- Patient Health Questionnaire-9 (PHQ9)
- Hamilton Rating Scale for Depression (HAM-D)
- Beck Depression Inventory (BDI)
Only qualified health care providers, like a primary care doctor, psychologist, psychiatrist, advanced practice nurses, licensed clinical social workers, and licensed professional counselors. These professionals use the diagnostic criteria specified in the DSM-5 to give an official diagnosis.
How is depression treated?
Depression is generally treated with antidepressant medications, psychotherapy, or a combination of the two. The medications used to treat depression include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Atypical antidepressants
- Tricyclic antidepressants
- Monoamine oxidase inhibitors (MAOIs)
- Other medications, such as mood stabilizers or antipsychotics
Many types of therapy can be beneficial in treating depression, including cognitive behavioral therapy, interpersonal therapy, and group therapy.
In cases of treatment-resistant depression, brain stimulation therapies, such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS), may also be considered.
Applying the nursing process to depression
Whether you work in a psychiatric unit or a nursing home, you should consider a depression diagnosis in your nursing care plans. Here are some ideas for how to care for a patient with depression.
Assessment
During a nursing assessment, nurses gather information about the patient. When assessing for depression, consider the following:
- Appearance. Clients with depression may present with poor grooming, flat affect, or avoid eye contact.
- Behavior. Depression can lead to withdrawal from friends, family, and things the person once enjoyed.
- Risk factors. Some common risk factors for depression include a chronic illness, recent loss, a family history of depression, substance use, significant stress, a generally pessimistic attitude, and exposure to violence, neglect, or poverty. When caring for a patient with depression, nurses should also assess suicide risk, medication adherence, and safety planning.
- Psychosocial assessment. Gather information about the patient’s mental and social environment, including the patient’s health history, symptoms, and available family and peer support. Consider cultural factors and whether the patient has a social support system.
Nursing Diagnosis
If you’re looking for a nursing diagnosis for major depression or other mood disorders with depressive symptoms, consider if the following apply:
- Risk for self-directed violence related to feelings of worthlessness and hopelessness
- Ineffective coping related to situational crisis
- Chronic low self-esteem
- Self-care deficit
- Fatigue related to disrupted sleep patterns
- Imbalanced nutrition, less than body requirements
- Social isolation related to social withdrawal
Planning
In the planning stage, aim to set measurable short- and long-term goals that can help the patient learn to manage their depression. Remember that goals should be SMART: Specific, Measurable, Achievable, Relevant, and Time-bound.
Goals vary from patient to patient depending on their unique circumstances. For example, if your patient is socially isolating, a suitable goal may be to attend at least one social activity per week.
If your patient is demonstrating a lack of self-care, a suitable goal could be for the patient to begin engaging in proper hygiene and activities of daily living with minimal prompting within four days.
Implementation
In this step, it’s time to implement nursing interventions related to depression to help patients achieve their goals. Possible nursing interventions for depression and their rationales can include:
Nursing Intervention
Nursing Intervention |
Rationale |
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Interact with the client in a slow, calm, yet firm tone using therapeutic communication. |
Depression can impact cognitive and communication abilities, which can make it difficult for people with this condition to process information. Interacting with clients in a slow, calm manner helps them process what you are saying, models emotional control, and helps prevent the patient from becoming overstimulated. |
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Maintain a therapeutic distance, exhibiting an open posture. |
Maintaining a therapeutic distance demonstrates that the nurse is there to help and be supportive while also respecting the patient’s boundaries, which can help build trust while allowing the patient to have autonomy. |
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When the client regains the energy to perform tasks, encourage them to practice personal hygiene. |
If the patient regains the energy to perform tasks, it can be a sign of recovery. Encouraging gradual independence can be helpful to the patient’s overall confidence and establish healthy self-care routines. |
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Be calm and supportive when the client shows irritability or expresses anger. |
Acting in a calm and supportive manner can prevent escalation and help the patient feel at ease. When a nurse responds with understanding instead of anger, it can help build trust and make the client feel supported. |
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Conduct a spiritual assessment to understand whether the patient’s spiritual needs are being met, and consult with a chaplain, priest, pastor, or other appropriate spiritual leader if needed. |
Spiritual health can be a key component of nursing care, helping to identify a patient’s beliefs, values, and sources of meaning or support. These factors can significantly influence their emotional well-being, coping strategies, and overall recovery, ultimately facilitating the development of a therapeutic alliance with their nurse. |
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Praise their strengths and recognize accomplishments to help them improve self-esteem. |
Praising strengths can help improve the patient’s self-worth, change negative self-perceptions, and motivate change, which can help build momentum for recovery. |
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Identify or ask the client about activities they may be interested in, such as coloring, drawing, or painting. |
Low-pressure, creative activities that are not over-stimulating or triggering can help clients engage with their emotions in a beneficial way. It provides a non-verbal emotional outlet and promotes mindfulness, and gives the patient a sense of control. |
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Prevent suicide by helping the client feel that life is worth living. Make yourself available for them to confide in and listen for cues of suicidal tendencies. Explain that a person with suicidal thoughts is not bad; instead, it is just part of the illness. Encourage them to express their thoughts, emphasizing that doing so is helpful and that you could do something about it. |
Providing consistent emotional support, active listening, and nonjudgmental reassurance can reduce the client’s sense of isolation, despair, and stigma. By recognizing suicidal cues early, the nurse can intervene promptly and collaboratively develop strategies to ensure safety and promote hope. |
Evaluation
The purpose of the evaluation stage is to determine the effectiveness of the interventions in helping the patient meet their goals. Progress toward each goal should be regularly evaluated, and the patient’s care plan should be adjusted as needed if they do not meet the expected outcomes.
Questions to ask will depend on specific goals, but some examples may include:
- Is the patient engaging more with others?
- Has their mood stabilized or improved?
- Can they use at least one coping skill to manage feelings of depression?
- Have they responded positively to encouragement?
- Are they showering, brushing their teeth, or performing other self-care activities independently?
- Is the patient taking their medication as prescribed?
Remember, evaluation questions should be tailored to individual patient goals. If the interventions in place are not helping the patient reach their goals, the care plan may need to be adjusted. Use your clinical judgment to determine if you need to revise the goals or modify the interventions.
If you need to modify the care plan, ask yourself, Why were these goals unmet? Are they too broad? Are they realistic? Are the interventions ineffective or ill-suited to helping the patient meet their goals? What barriers are preventing the patient from meeting their goals?
Frequently Asked Questions
What are the interventions for depression patients?
The most common treatments for depression are psychotherapy, medication, or a combination of the two. For patients with severe depression who don’t respond to these interventions, brain stimulation therapies, like electroconvulsive therapy and transcranial magnetic stimulation, may be necessary.
What are the 5 R’s of depression?
The 5 R’s of depression are the treatment goals of Response, Remission, Recovery, Relapse and Recurrence.
- Response: One goal of treatment is to achieve a response level, which is defined as experiencing an improvement in initial symptoms. In other words, is the person feeling any better?
- Remission: This goal focuses on getting to a complete state of remission; that is, being symptom-free from depression.
- Recovery: Recovery is defined as the absence of symptoms for 4 months after achieving remission. It can be marked with good days and bad days, but the patient must continue to monitor themselves and stick to their treatment plan.
- Relapse: Relapse is the full return of depressive symptoms after being in remission but not achieving recovery.
- Recurrence: Recurrence is when a separate, subsequent depressive episode happens after recovery has been achieved.
What are the three basic approaches to treating depression?
Three basic approaches to treating depression include psychotherapy, antidepressant medication, and general lifestyle interventions and measures, like relaxation techniques or exercises.
The essential role of the nurse in caring for patients with depression
Depression is a complex mental health condition that affects patients in all settings, and understanding how to care for a patient with depression outside of psychiatric nursing is essential for evidence-based practice. As a nurse, understanding how to recognize signs of major depressive disorder or depression and care for patients with symptoms of this disorder ensures compassionate and individualized care. Whether you work in a hospital, nursing home, or home care setting, your knowledge and empathy can help make a difference in the life of a patient experiencing depression.
References
- Mental Health America. (n.d.). Quick facts and statistics about mental health. Retrieved September 30, 2025, from https://mhanational.org/resources/quick-facts-and-statistics-about-mental-health/
- Chand, S. P., Arif, H., & Kutlenios, R. M. (2023). Depression (Nursing). In StatPearls [Internet]. StatPearls – NCBI Bookshelf. Retrieved September 30, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK568733/
- Bains, N., Abdijadid, S., & Miller, J. L. (2023, April 10). Major Depressive Disorder (Nursing). StatPearls – NCBI Bookshelf. Retrieved October 2, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK570554/
- Aacap. (n.d.). Depression in children and teens. Retrieved October 2, 2025, from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Depressed-Child-004.aspx
- Depression in Women: 4 things to know. (n.d.). National Institute of Mental Health (NIMH). Retrieved October 2, 2025, from https://www.nimh.nih.gov/health/publications/depression-in-women
- Depression in older adults: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved October 2, 2025, from https://medlineplus.gov/ency/article/001521.htm
- Depression (major depressive disorder) – Symptoms and causes. (n.d.). Mayo Clinic. Retrieved October 2, 2025, from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
- UpToDate. (n.d.). UpToDate. Retrieved October 2, 2025, from https://www.uptodate.com/contents/image?imageKey=PSYCH%2F89994
- What is depression? (n.d.). Retrieved October 2, 2025, from https://www.psychiatry.org/patients-families/depression/what-is-depression
- Serani, D. (2011, March 24). Depression: Do you know all your R’s? Psychology Today. Retrieved September 30, 2025, from https://www.psychologytoday.com/us/blog/two-takes-on-depression/201103/depression-do-you-know-all-your-rs-
- Institute for Quality and Efficiency in Health Care (IQWiG). (2024, April 15). Depression: Learn More – How is depression treated? InformedHealth.org – NCBI Bookshelf. Retrieved October 2, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK279282/
