Health care of young people with depression

Riječ depresija svoje korijene nalazi u latinskoj riječi „deprimere“ što označava pritisnuti, utisnuti. Depresiju možemo opisati kao emocionalno stanje u kojem se javlja i prevladava neugodan osjećaj tuge i očaja koji prati osjećaj obeshrabrenosti i bezvrijednosti, zle slutnje, otežano i usporeno mišljenje te smanjena psihofiziološka aktivnost. Jako dugo smatralo se da djeca i adolescenti ne mogu patiti od depresivnih poremećaja te da postoje maskirane depresije u koje su uključeni različiti tipovi emocionalnih problema i poremećaja ponašanja za koje se smatra da je depresija glavni uzrok. Depresija u adolescenata vrlo je slična depresiji odraslih, no ključne razlike pronalaze se u opsegu, žestini i utjecaju simptoma. Uzroci psihičkih poremećaja u adolescenata svrstani su u tri grupe: naslijeđe, psihički uzroci i uzroci okoline. Čimbenici rizika za nastanak depresije u adolescenata su: obiteljska povijest depresije (nasljedni faktori), izloženost psihosocijalnom stresu, faktori razvoja, hormonski čimbenici (također i spolni hormoni) i poremećeni neuronski putovi. Depresivni poremećaji prema DSM-IV,5 klasifikaciji su: disruptivni poremećaj disregulacije raspoloženja, veliki depresivni poremećaj, distimija, predmenstrualni disforični poremećaj i depresivni poremećaj prouzročen psihoaktivnim tvarima/lijekovima. Disruptivni poremećaj disregulacije raspoloženja karkteriziraju teška, kronična i perzistentna razdražljivost koja nije u skladu s razvojnom dobi osobe koja se manifestira učestalim izljevima bijesa, a također između epizoda izljeva bijesa javlja se kronično, perzistentno, razdražljivo ili ljutito raspoloženje. Predmenstrualni disforični poremećaj teži je oblik predmenstrualnog simptoma, a opisuju ga uznemirujući emocionalni i bihevioralni simptomi kao što su razdražljivost i emocionalna nestabilnost koji se javljaju češće nego depresivno raspoloženje i anksioznost. Veliki depresivni poremećaj karakterizira depresivna epizoda, jedna ili više njih, bez maničnih, miješanih ili hipomaničnih epizoda. Velika depresivna epizoda opisana je trajnim depresivnim/iritabilnim raspoloženjem ili gubitkom zanimanja u aktivnostima te uživanjima u njima koje traje najmanje dva tjedna. Depresivni poremećaj prouzročen psihoaktivnim tvarima/lijekovima manifestira se opetovanom zlouporabom psihoaktivnih tvari/lijekova radi suočavanja sa problemima, a kasnije uporaba psihoaktivnih/tvari lijekova otvara vrata mnogim fizičkim i psihološkim problemima koji se mogu, ali ne moraju javljati te u njih spadaju psihoza, povlačenje u sebe, tjeskoba i seksualna disfunkcija. Za pružanje kvalitetne zdravstvene njege medicinska sestra mora biti dobro obrazovana, a za pružanje primjerene skrbi nužno je poznavanje simptoma koji određuju depresiju. Depresija mijenja biološku, psihološku, socijalnu i duhovnu dimenziju čovjeka stoga pristup u liječenju te zdravstvenoj njezi treba biti multidimenzionalan i zasnivati se na holističkom načelu. The word depression has its roots in the Latin word "deprimere" which means pressed, imprinted. Depression can be described as an emotional state in which an unpleasant feeling of sadness and despair occurs, accompanied by feelings of discouragement and worthlessness, evil suspicion, difficult and slow thinking as well as diminished psychophysiological activity. For a long time, it was thought that children and adolescents could not suffer from depressive disorders and that there were masked depressions that involved various types of emotional and behavioral disorders. Adolescent depression is very similar to adult depression, but key differences are found in the extent, severity, and impact of symptoms. Causes of psychiatric disorders in adolescents are classified into three groups: inheritance, psychological causes, and environmental causes. Adolescent depression risk factors include: family history of depression (hereditary factors), exposure to psychosocial stress, developmental factors, hormonal factors (also sex hormones) and impaired neural pathways. According to the DSM-IV, 5 classification depressive disorders include: the disruptive mood dysregulation disorder, major depressive disorder, dysthymia, premenstrual dysphoric disorder and depressive disorder caused by psychoactive substances / drugs. Disruptive mood dysregulation disorder is characterized by severe, chronic and persistent irritability that is not consistent with the developmental age of the person manifesting with frequent outbursts of anger and chronic, persistent, irritable or angry moods occuring between episodes of outburst. Premenstrual dysphoric disorder is a more severe form of premenstrual symptom and it is described by disturbing emotional and behavioral symptoms such as irritability and emotional instability that occur more frequently than depressed mood and anxiety. Major depressive disorder is characterized by depressive episodes, one or more of them, without manic, mixed or hypomanic episodes. A major depressive episode is described by a persistent depressive / irritable mood or loss of interest in and enjoyment of activity for at least two weeks. Depressive disorder caused by psychoactive substances / drugs is manifested by repeated abuse of psychoactive substances / drugs to deal with problems. Later on, drug substances open the door to many physical and psychological problems that may or may not occur and those include psychosis, withdrawal, anxiety and sexual dysfunction. In order to provide quality nursing care, the nurse must be well educated and knowledgeable of the symptoms that determine depression is necessary to provide adequate care. Depression changes the biological, psychological, social and spiritual dimensions of a person, so the approach to treatment and health care should be multidimensional and based on a holistic principle.