Page 11 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

• personal strengths and resources, including supportive relationships

• difficulties with previous and current interpersonal relationships

• current lifestyle (for example, diet, physical activity, sleep)

• any recent or past experience of stressful or traumatic life events, such as redundancy,

divorce, bereavement, trauma (also see the NICE guideline on post-traumatic stress
disorder)

• living conditions, drug (prescribed or illicit) and alcohol use, debt, employment
situation, loneliness and social isolation. [2009, amended 2022] [2009, amended 2022]

Risk assessment and management Risk assessment and management

1.2.8 Always ask people with depression directly about suicidal ideation and intent. If
there is a risk of self-harm or suicide:

• assess whether the person has adequate social support and is aware of sources of help

• arrange help appropriate to the level of need

• advise the person to seek further help if the situation deteriorates. [2009] [2009]

1.2.9 If a person with depression presents considerable immediate risk to themselves
or others, refer them urgently to specialist mental health services. [2009] [2009]

1.2.10 Advise people with depression of the potential for increased agitation, anxiety
and suicidal ideation in the initial stages of treatment. Check if they have any of
these symptoms and:

• ensure that the person knows how to seek help promptly

• review the person's treatment if they develop marked and/or prolonged agitation.

[2009] [2009]

1.2.11 Advise a person with depression and their family or carer to be vigilant for mood

changes, agitation, negativity and hopelessness, and suicidal ideation, and to
contact their practitioner if concerned. This is particularly important during
high-risk periods, such as starting or changing treatment and at times of
increased personal stress. [2009, amended 2022] [2009, amended 2022]

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