Caring for a person with depression: safety, self-care, activity and hope
- Safe practice
Keep the person safe, help with food, sleep, bowels and hygiene step by step, stay present even in silence and rebuild hope without false promises.
What it is
Nursing care in depression puts safety first, because suicidal ideation is part of the illness. Around it, the nurse supports the body (nutrition, fluids, sleep, elimination, hygiene), keeps a calm, structured day, offers short one-to-one contact and teaches about treatment and coping. Findings are compared with the admission baseline at every assessment. Hopelessness, worthlessness and helplessness are reported at once and the person is not left alone while voicing them.
What it requires
- A baseline at admission (mental status, weight, sleep, intake, self-care) to compare against.
- Rounding on a varied schedule and a team that shares the suicide risk and any medication cheeking.
- A care plan that matches the phase: active, continuation or maintenance.
- Family involvement and written crisis contacts at discharge.
Components
- Safety: risk screening, a safe room, observation as ordered.
- Physical care: nutrition, fluids, sleep, elimination, hygiene and grooming.
- Relationship: therapeutic presence, short one-to-one contact, hope.
- Teaching: the illness, the medicines and their time course, coping and support.
How it is applied (and why)
- Ask directly about suicide plans and listen for hidden messages — sharing the thought often brings relief and lets the team act.
- Open each medicine in front of the person and check that it is swallowed — saved pills can be used in an attempt.
- Offer small, frequent, high-protein snacks and drinks they choose, with company when possible — small portions suit a poor appetite and eating is social.
- Weigh weekly, record intake and bowel movements, and encourage fluids, fibre and walking — depression slows the gut and the body.
- Get the person up and dressed by day, plan rest after activity and a calm evening without caffeine — a regular rhythm improves night sleep.
- Give self-care in small spoken steps («now wash your face») — slowed thinking makes organising a task hard, and being clean lifts self-esteem.
- Sit with a silent person, use short concrete words, wait for the reply and comment on what you see — direct questions can raise anxiety.
- Avoid platitudes and false reassurance; help the person name strengths and small future plans — this restores hope without denying the pain.
In nursing practice
- Statements of hopelessness or a sudden calm after deep sadness raise the suicide risk: report them.
- In an older adult, new depression can worsen memory and look like dementia; report new symptoms.
- If the person is pregnant or planning a pregnancy, the prescriber reviews the antidepressant.
- Before discharge, give written follow-up and crisis contacts; in Colombia the national mental-health teleorientation line is 106 (24 hours).
Common mistakes
- Saying «everyone feels down sometimes».
- Leaving the person alone right after they speak of death or worthlessness.
- Letting them stay in bed all day «to rest».
- Assuming the medicine has failed after a few days.
Test yourself
Think of the answer, then tap the question to see it.
Which statements from a person with depression must be reported at once?
Hopelessness, worthlessness and helplessness, and any suicidal, homicidal or violent ideation. Do not leave the person alone meanwhile.
Why open medicines in front of the person and check they are swallowed?
People with depression may hold pills in the cheek and save them for a later suicide attempt; watching also reduces suspicion.
Why is the start of antidepressant treatment a time of close watching?
Energy can return before mood improves, so a person who had suicidal thoughts may now have the energy to act on them.
How can the nurse communicate with a severely withdrawn person?
Sit with them, use simple concrete words, allow time to answer and make observations rather than direct questions; avoid platitudes.
Elsewhere in DurgiPedia
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Nursing: Mental Health and Community Concepts, 7.5: Applying the nursing process to depressive disorders (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2022); Nursing: Mental Health and Community Concepts, 7.4: Treatments for depression (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2022); Directorio nacional de líneas territoriales de atención en salud mental en Colombia (agosto 2025) (Ministerio de Salud y Protección Social, Colombia, 2025).
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