Melancholy and depression. “Is it really necessary to be ill in order to see human nature so clearly?” Freud exclaims.

Melancholy is a state of mind characterized by a dull mood, general depression, spleen, sadness and a decline in strength. The state under consideration is accompanied by a feeling of one's own uselessness, worthlessness, uselessness, alternating with a bleak mood. However, for the occurrence given state perhaps there is no good reason. Previously, the term described was called "gloomy insanity." Also, melancholy means one of the four types of temperament. In other words, she is congenital feature attitudes and adaptation to society. Melancholics are typical introverts, they feel good alone with their own personality, they differ hypersensitivity, any events are experienced deep in the soul.

What it is

The term under consideration implies one of the variations of a mental disorder. The very word melancholy means gloomy despondency, melancholy, sadness, gloomy insanity, and is translated as black anger.

The essence of mental transformations in melancholia lies in the individual's being in a sad, dejected state. The surrounding reality does not motivate or insufficiently motivates such individuals, and their mental activity accompanied by agonizing pain. At the same time, representations corresponding to a dull mood prevail in the melancholic consciousness. The memories and fantasies of such people are focused only on unpleasant images and events. They look at everything in a gloomy tone.

Nothing can give them joy, their own existence becomes a burden, their interest in activities weakens or disappears completely, they become inactive, indifferent to reality and their own hobby, they consider death to be the best way out, which is often achieved by suicide.

Often, on the foundation of sadness and indifference, deceptions of feelings and absurd crazy ideas sprout. As for the latter, they are mainly in the nature of self-accusation: melancholic individuals blame themselves for this or that misconduct or committed crime, for example, against religion, morality. They can also ascribe to themselves absolutely monstrous deeds, expecting a similar monstrous punishment for them. In addition to the delusional ideas of self-accusation, there is also the delusion of persecution or denial: people disappear, there is nothing else, the world and existence come to an end.

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

Patients are sometimes subjected to attacks of increased melancholy, interspersed with motor excitement and fear. Under the influence of such attacks, melancholics sometimes fall into.

Melancholy is often accompanied by a deterioration in nutrition, which occurs either due to a decrease in appetite, or due to a violation of the processes of assimilation, metabolism and blood circulation. Also, the disorder under consideration is often accompanied by a stable one.

Melancholia can be a separate ailment or be a sign of another more serious ailment. It can occur with mania, periodic insanity. At the same time, it is characterized by a short duration of the flow. When is melancholy separate violation, it is characterized by duration.

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

Increasingly today in medical practice instead of the previously popular term "melancholia", the term "depression" is used, and melancholia in simple words, that is, in everyday life, often means a sad, dull, depressed mood.

Causes

Enough common cause, leading to the violation in question and resistant to self-correction, is a congenital mental peculiarity. Often expectant mothers lead unhealthy image being, are prone to negative thinking, which can lead to the appearance of a baby with a melancholic variation in the world. Scientists have established that even in fetal formation, the fetus feels the parental attitude, external problems.

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

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

Mental anguish and non-standard views on everyday situations that differ from the judgments of so-called “adequate” people can also give rise to the described disorder. For example, an individual's belief in the existence of life on the Moon can often cause a series of ridicule and ironic phrases from "knowledgeable" subjects. And this often leads to a feeling of worthlessness.

The causes of melancholy are often hidden in childhood. Parental overprotection, difficulties in interaction among peers, rejection in the school team - all this can provoke the appearance of melancholy isolation.

Socio-ethical phenomena that are connected with worldview issues also lead to a depressed mood and the appearance of the described disorder. So, for example, the lack of faith in the conscientiousness of people, their disinterestedness, social progress make the individual a skeptic and plunge depression.

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

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

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

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

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

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

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

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

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

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

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

Symptoms

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

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

Other signs of melancholy include:

- hypothymia, which is found in a stable bad mood, fixation on negative, joyless experiences, the individual is not able to tune in to positive communication, constantly thinking about his emptiness, against this background, suicidal thoughts arise;

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

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

Thus, the two terms under consideration are actually leveled, regardless of their literal meaning, which reveals the essence. So melancholy is literally interpreted as "black bile or anger", but it means sadness, melancholy, despondency, and depression - deepening, lowering or suppression.

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

The concept of "depression" did not exist before. All characteristic manifestations The illness now called depression used to be classified as melancholia. Medieval healers considered it as a violation of mental processes and agreed in the views that melancholy was generated by black bile.

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

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

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

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

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

It always arises against the background of serious or stress (loss of a loved one, incurable disease). The depressed individual does not want anything because of a certain event.

The psychosocial reason for melancholia is either not so obvious, or is of an accompanying nature, in other words, does not determine true melancholia, which can be detected at an early age. age stage even in active and cheerful outwardly people. However, this optimism is only an external mask.

Depression is easily diagnosed by showing up in failure emotional sphere, loss of activity and decrease, suppression of libido. This gives rise to a sharp decline in immunity.

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

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

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

In depression, a mostly self-deprecating attitude arises from a rejecting attitude. certain persons or a particular system.

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

In a number of individuals, depression can transform into melancholy, but the latter will never be reduced to the level of depression.

Treatment

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

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

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

Along with the competent organization of the day, adequate nutrition, exercise and means alternative medicine psychotherapeutic practices are also successfully applied.

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

If the funds listed above turned out to be useless, then the patient is shown hospitalization in a psycho-neurological institution, where conditions are created for a set of procedures that allow stopping the main symptoms of the disease. For this, various pharmacopoeial preparations are usually prescribed, which have psychotropic action, for example, neuroleptics (suppress the feeling of fear, reduce the response to stimuli from the outside, weaken psychomotor agitation, reduce affective tension, soothe), antidepressants (reduce melancholy, improve mood, reduce lethargy, eliminate apathy, relieve anxiety and irritability), mood stabilizers (stabilize mood ).

Doctors say depression out acute phase imperceptibly flows into a heavier one, chronic form. Dealing with it is much more difficult. Crush melancholy should be in the bud.

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

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

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

We must accept this knowledge only as knowledge. Never settle for the inevitable. Maybe you are just in that rare one percent that has outlived depression once and for all.

This knowledge should not interfere with our lives, since such happiness has fallen to us.

What you need to know to recognize the enemy and take timely action. Some methods of struggle and diagnostics are described in the article "

What signs of depression should alert you?

- In your habitual life something unexpected happened that changed your life.

job loss, loss loved one, parting with your loved one, changing your place of residence, and so on and so forth ... Your hands have dropped, and you do not see the point in later life.

- You started to quarrel with everyone in a row and explode for any reason. Gets both right and guilty. The conflict is on the rise.

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

- You are attacked constant sleepiness or you, on the contrary, have stopped sleeping, and insomnia has become your nocturnal friend.

- This state lasts for more than one week, and you cannot remember anything joyful during this time. Colors of only one coller: gray-black.

You don't want to dress up, make up. You don't care what you look like.

Enemy detected. So you are ready to fight depression.

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

But first, take the simplest measures. Everyone knows about them, but few do. And you need it right now.

How to deal with depression:

- Adjust good nutrition, rich in vitamins. Through "I do not want" at first.

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

Take a relaxing herbal bath and go to bed following a specific ritual. Strictly at the same time.

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

Read poems to remember.

Relatives will understand or not understand - this is in this moment you shouldn't worry. You yourself understand that your health is above all.

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

Here are your first steps, which you should take on your own, without resorting to the help of specialists.

Perhaps they will be enough. You will again begin to meet with friends with pleasure, the problems of loved ones will become commonplace, not global.

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

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

Authorship of the article is confirmed in GOOGLE

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

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

In his work Mourning and Melancholy, Freud separates melancholy and sorrow (there is different variants translation of the word "Trauer" into Russian - mourning, sorrow, sadness, grief. "Mourning" is clearly more accurate).

For some people, grief arises at the loss, for others, melancholy. Freud draws attention to the fact that melancholia has a psychogenic nature and suggests that there may be a predisposition to it.

Sorrow (sorrow, mourning)

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

Sorrow, unlike melancholy, is not burdened by the conflict of ambivalence.

Grief causes the "I" to abandon the object, declaring the object dead. The fixation of the libido on the object is weakened (depreciation, humiliation, destruction of the object). "I" is satisfied with its superiority over the object.

The work of mourning (mourning)

The person realizes that the beloved object no longer exists in reality. Accordingly, there is a need to take away your libido from this object. And there is resistance to this process; one does not easily give up the direction of one's libido. And this resistance can be so strong that the lost object is held by hallucinations. At normal operation mourning the demand for reality (object lost) still triumphs over resistance (which tries to hold on to the object). This process of accepting reality takes some time and internal forces. While there is a partial acceptance of reality, the lost object continues to exist in the psyche. Each of the expectations or memories in which the libido is attached to an object is suspended and the release of the libido takes place on it. This process is accompanied heartache. At the end of the work of sorrow, the "I" (Ego) becomes again free and liberated from delays.

Melancholia (depression)

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

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

At the heart of melancholy lies the loss of a loved one. This is the perfect loss. The object of love does not really die, but is lost as an object of love. In some cases, a person is aware of the loss, but cannot understand what exactly he has lost, or understands whom he has lost, but does not understand what exactly he has lost along with this object.

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

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

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

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

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

Symptoms of melancholia

• Moral dissatisfaction with oneself
  • Self-hostility
  • Self-accusation
  • Waiting for punishment
  • He sees himself as an unworthy, terrible person. He regrets those around him for having to deal with him
  • self humiliation
• Physical loss of strength, weakness, decreased well-being
• Psychological impoverishment
• Decreased appetite, refusal to eat
• Insomnia
• Termination of all interests
• Loss of ability to love
• Inhibition of activity, may lose the ability to work
• Impoverishment, devastation of "I"
• Suffering

Psychodynamics of melancholy

1. Libido was tied to the selected object
2. There was a shock to this attachment (there was grief, resentment, disappointment). Ambivalence conflict intensifies (love-hate)
3. Normally, at this stage, one would take away the libido from the chosen object and transfer it to a new object (the work of mourning)
4. In melancholy, the attachment to the chosen object is destroyed, but the libido is not transferred to a new object, but is returned to the structure of the "I" (Ego).
5. The libido inside does not find application and initiates the process of identification of the part of the "I" with the lost object.
6. Internal relations are established: one part of the “I” and another part of the “I”, which is identified with the lost object. This identified part of the "I" is also considered as a lost object. The loss of the object becomes the loss of the Self.
7. One part of the "I" begins to criticize the other part of the "I" (considered as a lost object). Hatred is directed at the object, it is insulted and humiliated, due to which hatred receives sadistic satisfaction. Self-torture of the melancholic gives him satisfaction (as if it were expressed to the object).
8. A patient with depression through self-torture still indirectly takes revenge on the original real object (without showing his direct hostility to him)

Components of the occurrence of melancholy

• The choice of the object of love occurs on a narcissistic basis (the idea of ​​Otto Rank)
• Strong fixation on the chosen object of attachment
• An unstable attachment can easily break away from the object of love if there are obstacles on the way to attachment. Severed attachment regresses back to narcissism
• Narcissistic identification with the object replaces attachment. Love for the object is replaced by narcissistic identification with the object. In this case, the love relationship is maintained (despite the conflict with the loved one)
• The structure of the "I" wants to absorb this object into itself, to merge with it by absorbing it (as a result of regression to the oral or cannibal phase). Therefore, in severe forms depression occurs refusal of food (Abraham)
• Ambivalence conflict
  • The melancholic's love attachment to the object regresses to identification with the object.
  • Love attachment regresses to sadism
  • In melancholy, there are constant battles in which there is a struggle between love and hate. There is a desire to take the libido away from the object, and there is a desire to hold onto the position of the libido.

3 prerequisites for melancholy:

• Object Loss
• Ambivalence
• Regression of libido to "I"

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

The melancholy process attracts the energy of all attachments, which devastates the "I" to complete impoverishment.

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

Therapy

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

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

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

Symptoms

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

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

The main features of melancholic depression include:

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

Causes

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

In addition, it was found that melancholia is quite often observed in persons with bipolar disorder I. It may also be present in bipolar depression II with features psychomotor agitation. Melancholic depression is quite common in a hospital setting. Persons with mental functions may also be more prone to this disorder.

Treatment

There are three most common treatments for depression:

• psychotherapy,
• medical treatment,
• electroconvulsive therapy.

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

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