A nurse is assessing a client who has been experiencing persistent feelings of sadness, fatigue, and difficulty concentrating. The client denies any history of manic episodes. Which of the following conditions should the nurse consider as a possible differential diagnosis for this client?

Choice A rationale:

Bipolar disorder involves both depressive episodes and manic episodes. The client in question denies any history of manic episodes, making bipolar disorder less likely as a diagnosis. Manic episodes are characterized by elevated mood, increased energy, impulsivity, and risky behavior.

Choice B rationale:

Dysthymia, also known as persistent depressive disorder, involves chronic feelings of sadness and a lack of interest or pleasure in activities. It is a milder form of depression that persists for at least two years in adults. The client's persistent feelings of sadness align more closely with the criteria for dysthymia.

Choice C rationale:

Substance-induced mood disorder occurs when the client's mood disturbances are a direct result of substance use or withdrawal. Since there is no mention of substance use or withdrawal in the client's history, this choice is less relevant to the scenario.

Choice D rationale:

Adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressor, and these symptoms typically resolve within six months of the stressor's resolution. In the scenario, there is no indication of a recent stressor, and the client's symptoms seem to be chronic rather than time-limited, making adjustment disorder less likely.

Choice A rationale:

Genetic theory suggests that a person's genetic makeup can predispose them to develop depression, but it does not specifically address the role of neurotransmitters in depression. While genetics can contribute to the risk of major depressive disorder (MDD), this choice doesn't focus on the neurotransmitter imbalances.

Choice B rationale:

Neuroendocrine theory pertains to the role of hormones in depression, particularly abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. While hormones play a role in mood regulation, this theory does not primarily revolve around neurotransmitter imbalances.

Choice C rationale:

Neurotransmitter theory proposes that an imbalance of neurotransmitters, such as serotonin, norepinephrine, and dopamine, contributes to the development of major depressive disorder. This theory aligns with the idea that these neurotransmitters are responsible for regulating mood, motivation, reward, cognition, and stress response.

Choice D rationale:

Environmental theory suggests that external factors, such as life events and stressors, contribute to the development of depression. While environment can indeed influence depression, it does not specifically address the neurotransmitter imbalances that are central to this question.