melancholic depression. Psychotherapy for melancholy and depression

depression and melancholy

Depression

Let's look at what happens to the world and to us when it comes - Depression. We will not talk about “depression”, as a psychiatric diagnosis that leads to complete maladaptation of the personality, but about such a common condition when a person seems to live, and even goes to work and somehow copes with this life, but you can talk about him say he is "depressed".

Depressed people are my favorite patients. And although many psychoanalysts believe that it is extremely difficult to work with them, and that the constant complaints of depressed patients are unbearable, and that the worst thing is that this condition is contagious - all this is true. But I love them. Why?

Because only they found the courage to see the truth about the world and about themselves. And I like people who gave up a life of self-deception and illusion. After all, if you remove many of the human illusions, then our world is really an extremely dangerous and difficult place to live.

A depressed person (let's call him a melancholic) begins to see our common human shortcomings much more clearly. His eyes seem to open, or vice versa, a magic mirror gets into his eye, and he sees the imperfections of the world and people with such clarity that it hurts him. And at the same time, he understands that the world is indifferent and hopeless, and nothing can be changed in it. With the same clarity and tragic hopelessness, he realizes that practically all these imperfections are in himself.

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

Depression, if it is briefly described, is the experience of feeling the loss of something: a loved one or love in general, status, illusions, hopes ... Sometimes this loss is obvious to others and the sufferer himself, sometimes it is mysterious and incomprehensible. When a real misfortune occurs, such as the death of a loved one or the breakup of a relationship, the person experiences similar states, but this is not depression. When there is a real reason for grief, this is understandable, and everyone sympathizes and pities the unfortunate.

In real depression, no one understands what is happening. A person experiences an internal catastrophe, the world collapses, he experiences all the torments of real grief, and often also fear.

And in this state, a person, as a rule, is faced with a total misunderstanding of loved ones, who seem to want to sincerely help, but do even worse. Phrases like: "Pull yourself together, stop whining, look around, everything is fine" - make it even more painful, because they emphasize the total loneliness of the melancholy sufferer, his complete separation from others, the impossibility of salvation.

Attempts to say that in fact everything is fine and nothing terrible is happening completely devalues the feelings and suffering of a depressed person. Understand, if you do not understand the cause of a person's suffering, this does not mean that he does not suffer.

The melancholic is always lonely, and if his condition is delayed, then people begin to avoid him. Why? Yes, because it is very difficult to be near such a person, because others are experiencing their own impotence from futile attempts to help him, and because no one wants to be inside his world, rushing to disaster.

The salvation and dream of the melancholic was shown by Lars von Trier in the film Melancholia.

When the heroine alone experiences a nightmare of a universal scale, as her own melancholy, she is lonely and no one understands why she is so. After all, she could get married and live a normal life? And now her inner nightmare becomes a reality - the planet Melancholia rushes to Earth and no one will survive. And here we saw how everyone else copes in reality with what she already felt. They can't cope, because it's so scary and impossible that ... But the heroine gets better, because for her the whole world comes into balance. The catastrophe inside and the catastrophe outside coincide, complete harmony sets in. And she can finally get the most important thing - a feeling of merging with the world, which is the same as her, belonging and unity with loved ones who are experiencing the same thing as her.

What can you do to help yourself or your loved ones when Depression hits?

Do not discount your (his) feelings. Do not say that he is doing well, and that you just need to pull yourself together. The suffering of the melancholic is real and enormous, even if it seems to you that there is no reason for this.

Understand that the melancholic is like a person without skin, he feels everything so sharply, to the point of pain. And if the pain goes off scale, then he just lies down and falls into apathy.

Even if it is very difficult for you, you are still there. Do not get annoyed and try not to collapse, but just silently be there. Because when the melancholic is able to return from his journey to hell, it is important for him that someone is waiting for him in the real world.

Watch what's going on, note the symptoms.

Major depression (also known as major depressive disorder) is the most common form of depressive disorder. Major depression can manifest itself in different ways for different people. As a rule, this is a feeling of sadness that does not go away for a long time. Favorite activities are not fun. Along with this, the following mental and somatic disorders are noted:

- insomnia,

- inability to concentrate

- forgetfulness

- loss of appetite,

- Pain in different parts of the body.

People suffering from this disease note a heavy feeling of deep mental pain, longing. In a state of great depression, a person considers himself worthless, incapable of anything, and his situation is hopeless and hopeless.

If the state of depression lasts more than 2 months, then by all means, by any means, take the melancholic to a psychoanalyst and / or a psychiatrist.

Antidepressants will help relieve symptoms, and psychoanalysis will help to understand the causes and help cope with relapses. And remember, depression kills at least as many people in the world as cancer.

A bad mood is inherent in people from time immemorial. This will not surprise anyone. You never know what can happen when the mood suddenly deteriorates. Let's say he received some bad news, or it seems like such a trifle: he accidentally poured (a) coffee on his trousers (dress). A fleeting incident, but left an unpleasant aftertaste in the soul. Often in such cases they jokingly say that “today I got up on the wrong foot.”

You can suffer from emotional experiences from childhood, when external adverse factors, for example, the constant “buzz” of parents that the child is doing everything wrong, are superimposed on the characteristics of the baby’s psyche.

Such a dreary mood "seriously and for a long time" the ancient Greeks called melancholy. The "father of medicine" doctor Hippocrates believed that bile contributes to this - a specific dark liquid produced by the liver and accumulated in the gallbladder. Its excess spreads throughout the body and acts depressingly. A person becomes lethargic, passive, he does not want to do anything, he is overcome by gloomy thoughts, he is tormented by a feeling of loneliness and his worthlessness. The Roman physician and philosopher Galen deepened the theory of melancholic mood.

This view of the causes of the origin and development of melancholy lasted in European science for almost two thousand years. The English philosopher Robert Burton wrote an extensive work, Anatomy of Melancholy, in 1621. It examines the essence of the disease from different points of view.

Some of his reasoning now causes only a smile, for example, that witchcraft, bad omens and the "wrong" alignment of the stars provoke a melancholic mood. But his work is valuable if only because it shows the history of the development of prejudices and medicine in relation to this disease.

In Russia, melancholy was called "spleen" or, in the English manner, "spleen", they considered it the lot of persons from high society. Suffice it to recall Pushkin's Eugene Onegin, who was taken over by the "Russian melancholy" when he became "gloomy, languid", and women ceased to excite him. But these are already social signs of the manifestation of melancholic illness, clearly shown in the novel by I.A. Goncharov "Oblomov". With his light hand, they began to be called "Oblomovism".

Today, melancholy is no longer associated with bile. Some doctors believe that the individual characteristics of the individual, her temperament, are “guilty” of this. Even at the slightest failure, such people are deeply worried (affective problems), but their external reaction to adverse factors is sluggish. They are emotionally unstable, and therefore easily vulnerable. The Russian physiologist Pavlov considered this type of temperament to be weak.

Others consider melancholy a sign of a serious mental illness, depression is the reason for it. The currently accepted international classifications of mental illness (DSM, ICD) characterize the melancholic state as an "anxious personality disorder". This is a psychosis that needs to be treated.

It's important to know! If a person is suspicious and deeply worries about his bad luck, this does not mean at all that he is a weak, unsuccessful person. Many famous scientists and creative people were melancholic, but managed to express themselves brightly. For example, Charles Darwin, Nikolai Gogol, Pyotr Tchaikovsky.

Causes of melancholia

It is impossible to determine the exact causes of melancholy. It can appear from a violation of the function of the brain or other internal organs. One thing is certain that its development comes from strong experiences when the psyche is in a depressed state for a long time. And this is depression.

In psychiatry, there is the concept of "melancholic depression". This is when they kill their personal problems so much that gloomy thoughts appear, often about suicide. According to recent studies in Russia, up to 15% of able-bodied women suffer from this form of mental disorder. Among men, depression is 5% less. The difference is small, but it indicates a more vulnerable female psyche. The fair sex is longer and deeper experiencing their life's failures.

The causes of melancholy can be:

congenital melancholy. Associated with abnormal intrauterine development of the fetus, when the mother led an unhealthy lifestyle. Already at the embryonic level, the “little man” hears everything, and if the woman did not want to give birth, these disturbing thoughts were transmitted to the child. A melancholic personality can also be born from too old parents.
Temperament. When one of the parents or both are melancholic. There is a high probability that the child will be like that.
Various depressive states. Here it is necessary to single out melancholic depression, which is accompanied by a dreary, extremely gloomy mood, when thoughts about one's worthlessness and suicide appear.
Sudden mood swings. Such factors of melancholia serve as a sign of bipolar disorder of the first and second types. The difference between them is that with the latter there is no obsessive manic state, which is dangerous because a suicide attempt can be made.
Mental disorders. Hereditary or acquired in the course of life. For example, schizophrenia can be accompanied by gloomy thoughts, unsociableness, decadent mood.
Severe and prolonged illness. She is exhausting physically and mentally. Heavy thoughts appear, a depressive melancholic state may develop.
Old age. With age, irreversible processes occur in the body. A person is no longer so fast and dexterous, diseases are pestering. It affects the psyche. Often the mood becomes sad - melancholy.
Fear. When, due to mental characteristics, fear is constantly present in the soul. For example, falling in love or getting married, disbelief in something new. This is a serious criterion for a melancholy mood.
Inferiority complex. When a person does not believe in his own strength, considers himself flawed and leaves his fate to the will of others, this ultimately depresses him. He suffers and suffers from the realization of his weakness, becomes a melancholic.
Socio-ethical problems. Associated with worldview issues. For example, the lack of faith in social progress, that people can act according to their conscience, and not because of profit, makes a person a skeptic. Such views lead to a decadent mood - melancholy.
Pessimism. Spiritual development leads to the idea of death, that everything in the world is temporary and short-lived. Ahead of everyone is only a coffin and a grave. Such "black" thoughts are nothing more than a severe mental illness - melancholic depression.
Unrealized passion. Let's say unrequited love. She burns, burns, but there is no reciprocal feeling. A depressive melancholic state sets in, if for a long time, this is already a psychosis that requires urgent treatment.
Deep emotional experiences. Most of them are negative. For example, envy, sadness, anger, greed corrupt the soul, often lead to a depressed state.
Alcohol and drugs. Alcoholism and drug addiction literally kill the psyche when thoughts become gloomy, incompatible with life. Such people become melancholic and often commit suicide.
gambling. Pernicious passion often ends in a big loss. Such people are constantly in a bad mood, they only think about how to get money. Against this background, pessimism and melancholy develop.

It's important to know! Melancholy can have both natural, biological and social causes. However, they all lie in the psychological characteristics of the individual.

The main symptoms of melancholia in humans

How does the "black" mood manifest itself in life? In different categories - children, adults and the elderly - the symptoms of melancholy correspond to their age. Let's consider this in more detail.

Symptoms of melancholia in children

It is not so difficult to determine the symptoms of melancholy in a child, you just have to look closely at him. This kid is very different from his peers. He is timid and therefore insecure. Outwardly, this manifests itself in tearfulness, the causes of which are sometimes difficult to determine.

Often a melancholic child clings to his mother because he is afraid to be alone with strangers, for example, in a kindergarten. For him, the period of adaptation in the kindergarten is very difficult. Parents and educators should be attentive to such "capricious" and be able to find a common language with them.

On the other hand, such a child is obedient, when he gets comfortable in kindergarten or at school, he will not have problems with behavior. The positive features of little melancholics include diligence. They are very responsible to the task assigned, they always try to bring it to the end. Such children are creatively gifted if they develop their abilities, often becoming outstanding people, for example, writers, artists or composers.

However, they also have weaknesses. They rarely show initiative, they are closed, and therefore it is far from always possible to “stir up” them for friendly communication. But if such a child has become attached to someone, for the sake of friendship he can even sacrifice his own interests. And then he is very disappointed when he does not receive the same return in return. This becomes especially noticeable in adolescence.

It's important to know! So that the symptoms of melancholy in a child do not develop into a real illness, you do not need to constantly scold and reproach him, for example, for "snot." It is necessary to encourage the best character traits of the baby, then he will grow up a healthy personality, not subject to melancholy attacks.

Symptoms of melancholia in adults

According to statistics, the symptoms of melancholia in women appear at the age of 40-55 years, in men, on average, 10 years later. Their external signs are similar with the only difference being that the fair sex is more sensitive to age-related changes and experiences them more deeply.

Obvious symptoms of melancholic depression can be: dry skin, dilated pupils, sudden weight loss, poor digestion. Other signs are:

hypothymia. When you're in a bad mood all the time. A person does not see anything good around him and is fixated on negative experiences. He is not able to tune in to positive communication. Often this is due to reflections on one's own emptiness. Against this background, thoughts of suicide arise.
Apathy and lethargy. They are characterized by a lack of energy. Outwardly, they manifest themselves in complete indifference, indifference to everything, even to pleasures. You cannot drag a person, say, to a cinema or a restaurant. Digging through his "mental" wardrobe is the most important thing for him. If something is done, then carelessly. I don’t want to eat, I’m even too lazy to go to the toilet. In this case, one speaks of a vital affect, when all physiological needs are reduced.
Guilt. A complex psychologically inexplicable feeling. A person blames himself for everything, even for being born into the world. He is "guiltlessly guilty" and he himself is aware of it.
winding up problems. When difficulties are created out of the blue. For example, going to the store for bread is a difficult task, because you need to get dressed and even go.
Inhibition of actions. Let's say something needs to be done, we think about it a lot, but a lot of time passes before the matter begins to be decided.
Constant desire to sleep. Even a full sleep does not eliminate the intention to take a nap a few hours after waking up.
Poor concentration. Thoughts are constantly on the move, and it is hard to concentrate.

It's important to know! If a person is in a depressed state for a long time, when it seems that life is not interesting, then a melancholic depression has developed. Here the help of a doctor is needed.

Symptoms of melancholy in the elderly

In older people, the symptoms of melancholia are primarily related to health. After 60 years, all the functions of the body have already been rebuilt for "autumn". It affects the mood, causes sad emotions. If they are not extinguished in time, they will develop into an anxiety state that can lead to depression.

Often, older people are lonely, the children have already grown up and “scattered”, this is also an important factor in experiences. Any deviation from an already established lifestyle is stressful for them, which leads to the development of melancholic depression.

It's important to know! So that old people in their declining years do not fall into a melancholic state, it is necessary to give them not on duty, but truly warm, human participation.

Features of the fight against melancholy

Treatment of melancholia in stationary conditions is not always required. Light blues, when overcome by sad thoughts, you just need to shake it up. You just have to follow the simple advice.

Independent ways to deal with melancholy

There are many ways to get rid of melancholy on your own. Some of them are more suitable for women because of their temperament, while others are truly masculine. But it is unlikely that there is a clear gradation between them. In the end, everyone's business is what he likes.

How to deal with melancholy on your own:

The main thing is to try to be in public. It is much easier to get rid of your blues among them than in "proud" loneliness. It is good for women to do aerobics, and for men to play volleyball or football. I think this is for anyone. Shopping is also a great way to unwind.
When there is no desire to play sports, you can visit the library, cinema or theater. At worst, read a book at home, watch TV or sit at a crossword puzzle. It's good to clean up, it will occupy your thoughts.
We should not forget about sensual pleasures. Intimacy here, of course, comes first. However, good company, great conversation and treats are also a great way to distract yourself from sadness. Just don't get drunk or, God forbid, drugs. This is the other side of having a good time, it will only aggravate the blues and wind up new problems.
A great way to get rid of melancholy is to support those who are very ill. "Help others and you will be rewarded a hundredfold." Quite right! Those who help those in need help themselves. Such a person begins to think positively, and this dispels sadness and longing.
The church will help get rid of melancholy. She is a collective psychologist. Many believe their sorrows to God and find peace in prayers for their souls. But this is advice for people who believe that they came into this world by the Providence of God.

It's important to know! It is quite possible to get rid of melancholy on your own, it is only important to really want it.

Help for melancholy

If you yourself cannot escape from your sad thoughts, you need to contact a psychologist. To date, there are many different psychological techniques that allow you to get rid of neuroses and depressive states. For example, cognitive behavioral therapy. Its meaning is that it helps the patient to break the chain of negative associations and develop new positive thinking.

This can happen in figurative games. Suppose the patient imagines that the car had an accident, the windshield shattered to smithereens, he barely survived. The car needs an overhaul. The psychotherapist brings the patient to the understanding that trouble has happened to him, and his old negative thoughts have shattered and shattered. There is no return for them. You should not regret it, but tune in to a new wave of thinking, which will thoroughly “repair” it.

Without sincere contact between the psychologist and the patient, the latter is unlikely to be able to get rid of his melancholy.

Treatment of melancholia in the clinic is the same as in severe depressive states. The patient is placed in a psycho-neurological hospital and a complex of medical procedures is carried out to stop the obvious signs of the disease. For this, various psychotropic drugs are prescribed. It can be antipsychotics, antidepressants, mood stabilizers. The latter stabilize the mood, which is especially important in melancholic depression.

After discharge from the hospital, supportive treatment is necessary so that there are no relapses, which often happens with a long course of the disease.

It's important to know! In the hospital, only chronic melancholy is treated, when "black" thoughts stubbornly push a person to suicide.

How to get rid of melancholy - look at the video:

Melancholy is black glasses on the outside world. The melancholic does not see all the bright variety of colors around him, lives in the dark "cellar" of his gloomy thoughts and dreary mood. If he is not yet deeply bogged down in his sorrows, he may try to throw off the gloomy eyepieces in order to see the white light with a fresh and clear look. If he can't do it, then he needs to be treated. However, it is better not to bring yourself to such a state, since chronic diseases cannot be completely cured.

Melancholic depressions are associated with a high suicidal risk, although suicidal thoughts and actions do not depend entirely on the severity of the depression.

True melancholic depressions in the traditional sense have always been classified as severe depressions with typical somatovegetative manifestations (the so-called vitalization of the depressive affect up to unbearable pain, heaviness or burning in the chest), with an unusually painful, incomparable with everyday experience, dreary or dreary-anxious mood changes, with lethargy up to stupor or excitement up to raptus, oppression of vital drives (libido, appetite) and urges to activity. Characterized by daily fluctuations with morning deterioration.

The content of experiences is determined by the ideas of low value, self-abasement, self-accusation, sometimes condemnation, hypochondriacal formations. The psychopathological structure of depressive ideas is not an unconditional differentiating feature of "simple" and "melancholic" depressions. Here, overvalued, and delusional (such as metaphorization of experiences), and actually delusional ideas are possible. More significant is the vital intensity of the depressive affect, as well as the complete absorption in depressive experiences.

Melancholic depressions are characterized by a general decrease in reactivity in relation to the environment, detachment from the external situation. At the biological level, a decrease in reactivity may be manifested by a lack of response to standard doses of antidepressants and other drugs. Recently, this kind of severe depression has become relatively rare. Meanwhile, states “with characteristic somatic symptoms” began to be classified as “melancholic” in American taxonomy. By no means all North Americans agree with such a substitution of concepts. In itself, the selection of “characteristic somatic symptoms” requires clarification, since somatovegetative manifestations in various forms are characteristic of almost all variants of depression, and “numerous somatic complaints” are just not typical for melancholic depressions: on the contrary, with melancholia, vital depression, complaints as such are often absent. . In addition, loss of interest (i.e., a motivational phenomenon) and, along with this, anhedonia, which are really inherent in depression, are incorrectly attributed to the number of somatic symptoms. The latter, although it is considered a characteristic symptom of depression, is, firstly, not specific to it, and secondly, it is more related to the emotional tone of any activity, and not to the actual somatic functions.

The article was prepared and edited by: surgeon

Video:

Healthy:

Structural features of the depressive syndrome in bipolar and unipolar depressive disorders differ mainly in the first ...
Post-stroke depression ranges from mild anxiety-depressive states to melancholic-type depressions. In a special...
When a patient develops depressive episodes after a manic episode, a diagnosis of bipolar disorder is made. AT...
A study has shown that the combination of anxiety and depression worsens heart failure outcomes....
Psychogenic depressions in the last decade are considered within the framework of dysthymia, i.e. chronic depression of moderate severity with ...
Repeatedly repeated, so-called recurrent depressions can be legitimately considered on a par with the depressive phases of bipolar ...

Melancholic depression is a form of major depressive disorder in which the main indicator is a 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 varying levels of severity, most researchers classify it as one of the more 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 a type of major depression that 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 the diagnostic criteria for melancholic depression, four of which must be noted in order to diagnose melancholic depression.

The main features of melancholic depression include:

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

The reasons

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

In addition, melancholia has been found to be quite common in individuals with bipolar I disorder. It may also be present in bipolar depression II with psychomotor agitation features. Melancholic depression is quite common in a hospital setting. Individuals 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. Therefore, treatment mainly consists of physical intervention with drugs that include antidepressants and a long period of observation by a specialist.