Depression or bad mood? Emotional manifestations of depression. What usually prevents seeking psychotherapeutic help

Depression is an affective disorder characterized by persistent depressed mood, negative thinking, and slow movement. Is the most common mental disorder. According to latest research, the lifetime risk of developing depression ranges from 22 to 33%.

People suffering from depression do not perceive the joys of the world around them, like everyone else, their thinking is aimed at aggravating negative manifestations in fact, they perceive any minor troubles exaggeratedly.

What this disorder is, why people tend to fall into this condition, and what symptoms a person encounters, we will consider further.

What is depression?

Depression is a mental disorder that is characterized by a depressive triad, which includes a decrease in mood, disturbances in thinking (a pessimistic view of everything that happens around, loss of the ability to feel joy, negative judgments), and motor inhibition.

According to statistics today, depression is observed in 10% of the population of our planet. Due to the volatility mental state women pathology they observed most often after 40 years. This is due to failures in hormonal background and the onset of the climax.

A depressed person is in such a sensual state that constantly repeats - "there is no way out." But it really isn't! There is always a way out, and even the most difficult stage can be treated!

Kinds

There are two main types of depression:

exogenous - in this case, the disorder will be provoked by some external stimulus (for example, loss of a job or death of a relative);
endogenous - depression is caused internal problems often inexplicable.

Psychologists distinguish the following types depression:

Dysthymia is a chronic depressive mood. It is characterized by bad mood, fatigue, lack of appetite and sleep. This type can be observed in postpartum depression and manic-depressive psychosis.
Recurrent depression - the symptoms of the disorder appear about once a month and persist for several days.
Reactive depression is characterized by spontaneity of occurrence against the background of the appearance of serious stressful situations.
Neurotic arises through emotional disorders in which the dominant link is occupied by neuroses.
Manic-depressive disorder is a disease characterized by the onset of bouts of depression or manic episodes. It is characteristic that such a disorder is not long-term - patients feel quite normal during periods of remission, lead a normal life and are no different from healthy people.
Postpartum depression is a depressive condition that develops in the first days and weeks after childbirth in women prone to such a pathology.

early signs of depression

In each individual case of the disease, the signs of the onset of depression may be different and expressed in varying degrees. The whole set of these signs is conditionally divided into four main groups.

Groups of initial signs of depression are:

emotional signs;
mental disorder;
physiological signs;
behavioral disorder.

The onset of the disease is indicated by:

decreased interest in favorite activities, neglect of simple duties, laziness to go to work, desire to have more rest;
fatigue, decreased libido, mild physical malaise, morning sickness;
increased resentment, the feeling that others have a negative opinion about a person, that they find fault with him;
Bad mood, increased nervousness, tension, feeling of anxiety;
change routine, difficulty falling asleep, causeless headache;
thinking aimed at avoiding problems, increasing fears, alcohol abuse.

The severity of symptoms depends on the duration of the disease and the presence of previous physical and mental disorders.

Causes

There is also depression against the background of progressive somatic diseases - for example, against the background of pathologies thyroid gland or from severe pain and awareness of the inevitable disability in arthritis, rheumatism, oncology.

Depression can be caused by some mental disorders - for example, this condition is often diagnosed in patients with schizophrenia, alcohol and drug addiction.

Various medicines, especially those used to treat high blood pressure may be the cause of depression. For unknown reasons, corticosteroids (hormones) often cause depression when they are produced in large quantities as a result of an illness (such as Cushing's syndrome).

For the most part, this condition is caused by quite simple and understandable reasons:

overwork;
peer pressure;
the inability to achieve the desired for a long period;
failures in personal life or career;
disease;
loneliness and so on.

If you understand that a black streak has come in your life, then try to mobilize all your strength so as not to become a victim of depression.

Relax, focus, even on small, but still joys, fight difficulties, and do not give in to them.

People prone to depression

There are 3 personality types that are more prone to developing depression:

statotimic personality (characteristic: exaggerated conscientiousness, excessive accuracy and diligence);
melancholic personality (characteristic: pedantry, desire for order, constancy, excessive demands on oneself);
hyperthymic personality (characteristic: self-doubt, constant worries, low self-esteem).

Symptoms of depression in adults

The main manifestation is the so-called depressive triad, which includes a steady deterioration in mood, a slowdown in thinking and a decrease in motor activity.

Typical (main) symptoms of depression are:

depressed mood, which does not depend on external circumstances, lasting two weeks or more;
persistent fatigue within a month;
anhedonia, which is a loss of interest in previously enjoyable activities.

Additional symptoms of the disease:

pessimism;
feelings of worthlessness, anxiety, guilt, or fear;
inability to make decisions and concentrate;
low self-esteem;
thoughts of death or suicide;
reduced or increased appetite;
sleep disturbances, manifested in insomnia or oversleeping.

Thoughts in a depressed person become negative, negative, and directed against oneself. A person tends to fix the denial of himself, he considers himself unnecessary, worthless, burdening relatives and friends. It is difficult for him to make any decisions.

Important! Some symptoms are characteristic of anxiety and other disorders, so do not self-diagnose or self-medicate!!!

Symptoms of depression in men and women

Symptoms in women are more pronounced than in men, which is associated with physiological characteristics brain. A man can be depressed for many years and hide it. In women, the picture of symptoms is visible quite clearly, so if the first signs of localization of the disease are found, then you should immediately consult a doctor.

	Symptoms and signs
emotional	Feeling of suffering, longing, despair; Anxiety; Irritability; Feeling of trouble; Guilt; dissatisfaction with oneself; Low self-esteem; Loss of ability to worry or anxiety for loved ones; Decreased interest in the environment.
Physiological	after sleep there is no feeling of cheerfulness, a feeling of an active start to the day; there is pain all over the body; feeling of fatigue, lack of sleep, weakness; permanent headache; pain behind the sternum, a feeling of compression in the region of the heart; , inability to get up, sleep intermittently; loss of appetite or vice versa; incorrect perception of sounds, colors; weak potency; dry mouth; increased feeling of thirst.
Behavioral	Passivity; Loss of interest in other people; Tendency to frequent solitude; Refusal to participate in purposeful activity; The use of alcohol and psychotropic substances.
Thinking	feel different from society; do not see the meaning in their lives; slowing down of thought processes; difficulty concentrating; inability to make decisions at the right time; avoidance of responsibility, fear for one's actions; obsessive return to the same thoughts; thoughts of suicide.

Important: most serious symptom depression are considered thoughts of death and in 15% of cases, patients have clear and persistent suicidal thoughts. Often patients voice the planning of their murder - this should be an unconditional reason for hospitalization.

Diagnostics

In a conversation with a patient, the doctor first of all pays attention to long periods depression, decreased range of interests, motor retardation. An important diagnostic role is played by patients' complaints of apathy, loss of strength, heightened anxiety, suicidal thoughts. There are two groups of signs of a depressive process that the doctor takes into account in the diagnosis. These are positive and negative affectivity (emotionality).

When talking with a patient, a psychologist or psychotherapist identifies the following criteria:

Depressed mood.
Feeling tired.
Rising concern.
Lack of desires and interests.
Decreased sexual interest.
Frequent nervousness and photophobia.
Careless attitude to personal hygiene and daily duties.
Constant need for rest.
Irritability, restlessness and nervous tension.

The above symptoms are starting. If they last long, they lead to mania.

How to treat depression in adults?

Depression is often perceived both by the patient himself and by others as a manifestation of a bad character, laziness and selfishness, promiscuity or natural pessimism. It should be remembered that depression is not just a bad mood, but a disease that requires the intervention of specialists and is quite treatable. The earlier delivered correct diagnosis and started proper treatment the greater the chance of a quick recovery.

The treatment regimen is selected individually, after being examined by a doctor and conducting the necessary tests. There is no average protocol according to which autotherapy can be recommended. Therapy may include one or all of the following elements:

Medication treatment.
Psychotherapy.
Social therapy.

Each patient needs his own treatment time, which depends on the characteristics of the psyche and the severity of the condition.

Antidepressants

In treatment various kinds depression, antidepressant medications are used. They restore the optimal balance biologically active substances And normal work brain, helping to cope with depression. The success of drug treatment largely depends on the patient himself.

Antidepressants in the treatment act as the main drugs. These include:

Melipramine,
Amitriptyline
fluoxetine,
sertraline,
paroxetine,
tianeptine,
milnacipran,
Moclobemide.

At correct application are a safe class of psychotropic substances. The dose is selected individually. Remember that the effect of antidepressants will appear slowly, so expect it to manifest positively.

Vitamins and minerals

In the treatment of depression, the following vitamins and minerals are also actively prescribed:

B vitamins;
calcium;
magnesium;
omega 3;
vitamin D (calciferol).

If within 4-6 weeks after starting the medicine you do not feel a positive effect, or you have side effects, contact your doctor.

Psychotherapy for depression

Three approaches are most effective in treatment: cognitive psychotherapy, psychodynamic psychotherapy, and behavioral psychotherapy. The goal of therapy is to recognize conflict and help constructively resolve it.

Behavioral psychotherapy

Behavioral psychotherapy allows current issues and eliminates behavioral symptoms (isolation from others, monotonous lifestyle, refusal of pleasure, passivity, etc.).

Rational

Rational psychotherapy consists in the patient's logical evidence-based conviction of the need to reconsider his attitude towards himself and the surrounding reality. At the same time, both methods of clarification and persuasion, as well as methods of moral approval, distraction and switching attention are used.

Cognitive Behavioral Therapy

A feature of the use of CBT for depression is to start treatment without using drugs. The point is to separate negative thoughts, the patient's reaction to the event and the situation as such. During the session, with the help of various unexpected questions, the doctor helps the patient to look at the ongoing action from the outside and make sure that nothing terrible is actually happening.

The result is a change in thinking that positively affects the behavior and general condition of the patient.

Food

Product leaders to help overcome signs of depression:

vegetables, fruits, having not only rich vitamin complex, but also bright colors ( bell pepper, oranges, carrots, beets, persimmons, bananas);
sea fish with great content fat in meat;
chicken broth and white poultry meat;
dishes from frozen (not canned) sea kale;
cheese of all kinds and varieties;
dark chocolate with a high content of cocoa beans;
nuts;
buckwheat, oatmeal;
eggs.

Antidepressant drinks:

A relaxing drink can be made from lemon balm and oranges. Squeeze the juice from four oranges thoroughly. Take two handfuls of fresh lemon balm leaves, chop and grind it and combine with orange juice. The drink is very tasty and uplifting.
A banana-based fruit drink has the same effect. In a blender bowl, put the pulp of one banana, a spoonful of the kernel walnut, a spoonful of sprouted wheat grains, pour in one hundred and fifty ml of natural milk and a spoonful of lemon juice.

Signs of a way out of depression are the appearance of interest in life, joy, the meaning of life, relief bodily sensations associated with this disorder, the disappearance of the desire to commit suicide. For some time after leaving this state, there is a decrease in the ability to empathize, elements of egocentrism, isolation.

What usually prevents seeking psychotherapeutic help?

Low awareness of people about what psychotherapy is.
Fear of initiation stranger into personal, intimate experiences.
Skeptical attitude to the fact that "talks" can give a tangible therapeutic effect.
The notion that with psychological difficulties you have to manage on your own, and turning to another person is a sign of weakness.

You should contact a specialist urgently if the condition seems unbearable, the desire to live disappears, and thoughts of harming yourself appear.

Forecast

The prognosis is determined by the type, severity, and cause of the depression. Reactive disorders usually respond well to treatment. At neurotic depressions there is a tendency to protracted or chronic course. The condition of patients with somatogenic affective disorders is determined by the characteristics of the underlying disease. Endogenous depressions do not respond well non-drug therapy, at correct selection drugs in some cases, stable compensation is observed.

IN last years the word "depression" has become fashionable. As soon as a person gets upset because of trouble, he immediately says: "I'm depressed." But if this is so, then it is time for him to run to the doctor for pills, since depression is a serious illness.

According to various estimates of experts, from 10 to 20 percent of people are prone to depression, and downward mood swings are generally characteristic of 1/3 of the world's population. But the statistics in this case are inaccurate, because people with such problems rarely turn to specialists. And how to determine - it's time or not time? Who will help - a psychologist or a doctor already? How to distinguish just a bad mood from an illness?

The main signs of depression low mood, motor retardation and mental retardation(thoughts flow more slowly than usual). This is the triad of depression. However, in fact, there are many varieties of depression, and each type has its own symptoms. For example, anxious depression characterized by motor excitement, when a person does not find a place for himself, he is restless and anxious. In combination with apathy, the disease can be characterized by indifference to everything. There are depressions with irritability, obsessive thoughts and fears, hypochondria, etc. The main signs of most types of depression, except for the triad, are:

depressed mood, melancholy, despair;

anxiety, fear;

irritability;

diffidence;

decreased interest in the outside world and the ability to have fun;

sleep disturbance;

change in appetite;

increased fatigue, weakness;

passivity;

avoiding contact with people;

refusal of entertainment;

use of alcohol or drugs with the aim of "forgetting";

difficulty concentrating;

negative thoughts about yourself, about your life, about the future, about the world as a whole (in severe cases, thoughts of suicide).

The presence of several of these signs for two or more weeks continuously is a reason to seek help from a psychiatrist.

The diagnosis of depression is complicated because it often has symptoms of other diseases, more often somatic (that is, physical). Therefore, a person can go to doctors for a long time and not understand that, in fact, he is sick not in body, but in soul.

Why does depression occur? Man lives in a world where he constantly faces a lot of stress. Troubles at work, in the family, accidents, difficult situations... But human nature is such that our body and brain are able to withstand a lot. Moderate stress is necessary for life: according to Hans Selye (creator of the famous doctrine of stress), zero stress equals death. That is, it means that no events at all occur in a person’s life - neither good nor bad. Stress can be positive (caused by positive life events) and negative. By maintaining a certain level of stress, the body turns on adaptation mechanisms. But what happens when stress levels go off the charts? Each person has different adaptive abilities. One can endure any life troubles, serious problems and even grief, survive it and become stronger as a person. And the other will not stand it, will “break” under the weight of suffering or even everyday worries. And then depression can become a consequence.

Why do some people steadfastly endure troubles, while others "surrender to the mercy" of hopelessness and longing? Exist factors that increase the likelihood of depression: predisposition to depression (heredity, character traits), late age(after 60 years of depression are more common), severe somatic diseases(depression as a reaction to physical suffering, intoxication of the body, fear for one's health and life). All these factors lower the threshold for sensitivity to stress and increase the risk of inadequate response on them in the form of depression.

The predisposition to depression, as I wrote above, is due to heredity and character traits. How much the presence of depressive conditions in family members can affect the likelihood of illness of one of the descendants is not an easy question. Of course, there is such an influence. But one should also take into account the fact that a person (especially a child) is strongly influenced by the situation in the family in which he grows up. If someone close is often in a bad mood, reacts sharply to troubles, yearns and is sad, then it is easy to assume that other family members can perceive such a state as normal. Children copy adults. This is for them the only way learn how to behave adult life. So it turns out that a child, living in the midst of melancholy and despondency, takes it with him into the big world as the norm. Risk factors are also conflict relations in the family, the lack of warmth and trust in it.

Regardless hereditary predisposition, a person with certain character traits may be prone to low mood and, accordingly, have a risk of depression. These are personality traits such as:

human tendency to see everything in negative light(yourself, your future, the world as a whole);

over-sensitivity to failure;

tendency to doubt;

unstable mood;

preoccupation with heavy forebodings;

lack of independence in making important decisions;

fear of conflicts;

fear of loneliness, etc.

But all of these risk factors will not necessarily lead to depression. A person may simply be prone to periodically low mood, or he may live normally, cope with stress and be happy.

And it may also happen that a person from healthy family, cheerful and cheerful in life, will face really severe stress (the consequences of a natural disaster, catastrophe, several deaths of loved ones, as a result of which a person is left alone, etc.). And depression in this case can be a reaction to severe stress.

So how do you tell a normal bad mood from real depression? The easiest way to distinguish depression from low mood is moderate to severe depression. Such depression is characterized by vivid mood disorders: a person complains of feeling oppressive longing, severe anxiety (the very word "depression" in Latin means "pressure"), emptiness. He sees everything in black, exaggerates the negative. He accuses himself of "all mortal sins", talks about his guilt for everything around him and even thinks about suicide. However, he does not cry, his eyes are dry. These people, as a rule, do not experience mood swings during the day, it is monotonously lowered all the time. For such conditions, it is common serious violations sleep (insomnia, superficial sleep, frequent awakenings), lack of appetite, problems with the digestive system. If you knew the patient before, before the disease, you will be surprised to see a completely different person in front of you.

The most difficult option to recognize is mild degree depression. In this case, her line with a bad mood is very thin. A person feels sadness and a seal, nothing pleases him. At the same time, working capacity is preserved, although noticeably reduced. There are daily (in the evening a person feels better than in the morning) and seasonal (exacerbations in autumn, spring) fluctuations in the state.

In a bad mood, such fluctuations, as a rule, are not observed, or there may be an opposite picture: a person feels better in the morning, and worse in the evening. And in general, the state of bad mood is not persistent. There is reason to worry when such states of low mood, sadness and melancholy last continuously for more than two weeks. When in a bad mood, a person usually thinks that the reason is outside (weather, conflict at work, unpleasant circumstances), in contrast to the tendency to self-blame and self-abasement in a depressed state. A bad mood is a reason to cry about your unfortunate fate. Depressed patients no longer cry, they simply do not have the strength to do so. A person in a bad mood falls asleep hard, he is overcome anxious thoughts, but there is no insomnia, as well as restless superficial sleep.

It is worth remembering that everything is individual and one degree of depression can turn into another, just as a prolonged bad mood can go over that fine line with mild depression, and vice versa.

So, if you have found signs of moderate or severe depression, you need the help of a doctor who, if the diagnosis is confirmed, will prescribe you medication. Without treatment, depression can linger for months or even years. Self-medication is dangerous!

Psychotherapy recommended as in case of more severe forms depression, as well as in the case of just a bad mood or mild depression. The goal is to help the person. This will help you get through a difficult period in the present and cope more successfully with stressful situations in future. In addition, the ability to enjoy every day, healthy lifestyle life, morning work-out, the correct mode of work and rest - that's what will help you deal with stress and maintain peace of mind!

How often in everyday life we call the usual mood swings or fatigue depression. In fact, depressive disorder is the most serious mental illness, which should be distinguished from a bad mood or overwork.

In recent years medical workers noted a catastrophic increase in the number of patients with depression. The insidiousness of this disease lies in the fact that the sick person himself does not immediately realize that he has fallen into the network of depression. characteristic features depressive disorder, experts consider the presence of a “depressive triad”, which includes a sharp and steady decrease in personal self-esteem and general mood, loss of interest in what is happening around and the ability to experience joyful moments, motor inhibition.

According to medical statistics, every year there is an increase in the number of people with depression. Psychiatrists note that every fifth inhabitant on our planet has experienced at least once a depressive disorder in his life.

Most often, the disease affects the older generation, about 30% of people over 65 years of age are prone to depression. However, this mental disorder has become much younger in recent years. Approximately 10% of adolescents aged 10 to 16 suffer from depression. The same number of cases applies to the category of 40-year-old inhabitants of the planet.

Causes of Depressive Disorder

According to experts, on this moment there is no single explanation that can explain the phenomenon of depression. So the same factor is capable of causing a severe state of depression in one person, while the same factor applicable to another individual does not cause any deviations in the mental state.

However, in psychiatry, the following causes contribute to the development of depression:

strong feelings associated with the loss of something or someone very significant (death of a loved one, breakup of a relationship, loss of a job, change in status in society, etc.);
lack of biogenic amines (serotonin, dopamine);
side effects of drugs;
insufficient amount of sunlight;
uncontrolled intake of neuroleptics;
somatic diseases - neurological, endocrine, oncological;
avitaminosis;
pregnancy, childbirth;
head injury;
alcohol abuse, drugs and psychostimulants.

According to psychiatrists, the development of depression requires the simultaneous interaction of several factors. For example, beriberi and divorce, pregnancy and maternity leave.

Moreover, in any case, heredity is of primary importance, according to doctors. This theory is supported by medical statistics, according to which, in some families, in each of the generations, there is a state of depressive nature. However, this does not mean at all that depression is not characteristic of people who are not burdened with bad heredity.

Most common cause the occurrence of a depressive disorder become stress. That is why in our life, overflowing with various stresses, experts note an increase in depression. An initial mood swing, caused by overwork at work or troubles in your personal life, can provoke this serious mental illness. Subsequent negative events will only intensify the episode that has arisen. Gradually, mood swings turn into prolonged periods, and the negative impact of stress begins to manifest itself in the form of inhibition of brain structures.

Symptoms of depression

According to the ICD-10 classification accepted in medicine, it is customary to divide into basic and additional. The presence of the disease is indicated by the presence of two symptoms from the main group and three or more from the additional group.

The main ones include:

bad mood, the formation of which is not influenced by any circumstances, lasting more than 14 days;
anhedonia, or loss of pleasure from previously interesting and pleasurable activities (refusal of hobbies);
a stable feeling of "failure", lasting more than three to four weeks.

Additional symptoms are:

low self-esteem;
negative perception of the surrounding reality;
feeling of helplessness and worthlessness, guilt, anxiety and overwhelming fear;
thoughts about possible death;
inability to concentrate and make decisions;
thoughts of possible suicide
appetite disorders, its absence or not passing feeling of hunger;
sleep disorders, expressed in insomnia or drowsiness;
marked weight loss or gain;
the appearance of a sweet taste in the mouth for no reason.

Based diagnostic criteria ICD-10, depressive states are diagnosed if there is the presence of the listed symptoms that persist for more than two weeks. However, this diagnosis can also be established in cases characterized by a shorter time period, but with unusually severe and rapidly onset symptoms.

It should be noted that children are less susceptible to the development of a depressive state.

The symptoms of childhood depression are somewhat different. The presence of a mental disorder in a child is evidenced by:

nightmares;
insomnia;
loss of appetite;
decrease in academic performance;
problems in relationships with teachers and peers: distance; aggressiveness, arrogance.

IN medical practice the criteria for determining the disease are used, which are offered by another medical classification system - DSM-IV-TR. According to this system, a depressive state is diagnosed if there are five or large quantity symptoms out of 9, and, as in the previous classification, the symptoms of the disease must include at least one of the two main signs - loss of interest or depressive mood.

Additional DSM-IV-TR symptoms:

a significant decrease in enjoyment of activities or interest in all or almost all activities and hobbies;
the presence of a depressive mood - in children and adolescents, it can manifest itself in the form of irritability;
drowsiness or insomnia
weight loss and appetite or increased appetite and, as a result, weight gain;
psychomotor inhibition or agitation;
increased fatigue and decreased energy;
feeling of worthlessness, inadequate guilt, low self-esteem;
thought retardation or reduced ability to concentrate;
suicidal thoughts, conversations.

In addition to the above symptoms, the sick person may experience frequent headaches and pain in different parts body for no reason. In such cases, even experienced therapists do not immediately recognize the presence of depression, but try to cure a non-existent disease.

Types of depression

In medical practice, there are several dozen types of depressive conditions.

The most common classification is belonging to the seasonal change of seasons. In this case, there are: spring, autumn, winter depression. However, it is worth knowing that the conditional division, since the disease is able to "visit" a person at any time of the year.

If we turn to the already known to us medical classification DSM-IV, then unipolar and bipolar disorder. The difference between them lies in the fact that in the first case, the mood remains within one, reduced, "pole", and in the second case, when the disease is integral part bipolar affective disorder, punctuated by hypomanic, manic, or mixed affective episodes. Note that the occurrence of minor depressive episodes is possible with such affective disorder like cyclothymia.

In DSM-IV, the following forms of unipolar depressive states are distinguished:

or major depressive disorder. Its variety is a resistant depressive state. The peculiarity of this disease is the absence or insufficiency clinical effect in the case of the use of antidepressants for two courses, each of which lasts three to four weeks.
Minor depression. Its peculiarity is that the description of the disease does not meet all the available criteria for the clinical form of pathology, however, a person has two main symptoms for 14 days.
Atypical depression is a condition characterized by the presence of additional specific features, such as increased appetite, severe sleepiness, weight gain and "emotional reactivity".
Postnatal depression is the female form of the disorder. As the name implies, the disease develops after the birth of a child.
- a disease that differs from the classic disorder by differences in duration. Patients with this form of the disorder experience episodes of depression about once a month, with occasional attacks lasting less than two weeks. With such a disease, episodes usually persist for two to three days. This type of disorder is diagnosed if the episodes occur for at least one year. In the event that a woman fell ill with depression, then the symptoms should appear without taking into account menstrual cycle. Note that this type of disorder can also occur when clinical form depression.
Dysthymia is a condition in which there is a moderate persistent mood disorder. With this disease, patients complain of a bad mood almost daily for at least two years. The signs of the disorder are not as severe as in clinical depressive illness. However, people with dysthymia may also be susceptible to periodic occurrence episodes clinical depression. In medical practice, it is customary to call this condition "double depression".

The remaining types of depressive states in the DSM are designated by the code 311 and are called others. depressive disorders. They include conditions that are detrimental to the normal state of a person, but do not meet the criteria for officially defined diagnoses or, as the classification itself says, "do not correspond to the signs of any particular disorder."

We note another type of depressive state, which is diagnosed by domestic doctors, it is called vital depression. According to the name of the disease, "vital" - life depression characterized by pronounced anxiety and longing, which the sick feel on physical level. Subject to vital depression may feel longing in the form of pain in the area solar plexus. Previously, doctors believed that this type of mental disorder was caused by violations of " life processes” and develops cyclically, and occurs for no reason and is inexplicable for the patient himself. By the way, this character is inherent in both and "bipolar".

As for vital depression, it is also called dreary, as a person literally drowns in a sea of despair and longing. In medicine, this type of disorder is classified as a severe depressive illness without the presence of psychotic symptoms. Despite the fact that the disease is characterized by the severity of the course, it responds quite well to treatment with special means, which include antidepressants and special ways therapy.

State Danger

No one is immune from the likelihood of developing a depressive state. As we have already noted, this disease is quite insidious, a person cannot always understand that he has been living in a state of depression for several weeks. Most often, we explain our dull state, fatigue and reduced performance by lack of sleep, overwork or beriberi, etc. However, it is worth remembering the danger of depression and the difficult cure for it.

Proceeding from this, there is no doubt that nothing itself will go anywhere and will not resolve itself. The disease must be treated, otherwise it will gradually affect not only the behavior of a person, but also his character.

In addition, it is worth knowing that without help qualified specialist there will be a deterioration in both psychological well-being and physical condition. Remember that depression is pathological changes nervous system, therefore, in the event of a disorder, correct and timely treatment is required.

Delaying the visit to a specialist can be life-threatening, as many sick people find salvation in suicide. With timely seeking help, depression can be successfully treated.

Specialists such as a neurologist, psychiatrist, psychotherapist, therapist, gynecologist, endocrinologist and clinical psychologist will help.

Depression has become a buzzword. We, without hesitation, say “I have depression”, as soon as the mood goes down. In fact, there is a huge difference between a bad mood and depression. If the first is a transient condition, then the second is a serious illness. How do you know when it's time to go to the doctor? We learn to distinguish simply a breakdown and a bad mood from depression, and depression from neurosis and neurasthenia.

Depression or bad mood?

Bad mood - normal condition person. You can not always be satisfied with yourself and life: from time to time, any person experiences bouts of bad mood, melancholy or depression. The only problem is that outwardly depression is very similar to the most banal bad mood.

So, in both cases, everything around is seen in a black light or, on the contrary, it seems gray and hopeless, tearfulness and irritability are noted. How to find out what it is? Let's try to figure it out on our website.

In fact, distinguishing low mood from depression is quite simple - much easier than distinguishing depression from neurosis.

Low mood always depends on external circumstances. But depression always depends on internal state. The external circumstances of life can only provoke depression at the very beginning, but do not affect it in any way - they do not strengthen, do not weaken.

You can also understand what you have with the help of simple test: one must imagine that external circumstances have changed. For example, there was a lot of money, a long-awaited vacation. If these thoughts cause a change in mood, bright thoughts appear, then there is just a temporary deterioration in mood. With true depression, no pleasant external changes do not cause any movement of the soul.

In a bad mood, a person's aggression is directed at the world, while in depression - at himself. People who are in a depressed state tend to engage in self-flagellation and self-accusation. In a person who is simply in a bad mood, self-esteem does not suffer and does not change in a low direction.

In a bad mood, as well as in depression, there are problems with sleep. But when the mood is lowered, it is difficult to fall asleep. The dream itself is quite complete. With depression, the quality of sleep changes, it becomes superficial, intermittent, not restful. With depression, seasonal exacerbations are noted. In the morning, a person may feel worse than in the evening. With a low mood, a person feels worst in the evening.

The most important thing is the duration of the symptom. Bad moods don't last long. If it lasts more than two weeks without any changes, then we are talking about a depressive state.

When depressed, it becomes difficult for a person to adequately assess himself, external circumstances, reality as a whole. It is characterized by a triad - a persistent decrease in mood, motor and mental retardation. This manifests itself in apathy or anxiety, difficulty concentrating, difficulty managing thoughts, fatigue, weakness, lack of appetite. Depression is characterized by an inability to enjoy life and a refusal to communicate (unwillingness to communicate, difficulties in communication, inability to maintain a conversation). In severe cases to mental manifestations physical ones join - problems with the gastrointestinal tract, a disorder in the work of many organs.

It is easiest to distinguish between mean and severe depression from bad mood. At the same time, all the signs of depression are so pronounced that it is almost impossible to make a mistake. But mild depression looks a lot like a bad mood: a person is not happy with anything, but his working capacity is almost normal, and there are even improvements in his condition.

Depression can have a different nature, so the treatment required is different. If this condition is caused by a violation biochemical processes in the brain, then long-term drug treatment with antidepressants will be required. A bad mood does not require treatment: you need to remove the stressor, and sometimes just sleep or go on vacation. With depression, no vacation will help to improve the condition.

Depression or neurosis?

Neurosis also manifests itself as depressed and anxiety. Therefore, it can be easily confused with depression. Training exercises for endurance and speed. Especially with anxious depression, when a person is not apathetic, but unnecessarily restless. A variety of neurosis, many doctors consider neurasthenia, which is severe exhaustion nervous system.

Put accurate diagnosis only a specialist can do it. But also a common person can still distinguish depression from neurosis on a number of grounds.

It is important to track how changes in human behavior began. Neurosis is always called external causes. Depression, even when there are good external causes, is caused by internal ones.

The neurotic reaction is often shorter. depression wears prolonged nature- if left untreated, it lasts for months and years, leading to a suicidal syndrome. Neurosis rarely causes thoughts of suicide.

Other symptoms are also characteristic of neurosis, with which people often go to doctors of various specialties. These include fatigue, insomnia, dizziness, headaches, palpitations of an unclear nature, pain in the heart, sweating, anxiety, trembling fingers, stomach pain, intestinal disorders.

For neuroses, a state of excitement, fear is characteristic. At the same time, a person can experience completely different fears, the number of which is multiplied. The most common are fear of death, fear for loved ones, cancer, fear of heights, streets, people. With fear of communication, a person is afraid to communicate with people, but feels the need for it. When depressed, a person does not feel the need to communicate. With depression, fears rarely bother - a person is not afraid either for his life or for the lives of other people.

There are many types of neuroses. It is for them that obsessive states that can prevent a person from living a full life.

Another difference is that with neurosis, taking antidepressants does not lead to relief, because there are no violations. biochemical reactions in the brain. Psychotherapy and sedatives can help with neurosis.

Neurosis or psychosis?

It is quite easy to distinguish neurotic reactions from psychoses, although often a neurotic may not look like a completely healthy adequate person. Indeed, some obsessive rituals such as endless handwashing, cleaning, compulsively arranging dishes in a certain order, counting objects, can suggest big problems.

But a person suffering from a neurosis or neurotic reactions is aware of the existence of a problem and understands that his behavior prevents him from living. He can be aware of the connection of his behavior with the outside world, understands that his behavior is caused by external causes, and tries to eliminate them. Patients with neurosis understand the need for treatment and seek help from specialists. Neurosis is reversible, that is, it is enough just to cure them completely.

Psychosis is a persistent mental disorder in which a person perceives himself and the world inadequately. A person does not control himself and lives in a different reality. Hallucinations, illusions, obsessive delusions, personality changes, can be noted here. With psychosis, a person does not feel that they need help, and may even react aggressively to any treatment. He is not critical of himself.

Psychosis begins imperceptibly, personality changes occur gradually, the problem grows over a long time. Neurosis often begins in a very definite way, and one can even trace what event provoked it. Neurosis never turns into psychosis, so there is no need to be afraid of this.

Neurosis can be cured, psychosis is very difficult to treat.

Neurasthenia

Neurasthenia is a mild form of neurosis caused by stress and overwork. Prolonged overwork of the nervous system leads to its exhaustion. The so-called breakdown and neurasthenia develops.

It is characterized by rapid fatigue, mental and physical, weakness, insomnia, apathy. Very often irritability develops, and the most harmless things like laughter or phone calls can annoy and cause fits of anger. With neurasthenia, it is difficult to focus on one thing.

If the problem goes too far, then tearfulness develops. A person suffering from neurasthenia can cry for absolutely no reason: tears can cause sharp sounds, a doorbell, a bright light.

Unlike depression and neurosis, neurasthenia is treated quite easily. But here, first of all, it is important to strengthen the nervous system, which requires a long rest and the elimination of stress. It is necessary to change the way of life: it is not medicines that work best, but walking, running, water procedures especially swimming, good sleep And good food with an abundance of vitamins. With neurasthenia, simple sedatives- valerian, motherwort.

So, a bad mood is a sign of many diseases. Feeling that the world has lost its colors, you need to listen to yourself and understand what caused the breakdown and bad mood. And this, in turn, will help to contact the right specialist in time.

Depression worsens the quality of a person's life, negatively affects relationships with loved ones, colleagues, and reduces a person's efficiency at work.
It is worth noting that if earlier the intellectual and economic elite of society, aware of the importance of a full-fledged active life, then in recent years the number of people among all segments of the population who prefer to use professional psychotherapeutic help has increased.

How to understand that you or your loved ones are not just in a bad mood, but depression, with which you need to seek help from a psychotherapist?

Any consists of three components - mood disorders, autonomic disorders and fatigue.

The first component of depression has to do with mood changes - sad depressed mood lasts more than two weeks. With depression, a dull perception of the world around appears, everything around seems gray and uninteresting. There are mood swings during the day - in the morning the mood can be good, but worsen in the evening. Or the mood is bad in the morning, and is somewhat dispelled by the evening. Some people may not have diurnal mood swings - it is constantly sad, sad, depressed and tearful.

Depressed mood comes in different shades. Sometimes it is a depressed mood with a hint of longing, with a hint of anxiety, with a hint of despair, as well as indifference or irritability. Sometimes a person may not be aware of his sad mood, but feel the so-called bodily manifestations of depression. With depression, there may be a feeling of intense heat in the chest, "a heavy pressure stone on the heart." Less often, depression manifests itself as a chronic sensation of pain in some part of the body, while doctors of other specialties do not find it. organic causes for pain.

Very often, a person reacts to a situation of prolonged stress with depression with a touch of anxiety. People feel anxiety in different ways. It can also manifest itself in the fear of falling asleep, nightmares, and in the constant fear and imagination that something terrible will happen to loved ones and relatives. Sometimes a person describes anxiety as nervousness and the inability to sit in one place. Constant feeling anxiety makes it impossible to relax, for example, a person cannot sit still on a chair for more than two or three minutes - “fidgets in a chair, then jumps up and starts walking around the room.”

Very strong anxiety (57 points on the Sheehan scale or more) occurs against the background of an extended depression, and manifests itself in the form of panic attacks (feeling short of breath, palpitations, trembling in the body, sensations of heat). If there is a strong anxiety, this indicates that a huge underwater part of the iceberg of depression has formed in a person, and anxiety disorder is the tip of this iceberg of depression.

If at anxious depression a person cannot sit still, then with other forms of depression, on the contrary, it becomes more difficult for him to move. If a person sleeps 12-14 hours a day, he does not have a feeling of cheerfulness in the morning, and ordinary actions - cooking soup, cleaning the apartment with a vacuum cleaner - seem overwhelming or meaningless to him, this may turn out to be a manifestation of apathetic depression.

The processes of inhibition during depression cover the entire body - it becomes more difficult for a person to think, his memory and attention deteriorate significantly, which noticeably affects his working capacity. Difficulty concentrating when a person gets tired from watching TV for a short time or from reading a few pages. interesting book. Or, for example, a person can sit in front of a computer for a long time, but is unable to concentrate on work.

The second component of depression includes autonomic disorders (manifestations of vegetative-vascular dystonia). If the cardiologist and the therapist have ruled out the relevant organic diseases, then frequent urination, false urges, headaches, dizziness, fluctuations in blood pressure and temperature are treated as additional vegetative signs depression.

On gastrointestinal tract depression affects as follows: a person loses his appetite, constipation is noted for 4-5 days. Much less often, with an atypical form of depression, a person has increased appetite, diarrhea, or false urges.

Depression does not bypass reproductive system organism. As a result of developing depression in men and women, sensations in the sexual sphere are dulled. Much less often, depression manifests itself in the form of compulsive masturbation, or in the form of flight into numerous promiscuous relationships. Men often have problems with potency. In women with depression, there may be a regular delay in menstruation for 10-14 days, for six months or more.

The third component of depression is asthenic, which includes fatigue, sensitivity to weather changes, and irritability. Irritation cause loud sounds, bright light and sudden touches strangers(for example, when a person is accidentally pushed into the subway or on the street). Sometimes, after a flash of internal irritation, tears appear.

With depression, various sleep disorders are observed: difficulty falling asleep, superficial restless sleep with frequent awakenings, or early awakenings with a simultaneous desire and inability to fall asleep.

Depression has its own laws of development. There are signs that indicate the severity of depression. Reflections on the meaninglessness of life and even suicide are a sign of a significant increase in depression. Thus, a general feeling of unwillingness to live, thoughts about the meaninglessness or aimlessness of life, as well as more pronounced suicidal thoughts, intentions or plans appear consistently with severe depression. The appearance of these symptoms in you or your loved ones is an indication for an urgent appeal to a psychotherapist. In this state, it is important to start as soon as possible medicinal treatment depression in an adequate dose.

Drug treatment for depression is prescribed if the level of depression on the Zung scale equals or exceeds 48 points. The effect is due to the influence of the drug on the system of serotonin (the hormone of happiness and pleasure), norepinephrine, etc. Against the background of a stable mood, it is much easier to decide psychological problems to resolve conflict situations.

Many people are afraid to take antidepressants because they believe that allegedly these drugs develop addiction (dependence on the drug). But this is not at all the case; addiction to antidepressants (drug dependence) does not develop at all. Addiction is caused by strong sedatives and sleeping pills from the group of tranquilizers (benzodiazepines). Depression is treated with fundamentally different drugs - antidepressants.

Depending on the shade of depressed mood, the psychotherapist prescribes different antidepressants. There are antidepressants that treat anxiety-tinged depression. There are drugs to treat depression with a touch of apathy, indifference, and so on. With the right dosage of drugs, after three to four weeks, depression begins to undergo reverse development- suicidal thoughts, anxiety disappear, a desire to act actively appears, mood stabilizes.

Antidepressants begin to act at the end of the second or third week. Feeling the improvement, most people stop taking the antidepressant by the fourth week, and, as a result, depression returns after a few weeks. To fully cure depression, it is very important to endure the entire course of depression treatment prescribed by a psychotherapist.

The duration of the course of treatment with antidepressants is determined by the psychotherapist individually in each case. But, as a rule, the course of treatment with antidepressants lasts from 4 months to a year, sometimes longer. Sometimes a psychotherapist after the main course of treatment may prescribe a course of maintenance treatment to consolidate the effect of depression treatment. Depression lasting less than six months is the easiest to treat. If a person postpones treatment for two to three years, or even eight to ten years, then the course of treatment increases significantly, and can reach one and a half years with one and a half years of maintenance therapy.

Depression in psychotherapy should be treated like high fever in the practice of general illness. A high temperature is not a diagnosis, it indicates bodily trouble. When a person has heat, he goes to the doctor, and the specialist understands - is it the flu, appendicitis or something else. So depression says that a person’s soul is bad, and he needs psychological help. A psychotherapist prescribes an "antipyretic" - an antidepressant, and then, using psychotherapy methods, helps a person deal with the problem that caused the depression.