Depression. Causes, symptoms, treatment of the disease
Most women experience special trepidation before future motherhood. They perceive pregnancy as a kind of blessing and try to follow all the rules of nutrition during this period, avoid stress and physical overload.
But female body is designed in such a way that pregnancy can be terminated suddenly, i.e. a miscarriage occurs. The situation is quite difficult, requiring physical and moral recovery. Depression after a miscarriage develops in almost every woman who has experienced such a loss.
Psychological state^
The psychological state after termination of pregnancy is severe, colored by negative thoughts and an unstable emotional background.
A woman at this moment tends to torment herself with endless conversations and thoughts about what she did something wrong.
The first time after the incident, melancholy and sadness are expressed in visiting forums dedicated to motherhood, going to children's stores and looking at small children in parks.
After a miscarriage, a woman’s emotions and feelings become dull, and blaming herself for what happened and despair come to the fore. It seems that life is over and will never be the same again. The woman feels lonely and driven into a dead end.
This state of affairs has a negative impact on the flow physiological processes when there is simply no appetite, and normal rest and basic sleep are out of the question.
Recovering from a miscarriage is much more difficult mentally than physically. This is a difficult path that requires persistence, perseverance and support from family and friends.
How to cope with depression after a miscarriage^
It is quite difficult to restore emotional balance, but there are several techniques that can help alleviate your condition.
How to get rid of alcoholic depression? Read on.
Find out about best books from depression in our article.
After a miscarriage, thoughts of a new pregnancy will be scary, but over time they will begin to appear more and more often, and the fear will begin to go away. In order to properly prepare for a new stage in your life, it is important to understand and realize the tragedy that happened. Only in this case can we talk about meaningful work on oneself.
A woman will never be able to forget about her loss, but even in such grief one can see the creative beginning contained in gaining strength and wisdom for a further full life.
Stroke: psychosomatics and consequences
Psychosomatics of stroke are two words that at first glance do not have much in common. The fact is that in traditional medicine, a stroke is considered to be a violation of blood circulation in the vessels of the brain. From a physiological point of view, the occurrence of disease is so. However, doctors are increasingly coming to the conclusion that stroke develops under a huge number of different factors, one of which is psychosomatics or the psychological state of a person. As a result of such problems, patients suffer from psychosis and a host of other psychological disorders. To understand the psychosomatic causes and consequences of an attack, it is necessary to consider the situation from different angles.
What is psychosomatics?
The word psychosomatics in the medical community means the development of diseases, psychosis, and other pathological conditions that develop under the influence of a person’s psychological perception. We can say that all ailments in the body come from incorrect thinking; we ourselves attract them and contribute to their development. In fact, an experienced rehabilitation psychologist will say that many diseases occur not so much from an emotional state, but from mental health.
A person who is often subject to stress, depression, and easily moves into a state of aggression harms his body by subjecting it to constant “shocks.”
First of all, such manifestations of emotionality affect the functioning of the heart, blood vessels, and brain, but if a person has a disturbed psyche, damage is caused to the entire body as a whole. Moreover, there are many cases proving that psychosomatic disorders increase the chance of psychological complications after a stroke. In such cases, in addition to functional problems caused by poor circulation, a person faces the following troubles:
Such complications not only complicate the rehabilitation process, but the very issue of recovery is jeopardized.
Due to the fact that the patient’s psyche is disturbed, his emotional state affects not only his health, it becomes a real test for loved ones, because they are the ones who experience the patient’s depressive, aggressive or other states.
Psychosomatic causes of stroke
Dizziness, headaches, deterioration of memory, vision, hearing, and so on - all these are signs of problems with blood circulation in the brain and precursors of a stroke. In most cases, the causes of “brain stroke” are pathologies of the cardiovascular system and concomitant diseases. But if we associate a stroke with a person’s psychological conditions and psychosomatics, the reasons contributing to its development will be the following:
- Constant stress - problems at work, frequent worries and worries.
- Jealousy - discord in the family, groundless or justified jealousy, results in serious mental disorders.
- Anger and hatred are so strong feelings, even if they are pathological manifestations, also contribute to the development of an attack.
- Success race - we are talking about competition with oneself to achieve some goals or the desire to surpass others. Such states are emotionally exhausting.
- Depression – this state abnormal for a healthy person, only its manifestation or state of psychosis can indicate problems in the head.
All the factors described indicate that the person has a mental disorder. Constant exposure to such conditions provokes health problems, increasing the likelihood of developing a stroke; they cannot be ignored.
Psychosomatic consequences of stroke
As mentioned earlier, a person who has experienced a stroke also faces psychosomatic problems. This is not only due to pathological disorders caused in certain areas of the brain or manifestations of dementia. Loss of motor functions, inability to perform tasks that previously seemed simple, to take care of oneself, etc. All this makes the patient feel inferior, hence the following psychological problems appear.
Aggression after stroke
Often these behaviors are caused by lesions in the temporal lobe involving the parahippocampal or anterior cingulate cortex. In this case, patients experience psychosis and emotional imbalance. To get rid of such complications, sedatives may be required, but the most important thing is the understanding attitude of others and tolerance.
Depression after stroke
Another severe disorder, which is a certain type psychosomatic complications. The reasons for its development are the same, but now, in addition to psychosis and anger, it is noticeable that the patient has become depressed, detached, there is a general deterioration of not only psychological, but also physical condition, dizziness. In such situations, in addition to the main treatment, the patient is prescribed antidepressants.
Dementia after stroke
This manifestation is difficult to consider as a consequence of psychotic problems; rather, it is a direct consequence of certain disorders caused by extensive damage. It is difficult to cure a person with such a diagnosis; means are used aimed at activating the work of brain neurons and stimulating mental activity, as well as a long course of therapy.
Psychogenic dizziness
Such dizziness is direct evidence of certain disorders directly related to the psychological and mental state. Depending on the nature of the problem, both antidepressants and sedatives are used.
Mental disorders after a stroke are much more widespread; the common ones are listed above pathological disorders behavior of patients who have had an attack. In addition, if before the stroke the patient was exposed to certain psychosomatic problems, the likelihood of their occurrence after the “impact” increases significantly. What to do and how to act in such situations is decided by the attending physician, however, for full treatment, the help of more specialized specialists may be required, among whom should be a rehabilitation psychologist.
If a person’s psyche is noticeably “shaken” after a stroke, there is depression, anger, grumpiness, aggressiveness, etc., he requires not only a standard course of treatment, but also psychological help, and possibly therapy with appropriate medications.
In the treatment of all kinds of psychosomatic disorders, psychostimulants are used, therapy is carried out with antidepressants, some sedative, neuroleptics. In any case, each medicine is taken only as prescribed by a specialist; the course and dosage of its administration is prescribed by the attending physician and a rehabilitation psychologist. Before prescribing treatment and during its process, the patient may require a number of diagnostic measures aimed at assessing the condition and extent of damage caused by impaired blood circulation in the brain, as well as the dynamics of improvement.
Often, only relatives can understand that a person’s psyche is disturbed after a blow. It is for this reason that the person who has experienced such a shock should have a special attitude from the people around him. It is necessary to help the patient in every possible way to cope with the misfortune that has befallen him and to be patient, because treatment can last for months.
Post-alcohol depression
Post-alcohol depression is an emotional and psychological condition that develops against the background of alcohol dependence. In terms of its symptoms, it is similar to withdrawal syndrome, but these conditions have fundamental differences.
While a severe hangover is often accompanied by physiological symptoms, depression is characterized by psychological problems.
The relief that comes with drinking more alcohol is deceptive. It is temporary and after short period Over time, the unpleasant symptoms return. For this reason, experts note that post-alcohol depression turns into chronic form more often than other forms of disease.
Mechanism of the disease
It has long been proven that drinking alcohol disrupts work internal organs person. The most serious damage is caused to the nervous system and brain. Regular toxic exposure weakens the protective functions of the nervous system, which leads to mental disorders.
Each new dose of alcoholic beverages allows a person to feel joy, a sense of euphoria, and satisfaction. Psychological barriers to behavior are removed, fear goes away. In some cases, aggression towards others increases. But after a few hours this condition passes. In its place comes fatigue and emptiness. Symptoms of withdrawal syndrome occur. As a result, any conflict leads to anger and the desire to drink a new portion of alcohol.
Post-alcohol depression occurs not only after drinking alcohol, but also as a result of its abrupt cessation. For a person who has stopped drinking:
Gradually, a person develops a chronic depressive state. At first glance, there may be no signs of the disease. The person will live everyday life, do ordinary things. The disease will begin to progress and classic symptoms depressive state.
Symptoms of depression
Symptoms of psychological depression can easily be confused with a hangover. The latter usually occurs within 5–10 hours after drinking alcohol. Its symptoms are mainly related to the physical condition of the patient. They manifest themselves in the form of headache, nausea, photophobia, general weakness. Post-alcohol depression affects the psychological state, so its symptoms are related specifically to a person’s psychological health. It affects your emotional state, outlook on life, attitude towards yourself and the world around you.
Experts identify a number of main signs of post-alcohol depression:
- Feeling depressed. It manifests itself in a feeling of guilt towards oneself and others.
- Slowing down the pace of life. When depressed, a person refuses to participate in social life.
- The pace of his vital activity slows down. A person spends more time alone, sitting in front of a TV or computer monitor.
- Slowdown psychological reaction. A patient in a state of depression reacts slowly to the environment. A feeling of joy or other emotions does not appear on the face immediately, but gradually. The patient seems detached and thoughtful.
- Decreased self-preservation instinct. Against the background of depression, a person begins to have difficulty discerning danger. He reacts inattentively to his surroundings and can provoke an accident.
- Thoughts about suicide. With prolonged depression against the background of chronic alcohol dependence, suicidal tendencies arise. They are associated with the fact that the patient excludes himself from social life, loses connections, and becomes unclaimed professionally.
- Loss of meaning in life. On the background constant need in alcohol, everything around you becomes uninteresting, boring, monotonous. Patients do not feel joy. Satisfaction comes only after drinking a new portion of alcohol.
The latter signs (lack of self-preservation, loss of meaning in life, suicidal tendencies) are signs of chronic depression and severe course alcoholism. When they appear, immediate medical and psychological assistance is indicated. In such a situation, the patient is not able to cope with the problem on his own.
Types of depression
Post-alcohol depression is divided into two types according to its condition:
The first occurs as a complication of hangover syndrome. It is associated with serious poisoning of the body with alcohol. Severe form psychological disorder occurs with alcoholism of the II or III degree.
SENSATION! Doctors are dumbfounded! ALCOHOLISM goes away FOREVER! You just need it every day after meals. Read more—>
A mild form of depression occurs when withdrawal syndrome. The pathology is typical for males and females prone to hangovers. Experts attribute the deterioration in emotional state to developing hypoglycemia. It occurs against the background of a decrease in blood sugar levels. It is required to process large quantities of ethyl alcohol entering the body. The main signs of hypoglycemia are:
To eliminate unpleasant symptoms, it is often enough for a person to administer a glucose solution. In addition to a lack of glucose, with a mild depressive state there is a deficiency of magnesium and potassium in the blood. Characteristic signs of a deficiency of these substances are irritability, tremors of the limbs, rapid heartbeat, and convulsions. The problem can be solved by introducing solutions of calcium and magnesium.
Against the background of general malaise, a feeling of shame for inappropriate behavior, remorse, anxiety, and self-flagellation develops. Normally, symptoms go away within 2–3 days. With drug treatment, the syndrome is relieved much faster.
Post-alcohol depression in severe form occurs when abrupt refusal from alcoholic products. Its characteristic features are severe symptoms manifestations and duration of the course. In the first stages, the disorder passes in the form of withdrawal syndrome - a feeling of anxiety, depression, and apathy develops. If you give up alcohol and lack proper treatment, these feelings turn into a deep emotional crisis. The feeling of insignificance is aggravated by the lack of satisfaction from new portions of alcohol. In search of positive emotions, there is a need for strong sensations: drugs, gambling. It becomes very difficult to get out of this state. Treatment of severe forms of post-alcohol depression requires an integrated approach. It consists of timely support from family and friends, drug therapy, and psychological assistance from a specialist.
Methods to combat depression
The effectiveness of combating post-alcohol depression is associated with the patient’s psychological readiness. When refusing to drink alcohol, the patient should prepare for a general deterioration in health. With the development of severe forms of depression, patients require medication support. For isolated emotional disorders, gentle therapy is sufficient.
In the absence of chronic forms of the disease, a fundamental change in lifestyle allows you to relieve the depressed state. It is important to find activities that will allow you to feel joy and satisfaction again without the use of alcohol. Mild forms of depression are treated:
The freed up time needs to be filled as much as possible with new hobbies and establishing social connections that do not involve alcoholic beverages. Preference should be given to active activities. It can be:
In situations where depression takes a chronic form, patients are prescribed comprehensive treatment. It includes 3 main areas:
An important role in the treatment of post-alcohol depression is played by timely diagnosis of the disease and competent treatment. For this reason, the patient’s close relatives should provide him with maximum support during rehabilitation and help him establish a normal lifestyle.
It is impossible to cure alcoholism.
Psychotherapy for menopause: when is it necessary?
The article describes the types of psychological state of women during menopause, indications and directions of psychotherapy.
Climax - physiological changes in the body of women 40-50 years old, caused by hormonal changes. Characterized by phasing out menstruation until the cycle completely subsides. The duration of the period is up to 10 years. The condition may be accompanied by vegetative - vascular, endocrine and psychological disorders, and in severe cases - mental disorders. Translated from Greek, “klimax” is a ladder, meaning the stepwise development of a woman.
Psychological state of women during menopause
Manifestation psychological characteristics Women during menopause depend on their personality type, health status (chronic diseases), age and environmental factors (attitudes of relatives and colleagues, nature of work, presence of stress).
Due to hormonal changes During menopause, the following picture is observed:
- the skin becomes dry and wrinkled;
- hair turns gray and falls out;
- heartbeat and pulse increase;
- feeling of “flushes” of heat, thirst;
- frequent headaches, digestive problems;
- sleep is disturbed, appetite and libido decrease.
- decreased self-esteem;
- anxiety;
- tearfulness over minor issues;
- various fears (phobias);
- loss of the ability to enjoy something, to enjoy life;
- loss of interest in oneself, one’s appearance, work, favorite activities.
- sudden outbursts of unmotivated aggression;
- constant dissatisfaction with oneself and/or the behavior of others;
- provoking conflict situations at home and at work;
- mood is unpredictable, changes quickly for no apparent reason.
- inability to concentrate;
- weakening of memory;
- in advanced cases - a violation of thinking in the form of ideas of self-deprecation, hypochondria (confidence in the presence of an incurable disease), obsessive overvalued ideas.
- for your life and the lives of loved ones;
- get sick with an incurable disease;
- losing a loved one (due to your changed appearance and condition);
- loneliness - due to a change in character, a woman is afraid that not only her husband, but also her children will leave her;
- lose your job (memory and attention decrease, uncertainty appears in own strength ah), often - lack of desire to do something;
- lose property;
- a new stage in their lives, which fills them with horror.
- get into an elevator (claustrophobia);
- ride public transport (amaxophobia);
- being among people in open spaces (agarophobia).
- Cognitive behavioral therapy. The goal is to help a woman realize that menopause is a natural physiological stage in a person’s life. During the sessions, a woman learns about the causes of her condition and ways to overcome it. She will have a desire to get rid of negative symptoms - anxiety, aggression, fears. She will be able to increase her self-esteem and learn ways to deal with stress.
- Interpersonal - helps to normalize relationships with others, teaches how to avoid conflict situations and how to get out of them. It is carried out both individually and in group form.
- Family - aimed at stabilizing family relationships, improving " psychological climate" in family. The effect will be achieved only with the participation of all family members.
All this leads to a woman’s depressed mood; she often imagines herself old and useless to anyone. In the absence of support from loved ones; interesting, all-consuming work or activity; with the help of a specialist, the following psychological disorders are formed.
a) With elements of depression:
Depressive symptoms may deepen and lead to suicidal thoughts and actions.
b) With a tendency to excitability:
The manifestation of certain psychological characteristics depends on the woman’s personality type. During menopause, character traits sharpen and manifest themselves in extreme forms - thrifty people become greedy, anxious people become fearful, cautious people become suspicious.
But there are also paradoxical reactions: a previously shy, self-conscious person suddenly “disinhibits”, becomes active to the point of obsession, strives to be the center of attention, changes his appearance to a catchy, bright one, and his behavior becomes demonstrative. A woman is afraid of growing old, becoming unattractive, and being abandoned, so she subconsciously strives to prove the opposite, first of all, to herself.
Menopausal fears
Let's talk separately about fears during menopause. They are varied and manifest themselves with different intensities. Women are afraid:
If fears are constant, they develop into obsessions (phobias), which are no longer possible to get rid of on your own. The types of phobias are expanding - women cannot:
They are terrified of getting infected, neatness becomes pathological (they repeatedly clean the house), the feeling of disgust reaches the point of absurdity (they cannot eat, drink outside the house, or take anything with their bare hands without gloves). A common symptom is constant hand washing.
The development of phobias can be prevented by promptly contacting a psychologist, and, if necessary, a psychiatrist.
Help with menopause: psychologist or psychotherapist?
In order for the menopause to be painless both physically and psychologically, a woman needs comprehensive medical and psychological support. Doctors will provide treatment aimed at maintaining hormonal balance and symptomatic therapy to correct disorders of the internal organs. For mental disorders, psychiatric treatment will be prescribed.
Psychological support includes a consultation at which a range of psychological problems will be identified. If a woman has unstable emotional disturbances, a favorable family climate, there are good resources for quick recovery, - 1-2 sessions of short-term psychotherapy, which can be conducted by a psychologist, is enough.
Indications for long-term psychotherapy are deep mental disorders. The following directions apply:
The standard course of therapy is six months with a frequency of 1-2 times a week. If necessary, the course is extended.
The results depend not so much on the qualifications of the psychotherapist, but on the woman herself. She should try to communicate more often with family and friends, not hide her problems to herself, find time to take care of herself, and, ultimately, love herself in a new state.
Only with joint efforts is complete success of therapy possible.
Psychological state depression
- characterized by a feeling of loss of orientation in life;
- arising when an individual is faced with the need to fulfill norms that contradict each other.
Autism is a painful mental condition; the individual’s withdrawal from contacts with the surrounding reality and orientation towards the world of his own experiences. Autism leads to a loss of the ability to understand the surrounding reality and to inappropriate behavior of the individual in society. There are Kanner's early childhood autism, Asperger's autistic psychopathy, organic autism, etc.
Autistic type of behavior - immersion in the world of personal experiences with weakening or loss of contact with reality, loss of interest in reality, lack of communication with other people, poverty of emotional experiences.
Personal disorganization
Personality disintegration
Disintegration of personality
Personality disorganization is a condition in which an individual is unable to function effectively due to internal confusion resulting from accepting conflicting standards of behavior and loyalties to different groups.
From Latin Depressio - depression
Depression is a painful state of depression and lethargy mental activity; a state of frustration leading to anemia.
Children's pathological fantasies
Childhood pathological fantasies
Children's pathological fantasies are a component of autism, obsessive or delusional ideas, manifested in the imagination of children suffering from neuroses and psychoses, during games and in statements.
Childhood autism- uneven development of mental functions in children. Childhood autism is accompanied by difficulties in establishing relationships with people, weak emotional response, “closedness in oneself,” fear of novelty, sleep disturbances, phobias, avoidance of contacts with other people and with the outside world in general.
Inertia of inclusion
Inertia of inclusion is a psychological state of a person, characterized by the absence of liberation of consciousness from feelings and thoughts associated with certain past events or life facts.
The cognitive dissonance
Cognitive dissonance
Cognitive dissonance, according to L. Festinger, is a state characterized by a collision in the mind of an individual of contradictory knowledge, beliefs, and behavioral attitudes regarding some object or phenomenon. A person seeks to overcome cognitive dissonance by changing one of the conflicting knowledge and establishing correspondence between knowledge and behavioral attitudes.
Cognitive consonance
Cognitive consonance
Cognitive consonance is mutual consistency, a balanced state of the elements of the cognitive system; state of correspondence between expected and received information.
From the Greek Melaina chole - black bile
Melancholia - in psychiatry - deep endogenous depression, sometimes leading to suicidal mania.
Mental conflict - in social psychology - mental conflict,
- characterized by a state of frustration and indecision;
- resulting from an individual’s inability to act due to fear of increasing adverse consequences (when all possible alternatives are equally undesirable).
The basis of mental conflict is the inconsistency of role expectations and values, which increases significantly during periods of dramatic social change.
Tension is an emotional state of an individual or group, characterized by disturbed internal balance, anxiety, restlessness, and agitation. The voltage is:
- either as a result of mobilizing all the forces of the individual before committing significant actions;
- or the result of frustration, the action of conflicting motives, the inability or inability to act in a manner adequate for a given situation.
Irresponsibility; Insanity
Insanity is a mental state of a person, characterized by his inability to account for his actions and control them due to a chronic illness or temporary mental disorder, dementia, etc.
From Latin Passivus - inactive
Passivity - inactivity, indifference to the environment. Passivity results from:
— social and individual mental factors;
— the simultaneous presence of incentives inducing oppositely directed actions.
Personification - in psychology - the desire of an individual to shift blame for events or situations that cause frustration onto another person.
Need - internal state psychological or functional sensation lack of something. Needs manifest themselves differently depending on situational factors. The needs are distinguished:
— by areas of activity: the needs of labor, knowledge, communication, recreation;
- by object of needs: material, spiritual, ethical, aesthetic and other needs;
— by functional role: dominant/minor, central/peripheral, stable/situational needs;
- by subject of needs: group, individual, collective, public.
From Latin Prostratio - decline
Prostration is a state of complete physical and neuropsychic relaxation of the body, which occurs after serious illnesses, severe overwork, nervous shock, and starvation.
From lat.Relaxatio - weakening
Relaxation - withdrawal mental stress. Relaxation occurs as an involuntary or voluntary reaction as a result of a person’s special work on his own mental state and is associated with the ability to escape from unpleasant thoughts and emotions through a combination of physical and mental relaxation.
Happiness is a human state that corresponds to:
— the greatest internal satisfaction with the conditions of one’s existence;
- fullness and meaningfulness of life;
- fulfillment of one's human purpose.
Fatigue is a complex of subjective experiences that accompany the development of a state of fatigue. Fatigue is characterized by:
- weakness, lethargy, impotence;
- a feeling of physiological discomfort;
— awareness of disturbances in the course of mental processes;
- loss of interest in work,
— predominance of motivation to terminate activities;
- negative emotional reactions.
Tiredness; Weariness; Fatigue
Fatigue, in psychology, is a state of temporary decrease in the functional capabilities of the human body due to intense or prolonged activity.
From lat. Frustratio - destruction of plans
Frustration is a psychological state of an individual characterized by the presence of a stimulated need that has not found its satisfaction. Frustration is accompanied by negative emotions: anger, irritation, guilt, etc. There are:
— frustrator — the cause causing frustration;
Depression as a state of emotional depression has been known since ancient times. Eight centuries before the birth of Christ, the great ancient Greek singer Homer described the classic depressive state of one of the heroes of the Iliad, who “... wandered around, lonely, gnawing at his heart, running away from the traces of a person...”
In the first collection of medical treatises ancient Greece, whose authorship is attributed to the “father of scientific medicine” Hippocrates, the suffering caused by depression was quite clearly described and a definition of the disease was given: “if sadness and fear continue long enough, then we can talk about a melancholic state.”
The term “melancholy” (literally black bile) has been used in medicine for a long time and has remained in the names of some mental pathologies to this day (for example, “involutional melancholia” - depression that develops in women during menopause).
Descriptions of pathological emotional experiences leading to inadequate perception the surrounding world, is also in the Old Testament. In particular, the First Book of Kings describes a clinic of severe depression in the first king of Israel, Saul.
In the Bible, this state is interpreted as punishment for sins before God, and in the case of Saul it ends tragically - the king committed suicide by throwing himself on the sword.
Christianity, largely based on the Old Testament, for a long time retained extremely negative attitude to all mental illnesses, associating them with the machinations of the devil.
As for depression, in the Middle Ages it began to be designated by the term Acedia (lethargy) and considered as a manifestation of such mortal sins as laziness and despondency.
The term “depression” (oppression, depression) appeared only in the nineteenth century, when representatives of the natural sciences began studying mental illnesses.
Current Statistics on Depression
The topics of loneliness in a crowd and the feeling of meaninglessness of existence are some of the most discussed topics on the Internet,Today, depression is the most common mental pathology. According to WHO data, depression accounts for 40% of cases of all mental illnesses, and 65% of mental pathologies that are treated on an outpatient basis (without placing the patient in a hospital).
At the same time, the incidence of depression is steadily increasing from year to year, so that over the last century the number of depressed patients registered annually has increased more than 4 times. Today in the world, every year, about 100 million patients consult a doctor for the first time about depression. It is characteristic that the lion's share of depressed patients occurs in countries with a high level of development.
Part of the increase in reported cases of depression is due to the rapid development of psychiatry, psychology and psychotherapy. So even mild cases of depression that previously went undetected are now being diagnosed and successfully treated.
However, most experts associate the increase in the number of depressed patients in civilized countries with the peculiarities of life of a modern person in big cities, such as:
- high pace of life;
- a large number of stress factors;
- high population density;
- isolation from nature;
- alienation from traditions developed over centuries, which in many cases have a protective effect on the psyche;
- the phenomenon of “loneliness in a crowd,” when constant communication with a large number of people is combined with the absence of close, warm “informal” contact;
- deficit motor activity(it has been proven that banal physical movement, even ordinary walking, has a beneficial effect on the state of the nervous system);
- aging population (the risk of depression increases many times with age).
Different Differences: Interesting Facts About Depression
- The author of “dark” stories, Edgar Poe, suffered from bouts of depression, which he tried to “treat” with alcohol and drugs.
- There is a hypothesis that talent and creativity contribute to the development of depression. The percentage of depressed and suicidal people among prominent cultural and artistic figures is significantly higher than in the general population.
- The founder of psychoanalysis, Sigmund Freud, gave one of the best definitions of depression, defining pathology as irritation directed at oneself.
- People suffering from depression are more likely to experience fractures. Research has shown that this is associated with both decreased attention and worsening conditions. bone tissue.
- Contrary to popular belief, nicotine is in no way capable of “helping you relax,” and a puff of cigarette smoke only brings apparent relief, but in fact aggravates the patient’s condition. There are significantly more patients suffering from chronic stress and depression among smokers than among people who do not use nicotine.
- Alcohol addiction increases the risk of developing depression several times.
- People suffering from depression are more likely to become victims of influenza and ARVI.
- It turned out that the average gamer is a person suffering from depression.
- Danish researchers have found that fathers' depression has an extremely negative impact on the emotional state of infants. Such children cry more often and sleep worse.
- Statistical studies have shown that overweight children of kindergarten age have a significantly higher risk of developing depression than their peers who are not overweight. At the same time, obesity significantly worsens the course of childhood depression.
- Women prone to depression have a significantly higher risk of premature birth and other pregnancy complications.
- According to statistics, every 8 out of 10 patients suffering from depression refuse specialized help.
- Lack of affection, even with relatively prosperous material and social status, contributes to the development of depression in children.
- Every year, about 15% of depressed patients commit suicide.
Causes of depression
Classification of depressions according to the cause of their development
Participates in the development of almost any depressive state whole line factors:- external influences on the psyche
- acute (psychological trauma);
- chronic (state of constant stress);
- genetic predisposition;
- endocrine shifts;
- congenital or acquired organic defects of the central nervous system;
- somatic (bodily) diseases.
- Psychogenic depression, which are a reaction of the psyche to any unfavorable life circumstances.
- Endogenous depression(literally caused by internal factors) representing psychiatric diseases, in the development of which, as a rule, genetic predisposition plays a decisive role.
- Organic depression caused by a severe congenital or acquired defect of the central nervous system;
- Symptomatic depression, which are one of the signs (symptoms) of any physical disease.
- Iatrogenic depression, which are a side effect of any drug.
Causes of development of reactive and neurasthenic depression
Psychogenic depression is the most common type of depressive condition, accounting for up to 90% of all types of depression. Most authors divide all psychogenic depression into reactive - acutely occurring depressive states and neurasthenic depression, which has an initially chronic course.
Most often the reason reactive depression become severe psychological trauma, namely:
- tragedy in personal life (illness or death of a loved one, divorce, childlessness, loneliness);
- health problems (serious illness or disability);
- disasters at work (creative or production failures, conflicts in the team, loss of a job, retirement);
- experienced physical or psychological violence;
- economic turmoil (financial collapse, transition to a lower level of security);
- migration (moving to another apartment, to another area of the city, to another country).
A common feature of all reactive depressions without exception is the presence of a traumatic factor in all the emotional experiences of the patient, who is clearly aware of the reason why he is suffering - be it loss of a job or disappointment after entering a prestigious university.
The reason neurasthenic depression is chronic stress, therefore in such cases the main traumatic factor by the patient, as a rule, is not identified or is described as a long streak of minor failures and disappointments.
Risk factors for the development of psychogenic depression
Psychogenic depression, both reactive and neurasthenic, can develop in almost any person. At the same time, as banal experience shows, people accept the blows of fate differently - one person will perceive dismissal from work as a minor nuisance, another as a universal tragedy.
Consequently, there are factors that increase a person’s tendency to depression - age, gender, social and individual.
Age factor.
Despite the fact that young people lead a more active lifestyle and, therefore, are more susceptible to adverse external factors, depressive states in adolescence tend to occur less frequently and are milder than in older people.
Scientists associate the vulnerability of older people to depression with an age-related decrease in the production of the “happiness hormone” - serotonin and a weakening of social connections.
Gender and depression
Women, due to physiological lability of the psyche, are more susceptible to depression, but in men depression is much more severe. Statistics show: women suffer from depression 5-6 times more often than men, and, nevertheless, among 10 suicides, only 2 are women.
This is partly due to the fact that women prefer to “treat sadness with chocolate”, while men are more likely to seek solace in alcohol, drugs and casual relationships, which significantly aggravates the course of the disease.
Social status.
Statistical studies have shown that wealth and poverty are most susceptible to severe psychogenic depression. People with average incomes are more resilient.
In addition, each person also has individual mental characteristics, worldview and microsociety (close environment), increasing the likelihood of developing depressive conditions, such as:
- genetic predisposition (close relatives were prone to melancholy, attempted suicide, suffered from alcoholism, drug addiction or some other addiction, often masking manifestations of depression);
- transferred to childhood psychological trauma (early orphanhood, parental divorce, domestic violence, etc.);
- congenital increased vulnerability of the psyche;
- introversion (a tendency to self-absorption, which during depression turns into fruitless soul-searching and self-flagellation);
- characteristics of character and worldview (pessimistic view of the world order, high or, conversely, low self-esteem);
- poor physical health;
- lack of social support in the family, among peers, friends and colleagues.
Endogenous depressions account for only about 1% of all types of depression. A classic example is manic-depressive psychosis, which is characterized by a cyclical course when periods of mental health are followed by phases of depression.
Often, phases of depression alternate with phases of so-called manic states, which, on the contrary, are characterized by inadequate emotional upsurge and increased speech and motor activity, so that the patient’s behavior is manic phase resembles the behavior of a drunk person.
The mechanism of development of manic-depressive psychosis, as well as other endogenous depressions, has not been fully studied, however, it has been known for quite some time that this disease is determined genetically (if one of identical twins falls ill with manic-depressive psychosis, then the likelihood of developing similar pathology for a genetic twin is 97%).
Women are more often affected; the first episode, as a rule, occurs at a young age immediately after adulthood. However, a later development of the disease is also possible. The depressive phase lasts from two to six months, while emotional depression gradually worsens, reaching a certain critical depth, and then recovery also gradually occurs. normal condition psyche.
“Light” intervals in manic-depressive psychosis are quite long - from several months to several years. An exacerbation of the disease can provoke some kind of physical or mental shock, but most often the depressive phase occurs on its own, obeying a certain internal rhythm of the disease. Often the critical period for the disease is the change of season (autumn and/or spring phases); some patients note the occurrence of depression on certain days of the menstrual cycle.
Another example of a relatively common endogenous depression is involutional melancholy. The disease develops at the age of 45-55 years, mainly in women.
The causes of the disease remain unknown. The hereditary factor in this case is not traced. The development of involutional melancholy can be provoked by any physical or nervous shock. However, in most cases, the disease begins as a painful reaction to decline and approaching old age.
Involutional melancholia, as a rule, is combined with symptoms such as increased anxiety, hypochondria (fear of death from a serious illness), and sometimes hysterical reactions occur. After recovering from depression, patients most often remain with some mental defects (decreased ability to empathize, isolation, elements of egocentrism).
Senile (senile) depression develop in old age. Many experts believe that the cause of the development of this pathology is a combination of a genetic predisposition to the disease with the presence of minor organic defects of the central nervous system associated with age-related circulatory disorders in the brain.
Such depression is characterized by a peculiar deformation of the patient’s character traits. Patients become grouchy, touchy, and traits of selfishness appear. Against the background of a depressed, gloomy mood, an extremely pessimistic assessment of the surrounding reality develops: patients constantly complain about the “wrongness” of modern norms and customs, comparing them with the past, when, in their opinion, everything was ideal.
The onset of senile depression is usually acute and is associated with some traumatic factor (death of a spouse, moving to another place of residence, serious illness). Subsequently, depression takes a protracted course: the range of interests narrows, previously active patients become apathetic, one-sided and petty.
Sometimes patients hide their condition from others, including those closest to them, and suffer in silence. In such cases, there is a real threat of suicide.
Depression associated with physiological endocrine changes in the body
Hormones play a leading role in the functioning of the body in general and in the functioning of the central nervous system in particular, so any fluctuations hormonal levels can cause serious disturbances in the emotional sphere in susceptible individuals, as we see in the example of premenstrual syndrome in women.
Meanwhile life cycle a person implies the existence of periods when a kind of hormonal explosion occurs. These periods are associated with the functioning reproductive system and include maturation, reproduction (in women) and extinction (menopause).
Accordingly, depression associated with physiological endocrine changes in the body includes:
- teenage depression;
- postpartum depression in women giving birth;
- depression during menopause.
- increased fatigue;
- reversible decrease in intellectual functions (attention, memory, creativity);
- reduced performance;
- increased irritability;
- tendency to hysteroid reactions;
- emotional weakness(tearfulness, moodiness, etc.).
Changes in hormonal levels cause a tendency to impulsive actions. It is for this reason that “unexpected” suicides often occur in relatively mild depressive states. Another characteristic feature of depressive states associated with deep hormonal changes is that their development is in many ways similar to psychogenic depression, since there is a significant traumatic factor to the psyche (growing up, the birth of a child, the feeling of approaching old age).
Therefore, the factors that increase the risk of developing such depression are the same as those for psychogenic disorders (genetic predisposition, increased vulnerability of the psyche, past psychological trauma, personality traits, lack of support from the immediate environment, etc.).
Organic depression
The incidence of depression in some brain lesions is quite high. Thus, clinical studies have shown that about 50% of patients who have suffered a stroke show signs of depression already in the early recovery period. At the same time, emotional depression develops against the background of other neurological disorders(paralysis, sensory disturbances, etc.) and are often combined with characteristic attacks of violent crying.
Depression is even more common in chronic cerebrovascular insufficiency (about 60% of patients). In such cases, emotional depression is combined with increased anxiety. Patients, as a rule, constantly bother others with monotonous complaints about their severe physical and mental condition. For this reason, vascular depression is also called “whining” or “complaining” depression.
Depression in traumatic brain injuries occurs in 15-25% of cases and most often develops in the long term - months or even years after the tragic event. As a rule, in such cases, depression occurs against the background of already developed traumatic encephalopathy - an organic pathology of the brain, manifested by a whole complex of symptoms, such as attacks of headaches, weakness, decreased memory and attention, irritability, anger, resentment, sleep disorders, tearfulness.
With tumors in the frontal and temporal lobe, as well as with such serious diseases of the nervous system as parkinsonism, multiple sclerosis and Huntington's chorea, depression occurs in most patients and may be the first symptom of pathology.
Symptomatic depression
Symptomatic depression is reported relatively rarely. This is partly due to the fact that depression that develops in the long term clinical stage a serious illness is usually considered as a patient’s reaction to his condition and is classified as psychogenic (reactive or neurasthenic depression).
Meanwhile, many diseases are especially often combined with depression, which allows us to talk about emotional depression as a specific symptom of this pathology. Such diseases include:
- damage to the cardiovascular system (coronary heart disease, chronic circulatory failure);
- lung diseases (bronchial asthma, chronic pulmonary heart failure);
- endocrine pathologies (diabetes mellitus, thyrotoxicosis, Itsenko-Cushing's disease, Addison's disease);
- diseases of the gastrointestinal tract (peptic ulcer of the stomach and duodenum, enterocolitis, hepatitis C, cirrhosis of the liver);
- rheumatoid diseases (systemic lupus erythematosus, rheumatoid arthritis, scleroderma);
- oncological diseases (sarcoma, uterine fibroids, cancer);
- ophthalmological pathology(glaucoma);
- genitourinary system(chronic pyelonephritis).
With some physical illnesses, a depressive state may be the first symptom of a disease that does not yet make itself felt. This primarily concerns oncological diseases such as pancreatic cancer, stomach cancer, lung cancer, etc.
A characteristic feature of symptomatic depression that occurs at the preclinical stage of cancer is the predominance of so-called negative symptoms. It is not sadness and anxiety that comes to the fore, but the loss of the “taste of life”; patients become apathetic, avoid colleagues and friends; in women, the first sign of this type of depression may be a loss of interest in their own appearance.
In the case of malignant neoplasms, depression can occur at any stage of the development of the pathology, which is why many oncology clinics employ psychologists who specialize in providing assistance to cancer patients.
Depression developing in patients with alcohol and/or drug addiction
Depression that develops with alcoholism and/or drug addiction can be considered as signs of chronic poisoning of brain cells with neurotoxic substances, that is, as symptomatic depression.
However, alcohol and/or drug addiction often occurs against the background of prolonged psychogenic depression, when the patient tries to “treat” mental pain and melancholy with brain-stupefying substances.
As a result, a vicious circle is often formed: mental drama prompts the patient to use substances that weaken moral suffering, and alcohol and drugs cause a whole cascade of everyday adversities (family quarrels, problems at work, poverty, social maladjustment, etc.), leading to new experiences, from which the patient gets rid of with the help of the usual “medicine”.
Thus, in the early stages of the development of alcoholism and drug addiction, depression can in many ways resemble psychogenic depression (protracted reactive or neurasthenic).
At the advanced stage of the disease, when physiological and psychological dependence on a psychoactive substance is formed, this type of depression has its own distinct features. The patient perceives the whole world through the prism of addiction to alcohol and/or drugs. So in such cases, group psychotherapy sessions (groups of Alcoholics and Drug Addicts Anonymous, etc.) can be especially effective.
In the final stages of the development of alcohol and drug addiction, when irreversible changes develop in the central nervous system, depression takes on a pronounced organic character.
The characteristic features of depression in alcohol and drug addiction became the reason for separating these pathologies into a separate group. The effectiveness of treatment in such cases is ensured by the involvement of several specialists (psychologist, psychotherapist, narcologist, and in the final stages also a neurologist and psychiatrist).
Iatrogenic depression
The very name “iatrogenic” (literally “caused by a doctor” or “having a medical origin”) speaks for itself - this is the name for depression associated with the use of drugs.
The most often “culprits” of iatrogenic depression are the following medications:
- antihypertensive drugs (drugs that reduce arterial pressure) – reserpine, raunatin, apressin, clonidine, methyldopa, propronalol, verapamil;
- antimicrobial drugs - sulfanilamide derivatives, isoniazid, some antibiotics;
- antifungals (amphotericin B);
- antiarrhythmic drugs (cardiac glycosides, procainamide);
- hormonal agents (glucocorticoids, anabolic steroids, combined oral contraceptives);
- lipid-lowering drugs (used for atherosclerosis) - cholestyramine, pravastatin;
- chemotherapeutic agents used in oncology - methotrexate, vinblastine, vincristine, asparaginase, procarbazine, interferons;
- drugs used to reduce gastric secretion - cimetidine, ranitidine.
Depression- is far from the only unpleasant side effect of such seemingly innocent pills as drugs that reduce the acidity of gastric juice and combined oral contraceptives. Therefore, any medications intended for long-term use must be used as directed and under the supervision of a physician.
Iatrogenic depression, as a rule, occurs only when long-term use named drugs. In such cases, the state of general depression rarely reaches significant depth, and emotional background patients completely return to normal after discontinuation of the medication that caused the symptoms of depression.
The exception is iatrogenic depression that develops in patients suffering from pathologies such as:
- cerebrovascular accidents (often accompanies hypertension and atherosclerosis);
- coronary heart disease (usually a consequence of atherosclerosis and leads to arrhythmias);
- heart failure (cardiac glycosides are often prescribed for treatment);
- peptic ulcer of the stomach and duodenum (usually occurs with increased acidity);
- oncological diseases.
In such cases, the prescription of “suspicious” drugs may provoke an exacerbation of symptomatic depression or aggravate the course of depression associated with an organic defect of the nervous system. Therefore, in addition to stopping the drug that caused depression, you may also need to special treatment symptoms of depression (psychotherapy, prescription of antidepressants).
Prevention of iatrogenic depression consists of observing all precautions when prescribing drugs that can cause depression, namely:
- patients with a tendency to depression need to select drugs that do not have the ability to suppress the emotional background;
- the named medications (including combined oral contraceptives) must be prescribed by the attending physician, taking into account all indications and contraindications;
- treatment must be carried out under the supervision of a doctor, the patient should be informed of all unpleasant side effects - timely replacement of the drug will help to avoid many troubles.
Symptoms and signs of depression
Psychological, neurological and vegetative-somatic signs of depression
All signs of depression can be divided into the actual symptoms of a mental disorder, symptoms of disturbances in the central nervous system (neurological symptoms) and symptoms of functional disorders various organs and systems of the human body (vegetative-somatic signs).TO signs of mental disorder refers, first of all, to the depressive triad, which unites the following groups symptoms:
- decrease in general emotional background;
- slowness of thought processes;
- decreased motor activity.
Slowness of thought processes is expressed in slow speech and short monosyllabic answers. Patients spend a long time thinking about solving simple logical tasks; their memory and attention functions are significantly reduced.
A decrease in motor activity is manifested in slowness, clumsiness, and a feeling of stiffness in movements. With severe depression, patients fall into a stupor (a state of psychological immobility). In such cases, the patient’s posture is quite natural: as a rule, they lie on their backs with their limbs extended or sit bent over, with their heads bowed and their elbows resting on their knees.
Due to a decrease in general motor activity, the facial muscles seem to freeze in one position, and the face of depressed patients takes on the character of a kind of mask of suffering.
Against the background of a suppressed emotional background, even with mild psychogenic depression, patients' self-esteem sharply decreases, and delusional ideas of their own inferiority and sinfulness are formed.
In mild cases, we are talking only about a clear exaggeration of one’s own guilt; in severe cases, patients feel the burden of responsibility for all, without exception, the troubles of their neighbors and even for all the cataclysms occurring in the country and in the world as a whole.
A characteristic feature of delusion is that patients practically cannot be persuaded and, even after fully realizing the absurdity of the assumptions made and agreeing with the doctor, after some time they return to their delusional ideas.
Mental disorders are combined With neurological symptoms , the main one being sleep disturbance.
A characteristic feature of insomnia in depression is early awakening (about 4-5 am), after which patients can no longer fall asleep. Often, patients claim that they did not sleep all night, while medical staff or loved ones saw them sleeping. This symptom indicates a loss of the sense of sleep.
In addition, depressed patients experience a variety of appetite disorders. Sometimes, due to a loss of satiety, bulimia (gluttony) develops, but more often there is a decrease in appetite up to complete anorexia, so patients can lose significant weight.
Disturbances in the central nervous system lead to functional pathology reproductive sphere. Women experience menstrual irregularities up to the development of amenorrhea (absence of menstrual bleeding); men often develop impotence.
TO vegetative-somatic signs of depression applies Protopopov's triad:
- tachycardia (increased heart rate);
- mydriasis (pupil dilation);
One more characteristic feature disturbances in the functioning of the autonomic nervous system - an abundance of complaints of pain (heart, joint, headache, intestinal), while laboratory and instrumental studies do not show signs of serious pathology.
Criteria for diagnosing depression
Depression refers to diseases, the diagnosis of which is usually established by external signs without using laboratory tests and complex instrumental examinations. At the same time, clinicians identify the main and additional symptoms of depression.Main symptoms of depression
- decreased mood (determined by the patient’s own feelings or from the words of loved ones), while a reduced emotional background is observed almost every day for most of the day and lasts for at least 14 days;
- loss of interest in activities that previously brought pleasure; narrowing the range of interests;
- decreased energy tone and increased fatigue.
- decreased ability to concentrate;
- decreased self-esteem, loss of self-confidence;
- delusions of guilt;
- pessimism;
- thoughts of suicide;
- sleep disorders;
- appetite disorders.
Positive and negative signs of depression
As you can see, not all symptoms encountered in depression are included in the criteria for diagnosis. Meanwhile, the presence of certain symptoms and their severity make it possible to recognize the type of depression (psychogenic, endogenous, symptomatic, etc.).In addition, focusing on the leading symptoms of emotional and volitional disorders - be it melancholy, anxiety, detachment and withdrawal, or the presence of delusional ideas of self-deprecation - the doctor prescribes one or another drug or resorts to non-drug therapy.
For convenience, all psychological symptoms of depression are divided into two main groups:
- positive symptoms (the appearance of any sign that is not normally observed);
- negative symptoms (loss of any psychological ability).
- Melancholy in depressive states has the character of painful mental suffering and is felt in the form of an unbearable oppression in the chest or in the epigastric region (under the stomach) - the so-called precordial or epigastric melancholy. As a rule, this feeling is combined with despondency, hopelessness and despair and often leads to suicidal impulses.
- Anxiety often has the vague nature of a painful premonition of irreparable misfortune and leads to constant fearful tension.
- Intellectual and motor retardation manifests itself in the slowness of all reactions, impaired attention, loss of spontaneous activity, including the performance of simple everyday duties, which become a burden to the patient.
- Pathological circadian rhythm– characteristic fluctuations in the emotional background during the day. Moreover, the maximum severity of depressive symptoms occurs in the early morning hours (this is the reason why most suicides occur in the first half of the day). By evening, your health usually improves significantly.
- Ideas of one’s own insignificance, sinfulness and inferiority, as a rule, lead to a kind of revaluation of one’s own past, so that the patient sees his own life path as a continuous series of failures and loses all hope for the “light at the end of the tunnel”.
- Hypochondriacal ideas - represent an exaggeration of the severity of accompanying physical ailments and/or fear of sudden death from an accident or fatal illness. In severe endogenous depression, such ideas often take on a global character: patients claim that “everything in the middle has already rotted,” certain organs are missing, etc.
- Suicidal thoughts - the desire to commit suicide sometimes takes on an obsessive nature (suicidemania).
- Painful (sorrowful) insensibility - most often found in manic-depressive psychosis and is a painful feeling of complete loss of the ability to experience such feelings as love, hatred, compassion, anger.
- Moral anesthesia is mental discomfort due to the awareness of the loss of elusive emotional connections with other people, as well as the extinction of functions such as intuition, fantasy and imagination (also most characteristic of severe endogenous depression).
- Depressive devitalization is the disappearance of the desire for life, the extinction of the instinct of self-preservation and basic somatosensory impulses (libido, sleep, appetite).
- Apathy is lethargy, indifference to the environment.
- Dysphoria - gloominess, grumpiness, pettiness in claims to others (more often found in involutional melancholy, senile and organic depression).
- Anhedonia is the loss of the ability to enjoy the pleasure that everyday life gives (communication with people and nature, reading books, watching television series, etc.), which is often recognized and painfully perceived by the patient as another proof of his own inferiority.
Treatment of depression
What medications can help with depression?
What are antidepressantsThe main group of drugs prescribed for depression are antidepressants - drugs that increase the emotional state and restore the patient's joy of life.
This group of medications was discovered in the middle of the last century completely by accident. Doctors used a new drug, isoniazid and its analogue, iproniazid, to treat tuberculosis and found that patients' mood significantly improved even before the symptoms of the underlying disease began to subside.
Subsequently, clinical trials showed the positive effect of using iproniazid to treat patients with depression and nervous exhaustion. Scientists have discovered that the drug's mechanism of action is to inhibit the enzyme monoamine oxidase (MAO), which inactivates serotonin and norepinephrine.
With regular use of the drug, the concentration of serotonin and norepinephrine in the central nervous system increases, which leads to an increase in mood and an improvement in the overall tone of the nervous system.
Today, antidepressants are a popular group of drugs, which are constantly being replenished with more and more new drugs. A common property of all these medications is the specificity of the mechanism of action: one way or another, antidepressants potentiate the action of serotonin and, to a lesser extent, norepinephrine in the central nervous system.
Serotonin is called the “joy” neurotransmitter; it regulates impulsive drives, facilitates falling asleep and normalizes sleep cycles, reduces aggressiveness, increases pain tolerance, eliminates obsessions and fears. Norepinephrine potentiates cognitive abilities and is involved in maintaining a state of wakefulness.
Different drugs from the group of antidepressants differ in the presence and severity of the following effects:
- stimulating effect on the nervous system;
- sedative (calming) effect;
- anxiolytic properties (relieves anxiety);
- anticholinergic effects (such drugs have many side effects and are contraindicated for glaucoma and some other diseases);
- hypotensive effect (reduce blood pressure);
- cardiotoxic effect (contraindicated in patients suffering from serious heart disease).
The drug Prozac. One of the most popular first-line antidepressants. Used successfully for teenage and postpartum depression ( breast-feeding is not a contraindication to the use of Prozac).
Today, doctors are trying to prescribe new generations of antidepressant drugs that have a minimum of contraindications and side effects.
In particular, such medications can be prescribed to pregnant women, as well as to patients suffering from heart disease (coronary artery disease, heart defects, arterial hypertension, etc.), lungs (acute bronchitis, pneumonia), blood system (anemia), urolithiasis (including including complicated renal failure), severe endocrine pathologies (diabetes mellitus, thyrotoxicosis), glaucoma.
New generations of antidepressants are called first-line drugs. These include:
- selective serotonin reuptake inhibitors (SSRIs): fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Fevarin), citalopram (Cipramil);
- selective serotonin reuptake stimulants (SSRS): tianeptine (Coaxil);
- individual representatives selective inhibitors norepinephrine reuptake (SNRI): mianserin (lerivone);
- reversible inhibitors of monoamine oxidase type A (OMAO-A): pirlindole (pyrazidol), moclobemide (Aurorix);
- adenosylmethionine derivative – ademetionine (heptral).
To second-line drugs include medicines of the first generations of antidepressants:
- monoamine oxidase inhibitors (MAOIs): iproniazid, nialamide, phenelzine;
- thymoanaleptics of tricyclic structure (tricyclic antidepressants): amitriptyline, imipramine (melipramine), clomipramine (anafranil), doxiline (sinequan);
- some representatives of SSRIs: maprotiline (Ludiomil).
However, a significant number of contraindications and side effects, poor compatibility with many therapeutic agents, and in some cases the need to follow a special diet (MAOIs) significantly limit their use. Therefore, second-line antidepressants are used, as a rule, only in cases where first-line drugs for one reason or another are not suitable for the patient.
How does a doctor choose an antidepressant?
In cases where the patient has already successfully taken an antidepressant, doctors usually prescribe the same drug. Otherwise, drug treatment for depression begins with first-line antidepressants.
When choosing a drug, the doctor is guided by the severity and predominance of certain symptoms. Thus, for depression that occurs predominantly with negative and asthenic symptoms (loss of taste for life, lethargy, apathy, etc.), drugs with a mild stimulating effect are prescribed (fluoxetine (Prozac), moclobemide (Aurorix)).
In cases where positive symptoms predominate - anxiety, melancholy, suicidal impulses, antidepressants with a sedative and anti-anxiety effect (maprotiline (Ludiomil), tianeptine (Coaxil), pirlindol (pyrazidol)) are prescribed.
In addition, there are first-line drugs that have a universal effect (sertraline (Zoloft), fluvoxamine (Fevarin), citalopram (Cipramil), paroxetine (Paxil)). They are prescribed to patients whose positive and negative symptoms of depression are expressed to the same extent.
Sometimes doctors resort to combined prescription of antidepressant drugs, when the patient takes an antidepressant with a stimulating effect in the morning and a sedative in the evening.
What drugs can be prescribed additionally during treatment with antidepressants?
In severe cases, doctors combine antidepressants with drugs from other groups, such as:
- tranquilizers;
- neuroleptics;
- nootropics.
The combination of antidepressants with tranquilizers is also used in patients with severe sleep disorders. In such cases, a stimulating antidepressant is prescribed in the morning, and a tranquilizer in the evening.
Neuroleptics– a group of drugs intended for the treatment of acute psychoses. In combination therapy for depression, antipsychotics are used for severe delusional ideas and suicidal tendencies. In this case, “mild” antipsychotics are prescribed (sulpiride, risperidone, olanzapine), which do not have side effects in the form of general mental depression.
Nootropics– a group of drugs that have a general stimulating effect on the central nervous system. These drugs are prescribed for combination therapy of depression that occurs with symptoms of nervous system exhaustion (fatigue, weakness, lethargy, apathy).
Nootropics do not have a negative effect on the functions of internal organs and combine well with medications from other groups. However, it should be borne in mind that they can, albeit slightly, increase the threshold for convulsive readiness and can cause insomnia.
What you need to know about drug treatment for depression
- It is best to take the tablets at the same time every day. Patients suffering from depression are often distracted, so doctors recommend keeping a diary to record data on the drug taken, as well as notes on its effectiveness (improvement, no change, unpleasant side effects).
- The therapeutic effect of drugs from the group of antidepressants begins to manifest itself after a certain period after the start of treatment (after 3-10 or more days, depending on the specific medicine).
- Most side effects of antidepressants, on the contrary, are most pronounced in the first days and weeks of use.
- Contrary to idle speculation, drugs intended for drug treatment depression, if taken in therapeutic doses, does not cause physical and mental dependence.
- Antidepressants, tranquilizers, antipsychotics and nootropics do not develop addiction. In other words: there is no need to increase the dose of the drug for long-term use. On the contrary, over time, the dose of the drug may be reduced to the minimum maintenance dose.
- If you abruptly stop taking antidepressants, withdrawal syndrome may develop, which is manifested by the development of such effects as melancholy, anxiety, insomnia, and suicidal tendencies. Therefore, medications used to treat depression are withdrawn gradually.
- Treatment with antidepressants must be combined with non-drug treatments for depression. Most often, drug therapy is combined with psychotherapy.
- Drug therapy for depression is prescribed by the attending physician and carried out under his supervision. The patient and/or his relatives should promptly inform the doctor about all adverse side effects of treatment. In some cases, individual reactions to the drug are possible.
- Replacing an antidepressant, switching to combined treatment with drugs from different groups, and stopping drug therapy for depression are also carried out on the recommendation and under the supervision of the attending physician.
Should you see a doctor if you are depressed?
Sometimes depression seems completely unreasonable to the patient and others. In such cases, it is necessary to urgently consult a doctor to find out the diagnosis. Almost everyone has experienced transient periods of blues and melancholy, when the world around them is seen in shades of gray and black. Such periods can be associated with both external (severance of relationships with loved ones, troubles at work, moving to another place of residence, etc.) and internal reasons (adolescence in adolescents, midlife crisis, premenstrual syndrome in women, etc.).
Most of us are saved from general depression by already proven means at hand (reading poetry, watching TV shows, communicating with nature or loved ones, favorite work or hobby) and can attest to the possibility of self-healing.
However, Doctor Time cannot help everyone. Behind professional help should be contacted if at least one of the following is present warning signs depression:
- depressed mood persists for more than two weeks and there is no tendency to improve the general condition;
- previously helpful methods of relaxation (communication with friends, music, etc.) do not bring relief and do not distract from gloomy thoughts;
- there are thoughts of suicide;
- social connections in the family and at work are disrupted;
- the circle of interests narrows, the taste for life is lost, the patient “withdraws into himself.”
A person who is depressed will not be helped by advice that “you need to pull yourself together,” “get busy,” “have fun,” “think about the suffering of loved ones,” etc. In such cases, the help of a professional is necessary because:
- even with mild depression there is always a threat of suicide attempt;
- depression significantly reduces the patient’s quality of life and performance and adversely affects his immediate environment (relatives, friends, colleagues, neighbors, etc.);
- like any disease, depression can worsen over time, so it is better to consult a doctor in a timely manner to ensure a speedy and full recovery;
- depression can be the first sign of serious physical illnesses (oncological diseases, multiple sclerosis, etc.), which are also better treatable in the early stages of the development of pathology.
Which doctor should you see to treat depression?
They consult a psychologist about depression. You should try to provide the doctor with as much useful information as possible. Before visiting a doctor, it is better to think through the answers to questions that are usually asked at the initial appointment:
- Regarding complaints
- What worries you more: melancholy and anxiety or apathy and lack of “taste of life”
- Is depressed mood combined with disturbances in sleep, appetite, and sexual desire;
- at what time of day are pathological symptoms more pronounced - in the morning or in the evening?
- whether thoughts of suicide arose.
- History of present illness:
- what does the patient associate with the development of pathological symptoms;
- how long ago did they arise;
- how the disease developed;
- what methods the patient tried to get rid of unpleasant symptoms;
- which medications The patient took it on the eve of the development of the disease and continues to take it today.
- Current health status(it is necessary to report all concomitant diseases, their course and methods of therapy).
- Life story
- suffered psychological trauma;
- have you had episodes of depression before?
- past illnesses, injuries, surgeries;
- attitude towards alcohol, smoking and drugs.
- Obstetric and gynecological history(for women)
- were there any menstrual cycle disorders (premenstrual syndrome, amenorrhea, dysfunctional uterine bleeding);
- how the pregnancies went (including those that did not result in the birth of a child);
- were there any signs postpartum depression.
- Family history
- depression and others mental illness, as well as alcoholism, drug addiction, suicide among relatives.
- Social history(relationships in the family and at work, whether the patient can count on the support of relatives and friends).
Severe endogenous depression is usually treated by a psychiatrist in a hospital setting. The psychologist conducts therapy for organic and symptomatic depression together with the doctor supervising the main pathology (neurologist, oncologist, cardiologist, endocrinologist, gastroenterologist, phthisiatrician, etc.).
How does a specialist treat depression?
Mandatory method The treatment for depressive conditions is psychotherapy or verbal treatment. Most often it is carried out in combination with pharmacological (drug) therapy, but can also be used as independent method treatment.The primary task of a specialist psychologist is to establish a trusting relationship with the patient and his immediate environment, provide information about the nature of the disease, methods of its treatment and possible prognosis, correct violations of self-esteem and attitude to the surrounding reality, and create conditions for further psychological support for the patient.
In the future, they move on to psychotherapy itself, the method of which is chosen individually. Among the generally accepted methods, the most popular are the following types of psychotherapy:
- individual
- group;
- family;
- rational;
- suggestive.
- deep study personal characteristics the patient’s psyche, aimed at identifying the mechanisms of development and maintenance of a depressive state;
- the patient’s awareness of the peculiarities of the structure of his own personality and the causes of the development of the disease;
- correction of the patient’s negative assessments of his own personality, his own past, present and future;
- rational solution of psychological problems with closest people and the surrounding world in its entirety;
- information support, correction and potentiation of ongoing drug therapy for depression.
Group psychotherapy is based on the interaction of a group of people - patients (usually 7-8 people) and a doctor. Group psychotherapy helps each patient see and realize the inadequacy of their own attitudes, manifested in interactions between people, and correct them under the supervision of a specialist in an atmosphere of mutual goodwill. Family psychotherapy– psychocorrection interpersonal relationships the patient's immediate social environment. In this case, work can be carried out either with one family or with a group consisting of several families with similar problems (group family psychotherapy).
Rational psychotherapy consists in the logical, evidential conviction of the patient of the need to reconsider his attitude towards himself and the surrounding reality. In this case, both methods of explanation and persuasion, as well as methods of moral approval, distraction and switching of attention are used.
Suggestive therapy is based on suggestion and has the following most common options:
- suggestion in a state of wakefulness, which is a necessary moment of any communication between a psychologist and a patient;
- suggestion in a state of hypnotic sleep;
- suggestion in a state of medicated sleep;
- self-hypnosis (autogenic training), which is carried out by the patient independently after several training sessions.
- physiotherapy
- magnetotherapy (use of magnetic field energy);
- light therapy (prevention of exacerbations of depression in the autumn-winter period with the help of light);
- acupuncture (irritation of reflexogenic points using special needles);
- music therapy;
- aromatherapy (inhalation of aromatic (essential) oils);
- art therapy ( healing effect from the patient's art activities)
- physiotherapy;
- massage;
- treatment by reading poetry, the Bible (bibliotherapy), etc.
For severe depression resistant to drug therapy, shock therapy methods can be used, such as:
- Electroconvulsive therapy (ECT) involves passing an electrical current through the patient's brain for a few seconds. The course of treatment consists of 6-10 sessions, which are carried out under anesthesia.
- Sleep deprivation is a refusal to sleep for one and a half days (the patient spends the night and the entire next day without sleep) or late sleep deprivation (the patient sleeps until one in the morning, and then goes without sleep until the evening).
- Fasting-dietary therapy is a long-term fasting (about 20-25 days) followed by a restorative diet.
What is postpartum depression?
Postpartum depression is a depressive state that develops in the first days and weeks after childbirth in women susceptible to this pathology.A high likelihood of developing postpartum depression should be considered when risk factors from different groups are present, such as:
- genetic (episodes of depression in close relatives);
- obstetric (pathology of pregnancy and childbirth);
- psychological (increased vulnerability, past psychological trauma and depressive states);
- social (absence of husband, conflicts in the family, lack of support from the immediate environment);
- economic (poverty or the threat of a decline in material well-being after the birth of a child).
These fluctuations occur against the background of strong physiological (weakening of the body after pregnancy and childbirth) and psychological stress (excitement in connection with the birth of a child) and, therefore, cause transient (transient) signs of depression in more than half of women in labor.
Most women immediately after giving birth experience mood swings, decreased levels of physical activity, decreased appetite and sleep disturbances. Many women in labor, especially first-time mothers, experience increased anxiety and are tormented by fears about whether they will be able to become a full-fledged mother.
Transient signs of depression are considered physiological phenomenon when they do not reach significant depth (women fulfill their childcare responsibilities, participate in discussing family problems, etc.) and completely disappear in the first weeks after childbirth.
Postpartum depression is said to occur when at least one of the following symptoms is observed:
- emotional depression, sleep and appetite disturbances persist for several weeks after childbirth;
- signs of depression reach significant depths (the mother in labor does not fulfill her duties towards the child, does not participate in the discussion of family problems, etc.);
- fears become obsessive, ideas of guilt towards the child develop, and suicidal intentions arise.
Depressive states of moderate depth are characterized by various phobias (fear of the sudden death of a child, fear of losing a husband, less often fears for one’s health), which are accompanied by sleep and appetite disturbances, as well as behavioral excesses (usually hysterical type).
With the development of deep depression, as a rule, negative symptoms predominate - apathy, a narrowing of the circle of interests. At the same time, women are disturbed by a painful feeling of inability to feel love for their own child, for their husband, for close relatives.
Often, so-called contrasting obsessions arise, accompanied by the fear of harming the child (hitting him with a knife, pouring boiling water on him, throwing him off the balcony, etc.). On this basis, ideas of guilt and sinfulness develop, and suicidal tendencies may arise.
Treatment of postpartum depression depends on its depth: for transient depressive states and mild depression, psychotherapeutic measures (individual and family psychotherapy) are prescribed; for moderate postpartum depression, a combination of psychotherapy and drug therapy is indicated. Severe postpartum depression often becomes an indication for hospitalization in a psychiatric clinic.
Prevention of postpartum depression includes attending courses on preparing for childbirth and caring for a newborn. Women who are predisposed to developing postpartum depression are better off under the supervision of a psychologist.
It has been noticed that depressive states after childbirth more often develop in suspicious and “hyper-responsible” first-time mothers, who spend a long time on “mother’s” forums and reading relevant literature, looking for symptoms of non-existent diseases in the baby and signs of their own maternal failure. Psychologists say that best prevention postpartum depression - good rest and communication with the child.
What is teenage depression?
Depression that occurs during adolescence is called adolescent depression. It should be noted that the boundaries of adolescence are quite blurred and range from 9-11 to 14-15 years for girls and from 12-13 to 16-17 years for boys. According to statistics, about 10% of teenagers suffer from signs of depression. Moreover, the peak of psychological troubles occurs in the middle of adolescence (13-14 years). The psychological vulnerability of adolescents is explained by a number of physiological, psychological and social characteristics of adolescence, such as:
- endocrine storm in the body associated with puberty; enhanced growth, often leading to asthenization (exhaustion) protective forces body;
- physiological lability of the psyche;
- increased dependence on the immediate social environment (family, school community, friends and acquaintances);
- the formation of personality, often accompanied by a kind of rebellion against the surrounding reality.
- Symptoms of sadness, melancholy and anxiety characteristic of depressive states in adolescents often manifest themselves in the form of gloominess, moodiness, outbreaks of hostile aggression towards others (parents, classmates, friends);
- often the first sign of depression in adolescence is a sharp decline in academic performance, which is associated with several factors (decreased attention function, increased fatigue, loss of interest in studying and its results);
- isolation and withdrawal into oneself in adolescence, as a rule, manifests itself in the form of a narrowing of the circle of friends, constant conflicts with parents, frequent changes of friends and acquaintances;
- The ideas of one’s own inferiority, characteristic of depressive states, in adolescents are transformed into an acute non-perception of any criticism, complaints that no one understands them, no one loves them, etc.
- apathy and loss of vital energy in adolescents, as a rule, is perceived by adults as a loss of responsibility (missing classes, being late, careless attitude towards one’s own responsibilities);
- In adolescents, more often than in adults, depressive states manifest themselves unrelated to organic pathology bodily pain (headaches, pain in the abdomen and in the heart), which are often accompanied by the fear of death (especially in suspicious teenage girls).
Most cases of teenage depression respond well to psychotherapy. At pronounced manifestations depression, pharmacological medications are prescribed that are recommended for use at this age (fluoxetine (Prozac)). In extremely severe cases, hospitalization in a hospital psychiatric ward may be necessary.
The prognosis for teenage depression in case of timely consultation with a doctor is usually favorable. However, if a child does not receive the help he needs from doctors and the immediate social environment, various complications are possible, such as:
- worsening signs of depression, withdrawal;
- suicide attempts;
- running away from home, the emergence of a passion for vagrancy;
- violent tendencies, desperate reckless behavior;
- alcoholism and/or drug addiction;
- early promiscuity;
- joining socially unfavorable groups (sects, youth gangs, etc.).
Does stress contribute to the development of depression?
Constant stress exhausts the central nervous system and leads to its exhaustion. So stress is the main cause of the development of so-called neurasthenic depression. Such depression develops gradually, so that the patient sometimes cannot say exactly when the first symptoms of depression appeared.
Often the root cause of neurasthenic depression is the inability to organize one’s work and rest, leading to constant stress and the development of chronic fatigue syndrome.
The exhausted nervous system becomes especially sensitive to the influence of external factors, so that even relatively minor life adversities can cause severe reactive depression in such patients.
In addition, constant stress can provoke an exacerbation of endogenous depression and worsen the course of organic and symptomatic depression.
If a person depression - emotional manifestations are quite difficult to hide. Even men. Although everyone knows that the stronger sex does not tend to shed tears for or without reason. This is especially true when it comes to psychological trauma.
And therefore, they quite often attribute frequent emotional breakdowns to fatigue at work, crisis, lack of time, or something else, but not to symptoms of impending depression.
Most representatives of the stronger sex are, in one way or another, hostages of the “real guys don’t complain about anything” stereotypes. Of course, who can argue that Superman is the standard of masculinity, reliability, and impeccability in everything. Whether it's health or behavior.
If you get sick, take an aspirin tablet and go on to perform great feats. Negative emotions come flooding in - pull yourself together. If you’re tired, take a week off and again go two years without a vacation.
And to the question: “How are you?” the answer should be simple and concise, even for those closest to you: “Everything is fine, no problems!” And suddenly, after being in such a “failure-free” mode for quite a long time, out of the blue, an emotional failure of the program occurs. A nightmare begins, obvious even to an outside observer.
Until recently, cold-blooded and impassive, a man becomes extremely unrestrained and touchy because of some trifles: a casual remark from the boss, a burst car tire or burnt meatballs.
He stops meeting with friends: they all suddenly turn into “rare bores” and don’t understand him at all. Has not communicated with loved ones for a long time.
He misses work without good reason or unexpectedly returns home in the middle of the week after a feast, but in a low mood. Dinner remains untouched, and sleep remains restless. Occasionally a phrase is heard about discomfort in the chest. When looking for reasons on your own, the arrows again point to negative emotions received at work or fatigue that has come from inexplicably after a recent vacation.
If all these symptoms go away on their own over time, very good. And if they only get worse, the specter of a serious illness called depression may loom on the horizon.
Statistics show that women are twice as likely to suffer from this disease. Of every hundred examined, approximately twenty percent are representatives of the fairer sex and only eight to ten percent are men.
But in the latter it is more problematic to diagnose. They are accustomed to hiding their emotions from others. Even in heart-to-heart conversations with friends and family, they don’t complain about anything and don’t look for sympathy. Although they share problems, they remain cheerful.
As a result, restoration of health begins when the disease is already quite advanced. Often they don’t do this at all.
The first, which does not occur often, is endogenous, due to the specific functioning of the brain and is predetermined by heredity. The second, somatogenic, manifests itself as a result of a head injury or serious illness.
The third, psychogenic, arises during experiences associated with various excesses (loss of a job, disappointment in some ideal, midlife crisis, etc.).
We list the manifestations of depression, the presence of which should alert you:
unpredictable headaches or heart pain, disturbances in appetite and sleep;
disruptions in the gastrointestinal tract;
an indifferent attitude towards one’s appearance, and sometimes neglect of personal hygiene: a man stops shaving and changing his shirts on time; begins to stoop and looks older than his age;
loss of interest in the opposite sex;
nervousness, irritability towards everything;
slowness in the construction of phrases and a certain clumsiness in body movements, problems with the perception of unfamiliar material;
prolonged inactivity near the TV, aimlessly looking at patterns on the ceiling.
This may alternate with sudden, hectic behavior: a person, out of nowhere, packs a backpack and goes kayaking or starts renovating the kitchen. It would be a mistake in this case to catch your breath: short-lived initiative is replaced by apathy;
infantility in solving current problems and a doomed look into the future;
unexpected addiction to unusual risky sports and alcoholic beverages;
thoughts about death.
In addition to disturbing the emotional background, depression negatively affects the physiological state of the body. Scientists have found that this disease seriously reduces immunity.
With depression, the activity of cells that rid the body of harmful substances. Thus, he becomes more susceptible to infections. And the man in
At the prime age of fifty, the immune system can begin to work like that of a seventy-year-old.
Studies have also shown that the amount of so-called “bad” cholesterol in the blood of men suffering from depression increases. As a result, the risk of another serious disease - atherosclerosis - increases. So one illness leads to another.
Another disease associated with depression is rheumatoid arthritis. Doctors have noticed that it often develops in humans against the background heavy losses and accompanying long-term negative emotions.
Of course, depression does not directly affect the course of the disease, but quite often it becomes the starting mechanism for its occurrence in the presence of unfavorable heredity.
Defeating depression with emotional restructuring
First aid for depression is support and positive emotions towards the sick person from family and friends. It will be very good to just spend time together. In addition, it is recommended:
In the modern world with its frantic rhythm depression became a constant companion of civilization. Many do not take it seriously, considering it a weakness of character and a temporary phenomenon. What do we tell our friends when they are depressed? "Get a hold of yourself! Keep your nose up!” But when depression affects us, we begin to realize that in reality everything is not as simple as it seems. Yes, depression is a disease and in most cases requires medical intervention. How to recognize depression and why does it appear?
Characteristic signs of depression
Depression can be called a disease that affects the entire body. Her symptoms may vary depending on the nature of the person, the cause that caused it and the severity of the disease. But a number characteristic features inherent in each of them.
Emotional disturbances
First of all, depression affects a person’s emotional background. Being under the pressure of overwhelming emotions, a person may experience the following feelings.
- Complete depression, vague melancholy, despair. At the same time, he feels completely unhappy, sincerely suffering from his state of mind.
- The feeling of anxiety does not go away for a minute, it seems that some kind of disaster can happen at any moment, internal tension is constantly growing.
- A person gets irritated over any trifle, explodes, irritation can reach hysteria.
- An oppressive feeling of guilt, self-flagellation, blaming oneself for mistakes, wrong actions, weaknesses and negative personal qualities.
- Decreased self-esteem, feeling like a useless person, incapable of anything.
- Previously enjoyable activities are no longer enjoyable.
- In the case of particularly deep depression, atrophy of feelings occurs - a person loses the ability to feel, experience or experience other emotions.
- Depression is complemented by anxiety for the life and health of loved ones.
Physiological disorders
The acute experience of negative feelings also affects the state of the body as a whole.
- Sleep is very often disturbed - the patient can toss and turn in bed for hours, trying to fall asleep, but painful insomnia does not allow this. Although the opposite effect can also be observed - constant drowsiness. In this case, a person can sleep all day long, but still not get enough sleep.
- The appetite changes - the person begins to “eat up” his grief or, conversely, refuses to eat.
- Intestinal functions may be impaired. Constipation - very common occurrence for depression.
- Sexual needs are almost always reduced. A person simply loses interest in the intimate side of his life.
- There is a loss of strength - rapid fatigue, weakness, decreased energy, reluctance to do anything.
- Pain may occur unknown etiology in the most unexpected place and for no apparent reason - in the heart, joints, muscles, stomach, etc.
Behavioral disorders
From the outside, depression is visible to the naked eye. A very drastic change occurs in a person.
- Now he gravitates more toward loneliness, tries to constantly be alone, and does not engage in conversations.
- Completely passive, it is difficult to involve him in purposeful activities.
- When trying to somehow distract him from his thoughts, offers to “unwind” are rejected.
- With prolonged depression, attempts may be made to escape reality with the help of alcohol, drugs and other mind-altering substances.
The occurrence of negative thoughts
All these symptoms are aggravated by constant heavy thoughts that arise one after another in the head. It is difficult for a person to concentrate on something, to grasp the essence of a conversation, he has difficulty perceiving information and cannot make a decision. Thoughts are exclusively gloomy in nature - a person thinks about himself, his life, the world as a whole and finds only negative sides. The future seems vague to him, but necessarily gloomy without any prospects for improving the situation. Thoughts arise about the meaninglessness of life and suicide.
Why does depression develop?
Where do these conditions come from that can destroy a person’s life and cause irreparable harm to his health? There can be many reasons and each case requires an individual approach. But we can identify groups of main reasons why depression most often develops.
Heredity
You can’t argue with genetics, and if someone in your family was prone to depression or tried to commit suicide, then it is likely that these tendencies could be passed on to you. In this case, carefully monitor your emotional state - do not let the onset of depression take its course.
Psychological factors
In order for depression to develop, an unstable emotional background is most often needed. In many cases, shocks experienced in childhood play a very important role. This could be the early loss of parents, severe corporal punishment in childhood, leaving a child alone for a long time and many other things that do not pass without a trace. Of course, they smooth out over time, and you don’t remember them every minute, but as soon as another similar event happens in life, the brain immediately brings to light the old pain and real severe depression develops.
Stress factors
In most cases, depression is caused by stress factors, as a result of which something has changed dramatically in a person’s life. There may be great amount– retirement, death in the family, problems with the law, divorce or betrayal of a loved one, conflicts. All these and many other situations provoke the release of certain stress hormones, which create an imbalance and lead to the development of depressive conditions.
Long-term illnesses
Depression can also be associated with protracted serious illnesses, when a person, exhausted by pain and his own powerlessness, loses hope of recovery and begins to paint a gloomy picture of the future. Some may also trigger the development of depression. medications, which are used in the treatment of these diseases.
Alcohol abuse
Reason chronic protracted depression may be alcohol abuse. A person in an attempt to alleviate his condition and get rid of obsessive thoughts drinks alcohol. At first he experiences relief, but as soon as the effects of alcohol wear off, the depression only worsens. A vicious circle is formed that is very difficult to break.
How to prevent the development of depression?
If you know that prone to depression, then you need to follow some guidelines that will help you prevent this condition.
- Get enough time to sleep. Since people with a depleted body and nervous system are more susceptible to depression, adjust your sleep schedule. Rest at least 8 hours a day.
- Try to avoid additional stressful situations - do not watch horror films and intense thrillers in the evenings.
- Diversify your diet. Make sure that the body receives everything it needs for the normal functioning of the nervous system. Additionally, you can take a course of vitamin supplements from time to time.
- In the evenings, relieve tension in a warm bath with added aromatic oils. Essential oils of lavender, lemon balm, mint, wormwood and pine perfectly relax.
- Try to give your body the optimal amount of physical activity - run in the morning, sign up for a fitness class, or just take a walk in the evening.
Treatment of depression
In most cases, depressive conditions require medical intervention. To begin with, it is recommended to visit a psychologist, and if necessary, a psychotherapist. Depending on the severity of the disease, you will be prescribed treatment:
- Psychotropic drugs - antidepressants.
- Auxiliary therapy aimed at improving the condition of the central nervous system.
- Psychological trainings.
Once again we remind you that depression – serious disease and self-treatment can lead to undesirable consequences. You can only prevent its occurrence, but treatment should be carried out by qualified specialists.
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Depression is inherently heterogeneous, as it manifests itself with extensive symptoms accompanied by functional disorders. Unfortunately, some of them are quite difficult to identify. In particular, this applies to anesthetic depression, which is characterized by “painful” insensibility.
The symptoms of this mental disorder (“melancholia anaesthetica”) were first described by A. Schafer back in 1880. Patients noted a pronounced lack of mental and bodily sensations, loss of interest in everything.
How to identify depersonalization depression? Is this disease treatable? Let's try to understand these issues.
You will need:
Differences from other disorders
Painful alienation of emotions and insensitivity are the main differences between depersonalization depression and other types of depression. Its “core” is dulling of feelings, alienation, mental anesthesia.
Anergic symptoms (excessive sadness, a feeling of hopelessness), as well as (gloomy and melancholy mood with the experience of boredom, attacks of irritability from external factors) have similar symptoms.
The phenomena of depersonalization are usually part of the structure of melancholy depression and manifest themselves in melancholic states. Most often, this dissociative disorder is secondary and develops against the background of some other disorder.
Depersonalization occurs in approximately 2% of the population. As a secondary pathology, it is detected in 80% of patients in psychiatric hospitals. Anesthetic depression is most often characterized by a chronic course and is difficult to treat.
Reasons for appearance
Almost always the root cause is stressful situation, difficult emotionally. Experiencing mental trauma, a person is faced with the problem of realizing his own personality, his “I”.
He's getting dull emotional sphere, and no feelings arise, which is why the depersonalized mechanism turns on.
Among the causes of the syndrome are also called:
- History of mental disorders.
- Neurological and biochemical disorders in the body (failures in the production of cortisol, modifications of receptor proteins, disturbances in the interaction of neurotransmitters).
- Organic diseases of the nervous system.
- Somatic and neurological diseases.
- Pathologies of the endocrine system.
- Neoplasms in the brain.
- Epilepsy.
- Traumatic brain injuries.
- Drug addiction and alcoholism.
- Psychotraumatic situations.
Against the background of severe emotional shock, especially impressionable people develop depersonalization depression syndromes: depressed mood and emotions, derealization, vital melancholy. Feelings become dull and the person withdraws into himself. In severe form, this pathology can lead to suicidal thoughts and attempts to commit suicide.
Accompanying disorders
Anesthetic depression is comparable to a phenomenon similar to local anesthesia.
The patient sees, hears and understands what is happening around him, but his sensations (both physical and emotional) are muted or completely absent.
The triad of main symptoms consists of hypothymia, andegonia and asthenergy - typical depressive symptoms.
Hypotymia
Depressed mood that occurs over a long period of time (more than 2 weeks). The occurrence of such a phenomenon is preceded by stress, various forms of addiction, borderline states psyche and psychological problems. A person experiences hopelessness, slight sadness, and it is difficult to cheer him up. Even the most joyful event will not be able to evoke emotions in him. The clinic consists of the following symptoms:
- Decreased physical activity;
- loss of interest and meaning in life;
- decreased mental activity;
- low self-esteem, self-blame;
- sleep disorders (insomnia);
- loss of appetite.
The etiology of pathological depression in mood is not fully understood. Hypotymia can develop against the background of chronic somatic diseases. The hereditary factor plays an important role.
Anhedonia
Or a partial loss of enjoying life. One of the main symptoms of anhedonia is loss of activity and motivation to perform activities. What previously brought satisfaction to a person (hobbies, communication with friends, career, sexual relationships) becomes unnecessary.
The causes of the disease are:
- Depression;
- schizophrenia;
- depersonalization;
- overestimation of a person’s own strengths ().
A person suffering from this disorder is unable to experience joyful emotions. He minimizes communication with people (social isolation), he is not touched by the care and love of others.
Astenergy
This is the name for increased fatigue, which is characteristic of depressive states. A person feels constant fatigue, lethargy, and apathy. It is difficult for him to find the strength to do his usual housework. Concentration decreases, there is literally not enough energy for anything (it’s difficult to even get out of bed).
Symptoms
A person painfully experiences the absence of any emotions and feelings: love, joy, compassion, affection. Such painful “unfeeling” is accompanied by apathy, sad mood, anxiety, psychomotor retardation or fussiness. Other symptoms include:
- A feeling of “numbness” in the soul (spiritual emptiness);
- Dulling of tactile sensations, taste and smell;
- Anesthesia of vital emotions (feeling of bodily changes);
- Alienation of thoughts and feelings;
- Feeling of aching melancholy in the chest;
- Confusion, lack of understanding of what is happening;
- The state of “already seen” (deja vu);
- Automaticity of actions;
- Decreased response to pain;
- Lack of natural needs (hunger, need for sleep, etc.);
- Lifelessness and dullness of the surrounding world;
- Darkened perception of reality (everything seems to be “in a veil”);
- Emotional discomfort against the background of the listed symptoms.
The patient feels like an “observer”, not taking part in life. Often he cannot adequately assess time and space, and therefore experiences increased anxiety. In addition, the patient may experience a decrease in intellectual abilities, a feeling of insignificance and helplessness. The person experiences emotional indifference to loved ones and people around him.
Traditional treatment
Therapy should begin with research and identification of the factors that caused the pathology. The doctor needs to explain to the patient information about the nature of the disease and methods of combating it.
The motivator technique of suggestion and auto-training sessions will help reduce the intensity of the manifestation of depersonalization syndrome.
These methods are aimed at ensuring that a person, when attacks occur, can switch his attention to the world around him.
Remedies for mild stage
- Antioxidants;
- vitamin complexes;
- nootropics (Cavinton, Mexidol, Cytoflavin);
- psychostimulant drugs.
Treatment of severe forms
The use of electroconvulsive and atropinocomatous therapy is required. Patients with panic attacks and anxiety need medications:
- Tranquilizers (Diazepam, Adaptol, Bellataminal, etc.);
- neuroleptics (Aminazin, Fluanxol, Sonapax, etc.);
- antidepressants (Amitriptyline, Clomipramine, Maprotiline, Fluoxetine, Sertraline).
Adjuvant therapy
- Acupuncture;
- physiotherapy;
- massage course;
- phytotherapy.
The effectiveness of treatment increases when positive emotions are involved. Improving the patient's condition during therapy is an emotional stimulus and increases his desire to get rid of the disease. In the vast majority of cases, antidepressants provide significant relief within 2-3 weeks of use.
Folk remedies
At home, you can prepare teas based on medicinal herbs with a calming effect (St. John's wort, mint, chamomile, etc.).
The patient needs proper nutrition. It is important to include in your diet foods that strengthen the immune system and increase the tone of the nervous system: natural honey, nuts, dried apricots, fresh fruits, berries, vegetables, etc.
St. John's wort
Contains hyperforin (a biologically active substance), which increases the production of serotonin - the hormone of happiness.
Valerian officinalis
