IntroductionMajor depressive disorder (MDD) is characterized by the presence of one or more major depressive episodes (MDE) without a history of manic episodes , mixed or hypomanic. Episodes of substance-induced mood disorders and mood disorders due to a general medical condition do not count toward the diagnosis of MDD, nor do episodes that might be better explained by schizoaffective disorder. , delusional disorder or psychotic disorder not otherwise specified. An MDE is defined as a period of at least two weeks in which an individual experiences either a depressed mood or a loss of interest or pleasure in almost all activities. Additionally, a diagnosis of MDE must involve at least four symptoms derived from a list that includes: changes in appetite or weight, sleep, and psychomotor activity; decreased energy, feelings of worthlessness or guilt; difficulty thinking, concentrating, or making decisions; or recurring thoughts of death or suicidal ideas, plans, or attempts. Over a period of at least two weeks, symptoms should appear for most of the day, almost every day. Finally, MDE must be accompanied by clinically significant distress or impairment in social, occupational, or other domain functioning (American Psychiatric Association, 2000). Major depressive disorder is one of the most common mental disorders in the United States. It is estimated that each year, almost 7% of adults will suffer from MDD. MDD affects individuals of all ages and has an average age of onset of 32 years. MDD affects significantly more women than men, with women being 70% more likely to develop MDD than men (Nation Institute of Mental Health, n.d.). MDD is important to healthcare providers because it is associated with a number of general medications...... middle of paper ......ack, I realize this simple action would have helped further convey my respect for the patient. Another action I did not take at the beginning of the interaction was to correctly define the duration of the therapeutic relationship. I managed to describe the amount of time I hoped to spend conversing with the patient, but failed to mention that I would only be on the unit one day a week. I shared this information with the patient at the end of our conversation, but I feel it would have been more appropriate to disclose this information at the beginning of our conversation. Recognizing both my strengths and weaknesses during my patient interaction will help me make positive changes in the future and further increase my therapeutic communication skills and thus help me become a caring and competent nurse..