General Principles:

1. Protect the patient from self-injuring acts, to keep him physically safe, and this of top priority;
2. Satisfying basic physiological needs: including appropriate nutrition, excretion, sleeping, recreation and individual health;
3. Arranging for suitable therapeutic environments, correcting inappropriate stimulation or conversely increasing stimulation in the environment, for example: safety inspections;
4. Encouraging transpiration of feelings, sentiments;
5. Increasing activity arrangements, encouraging participation in wholesome activities;
6. Checking negative or pessimistic thinking habits, instruct or help establish appropriate responding skills or interpersonal skills;
7. Increasing individualistically oriented supporting systems;
   
8. Promoting self-respect;
   
9. Instructing to identify sources of pressures, perception, handling and prevention of pressures;
   
10. Instruction the patients to be adequately informed of side effects of drugs prescribed for them.

Melancholia patients nursing measures:

1. Physical aspects:
   (1) Assessing environmental safety, remove dangerous articles and facilities or provide protection and supervision of same to ensure the safety of the patients (especially respecting the first three to six months of the rehabilitation phase of a melancholia case);
   (2) Watch for any premonitory sign of self-injuring acts, including, for instance; manifestation of wily speech or attitudes, extremely depressed, anxious or panic-stricken, helpless, shrunk or self-abusing, distributing proper assets or erecting testaments, outcrying for hallucination or delusion of being prosecuted;
   (3) Offer more meals at reduced ration, sufficient diet and water to facilitate assimilation, easy-to-chew for digestion high calorie, high protein and high dietary fibre food; so as to maintain adequate nutriment and input/output equilibrium; give sufficient time for the meal;
   (4) Respond to patient’s constipation problems;
   (5) Periodically remind the patient to go for passing water or for the toilet for natural discharge;
   (6) Pay attention to body circulation and warmth;
   (7) Maintain suitable amount of rest and sleeping (keep awake in daytime, still);
   (8) Help maintain a neat appearance and neatly attired, and a healthy body in general;
   (9) Arrange for a security-assured therapeutic environment (soft toned and cozy series color, access to bright lighting, brisk and rhythmic music, exemption from noise, well ventilated setting featuring simple layout;
   (10) Arrange for simple, easily accomplished, non-competitive, non-physically-consuming, easy-going activities: dynamic activities design. Encourage the patients to take part in constructive activities, dynamic group activities, to begin with. Arrange service activities for patients who strongly feel deposed to self-abuses.
   (11) Assist the patient to input drugs regularly on time and prevent them from hiding away their drugs which they should have taken on time.
2. Sentimental aspects:
   (1) Show that you do care for them, that you are friendly toward them. That your attitude is sincere and affectionate, that you do support them and feel reasonably sorry for them, so that the patients may be aware of their value and worth in the eyes of third parties;
   (2) Supply periodically and where appropriate information pertinent to the patients of their surroundings and relevant on people;
   (3) Contact the patients briefly and frequently to help build therapeutically oriented interpersonal relationship;
   (4) Let tow-way communications be constructed simply, repeatedly and straightforwardly;
   (5) Use open-ended phrases, restrict the use of close-ended phrases unless the patient being addressed keeps silent persistently;
   (6) Encourage the patient to speak out what he feels boldly.
3. Intellectual aspects:
   (1) You the nurse, medical staff need not repudiate or rebut when the patient voiced negative viewpoints, instead you may take a roundabout approach to induce his positive viewpoints and amour-propre by affirming and pinpointing his merits, strong points or attainments, to be expressed by way of concrete, tangible evidences or phenomenon; or through rational, logical reasoning;
   (2) Efforts to interrupt or reduce patients’ negativistic mode of thoughts may be employed alternatively;
   (3) Assist the patients to find an issue for this nefarious sentiments in a way that is however marginally acceptable to the society at large;
   (4) When the patient expresses his indignation to the medicare staff, respond approvingly and let him vent his spleen;
   (5) In the beginning assist your patient to reach a decision, but by and by on a slow but gradual beat let the patient make his decision independently or assume his responsibility on his own.
4. Social aspects:
   (1) By the gradual scheme, on a one-on-one, thence team basis, train the patients to actively participate in service activities or still better, to provide service to other people;
   (2) Give necessary safeguarding protections while your patient participate in group activities;
   (3) Encourage your patients to set off their capabilities to the extent possible with their potential;
   (4) Assist your patients to acquire what can be interpreted as a successful or gratified experience out of the group in which they are members, as well as concern and support to be extended to them from fellow patients;
   (5) Promote knowledge about the disease by which the patient is struck on the part of this family members, and assist his family to express their concern and to help the patient establish wholesome interpersonal skills;
   (6) Teach the patients new “Skill to respond to impending pressures” which should help to improve patient’s ability to deal with problems facing him, interpersonal interactions and social skills as well.
5. Spiritual aspects:
   (1) By the stark fact that his needs are highly esteemed, the patient is convinced of the implication and worthiness of his existence;
   (2) By his participation in suggested activities, the patient is reassured of a motivation to carry on and his will so to pursue;
   (3) Strike jointly with the patient a short range living protocol and living targets in which the patient himself is the sole beneficiary.