Stephanie Romero

February 25, 2016

ICF Write-Up Based on Major Depressive Disorder
Emily Messina
RCLS 245

The diagnosis I chose to do a write-up on is Major Depressive Disorder. Major depressive

disorder is diagnosed when a client displays depressive symptoms for more than a two week
period. These symptoms such as, trouble sleeping, unwanted weight gain or loss, loss of
pleasure, difficulty concentrating, feeling of hopeless or worthlessness, and suicidal ideation
(Porter, 2006, p. 84) all cause interference with daily activities. Major Depressive Disorder,
which is also known as MDD is commonly an internal struggle for clients or patients who may
suffer from it.
There are several ways in which MDD may be developed and they can either be from
genetics, drugs and alcohol, hormones, or simply from environmental triggers. Although genetics
may be a huge trigger for the disorder it is said that, Major depression seems to occur from one
generation to the next in some families, but may affect people with no family history of the
illness (webmd.com). Drugs and alcohol can lead to depression because abusing it can cause
you to make bad decisions resulting in regret. Drinking is known to be a depressant, so drinking
when you feel upset to forget your problems, may only make matters worse. According to an
online reference, hormones; especially in women can play a role in depression, for example
estrogen can help fight depression, irregular levels of progesterone can cause moodiness due to
lack of sleep, and abnormally high or low levels of cortisol may cause negative effects physically
and emotionally leading to depression. (bodylogicmd.com) Negative events may affect a
patients mental state. Whether environmental factors play a role on MDD, it is said to be
believed that If a stressful experience causes a person to become depressed, it may happen
indirectly (allaboutdepression.com); in other words a person already in family with a history of
depression may be more likely to become depressed after a death in a family.

Overall, Major Depressive Disorder can be triggered by a variety of variables in a

persons life. Clients suffering from this diagnosis may be as severe as showing suicidal
thoughts, or simply feeling hopeless or worthless, but it can negatively affect their everyday
lives. MDD should not stop a person from living there lives, because it can be treated through
many possible actions such as medication, one on one intervention, group interventions, or even
simply changing ones lifestyle.

Body Functions
1.) Code:
b1520 Appropriateness of Emotion; b1521 Regulation of Emotion
Description:
Appropriate of Emotions is Mental Functions that produce congruence of feeling or affect with
the situation, such as happiness at receiving good news. (Porter, 2006, p. 166) Regulation of
Emotion is described as, Mental Functions that control the experience and display an effect
(Porter, 2006. p. 166).
Reason relevant to Diagnoses:
This code is relevant to MDD because when suffering from this, a person may experience a
range of emotions bringing them down. This diagnosis can hit code b1520 Appropriateness of
Emotion because with the feeling of hopelessness, this may affect how someone takes on good
news or how relate to the new that are being presented to them. The code b1521 Regulation of
Emotion can also relate by how their emotions are changing their experience to something; they
may not enjoy someones birthday for example because of their depression.
2.) Code:
b1302 Appetite
Description:
Appetite is defined as mental functions that produce a natural longing or desire, especially the
natural and recurring desire for food and drink (Porter, 2006, p. 156).
Reason relevant to Diagnoses:
Appetite is relevant to MDD because typically some symptoms include weight loss or weight
gain. Those suffering from this may lose their appetite or have an excessive diet because eating
may either make them feel better or worse.
3.) Code:
b1343 Quality of sleep
Description:
Quality of sleep is Mental functions that produce the natural sleep leading to optimal physical
and mental rest and relaxation (Porter, 2006, p. 160).
Reason relevant to Diagnoses:

MDD is relevant to this code because there emotions of sorrow or worthlessness may affect how
well they sleep because they may have so much on their mind; which may ultimately cause
struggles to fall asleep.
Activities and Participation
1.) Code:
d160 Focusing Attention
Description:
According to the textbook d160 is described as, Intentionally focusing on specific stimuli; such
as by filtering out distracting noises (Porter, 2006, p. 264).
Reason relevant to Diagnoses:
Code d160 is relevant to MDD because those suffering may have difficulty concentrating. Their
ability to focus attention is affected because they may have no mental drive to even want to focus
because depression can take a toll on how you partake in daily activities.
2.) Code:
D230 Carrying out Daily Routine
Description:
Carrying out Daily Routine may be defined as Carrying out simple or complex and coordinated
actions in order to plan, manage, and complete the requirements of day-to-day procedures or
duties (Porter, 2006, p. 270).
Reason relevant to Diagnoses:
Code d230 is relevant to this diagnosis because typically someone suffering from depression is
not opposed to staying indoors, cooped up inside all day because it may make them feel better to
be alone. Managing and completing daily activities may be affected by this because a persons
daily routine will not be the same when they choose to isolate themselves. Day-to-day duties for
someone suffering from depression may not get accomplished with lack of energy and optimism
to complete.
3.) Code:
d7201 Terminating Relationships
Description:

Terminating relationships is ending temporary relationships at the end of a visit, ending longterm relationships with friends when moving to a new town or ending relationships with work
colleagues, professional colleagues, and service providers, and ending romantic or intimate
relationships (Porter, 2006, p. 318).
Reason relevant to Diagnoses:
Termination of certain relationships can be caused by certain circumstances in a persons life, for
example a death of a close family member may cause someone to develop MDD; therefore
isolating themselves and terminating close relationships with some people trying to comfort
them. Some people may have a different way of coping with these types of experiences in their
lives. Depression can cause a person to distance themselves from others, also causing
termination in long term relationships or even intimate ones.
Environmental Factors
1.) Code:
e2201 Animals
Description:
Animals may be characterized as ... pronounced response to stimuli, restricted growth, and fixed
bodily structure, such as wild or farm animals, reptiles, birds, fish, and mammals (Porter, 2006,
p. 356).
Reason relevant to Diagnoses:
Animals can play a major support system for people; especially those who may suffer from
MDD. A companion for a patient who is feeling emotionally unstable may be a huge impact for
them because even if they are feeling alone they really arent, simply because a pet can provide
compassion and support through their actual presence.
2.) Code:
e1101 Drugs
Description:
Any natural or human-made object or substance gathered, processed, or manufactured for
medicinal purposes, such as allopathic and naturopathic medication (Porter, 2006, p. 340).
Reason relevant to Diagnoses:

Prescribed drugs may be a facilitator for those suffering from MDD because it can help them feel
better when they are at the point where they cant help themselves feel better. Drugs may also act
as a barrier for those diagnosed with MDD because the wrong drugs not prescribed may possibly
become addictive substance for the short-term effects they cause to make them feel better and
escape reality.
3.) Code:
e310 Immediate family
Description:
Individuals related by birth, marriage, and other relationships recognized by culture as
immediate family (Porter, 2006, p. 365).
Reason relevant to Diagnoses:
Immediate family is relevant to this diagnosis because they can act as a facilitator for a client
suffering from MDD. MDD can make a patient feel alone with no one to turn to, but having
family or someone constantly around can benefit them and possibly eliminate there symptoms.
An immediate family member can assure they are not worthless and have a meaning in life
because everyone deserves to have people by their side during emotionally unstable times.

References
Porter, H.& Burlingame, J. (2006). Recreational therapy handbook of practice: ICF-based
diagnosis and treatment.Enumclaw, WA: Idyll Arbor, Inc
Goldberg, J. (2014). Depression Health Center. An Overview of Clinical Depression. Retrieved
from http://www.webmd.com/depression/guide/major-depression
(2016). Hormones and Depression in Women. Body Logic md. Retrieved from
http://www.bodylogicmd.com/for-women/hormones-and-depression
(2013). Environmental Causes of Depression. Retrieved from
http://www.allaboutdepression.com/cau_04.html