A nurse is providing teaching about self-care behaviors to a client who has major depressive disorder. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason: Avoiding talking about upsetting events reflects suppression and avoidance, which are maladaptive coping strategies in major depressive disorder. Suppression of emotions can worsen depressive symptoms, increase feelings of isolation, and prevent the client from processing distress in a healthy way. Therapeutic communication encourages clients to verbalize feelings and experiences, which promotes emotional regulation and reduces the risk of symptom exacerbation. Choice B reason: Attending a support group demonstrates adaptive self-care behavior. Support groups provide social connection, peer understanding, and shared coping strategies, which are protective factors against worsening depression. Participation in community-based support fosters resilience, reduces isolation, and enhances adherence to treatment plans. This behavior aligns with evidence-based interventions that emphasize social support as a critical component of recovery in major depressive disorder. Choice C reason: Avoiding crying in front of loved ones reflects emotional concealment, which is maladaptive. Hiding emotions can reinforce stigma, increase internal distress, and prevent loved ones from offering support. Emotional expression is a healthy coping mechanism, and sharing feelings with trusted individuals can strengthen relationships and provide emotional relief. Suppressing crying may worsen depressive symptoms by reinforcing feelings of shame and loneliness. Choice D reason: Staying in bed when exhausted may seem like self-care, but in major depressive disorder it often perpetuates inactivity and social withdrawal. Prolonged bed rest can worsen fatigue, disrupt circadian rhythms, and reinforce depressive behaviors such as anhedonia and lack of motivation. Evidence-based self-care strategies encourage structured activity, even when energy is low, to promote behavioral activation and improve mood regulation. Remaining in bed is therefore maladaptive and counterproductive to recovery.