A nurse is caring for an adolescent who is experiencing indications of depression. Which of the following findings should the nurse expect? (Select all that apply)

Choice A reason: Euphoria is associated with mania or bipolar disorder, not depression. Depression involves low serotonin and dopamine levels, leading to low mood, anhedonia, and fatigue. Euphoria reflects excessive dopamine activity, causing elevated mood, which is inconsistent with the neurochemical profile of major depressive disorder. Choice B reason: Chronic pain is common in depression due to altered pain perception from low serotonin and norepinephrine levels, which modulate pain pathways. Somatization of emotional distress can manifest as physical pain, and depression amplifies pain signaling in the brain, contributing to persistent, unexplained discomfort. Choice C reason: Insomnia is a hallmark of depression, resulting from disrupted circadian rhythms and reduced serotonin, which regulates sleep. Hyperactivity of the hypothalamic-pituitary-adrenal axis increases cortisol, disturbing sleep architecture, leading to difficulty falling or staying asleep, or early morning awakenings, exacerbating depressive symptoms. Choice D reason: Increased energy is not typical in depression, which is characterized by fatigue and low motivation due to decreased monoamine neurotransmitters like serotonin and dopamine. High energy levels are more associated with manic episodes or stimulant use, not the neurochemical deficits seen in depressive disorders. Choice E reason: Social withdrawal is a core symptom of depression, driven by anhedonia and low dopamine, reducing motivation for social interaction. The prefrontal cortex and amygdala dysfunction impair social reward processing, leading to isolation, as patients struggle with emotional engagement and perceive social activities as unrewarding or overwhelming.