Melancholy and depression. “Did you really have to get sick to see human nature so clearly?” - Freud exclaims

Melancholy is a state of mind characterized by a sad mood, general depression, melancholy, sadness and loss of strength. The condition in question is accompanied by a feeling of one’s own uselessness, worthlessness, uselessness, alternating with a joyless mood. At the same time, for the occurrence this state there may not be a good reason. The term previously described was “dark madness.” Also, melancholy means one of the four types of temperament. In other words, she is congenital feature attitude and adaptation to society. Melancholic people are typical introverts, they feel good alone with their own personality, they are different hypersensitivity, any events are experienced deeply in the soul.

What it is

The term in question implies one of the variations of mental disorder. The word melancholy itself means gloomy despondency, melancholy, sadness, gloomy insanity, and is translated as black anger.

The essence of mental transformations during melancholy lies in the individual’s presence in a sad, dejected state. The surrounding reality does not motivate or does not motivate such individuals, and they mental activity accompanied by unpleasant pain. At the same time, in the melancholic consciousness, ideas corresponding to a sad mood prevail. The memories and fantasies of such people are focused only on unpleasant images and events. They view everything in a gloomy tone.

Nothing can bring them joy, their own existence becomes a burden, interest in activities weakens or disappears completely, they become sedentary, indifferent to reality and their own hobbies, and consider death as the optimal solution, which is often achieved through suicide.

Often, on the foundation of sadness and indifference, deceptions of feelings and absurd delusional ideas sprout. As for the latter, they are mainly of the nature of self-accusation: melancholic individuals blame themselves for this or that offense or crime committed, for example, against religion or morality. They can also attribute completely monstrous acts to themselves, expecting a similar monstrous punishment for them. In addition to delusional ideas of self-blame, delusions of persecution or denial are also noted: people disappear, there is nothing more, the world and existence are ending.

A special type consists of cases where delirium is predominantly hypochondriacal in nature. For example, they feel that the holes in their body are overgrown, their intestines are rotting, and they themselves have become wooden, transformed into an animal. Deceptions of the senses, mainly in content, correspond to the ideas of delirium: melancholic people hear curses, the rattling of chains, children's moans, they see preparations for torture, the corpses of relatives, they smell sulfur and carrion.

Patients are at times subjected to attacks of increased melancholy, interspersed with motor agitation and fear. Under the influence of such attacks, melancholic people sometimes fall into depression.

Melancholy is often accompanied by a deterioration in nutrition, which occurs either due to a decrease in appetite or due to a disruption in the processes of absorption, metabolism and blood circulation. Also, the disorder in question is often accompanied by a stable disorder.

Melancholy can be a separate illness or a sign of another more serious illness. It can occur with mania or periodic insanity. At the same time, it is characterized by a short duration of the course. When does melancholy represent separate violation, then characterized by duration.

Today the described disorder is classified as “melancholy without the presence of psychotic symptoms”, and is a symptom of an illness called “depressive episode severe without psychotic symptoms." Alternative name of this disease is “agitated depression”, “vital depression”.

More and more often today medical practice Instead of the previously popular term “melancholy”, the term “depression” is used, and melancholy in simple words, that is, in everyday life, often means a sad, dull, depressed mood.

Causes

Enough common cause, leading to the disorder in question and not amenable to self-correction, is a congenital mental trait. Often expectant mothers lead unhealthy image beings, are prone to negative thinking, which can lead to the appearance into the world of a baby with a melancholic variation. Scientists have found that even in intrauterine development, the fetus feels the parental attitude and external problems.

Studies have also shown that temperament can be changed genetically. If both parents are melancholic, then it is likely that this type of temperament will be passed on to their offspring. However, there are no individuals with a “pure” type in the world. Belonging to a temperament type is determined by its leading property.

Sometimes people can turn into melancholics due to unfulfilled personal aspirations. For example, during a long unsuccessful job search. Such obstacles will only harden a strong individual, while they will turn a weak one into a pessimistic melancholic. It is easier for them to blame fate than to try to overcome ordinary everyday problems.

The described disorder can also be caused by mental anguish and non-standard views on everyday situations, which differ from the judgments of so-called “adequate” people. For example, an individual’s conviction in the existence of life on the Moon can often cause a number of ridicule and phrases of ironic content from “informed” subjects. And this often leads to a feeling of worthlessness.

The causes of melancholy are often hidden in childhood. Parental overprotection, difficulties in interaction among peers, non-acceptance in the school community - all this can provoke the appearance of closed melancholy.

Socio-ethical phenomena that are related to ideological issues also lead to a depressed mood and the appearance of the described disorder. So, for example, lack of faith in people’s conscientiousness, their selflessness, social progress make the individual a skeptic and plunge depressive state.

Spiritual development gives rise to thoughts about death and fragility, the realization that any road will always lead to a lethal end. Such “dark” thoughts are manifestations of melancholic depression.

Harmful addictions literally destroy the psyche, which gives rise to gloomy thoughts and reluctance to live.

Gambling is also a type of destructive addiction. In addition to endless thoughts about where to get the next amount for bets, a person also faces an inevitable big loss. Therefore, gamblers are usually dissatisfied, irritable, and constantly in a dejected state. Against the background of such a pessimistic mood, melancholy develops.

Row mental disorders accompanied by gloomy thoughts and decadent moods. Here melancholy will be a concomitant manifestation.

Often natural aging gives rise to melancholy, since the aging subject cannot come to terms with his own changed physical condition: he is no longer so fast and agile, many ailments have appeared, and his stamina has decreased. All this negatively affects the mood, as a result of which the person begins to be overcome by melancholy.

A protracted illness, in addition to being psychologically exhausting and physically tiring, also gives rise to difficult thoughts and leads to the development of a depressive melancholic state.

Fears count common factors, generating the described deviation. Constantly being in fear weakens a person psychologically, which leads to despondency and melancholy.

When an individual suffers from an inferiority complex and has lost faith in own strength, blindly surrenders to the whirlpool of fate, considers himself worthless, this has a depressing effect on his mood, which gives rise to mental anguish and leads to melancholy.

Unfulfilled passion, unrequited feeling also gives rise to a depressive state.

Deep spiritual manifestations of a negative orientation, such as anger, envy, greed, corrupt the soul, often plunging into a depressed state.

There is also such a thing in everyday life as autumn melancholy. Frequent prolonged rains, low skies covered with a gray haze of clouds, gusty winds, dirt, dampness and slush, contraction daylight hours, practically complete absence bright sunlight - all this negatively affects emotional mood of people. This is where the phenomenon of melancholy, caused by the change of season, arises.

Symptoms

The disorder in question is manifested by persistent groundless fear, self-criticism and self-destruction. If this deviation is not corrected, it can lead to suicide attempts.

Obvious manifestations of melancholic symptoms include: dry skin, indigestion, dilated pupils, weight loss.

Other signs of melancholy include:

– hypothymia, detected in stable bad mood, dwelling on the negative, unhappy experiences, the individual is unable to tune in to positive communication, constantly thinks about his emptiness, against the backdrop of this, suicidal thoughts arise;

Modern science interprets depression as a mood disorder, while melancholy is considered as a symptom endogenous depression. For the most part, the term is used in cases of significant manifestations of depression. Even P. Gannushkin calls such patients “constitutionally depressed.”

Today, the term “melancholia” is considered obsolete, as a result of which it was replaced by the concept of “depression”, leaving as a variation “melancholic depression”, which differs from agitated depression with the manifestation of aggression and signs of anger.

Thus, the two terms in question were actually equated, regardless of their literal meaning, which reveals the essence. So melancholy is literally interpreted as “black bile or anger,” but it means sadness, melancholy, despondency, and depression means deepening, lowering or suppression.

Consequently, the first term states a characteristic prolonged state of mind and the accompanying physiological features, and the second one speaks of a decrease in mood, and then in general condition.

The concept of “depression” previously did not exist at all. All characteristic manifestations The illness today called depression was previously classified as melancholy. Medieval healers viewed it as a disorder of mental processes and agreed in their views that melancholy was generated by black bile.

There is a bit of logic in this theory, since when high concentration bile, its yellow-green color may darken. And the accumulation of bile occurs due to a violation of its outflow due to dyskinesia.

According to statistics psychosomatic medicine, described congestion emanating from gallbladder, are observed in suspicious, touchy, extremely suspicious individuals, characterized by the viscosity of thought processes and suffering.

With melancholy, against the background of a dominant specific state (which can generally be described as “dull”), there is a special mood that reflects mental processes. Whereas, with depression, the mood disorder itself gives rise to a certain state and psychosomatic phenomena.

Thus, in order to see the difference between the two concepts under consideration, it is necessary to define what a mood is and what a state is.

So the mood is general characteristic emotional background of an individual at a particular moment, and the state represents the mood operating in the individual, the original nuance of human existence. Therefore, we can conclude that the causes that give rise to melancholy are in a different sphere and deeper than the causes of depression. This sphere is more significant in its impact on humans. That is why to this day people are interested in how to deal with melancholy, and not how to eliminate depression, if they feel loneliness even in the circle of loved ones, if they live in constant fear before being.

Always arises against the background of serious or stress (loss of a loved one, incurable disease). A depressed individual does not want anything as a result of a certain event.

The psychosocial cause for melancholy is either not so obvious or is of a concomitant nature; in other words, it does not determine true melancholy, which can be detected at an early age. age stage even among active and cheerful people. However, this optimism is only an external mask.

Depression is easily diagnosed by showing up in a malfunction emotional sphere, loss of activity and decreased, suppressed libido. This also gives rise to a sharp decline in immunity.

Melancholy, defined as a mental illness, is felt as special condition general mood of a person. As a rule, this condition is based on a feeling of loneliness in a group of people, a freezing fear of the Universe, derivative fears and melancholy. This condition is characterized by persistence. It releases individuals only for a short period.

With depression there is always some kind of loss (death, bankruptcy, infirmity). As a result, interest in the world disappears.

With melancholy, self-denial of love, generated by the fear of death, is noted. At the same time, the person continues his unsuccessful search, since everything is happening wrong, the people are not the same. A melancholic person feels a thirst for love, but is afraid to love himself. Any proposed feeling does not correspond to the parameters of the expected, and therefore is rejected. However, the melancholic person himself does not know the parameters of what is expected. Then interest in the pitiful world and the empty self is formed and strengthened. This is where sadness and melancholy come from. Denial of one's own person is denial of the world.

In depression, the self-deprecating attitude mainly arises from a rejecting attitude certain persons or a specific system.

Depression is characterized by a loss of beauty and order (in the world, relationships). Melancholy, in turn, consists of a person’s admiration for ugliness.

In a number of people, depression can transform into melancholy, but the latter will never simplify to the level of depression.

Treatment

First of all, in order for a melancholic person to change his own mood in life, it is recommended to create favorable living conditions for him: his home should be warm and ventilated, the air should be clean and comfortably humid. It is advisable to provide the premises indoor plants, having a pleasant appearance.

Aromatherapy, massage, and balneotherapy are often used in the treatment of any mental disorder.

A thorough analysis of the reasons that plunged an individual into a decadent mood is considered a universal cure.

Along with proper organization of the day, adequate nutrition, physical exercise and means alternative medicine Psychotherapeutic practices are also successfully used.

Today there are many different psychotherapeutic methods aimed at getting rid of depressive and neurotic conditions. For example, a fairly popular method is the cognitive-behavioral direction, the purpose of which is to help a melancholic person break the vicious circle of negative associations, as well as form positive thinking.

If the remedies listed above are useless, then the patient is indicated for hospitalization in a psychoneurological institution, where conditions have been created for a set of procedures that can relieve the main symptoms of the disease. For this purpose, various pharmacopoeial drugs are usually prescribed that provide psychotropic effect, for example, antipsychotics (suppress the feeling of fear, reduce the response to external stimuli, weaken psychomotor agitation, reduce affective tension, calm), antidepressants (reduce melancholy, improve mood, reduce lethargy, eliminate apathy, relieve anxiety and irritability), mood stabilizers (stabilize mood ).

Doctors say depression comes from acute phase imperceptibly flows into a heavier one, chronic form. It's much more difficult to deal with. Melancholy should be nipped in the bud.

There is another opinion, confirmed by observations: depression is inherited.

If among your close relatives there are sad and depressed people, it will be more difficult for you to cope with this condition. But difficult does not mean impossible.

And some more unpleasant things. If this dirty trick has visited you at least once, there is almost a hundred percent guarantee that it will appear again.

We must accept this knowledge only as knowledge. Under no circumstances should you expect the inevitable. Maybe you are just in that rare one percent who have overcome depression once and for all.

This knowledge should not interfere with our lives, since we have such happiness.

What you need to know to recognize the enemy and take timely measures. Some methods of control and diagnosis are described in the article "

What signs of depression should you be on the lookout for?

- In your usual life Something suddenly happened that changed your life.

Job loss, bereavement loved one, separation from a loved one, change of place of residence, and so on, and so on... Your hands have given up, and you see no point in further life.

- You started quarreling with everyone and explode for any reason. It goes to both the right and the wrong. The conflict is off the charts.

- You have lost the desire to communicate with friends, your family annoys you because it does not give you the opportunity to be alone and withdraw into yourself. But you don’t want to talk to absolutely anyone, you don’t want to see anyone.

- You are being attacked constant drowsiness or, on the contrary, you stopped sleeping, and insomnia became your nighttime friend.

“This condition lasts for more than one week, and you cannot remember anything joyful during this time. There are only one colors: gray-black.

- You don’t want to dress up or put on makeup. You don't care what you look like.

The enemy has been detected. This means you are ready to fight depression.

If you feel that you cannot take control of the situation yourself, consult a psychologist or visit a doctor. Get tested.

But, take the simplest measures first. Everyone knows about them, but few people implement them. And you need this now.

How to deal with depression:

- Set it up good nutrition, rich in vitamins. Through “I don’t want” at first.

- Start walking before bed. Drop everything and go outside. Walk for a long time until you get tired.

— Take a relaxing bath with herbs and go to bed, following a certain ritual. Strictly at the same time.

— Get at least 8 hours of sleep, don’t jump up if you can’t sleep. Try to think about something pleasant. Start writing fairy tales about fairies and gnomes.

Read poems for memory.

Whether your loved ones will understand or not understand is in this moment you shouldn't worry. You yourself understand that your health comes first.

Look for something that can captivate you, even if you don’t want anything at all and everything falls out of your hands.

Here are your first steps that you should take yourself, without turning to the help of specialists.

Perhaps there will be enough of them. You will again begin to enjoy meeting with friends, the problems of loved ones will become ordinary, and not global.

You will return to full life and neither melancholy nor depression can destroy either your health or your personality.

You can take a test to help you understand your condition better.

the authorship of the article is confirmed in GOOGLE

NB: Depression and melancholy are used synonymously here, although they are different phenomena.

NB: The words "mourning", "grief" and "sadness" are used interchangeably here.

In his work Mourning and Melancholia, Freud distinguishes between melancholy and grief (there are different variants translation of the word “Trauer” into Russian is mourning, sorrow, sadness, grief. “Mourning” is clearly more accurate).

Some people experience grief when they lose, others experience melancholy. Freud draws attention to the fact that melancholia has a psychogenic nature and suggests that there may be a predisposition to it.

Grief (sadness, mourning)

Grief is always a reaction to the loss of a loved one or an abstract concept that replaced it (for example, fatherland, freedom, ideal). People do not consider grief as painful condition, even though it has an impact on life.

Grief, unlike melancholy, is not burdened by a conflict of ambivalence.

Grief prompts the Self to abandon the object by declaring the object dead. The fixation of libido on the object is weakened (depreciation, humiliation, destruction of the object). The “I” feels satisfaction from its superiority over the object.

Work of grief (mourning)

The person understands that the beloved object no longer exists in reality. Accordingly, there is a need to take away your libido from this object. And resistance to this process appears; a person does not easily give up the direction of his libido. And this resistance can be so strong that the lost object is retained through hallucinations. At normal operation grief's demand for reality (the object is lost) still triumphs over resistance (which tries to hold on to the object). This process of accepting reality takes some time and costs internal forces. While there is a partial acceptance of reality, the lost object continues to exist in the psyche. Each of the expectations or memories in which the libido is connected with the object is suspended, and libido is liberated on it. This process is accompanied heartache. At the end of the work of sadness, the “I” (Ego) becomes free again and freed from delays.

Melancholy (depression)

It differs from grief in deep suffering, loss of interest in the outside world, loss of the ability to love, inhibition of activity, decreased well-being (expressed in reproaches and insults to oneself), and expectation of punishment. In the foreground is the theme of moral dissatisfaction with oneself.

With grief there is also suffering, loss of interest in the world, the ability to love is lost, there is inhibition. Distinctive feature melancholy is that there is a theme of punishment, self-accusation and reproaches. With grief, the effect of “impoverishment of the world” occurs; with melancholy, the effect of “impoverishment of the Self” occurs. “I” (Ego) is perceived by the client as unworthy, worthless, condemned, petty, insincere, selfish, and dependent. A person scolds himself and expects rejection and punishment. Such a person humiliates himself and feels sorry for those around him because they are associated with such an insignificant person. Melancholy can be complemented by insomnia and loss of appetite.

Melancholy is based on the loss of a loved one. This is an ideal loss in nature. The object of love does not really die, but is lost as an object of love. In some cases, a person is aware of the loss, but cannot understand what exactly he has lost, or understands who he has lost, but does not understand what exactly he has lost along with this object.

In grief there is nothing unconscious. With melancholia there is an unconscious component - the loss of an object is not realized. This entails melancholic delays (Hemmung), which produce an incomprehensible impression on others, because they do not understand what exactly was lost, what process captured them.

A person extends his perception of himself (humiliated, unworthy, condemned) to the past; it seems to him that he has never felt better.

Lack of interest in the world, loss of the ability to love and work is a reaction to a secondary phenomenon, a consequence of internal work, similar to the work of grief.

With melancholy, the “I” (Ego) is divided into parts. One part of the “I” is opposed to another and produces critical assessment her (as a foreign object). This critical authority is related to conscience. If you listen carefully to the self-accusations of a patient with melancholia, it becomes noticeable that the most severe reproaches have little correlation with the personality of the patient, and, with some modification, are more suitable for another person whom the melancholic person loves, loved, should have loved. From this we can assume that with depression, reproaches against the object of love are transferred to one’s own “I”.

Freud's example: a woman who feels unworthiness and feels sorry for her husband unconsciously wants to accuse her husband of unworthiness. Therefore, her self-reproaches are a reflection of her attitude towards another person, which is directed towards herself.

Symptoms of melancholy

• Moral dissatisfaction with oneself
  • Self-hostility
  • Self-accusation
  • Waiting for punishment
  • Sees himself as an unworthy, terrible person. He feels sorry for those around him because they have to deal with him
  • Humiliation of oneself
• Physical loss of strength, weakness, decreased health
• Psychological impoverishment
• Decreased appetite, refusal to eat
• Insomnia
• Termination of all interests
• Lost ability to love
• Retardation of activity, the ability to work may be lost
• Impoverishment, emptying of the “I”
• Suffering

Psychodynamics of melancholy

1. Libido was tied to the chosen object
2. There was a shock to this attachment (there was grief, resentment, disappointment). The conflict of ambivalence (love-hate) intensifies
3. Normally, at this stage it would be possible to take libido away from the chosen object and transfer it to a new object (grief work)
4. With melancholia, attachment to the chosen object is destroyed, but libido is not transferred to a new object, but is returned to the structure of the “I” (Ego).
5. The libido inside does not find use and initiates the process of identifying part of the “I” with the lost object.
6. Internal relationships are established: one part of the “I” and another part of the “I”, which has become identified with the lost object. This identified part of the Self is also considered as a lost object. The loss of the object turns into the loss of the Self.
7. One part of the Self begins to criticize another part of the Self (viewed as a lost object). Hatred is directed at the object, he is insulted and humiliated, thanks to which hatred receives sadistic satisfaction. The self-torture of a melancholic person gives him satisfaction (as if it were expressed to the object).
8. A depressed patient, through self-torture, also indirectly takes revenge on the original real object (without showing his direct hostility towards it)

Components of the occurrence of melancholy

• The choice of a love object occurs on a narcissistic basis (Otto Rank’s idea)
• Strong fixation on the chosen object of attachment
• An unstable attachment can easily become detached from the object of love if there are obstacles on the path to attachment. Severed attachment regresses back to narcissism
• Narcissistic identification with an object replaces attachment. Love for the object is replaced by narcissistic identification with the object. In this case, the love relationship remains (despite the conflict with your loved one)
• The structure of the “I” wants to absorb this object, to merge with it by absorbing it (as a consequence of regression to the oral or cannibal phase). Therefore in severe forms depression, food refusal occurs (Abraham)
• Conflict of ambivalence
  • The melancholic's loving attachment to an object regresses to identification with the object.
  • Love attachment regresses to the stage of sadism
  • With melancholy, there are constant battles in which there is a struggle between love and hate. There is a desire to take libido away from the object, and there is a desire to maintain the position of libido.

3 prerequisites for melancholy:

• Lost object
• Ambivalence
• Regression of libido to "I"

Dynamics of suicidal thoughts: a person wants to destroy not himself, but another (object), but since the object is inside, hostility is directed towards himself. This occurs in a situation where attachment to objects is directed towards oneself.

The melancholic process attracts the energy of all attachments, which devastates the “I” to the point of complete impoverishment.

Melancholy can turn into its opposite - mania. A sequential change in the phases of mania-melancholia is possible. Mania can be explained by the same psychodynamics as melancholia. With melancholy, the complex triumphs over the “I”; with mania "I" the complex wins. With mania, the “I” experiences jubilation and triumph, but does not understand that it has overcome. During mania, the “I” is freed from the object and therefore “goes” to search for a new object of attachment.

Therapy

• You should not object to the patient when he treats himself this way (blames, sees himself as unworthy, worthless, the most terrible person). This perception may not coincide with the opinion of others about this person, but this is a psychological self-perception, which has its own grounds.
• It is worth admitting that he now has no interests, ability to love and work

Melancholic depression- form of strong depressive disorder, in which the main indicator is the state of melancholy. For a person suffering from melancholic depression, life often seems meaningless or without purpose.

In Russia, studies have shown that 12 to 15% of women and 8-10% of men suffer from this serious disorder. Although melancholic depression has different levels severity, most researchers classify it as one of the most serious forms of depression.

Symptoms

One way to detect this depressive state in a person is to look at the difference between emotions and mood.

Emotions are constantly changing, a person’s mood and thoughts are directed towards some bad moments in life. This condition can last for several months or even years. Melancholic depression is one of the types severe depression, which tends to be diagnosed more often in older people and affects men and women equally. According to the Diagnostic and Statistical Manual mental disorders", there are eight symptoms that make up diagnostic criteria for melancholic depression, four of which must be ticked to diagnose melancholic depression.

The main features of melancholic depression include:

People with melancholic depression may experience excessive feeling guilt, which characterizes an inadequate response to a situation or event. For example, a person may accidentally dial the wrong number and feel excessively guilty.

Causes

Not much is known about the causes of melancholy, however, it is believed that it is mainly due to some biological reasons. Some may also inherit this disorder from their parents. Depression is not caused life events, although stressful circumstances can cause similar symptoms.

In addition, it has been found that melancholia is quite common in people with bipolar disorder I. It may also be present in bipolar depression II with special features psychomotor agitation. Melancholic depression is quite common in hospital settings. Persons with mental functions, may also be more prone to this disorder.

Treatment

There are three most common treatments for depression:

• psychotherapy,
• drug treatment,
• electroconvulsive therapy.

Psychotherapy is prescribed to patients under the age of 18, while electroconvulsive therapy is used only for older people.

Melancholic depression does not respond to psychotherapy and counseling, as it is a fairly severe psychotic mental disorder. Consequently, treatment mainly consists of physical intervention with medications that include antidepressants and a long period supervision by a specialist.