Depressive Disorders - Suicide
Mr. Sam Smith is a divorced man, 35 years of age, has 2 children and lives alone. His neighbor found him in on the bathroom floor in his home, bleeding from the arms, with obvious slash marks on his wrists. After calling 911, the neighbor tells the responding EMT's that his friend has been "down-in-the-dumps" for a long time, and has gained a significant amount of weight w/in the last month. He continues to say that he is worried because the two of them used to play golf together at least two times per week but Sam hasn't wanted to play at all over that last couple of weeks. The neighbor notices that Sam seems to stay up into the early morning hours every night and appears to drink more than he used to. Sam told him that he doesn't feel useful to anyone and his family would probably be better of if he weren't around any more.
Diagnostic criteria for Depression (DSM-IV-TR)
1. Client represents a change in previous functions
2. Symptoms cause a clinically significant distress or social impairment or occupational impairment.
3. Five or more of the following occur almost daily or for most of the waking hours over the same two week period:
Depressed mood most of the day
Significant weight loss or gain
Increased or decreased motor activity
Loss of interest in hobbies or joyful activities
Fatigue or loss of energy
Recurrent thoughts of death or suicidal ideation (with or without a plan)
Risk for self-directed violence related to recent divorce a.e.b. actual suicidal attempt (slashing of wrists). The nurse should work with the client on teaching coping skills, tension reduction skills, and problem solving skills. These learned behaviors will reduce the incidence...