(Select All That Apply): A nurse is teaching a group of nursing students about the diagnostic criteria for major depressive disorder (MDD) according to DSM-5. Which of the following are part of the diagnostic criteria? Select all that apply.

Choice A rationale:

Increased appetite is not a commonly associated side effect of antidepressant medications. In fact, some antidepressants can lead to decreased appetite or weight loss as side effects.

Choice B rationale:

Hypertension (high blood pressure) is generally not a common side effect of most antidepressant medications. However, there are specific cases where certain antidepressants might have an impact on blood pressure, but it's not a typical side effect across the board.

Choice C rationale:

This is the correct statement. Insomnia, or difficulty sleeping, is a commonly reported side effect of many antidepressant medications. It can disrupt sleep patterns and lead to increased sleep difficulties, which might exacerbate existing sleep problems or contribute to new ones.

Choice D rationale:

Excessive energy is not a common side effect associated with antidepressant use. Antidepressants typically work to regulate mood and alleviate symptoms of depression, and excessive energy would not align with the expected effects of these medications.

Choice A rationale:

Bipolar disorder involves distinct periods of both elevated mood (mania or hypomania) and depressive episodes. The scenario describes persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia, which are characteristic symptoms of major depressive disorder (MDD) but not necessarily indicative of bipolar disorder.

Choice B rationale:

An adjustment disorder is characterized by emotional or behavioral symptoms that arise within three months of experiencing a stressor (e.g., a major life change or event). The persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described in the scenario are beyond the typical time frame for an adjustment disorder.

Choice C rationale:

The correct answer. Major depressive disorder (MDD) is characterized by persistent feelings of sadness, loss of interest or pleasure, changes in weight or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and recurrent thoughts of death or suicide. The client's symptoms align closely with the diagnostic criteria for MDD.

Choice D rationale:

A normal response to stress usually involves transient feelings of sadness or anxiety in response to a stressor. However, the client's symptoms of persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia are indicative of a more serious and prolonged condition like major depressive disorder (MDD).