According to statistics, in 90% of cases, the main cause of a depressive illness is:
1. Affective disorder
2. Having psychological trauma
3. The prevalence of persistent chronic stress.
If trauma is the catalyst for depression, it is considered reactive. They are characterized by such events as the loss of a loved one, the destruction of relationships, the emergence of conflict situations with the work collective, an unstable financial situation, reaching the retirement age, moving to another city or country.
The emergence of a depressive state deserves special attention when a person achieves success in the business he has begun. Professional psychologists explain this phenomenon by the fact that there is a temporary loss of goals and meaning for further life. Depression of a neurotic nature arises from a constant stressful state. Often it is almost impossible to find a specific reason that can serve its development. As a rule, in the process of research, the patient begins to describe his life as a continuous series of failures and losses, which most often has an unrealistic assessment of what is happening.
Females are more likely to develop depression than men. In terms of age, the number of cases is higher in people of mature age than in the younger generation. However, there are other factors that cause diseases: these are extremely indicators on a scale of excessive financial wealth and poverty, low self-esteem, dissatisfaction with oneself, traumas in childhood, lack of social contacts in society, and the “black sheep” syndrome.
Considering the total number of affective disorders, 1% is endogenous depression as a rare disease. It occurs to depression of the periodic form with the spread of the manic form of psychosis. It appears as a result of pathologies arising in the metabolic process of amines of the biogenic group, slowing down or accelerating metabolic processes, which usually develop during aging.
The next group of anatomical causes implies diseases at the somatic level or pathological processes localized in the brain. According to the studies, in half of the cases, depression occurs during rehabilitation after a heart attack or stroke, 60% is due to chronic diseases of the cardiovascular system, 15% suffer from TBI (traumatic brain injury).
The likelihood of developing depressive conditions increases in case the hormonal background changes (pregnancy or the stage of menopause). The body undergoes significant physiological changes that affect the emotional and physical level. Often, a person begins to get tired faster, the period of active working capacity decreases, memory and attention deteriorate. Such changes are accompanied by age-related permutations: some grow up, some get old, adolescents go into a transitional age.
The most common somatic ailments include ischemia, diabetes mellitus of any group, diseases of the gastrointestinal tract, central nervous system, liver, and kidneys. Citizens suffering from any kind of addiction are also prone to the emergence of a depressive state.
CLASSIFICATION OF DEPRESSION
In the generally accepted classification, it is customary to distinguish the following types of depression:
Clinical or large
Treatment for schizotypal depression
Each species has its own specific features that deserve separate consideration.
Clinical (major) depression
A distinctive feature is a decrease in the positive emotional state, rapid fatigability appears, the supply of energy quickly disappears, previous hobbies no longer cause positive emotions, lack of interest in the world around them, appetite and full sleep disappear, a negative assessment of current events appears (a person sees everything in “black Color), suicidal thoughts may appear. The average period for the prevalence of symptoms is up to 14 days. Symptoms develop gradually, as a rule, their occurrence provokes the presence of constant stress or pressure.
Considering the disease from the point of view of the clinic, then this type characterizes a slight disorder. Typically, there is a maximum of 2 affective syndromes that persist for two weeks or longer.
Distinctive features are a depressed state, a lowered emotional background, an apathetic state. With regard to physiological signs, often the appetite begins to increase, drowsiness increases, anxiety is increased, and panic attacks may occur. In practice, in addition to the use of tranquilizers, stabilizers are used, as well as drugs that can quickly raise the emotional mood. They suppress anxiety and panic attacks.
One of the most common types that appears as a result of labor. This category also includes women who have experienced an abortion or stillbirth. The main reason for the occurrence of pregnancy is the occurrence of vivid hormonal disorders.
If a woman loses a child, the depressive state can transform into one of the classic types. It can be endogenous, classical, psychogenic, or some other kind. In practice, the onset of postpartum depression occurs in the first 2-4 months. The mother, first of all, ceases to show interest in her own child, the emotional background is heightened, there may be a lack of desire to take care.
A disease that is often classified as bipolar disorder. The hallmark is not the only repetition but the duration of presence. In practice, the disease occurs every month for several days. In some cases, the disease is diagnosed as a seasonal species: it can develop both in the autumn or winter period due to a change in the length of the day.
It is characterized as a steady decrease in the emotional background. However, the intensity of its manifestation is an order of magnitude lower than in the case of clinical depression. The disease can persist for more than two years. Some patients suffer from major depression against their background.
It is classified as a severe disease. As a rule, it gets a severe form of the disease as a result of internal changes in the body, which are localized in the brain. Neurotransmitters that are used to transmit nerve impulses to the brain begin to be produced in smaller quantities. As a result, the patient develops persistent signs of a depressive state, while minor experiences or stressful situations may be present. With the development of an endogenous type of depression, its development occurs gradually. In a few weeks, the patient’s condition can completely change. Apathy, tearfulness, and despair quickly appear.
The patient refuses to contact loved ones, may not leave the walls of his home for a long period of time, apathetic state and tearfulness appear. Physiological changes also occur refusal to eat, intermittent and restless sleep. A person stops responding to external irritating factors.
Treatment of the disease is carried out exclusively in a medicamental manner since the main reason is a decrease in the concentration of hormones in the brain. By taking antidepressants, the content of norepinephrine increases serotonin increases. Normalization of physical condition can be achieved within a couple of weeks.
Among the main signs of monopolar depression, as a rule, general depression, sadness, and tearful mood are manifested. Rarely, when a patient experiences positive emotions, most often life is seen in black and gray colors. Depending on the degree of disease progression, specialists select treatment on an individual basis: drug therapy and mandatory work with psychologists.
Monopolar depression is characterized by observing one’s own life only in a negative way. However, from a manic-depressive state, the bipolar appearance does not imply a sharp change in the emotional background. A change in depressive mood is characterized by the onset of a lighter streak in life.
Important: since the 20th century, cases of the disease have begun to increase. According to studies, about 18% of the world’s population suffers from this disease. Also, numerous observations of specialists have shown that the female sex is more prone to a depressive state than men. Has no relationship with the age category. If the most effective therapy is carried out, then in 2/3 of cases there is a significant improvement and complete elimination of the disease.
How is the diagnosis carried out?
Any mental illness manifests itself in every patient with peculiar symptoms, and monopolar depression is no exception. In total, there are five symptomatic categories that describe monopolar depression:
Emotional. A person experiences a feeling of melancholy, loneliness, often unreasonable tearfulness appears. Anxiety and anger levels increase;
Motivational. For the patient, any activity loses any meaning. Any actions (communication with other people, work, participation in family life) do not bring any positive emotions. With an advanced form, suicidal tendencies may appear;
Behavioral. Activity is reduced to a minimum, most often a person spends time in bed. Often there is a slowdown in the execution of any action, even if it is performed every day;
Cognitive. Reduced self-esteem leads to a lack of self-confidence, there is a desire to protect yourself from the people around you and reduce the number of contacts with them;
Physical. Somatic manifestations appear in the form of headaches of varying intensity, dizziness, and often the background of activity is reduced.
As a rule, a diagnosis is made if at least 5 of the above symptoms are present. The duration of each is at least two weeks. In addition, the diagnosis is confirmed by specialists in the event that hallucinations of various types (semantic, auditory, visual) or delusions occur.
In order to identify what type of depressive disorder a person suffers, therapeutic methods are used: cyclic, cationic, or postpartum. Also, the patient attends obligatory conversations with a psychologist, which makes it possible to identify the causes of the development of a depressive state.
Since the XX century, the depressive state is increasingly manifested in people living in large cities. An endlessly active lifestyle, the everyday solution to a large number of problems leads to the fact that people of the middle age 30-40 years old become patients. According to statistics, unipolar depression is most often diagnosed in women. In addition to a pathological condition, with this type of disease, a person has a mental disorder.
A distinctive characteristic of this type of depression is the manifestation of negative emotions without manifestations of the manic type. Despite the fact that depressive manifestations tend to recur, mania does not manifest itself. The main reason for the development of unipolar depression is considered to be the impact of constant stress: a breakdown in relationships, the loss of a loved one, natural disasters.
In some situations, even a positive event that evokes strong emotions can lead to the development of depression. If a person has many small troubles or one major event. However, it acts only as an impetus and does not affect the progression of the patient’s condition in the future. Among the studies conducted by experts, it was concluded that the most common event that affects the formation of unipolar depression is divorce. Another equally important aspect is learned helplessness. When stress affects the body so much that normal sleep, appetite disappears, general physical weakness develops.
Among the main signs of unipolar depression, the following aspects can be distinguished:
Loses interest in the surrounding events
Low self-esteem prevails
Lack of emotional expression
Dark and negative thoughts prevail
Sleep problems begin.
Often, the patient loses interest in the events that take place in the world. It turns out to be more difficult to concentrate one’s attention on performing various tasks. Despite constant fatigue, it is difficult for a person to fall asleep at night. The prevalence of low self-esteem leads to the fact that a person becomes unsure of himself, constantly feels guilty in any events. The further future is perceived only in negative colors.
The main difficulty is the fact that a person is purposefully looking for only negative moments in all his actions and events. Suicidal thoughts can often occur. Since the level of aggression often becomes elevated, a person tries to protect himself as soon as possible from contact with other people, even close ones and relatives. How actively side symptoms will appear depends on the stage of development of the disease. To fight unipolar depression, a visit to a psychologist is a must. For acute attacks, medications may be used.
SYMPTOMS OF DEPRESSION
In medicine, a triad of symptoms is defined, which is the main one when depression occurs as a disease:
Decreased activity of the locomotor system
Inhibition of thought processes.
The first aspect is often characterized as melancholy, a sense of hopelessness, a feeling that a person is losing bright prospects for future life. An increased level of anxiety is often observed, which has received an alternative name as anxiety depression. It seems that the meaning of life is lost, the old hobbies and hobbies lose their meaning and do not bring any satisfaction. Self-esteem suffers. First of all, the patient begins to blame himself for all “mortal sins.” Suicidal thoughts may appear, and less and less contact occurs with other members of society. With the development of neurotic depression, as a rule, the situation develops in the opposite way: they begin to blame the people around them for all the hardships. With the development of a complex and prolonged depressive state, a person may lose emotional sensitivity. He may feel a kind of emptiness inside. Some patients associate with unbearable physical pain.
Throughout the day, sensations can seriously fluctuate. If an endogenous type of disease develops, then the peak of negative emotions occurs in the first half of the day or at the earliest in the morning, and in the afternoon the situation changes dramatically since the state of health improves significantly. Psychogenic depression, on the contrary, presupposes a normal emotional background in the first half of the day, and the closer to evening, the more the depressive state manifests itself. Due to the fact that the thought processes are seriously slowed down, a person may have difficulty planning his own day, the learning process is difficult, and solving standard problems requires maximum effort. Perception worsens, information is practically not remembered. According to the patients themselves, they begin to feel slower in their actions, in order to carry out a mental operation, a large amount of effort is required.
The disease also negatively affects the formation of speech: the patient more and more arrives in silence and practically does not conduct dialogues. As a rule, the answers are monosyllabic “yes” or “no”.
The principle of treatment depends on the diagnosis of a certain type of depression. Some of them may not require the serious intervention of specialists, but with a stable form, a whole work plan is developed, which the patient must follow without fail in order to achieve the most effective results.
Treating depression at home
Complex forms of depression do not need to be treated in a hospital setting. When visiting, specialists can prescribe medication. As a rule, they are selected on an individual basis, depending on the state of health of the body and its specifics, therefore, doctors strongly do not recommend purchasing medications without prior consultation.
Folk methods are also effective, among them herbal preparations can be noted, which soothe and tone the central nervous system. An equally important and responsible event is the normalization of the schedule and diet, sleep. In addition, you can see a psychoanalyst who will help stabilize your emotional state.
Another effective method of reducing anxiety and raising the emotional background is aromatherapy. This is a pleasant procedure that is not difficult and not materially expensive to organize at home.
Treatment of depression at our clinic
Treatment of depression is exceptional in the most severe cases, when a person flatly refuses to eat, practically does not sleep, and completely renounces the outside world. It is important to take into account that in most cases, in order to get rid of a complex form of depression, specialists act in a complex manner, using not only effective medications but also conduct individual therapy, conversations, hypnosis.
Treatment should be selected exclusively on an individual basis, after a high-quality history collection, as well as determining the degree of the disease and its progression.
Depression Treatment with antidepressants
Some antidepressants can be purchased on your own at any pharmacy and you do not need to present a doctor’s prescription. However, this does not mean at all that they can be taken thoughtlessly, at the first possible signs of a depressive state. Before you start taking any drug, it is highly recommended to visit a doctor who will tell you what drugs are allowed in a particular situation.
It is customary to single out several groups of medicines that affect the braking process:
Tricyclic. Drugs in this category belong to the first generation. When using them, norepinephrine and serotonin are not subject to reuptake. The most common drugs are Doxepin, Nortriptyline, Desipramine. However, the drugs have a large list of side symptoms: the appearance of tremors in the hands, the work of the cardiovascular system is disrupted, and disorders of the visual system occur.
Drugs whose action is aimed at capturing the reverse type of norepinephrine and serotonin. They are widespread if a person has a constant feeling of fear that cannot be overcome with ordinary methods. Panic attacks and aggression may also appear. If the prescribed dosage is not followed, serotonin will accumulate in the body. The main representatives include Sertraline, Fluoxetine. Selective inhibitors. Practiced to combat obsessive phobias.
Cyclical sleep disturbances and the development of a depressive state can be distinguished as common symptoms. As a result, weight can increase uncontrollably, and a constant feeling of lack of sleep appears.
Heterocyclic drugs. Relevant for use in the process of working with elderly patients, if there is a persistent sleep disorder or developing depressive state.
DIAGNOSTICS AND TREATMENT OF DEPRESSION
Depression is diagnosed only after collecting a high-quality and as complete anamnesis as possible, passing tests, and talking with the patient. To be diagnosed with depression, a patient must have at least two of the triad and three of the accompanying symptoms. Among the second group, unjustified feelings of guilt, increased anxiety, low self-esteem, suicidal mood, and decreased appetite are most often distinguished. If a doctor suspects the development of depression, then he redirects the patient to other specialists, depending on what symptoms he has.
Outpatient treatment is often subject to depression types such as recurrent, atypical, postpartum or dysthymia. If the disorder reaches a critical point, then inpatient treatment can be arranged. Depending on the individual case, various methods can be used, ranging from psychotherapy to the latest generation of pharmacological drugs. In the latter case, it is important to note that modern drugs cause a minimum number of side symptoms, which has a positive effect on the effectiveness of treatment.
Among the most popular drugs are antidepressants. If lethargy is observed, then drugs with a stimulating function are used, and in an anxious state – drugs with a sedative effect. The response to antidepressants also manifests itself in different ways, depending on the individual response of the body.