Depression ✧ Causes ✧ Types ✧ Drugs ✧ Treatment methods ☎

Depression is a certain form of disappointment in the world and people. In more scientific language, a mental disorder accompanied by apathy (anhedonia, or melancholy), as well as destruction of thinking and motor staticity.

According to statistics, every second person has experienced a set of symptoms characteristic of a depressive state at least once in their life. What kind of illness is this and is it really a neurotic disorder or simply a consequence of looseness of character? What is depression: sin or illness? Let's figure it out.

The history of depression goes back not only to ancient times, but also takes us back a couple of centuries. After all, in fact, this is a well-known disease among the intelligentsia; During the times of Tsarist Russia, it was even fashionable to suffer from this disease. If there is no depression, then it seems like the blood is not blue. From time immemorial, Russian intellectuals and bohemian characters have become accustomed to suffering, even receiving a certain amount of pleasure from experiencing their grief. The decadent moods of depression are clearly represented in the literature of the “golden age.” Just remember Onegin, falling into asthenia and apathy, Chatsky, always seeking the truth, the nihilist and anarchist Bazarov, who, perhaps, did not dissect frogs out of great love for life. And there’s no need to talk about Oblomov - a brilliant patient! By the way, in the case of “Oblomovism,” the hero’s depressive despondency is certainly presented as a significant “fall from grace.” And all because in a state of despondency and apathy, a person often derives quite a lot of “secondary benefit”, because any of his actions, or rather even inaction, can be justified by the legendary “I’m depressed.”

What is this “secondary benefit” and how is this possible, you ask.

By choosing such a sadomasochistic state, a person simultaneously gets time to think, reevaluate his life, take a break from the rush and boring routine of life. And finally, a person does not owe anything in everyday life, because he is depressed. And many, by the way, enjoy this. The other side of the coin is increased attention from loved ones. After all, sometimes, indeed, the condition in question allows you to deprive yourself of your share of love, affection and attention. In general, in anhedonia the patient can allow himself any feelings (pain, resentment, jealousy, sadness) and even actions.

Depression today, how to avoid it

Depression, ICD-10 code F32 – persistent decrease in mood for at least 2 weeks. However, it is always necessary to take into account the presence of existing concomitant diseases of a person, the medications he is taking, and the individual parameters of the formation of the body. Therefore, this period is always conditional. The main criterion of the disease is a decrease in quality of life. Influence on the external and internal life of the patient. As long as the body and psyche cope with the condition on their own, the help of specialists is not needed.

Treatment of depression - modern methods of restorative medicine 8.

How does depression manifest itself?

Depression often goes hand in hand with anxiety, sleep disturbances and general weakness. It occurs in response to unfavorable life circumstances or manifests itself as a result of a violation of brain biochemistry. There are also certain forms of depression that can be difficult to recognize. For example, somatization or postpartum depression, they are disguised as other diseases. These features require careful medical diagnosis and a completely different approach to treatment.

Depression is always associated with loss of energy. Be it the body’s struggle with a serious illness, a severe shock, or long-term difficult life circumstances from which a person cannot get out on his own.

In today's world, only a few manage to avoid depression. Depression affects everyone to one degree or another. But does everyone always need treatment?

How common is depression?

Doctors of various specialties often encounter depressive symptoms in their clients. Human emotions are a very mobile area of the psyche. But at times a person seems to be frozen on one emotional tone and is unable to return to his previous level.

Any statistics on depression will not reflect its true prevalence, since any disease, one way or another, upsets us and spoils our mood. This means that neurotic depressive symptoms will be added to the main disease. The pain will become more painful, the pressure will jump more strongly, and the heart will beat faster than this is reflected by objective changes in the organs. All this brings confusion to the therapeutic diagnosis of diseases. Doctors, and even patients themselves, are surprised that the prescribed treatment does not help as much as it should. And this will cause even more anxiety for the sick person.

At the same time, competent psychological assistance can almost completely relieve pain even in patients with advanced cancer or lower blood pressure without resorting to chemicals. All this indicates the significant influence of the subjective factor of perception of the symptoms of the disease and reaction to the surrounding reality.

How to determine if you have depression?

Pathology may appear after experiencing stressful situations. If there is no disorder, after the problem is resolved, the person returns to a good mood. But when the cause has been eliminated, and the person continues to feel apathy, depression and loss of strength, it is necessary to seek help from a specialist. Performance may also decrease.

You can determine the presence of depression yourself, but you should not self-medicate even at an early stage of development. This should be done by a doctor, since self-medication can only make things worse.

Depression in women often occurs postpartum, as their lives change dramatically, and sleepless nights add to their fatigue. This is where breakdowns and apathy appear.

When the pathology is in an advanced form, a person experiences the following symptoms of depression - not only bad mood and impotence, but also persistent disorders of the nervous system. There are also symptoms such as: a significant decrease in self-esteem, maladjustment in society, despondency and loss of interest in any events.

Physiologically, appetite changes, intimate needs and energy decrease, sleep and intestinal functions are disturbed (constipation, weakness, fatigue during physical and intellectual stress are observed), pain in the body (in the heart, in the muscles, in the stomach).

The patient exhibits signs of depression such as loss of interest in other people, a tendency to frequent solitude, refusal of entertainment, use of alcohol and psychotropic substances.

Mental signs of depression include difficulty concentrating, concentrating, making decisions, slowness of thinking, a pessimistic view of the future with a lack of perspective and thoughts about the meaninglessness of one's existence, suicide attempts, due to one's uselessness, helplessness, and insignificance.

Types of depression

First, you need to figure out whether depressive symptoms have reached the level of a disease or whether this is a manifestation of a secondary depressive syndrome within the framework of the underlying condition.

Depressive syndrome has less pronounced manifestations, the cause of these disorders is clearly visible, the manifestation of symptoms is not stable: short “light” and “dark” periods replace each other.

When depression itself is felt by a person as a painful state of loss of strength, lack of interest in life and has a persistent decrease in mood.

Circular depression

A feature of circular depression is daily, seasonal or other variations in mood fluctuations. Patients also describe the world as “dim,” uninteresting, and view it as if through glass. Early awakenings and the inability to sleep force such patients to lie in bed for a long time and think about the worthlessness of their existence and the futility of the future.

Important to remember:

Whatever the nature, depression is a mental disorder that requires qualified help from a psychiatrist.
Under no circumstances should you be allowed to take antidepressants on your own! Only a specialist can understand the painful condition and prescribe the correct comprehensive treatment.

The specialists at the Mental Health Clinic have more than 10 years of experience in treating various types of depression.

For any questions, call us Our phone number

Classification of depression

Perhaps the clearest division of depression into exogenous and endogenous.

Exogenous depression is caused by external factors.

Endogenous depression is the cause of the formation of metabolic disorders occurring in the body.

Exogenous depression

This is a neurotic state against the background of some external cause: a difficult life situation or illness. It happens that it is not possible to track it, but the patient’s explanation that depression decreases on vacation, it is easier in the morning, and the presence of other manifestations of neurosis speak for its psychogenic nature. Another criterion for exogenous depression is the unstable nature of stabilization of the condition from the treatment. As the patients themselves say: “it helps with varying degrees of success.”

Often, the effect of therapy for this disorder depends on subjective factors: disposition to the doctor, pleasant or unpleasant events in life, internal thoughts and the mood of the person himself. It is necessary to take this phenomenon into account and look for possible objective causes: hormonal disorders, taking medications that depress the nervous system, long-term infections, etc. If an examination by a therapist, narcologist and neurologist does not determine organic pathology, then you can safely refuse psychotropic drugs and be treated only with the help of psychotherapy.

Depression due to neurasthenia

Chronic fatigue syndrome or scientifically called neurasthenia: a painful psychological condition. It develops in people who are responsible, serious, and have high moral demands on themselves and others. These comrades pull everything alone “for themselves and for that brother” and eventually run out of steam. A characteristic sign of neurasthenia is severe asthenia (weakness), when there is no longer enough strength not only to help others, but even to take care of one’s basic needs. Often this condition requires hospitalization, at least in a day hospital, and intensive rehabilitation therapy.

Endogenous depression

This is a more complex mental illness within the framework of affective disorders. The reason is a disruption in the production and interaction of neurotransmitters of the central nervous system: serotonin, dopamine, melatonin, GABA and norepinephrine. That is why this form of depression is well treated with drug therapy: antidepressants, antipsychotics, mood stabilizers, anticonvulsants. In this disorder, the changes are so profound that constant chemical adjustments to the brain's imbalanced biochemical system are required.

The risk of developing endogenous depression depends on the psycho-constitutional type of people and is more common in families where there have already been cases of the disease. Although geneticists have not stated a clear genetic predisposition to the disease, a similar family scenario, a tendency to get stuck on a certain emotional tone and the habit of reacting in a certain way to difficult situations creates an additional background for the manifestation of the disease.

Of course, like any other mental illness, it can worsen due to stress and anxiety, but no direct relationship is found. The flow is more stable; already in the morning the patient gets up in a bad mood and only at the end of the day he walks around a little. It is the background of the mood that suffers: from anger to apathy, without admixture of other neurotic manifestations. Sometimes this may be accompanied by so-called depressive delusions with ideas of self-blame, sinfulness, and making imaginary mistakes. There may even be hallucinations with voices of accusation and images of disaster, one's own helplessness and uselessness. Psychosis can also manifest itself in the form of stupor - immobility of the patient with no possibility of contact with him. Even in moments of stable remission, such patients look melancholic, complain of increased fatigue, weakness and the inability to rest enough to start doing everything with full strength.

Larval depression

Larval or masked depression got its name due to the fact that it manifests itself hidden. It is sometimes called hidden or somatized depression. They are very different in flow. Such forms of the disease seem to be hidden under the masks of physical diseases, and have an atypical form of progression. Therefore, after visiting different doctors at the clinic, undergoing a bunch of unnecessary tests and lying in all departments of the hospital, such patients end up in the office of a psychiatrist or psychotherapist with already persistent destructive habits of hiding from life’s crossroads behind the image of a sick person. This condition is treated with intensive neurometabolic therapy, good physical activity and psychotherapy. Typically, somatized depression affects men or women with a reserved character who believe that showing weakness and asking for help is beyond them.

Treatment of depression

As in the treatment of any other neurotic disorder, in the case of depression, an integrated approach is used, including psychotherapeutic and medicinal techniques. If the situation is not advanced, then the chances of avoiding the use of medications are quite high.

Non-drug treatments

Prevention and self-help methods

Awareness, lifestyle and state of a person’s psyche are the components that significantly affect his ability to withstand stress factors and independently prevent the development of such conditions. Depression is often called a disorder of infantilism, to prevent which it is necessary to accept the fact that each of us is responsible for our own condition, and we can choose to be happy or unhappy. As soon as the patient manages to accept responsibility for himself and his condition, depression recedes by itself.

Psychotherapy for depression

The primary task of psychotherapy is to help a person realize that he himself has led himself into depression. One of the popular methods is “drawing”. The patient is asked to draw exactly what his depressed mood looks like (it can be visualized as a closet, a door to nowhere, a black hole and other images). And then decide for himself where he wants to go. Whether he goes into the black hole or not is his choice. A depressed mood essentially does not happen on its own, and it was not the world that led a person to depression - all these realizations are made with the help of a specialist. The next known method is to help the patient maintain social status and everyday activities. The therapist usually works on a program to create automatic actions to return to normal life: get yourself in order, go to the gym, meet friends, cook food. Sometimes the patient cannot and does not want to perform these simple ordinary manipulations, but they trigger physiological processes in the body that contribute to the production of the hormone serotonin and the establishment of chemical processes.

Types of psychotherapy

Cognitive - behavioral
- changing the initial incorrect attitudes that led to destruction.
Interpersonal
– changing the patient’s perception and style of communication with other people. Determines the form of a person’s social participation in society.
Psychodynamic
. Defines intrapersonal conflict as the root cause and is aimed at resolving it by bringing it to the plane of consciousness.

Treatment of depression with folk remedies

At certain unadvanced stages, in addition to psychotherapeutic methods, you can use herbal medicine; it certainly won’t make you worse. Still, the wisdom of centuries does not pass without a trace, and it is worth noting that our ancestors did not particularly suffer from neuroses. Herbal medicine, indeed, offers a large number of natural preparations that have a general strengthening effect on humans.

So, as we have found out, a depressive state is largely caused by disturbances in the functioning of the brain, which requires vitamins, microelements, proteins and amino acids to nourish it. Most of these important substances are found in herbal preparations such as St. John's wort, Chinese lemongrass, chamomile, oregano root, lavender flowers and many others. These herbs can be used in the form of tinctures and decoctions, either individually or in combination. Another excellent remedy is evening soothing baths with the addition of string or myrtle flowers. By the way, many of these products are sold in pharmacies and cosmetic stores in a form ready for use.

Remember that lifestyle and a healthy, balanced diet, including fruits, vegetables and grains, are also an excellent method for preventing stress and depression.

Drug therapy

If all the proposed methods do not have the desired effect or the stage is already quite advanced (major depressive or bipolar disorder), then a course of medications cannot be avoided. Only a specialist can prescribe antidepressant drugs. At a certain stage of leveling, you can stop taking medications, but to get out of the peak, if it has occurred, you need to start with them. In severe cases, medications serve as an auxiliary remedy, but not the main one, this must be remembered.

What medications are prescribed for depression?

Antidepressants

essentially stabilize the content of neurotransmitters in the brain, thereby improving mood. Unlike benzodiazenin tranquilizers (Phenazepam, Relanium, Elenium, Valocordin), antidepressants do not become addictive and do not develop withdrawal symptoms. The most popular today: “Imipramine”, “Anitriptyline”, “Attarax” and many others. There is no point in covering the full spectrum here, since the prescription of a medicine can only be carried out by the attending physician. Taking medications on your own can be extremely dangerous. All medications can cause side effects, and many require restrictions on diet or other medications.

Depression in the context of bipolar disorder

Depression often manifests itself as part of bipolar affective disorder (manic-depressive psychosis).

Most often, with this disorder, people end up in a psychiatric hospital at the time of a manic state, and depression either goes unnoticed or, with the first subtle depressive episode, goes under a different name. And only then, when the stages are repeated, a full and more accurate diagnosis is made.

The manifestation of depression in bipolar disorder has its own characteristics. Firstly, depressive periods here are much longer than manic episodes. Secondly, a decrease in mood after mania is more difficult for patients, because the decline of strength against the backdrop of recovery subjectively seems more depressing. And, thirdly, in its characteristics it resembles endogenous, but it can also have hypomanic inclusions: increased appetite, agitation (excitement with elements of anxiety and motor restlessness) and inadequate fun.

How to get out of depression

Psychologists advise to be attentive to your body, at the first signs of depressive episodes, try to help yourself before visiting a doctor. It is important to follow these rules:

There is no need to avoid a bad state and mood and hate yourself for it. The patient must accept himself as he is at a particular moment. This is a normal phenomenon that occurs under the influence of external and internal factors. Depression must be fought, but this must be done gently, without putting strong pressure on the psyche.
Redirecting focus to another activity. Reading books, riding a bike, going to the gym, swimming, and changing the environment helps a lot. If finances and time allow, you can go on a trip, see many interesting and new places, in this case the apathy often goes away on its own. Perhaps the person simply lacked impressions.
You need to get rid of the fear of losing your positive emotions. Manifestations of joy, euphoria, and pleasure should be enjoyed at the moment they appear, and not constantly replay bygone times in your thoughts.
Communication with new people, interesting contacts. You can go to an exhibition, cinema or theater, meet interesting interlocutors, let others help. There is no need to be afraid of being rejected or not needed; in most cases, such experiments end successfully.
The psychotherapist will recommend meditations that can be used when the first symptoms of depression approach. Such techniques help develop a sense of inner integrity.
Normalization of sleep and rest patterns. An exhausted body needs help first. A full eight-hour sleep helps restore its reserves and promotes inner peace.

Reactive depression

Another severe form of manifestation is reactive depression. This is an acute psychotic disorder against the backdrop of a severely traumatic situation. A person is so shocked by the events that have happened that he literally disconnects from the world and withdraws into himself. Outwardly, he may look either extremely excited, or completely in control, reasonable and even cheerful. But this is only apparent calm. At any moment such a person can break loose and cause trouble. Therefore, in difficult life circumstances, it is better not to leave the patient, especially if his behavior has changed to the opposite. You need to talk to him in a calm tone and give him a herbal sedative. Along with acute depressive symptoms, with this disorder, symptoms of psychosis are also observed: psychomotor agitation, fears, and possibly delusional-hallucinatory symptoms.

Severity of depression

It is incorrect to distinguish stages in depressive disorders, since the development of the clinical picture varies from person to person. The disease can manifest itself acutely or last for a long period with hidden symptoms.

More significant is determining the severity of the disorder by the number of symptoms, severity of symptoms, and level of decline in quality of life. According to ICD-10, depression is classified as:

Mild – 2-3 symptoms that impair social functioning, but the person retains the ability to perform most activities.
Moderate (moderate-severe) – 4 or more manifestations that create significant difficulties in everyday life.
Severe – a full picture of a depressive episode that significantly impairs social and professional functioning. With ideas of worthlessness, suicidal thoughts and actions.

There are some differences with the DSM-5 approaches. Much also depends on the reliability of the diagnostic scales used and the qualifications of the doctor.

Depression in schizophrenia

Depression that accompanies an exacerbation of the disease requires mandatory hospitalization and rapid administration of medications. Usually such states are accompanied by a feeling of universal melancholy and hopelessness. This can be either a reaction to the disease itself or be included in the general structure of delusional ideas.

The depressive state in schizophrenia reaches its apogee with Cotard's syndrome. The patient is in a sad and anxious mood, claims that he is a great criminal and all the troubles in the world are from him. They may believe that they have unusual incurable diseases or even believe that they are “long dead.”

Postschizophrenic depression

These are residual effects after a relapse of schizophrenia, when there are no acute symptoms, but individual ideas, disturbances in thinking and mood remain. Despite the absence of psychosis, due to their greatly reduced mood, such patients can also pose a danger in captivity of suicidal attempts. Therefore, a visit to a psychiatrist and, in some cases, hospitalization are necessary.

Depression due to organic changes in the brain

Depression in organic diseases of the brain: atherosclerosis, dementia, post-traumatic conditions and other diseases of the central nervous system is usually persistent and progressive. Patients are apathetic, sleep a lot, refuse food and any pleasures. They usually don’t complain about anything and rarely ask for help. Relatives of such patients should be especially wary if a family member becomes ill and stops complaining, since they commit suicide just as quietly and unnoticed. It is better to call such a person a psychiatrist at home, and he will prescribe medications that stimulate brain processes in order to at least stir the patient up a little. If it is not possible to observe the patient at home, then it is better to place him in a hospital for this time.

Overcoming depression:

Limit yourself. Don't expect to complete everything you were able to do before. Make a realistic work plan.
Don't give too much importance to all your negative thoughts, such as self-blame or expecting failure. Such thoughts are part of depression. They will disappear as soon as you get rid of depression.
Participate in activities that give you pleasure or give you a feeling of achieving a goal.
Avoid making important decisions while depressed. If you need to make this decision, ask someone you trust to help you.
Avoid drinking alcoholic beverages and drugs. Both make depression worse, and both can interact dangerously with the antidepressants you are taking.
Physical activity appears to cause chemical reactions in the body that improve your mood. Exercising 4 to 6 times a week for at least 30 minutes is an excellent achievement. However, even less activity can be beneficial.
Try not to be disappointed. It takes some time for you to be completely free from depression.

Depression in alcoholism

Alcoholic depression often has a mixed character. There are both personality traits that prevent a person from adequately coping with all life’s difficulties, which creates a certain depressive background and the desire to cope with the situation with the help of alcohol, and the toxic effect of alcohol metabolites causes damage to the cerebral cortex, which is an organic cause of depression in the patient’s mental sphere.

The addict's depression intensifies during alcohol withdrawal syndrome, has a sad and angry character, and can be accompanied by ideas of accusation and delusions of jealousy.

Postpartum depression

This topic requires writing a separate article, and it is on our website. But for a general idea, we will describe the signs of postpartum depression in 2 words.

The physiological and psychological changes in the female body during pregnancy, childbirth and after the birth of a child are so great that failure in these areas is completely justified. Initially existing circumstances: an unwanted or difficult pregnancy, a breakdown in relations with the child’s father, lack of help from loved ones, existing illnesses are unfavorable factors for the development of a depressive state after childbirth.

Such depression manifests itself in a very unusual way and is often interpreted by the patient herself and those around her as fatigue, bad character or moodiness and is in fact a sign of a mental disorder. So, a young mother is annoyed by her child or she loses interest in him. She may be aggressive towards him or overly concerned about his health. Along with this, there are other signs of illness on the face: asthenia, sleep disturbance, anxiety, perversion of appetite, etc.

Seasonal depression

Depression, in itself, is a sun-related disease. No wonder physiotherapists treat her with white light. Some experts distinguish seasonal depression as a separate form. With this type of depression, there is a clear cyclical pattern of symptoms depending on the time of year or weather. Neurophysiologists even explain this by the production of serotonin from the amino acid tryptophan in the sun. In bad weather and at night, serotonin turns into metatonin, which causes drowsiness and calm.

There is practically no mental or physical illness that is not accompanied by depressive syndrome. Another thing is how much this affects a person’s general well-being and whether there is a danger of aggressive actions towards oneself. If you can no longer cope with your mood or have heard from a loved one thoughts about wanting to die, this is a sufficient sign to run to a psychiatrist.

What is psychotherapy?

During a psychotherapy session, you discuss with your family doctor, psychotherapist or psychiatrist certain events that are happening in your life. The emphasis may be on your feelings, hopes or relationships. You can also focus on your behavior, how it affects you, and what you can change about it. A course of psychotherapy usually lasts from 8 to 20 sessions.

Will I have to go to the hospital?

Depression is usually treated without hospitalization. Inpatient treatment is required if you have comorbidities that may interfere with treatment or if you are at risk of suicide.

How long does depression last?

It depends on how soon you receive qualified help. Left untreated, depression can last for weeks, months, or even years. The main danger of untreated depression is suicide. Treatment can help relieve depression in 6 to 8 weeks or less.

Signs

Symptoms of depression largely depend on the form of the disease in which depression occurs. The modern classification of diseases does not consider the severity of depression, but many doctors continue to divide it into different levels of symptom severity. This allows you to accurately assess the patient’s condition and determine the form of treatment for the disease. The insignificant severity of depressive symptoms allows it to be treated on an outpatient basis, in a clinic. Moderate depression requires the use of antidepressants and many other medications. And its severe course must be treated only in a psychiatric hospital, resorting to injectable forms of medications and constant supervision of medical personnel.

Despite the variety of symptoms of depression, there are basic criteria that allow us to talk about the presence of this mental condition.

constant and long-term decrease in mood;
anxiety, restlessness, irritable weakness;
narrowing the range of interests and level of aspirations;
lack of feeling of satisfaction from usual activities;
persistent insomnia, with a long time to fall asleep, early awakening and daytime sleepiness;
tearfulness, increased sensitivity and sentimentality;
reduction of the body's defenses, literally and figuratively;
increased fatigue and constant fatigue;
decreased self-esteem;
problems with memory and concentration;
Chronic diseases may worsen, colds and allergic manifestations may be tormented;
poor appetite and weight loss;
There are pains of a functional nature that are not confirmed by an objective examination.

Diagnostics

Numerous psychological tests popular among the population do not reflect the true picture of depression and the variety of its forms. They play only a supporting role in tracking the dynamics of the disease.

Tests for depression

These are: Beck Melancholy Scale, visual and drawing tests for depression, SKL-90, DEPS.

There are no instrumental or laboratory instrumental parameters yet to determine the reduced background mood. An attempt to link the blood concentrations of the main neurotransmitters: serotonin and dopamine with the clinical picture of depression was unsuccessful. The fact is that our brain is well protected from other body systems by the blood-brain barrier, where the content of these biologically active substances is completely different than in the blood. But it’s not worth getting into your head with rough tools.

The diagnosis of depression is made exclusively by a psychiatrist during a face-to-face appointment. The doctor relies on his experience and knowledge of the disease, and also uses professional intuition.

For differential diagnosis and determination of the form of depression, the doctor may prescribe consultations with other specialists: a neurologist, narcologist, endocrinologist and therapist. Laboratory tests for signs of chronic inflammation, autoimmune complexes and hormonal levels also help to exclude the secondary nature of depression. If an organic pathology of the brain is suspected, a neurologist can conduct instrumental diagnostics: EEG, MRI or CT.

Depression symptoms

For each person, signs of depression can manifest themselves differently, it all depends on the stage and form of the pathology. Symptoms occur at different levels, affecting all aspects of the emotional sphere and behavioral reactions of the patient.

Emotional manifestation:

deep depression is accompanied by a loss of the ability to experience simple human feelings (anger, joy, surprise, fear);
there is no interest in surrounding events and people;
those activities that previously evoked pleasant emotions are of no interest to the patient at all;
a person is dissatisfied with himself, his appearance;
lack of self-confidence, low self-esteem;
constant feeling of guilt, even if the objective reason for this is not determined;
the patient often blames himself for everything, without necessarily saying it out loud;
increased irritability, nervousness;
depressed and depressed mood;
often falls into despair;
the patient is characterized by melancholy and suffering;
the feeling of internal tension increases;
a subconscious expectation of trouble arises;
increased anxiety even in the absence of any reason.

Fears about the health of loved ones are constantly present in depressed patients. They understand that they cannot do or change anything in this situation. Anxiety is also associated with fears of appearing stupid or ineffective in the eyes of the public. Going to a psychiatric clinic is the first step on the path to recovery.

The manifestation of the disease at the physical level is expressed in the following:

sleep disturbance (constant daytime sleepiness or insomnia);
complete loss of appetite or uncontrolled eating;
decreased libido, sexual needs cease to interest the patient;
disruption of the functioning of the gastrointestinal tract (constipation or diarrhea);
increased fatigue and chronic fatigue;
decreased energy level, exhaustion, feeling of lack of strength.

Even with ordinary physical or intellectual stress, general weakness of the body, unpleasant sensations in the body and pain of varying intensity occur.

Behavioral symptoms of depression:

it is impossible to involve a person in any activity that involves the implementation of a certain algorithm of actions;
he refuses entertainment;
There is a tendency towards solitude and avoidance of social contacts.

A depressed state can change the intensity of cognitive processes:

there are difficulties when trying to concentrate on any subject;
concentration suffers;
the patient experiences problems if he needs to make some decision and cannot rationally “weigh” the risks;
he constantly doubts whether he is doing the right thing, turning over the situation in his head, and in the end he never comes to a definite opinion;
constantly thinks about his own helplessness, insignificance for others;
thinking is slow, which is very noticeable to others;
in severe cases, thoughts of suicide occur, and the likelihood of committing it is high.

If there are two or more symptoms from this list, and they are observed in the patient for 2 weeks or more, the doctor may diagnose depression. The selection of effective treatment depends on which type of disorder the patient has:

Dysthymia.

This is a mild variant of the disease, which begins in adolescence and is formed against the background of intrapersonal conflicts, problems with parents, and constantly changing hormonal levels. People around him believe that this is a manifestation of a difficult character; such a person is called a melancholic or a pessimist.

Depressive episode.

This condition arose in the patient for the first time in his life; it did not have time to develop into a severe form. A short-term but memorable case of total sadness, exhaustion, lack of interest in everything that was happening.

Bipolar affective disorder.

Characterized by alternating moments of bad mood and pathological joy, the patient’s life is constantly between these two poles. He seems to float on the waves of mood, constantly moving from one peak of emotions to another.

Recurrent depressive disorder.

These episodes recur every few years, after which they may go away on their own. The pathology must be treated in a psychiatric center for a long time with the help of psychotherapy and periodic courses of medications.

Help for depression

When the diagnosis is established and the presence of a depressive episode is identified, the form of assistance to the patient is individually selected. A complex and interesting stage of therapy begins. It is complicated because it makes no sense to treat depressive syndrome separately from the underlying disease. And it’s interesting because sometimes alternative medicine methods can stabilize a patient’s mood no worse than the most modern antidepressants. Depression is a mental state that responds gratefully to any concern for a person.

This can be explained by the location of the feeling of “grief” on the emotional tone scale. Below it is “apathy”, and above it is the tone of “sympathy”. Those. all crying people need sympathy and empathy. If a person has already fallen into apathy and does not care about himself, then physical influence must be added to emotional care. Physiotherapy, baths, showers, massages can bring such a patient back to life. And if the patient cried and began to complain about his life, then this is already good, because... he has gained some energy and is able to ask for help.

So, if this is psychogenic depression, then it should be treated exclusively with psychotherapy. Taking even the most modern SSRI antidepressants is secondary here and will only bring temporary relief. Symptoms of depression will dull, but the thoughts that cause them will continue to rattle your soul and body. The fact is that our brain doesn’t care whether a scary and sad event is happening in reality or the scene is unfolding inside a person’s head. In both cases, he will react equally emotionally. This property can also be used to work with emotions. If you make it a habit to focus on the pleasant and useful events that happened during the day, then over time it will become much easier for you.

Psychotherapy for depression

Of course, this is more of an emergency therapy, and neurotic depression itself has its roots far back in the generation of our parents, and often the condition can only be dealt with through an in-depth study of existing life scenarios. Look for a psychotherapist who puts internal psychological work on yourself at the forefront of treating depression. Whether it is cognitive behavioral therapy, client-centered counseling or systemic family psychotherapy does not matter. The main thing is that the specialist and the method suited you. Gestalt therapy is also good at working through problems that are stuck on the emotional level. The main thing is to take a step forward and ask for help. “The hen pecks at the grain” is an important approach in the treatment of depression.

Psychotherapy for endogenous depression also plays a very important role in maintaining a stable mental state of the patient. A person learns to react more calmly to the cyclical nature of mood swings: not to be deluded during manias and not to despair when the emotional background drops. He begins to understand and accept the peculiarities of the structure of his psyche and adjust his life plans taking into account these fluctuations.

Medicines for depression

For any type of depression, a psychiatrist or psychotherapist may suggest taking medications. Psychological work on yourself requires strength, and for this you need to at least slightly balance your emotional state. Especially if it is depression as part of endogenous mental illnesses or it is accompanied by general asthenia, fatigue, sleep disturbance and mood instability.

How to treat severe depression

The first thing to do when you notice pronounced symptoms of the disorder is to consult a specialist. An important function in overcoming this syndrome is played by the patient’s relatives and friends, who are able to show understanding, provide support and assistance in maintaining everyday social stability. Unfortunately, it is impossible to overcome this disease without inter-drug therapy. The specialist will definitely prescribe a course of antidepressants, and if the situation is aggravated by endogenous factors (family situation), then mood stabilizers will be used in order to increase efficiency and create a preventive effect.

Predictions for success

With properly selected therapy and support from those closest to you, the chances of a complete recovery in the “here and now” are quite high. With the help of specialists, depression, even a pronounced syndrome, can be overcome without any global consequences. The sad news is that no temporary therapy is guaranteed to prevent relapse.

Antidepressants

Amitriptyline, a tricyclic antidepressant with a pronounced sedative (calming) effect, remains a powerful and fast-acting drug for depression. It is convenient in that it can also be used by injection in the form of droppers and injections.

Also included in the group of tricyclic antidepressants are imipramine, doxepin, mianserin, trazodone and lofepramine. They are usually well tolerated, have a pronounced therapeutic effect, and doctors have accumulated experience in their use for various mental conditions.

There is a separate class of tetracyclic antidepressants. They differ somewhat in action. Thus, lerivon has a longer duration of action and a good hypnotic effect.

The second popular group of antidepressants are MAO inhibitors (monoamine oxidase). This large group of drugs, unfortunately, has become less widespread due to more pronounced side effects, elimination through the liver in almost 100% form, unwanted interactions with other medications and a special diet that excludes the consumption of cheese, liver and alcohol. But moclobemide can be prescribed as the medicine of choice, imipramine can be prescribed for senile (senile) depression, selegiline is used for Parkinson’s disease. They have a good stimulating effect and can activate an elderly patient. Iprazide is a selective representative of this group with a powerful antidepressant effect. But now it is rarely used due to possible undesirable effects and long-term presence in the patient’s body.

SSRIs for depression

Selective serotonin reuptake inhibitors are the latest generation antidepressants. They have good anti-anxiety properties, stabilize mood and almost do not cause drowsiness. Most drugs in this group are well tolerated, there is a large selection of drugs - you can choose a drug for each patient: fluoxetine, escitalopram, paroxetine, sertraline and many others. The mechanism of antidepressant action is based on blocking the uptake of serotonin in the chain of transmission from the nerve to the blood. Thus, it is preserved in a free form and replenishes the deficiency of serotonin in the body. Some representatives of this class have the same effect in relation to dopamine and norepinephrine, which also has a beneficial effect on maintaining mental balance under stress, when the amount of these mediators rapidly decreases.

Antidepressants are now the most popular medications for a wide variety of mental and physical illnesses. They are able to relieve certain types of pain (for example, migraine). They are often prescribed for psychosomatic diseases: hypertension, gastric ulcer, irritable bowel syndrome. Treatment of fears, anxiety, obsessive-compulsive disorder, anorexia/bulimia and many other diseases occurs with the addition of an antidepressant to the drug regimen.

In view of this, people taking antidepressants have many questions about their use. Let's try to answer at least some of them.

Depression in women

There are several factors that lead to the development of depression in women. Among them are the following categories:

Biological

The disorder develops slowly and gradually under the influence of changes in the body. Increased nervous excitability, decreased levels of norepinephrine or serotonin, and hormonal imbalance lead to pathology. The situation is aggravated if the body lacks vitamins, microelements and other useful substances.

Social

This group of factors is associated with frequent stress, bad habits, polluted environment, increased physical and emotional activity. The female body is weaker than the male; it is not able to withstand such loads for a long time. The psyche is depleted, various unfavorable states arise, including depressive ones.

Interpersonal relationships

Psychotraumatic events that occur in a woman's life can cause this disorder. Among them are:

death of a loved one;
long-term separation or complete breakup of relationships;
lack of understanding on the part of relatives;
constant dissatisfaction with your appearance, excess weight or physical characteristics;
professional dissatisfaction.

The combination of these factors threatens an increase in symptoms and a gradual deterioration in a woman’s health.

The lack of joy in life radically changes the patient’s character; he becomes melancholic, constantly dissatisfied with himself and his loved ones, and makes complaints about everyone, even if there is no reason for this.

How to take antidepressants

Typically, antidepressants are prescribed for at least 4-6 months. There are some acute conditions (for example, post-traumatic stress disorder, reactive states) when they can be prescribed in a shorter course, along with other longer-term medications. For some depressions, they can be taken for years or even a lifetime. But this does not mean that once prescribed treatment does not require correction. If you take an antidepressant for a long time, you need to undergo regular examinations with your treating psychiatrist, therapist and endocrinologist to assess the effect of therapy and prevent side effects of the drug.

Why antidepressants don't help

Antidepressants are medications that do not work immediately. It takes at least 2-4 weeks for the drug to reach its full potential. If there is no improvement in the condition within 1.5 - 2 months of taking the medication, then you need to change the tactics of therapy. The arsenal of antidepressant drugs is very wide and you can find an approach to almost any patient. Keep in touch with your psychiatrist and let him know how you are feeling. Then the treatment will be more successful.

They prescribed me an antidepressant, I can’t tolerate it well

An antidepressant, like any other medicine, changes the chemical structure of your body. Therefore, the body needs time to get used to the drug. Usually these phenomena disappear by the end of 2-3 weeks of use. If after this time you continue to feel unwell, contact a psychiatrist in person.

While taking an antidepressant, anxiety increased and sleep was disturbed

An antidepressant is a drug with a stimulating effect on the central nervous system. Therefore, such an effect may well exist. If these phenomena are very pronounced, then you need to take the medicine under the cover of another group of drugs for the first time. Most antidepressants are taken in the morning and afternoon. Evening and nighttime intake may cause anxiety and insomnia. Follow your doctor's recommendations strictly.

In addition, some patients are prescribed antidepressants with a pronounced calming effect. Such drugs, on the contrary, are taken half an hour before bedtime and promote calm and sleep.

Is it possible to take 2 antidepressants at the same time?

Yes, sometimes doctors prescribe two antidepressants from different groups at once to create a combined effect. In this case, the doctor monitors your condition more clearly and the possible occurrence of side effects; at the same time, you cannot combine antidepressants from the group of MAO inhibitors.

How to Avoid Withdrawal Syndrome

Antidepressants from any chemical group do not have withdrawal symptoms. These are not drugs, sleeping pills or tranquilizers, the uncontrolled use of which can cause such a phenomenon. The antidepressant can be discontinued immediately, but it is better to do this gradually so as not to provoke a return of the previous symptoms. They go off the antidepressant according to the regimen suggested by the treating psychiatrist. And only on the recommendation of a doctor.

I'm getting tested by a narcologist. Will the antidepressant I am taking be detected? How long does it take for the body to clear the antidepressant?

Typically, narcologists determine the presence of alcohol, major drugs and sleeping pills in the body. But in some cases, testing for other groups of drugs can be carried out. The medicine may also give a false positive reaction to rapid tests. Therefore, you need to warn your narcologist that you are taking medications. And it’s better to bring prescriptions from a doctor or an extract from an outpatient card. Then there will be no problems at the appointment with the narcologist.

Stages of depression

Like many psychopathic conditions, depression has certain stages of development.

The first stage is called denial, and at this stage the person continues to live a normal life, as if nothing had happened. For example, in the event of the loss of a loved one, in denial it is common to talk about them in the present tense, to keep their things and photographs, as if this person is about to return. In general, the patient is unable to accept reality due to the activation of compensatory mental mechanisms.
At the second stage, along with the understanding that it is pointless to deny what happened, feelings of resentment and anger come. Often, the patient begins to look for those to blame for what happened and throw out his negative emotions on them.
The third stage is called “bargaining,” at which the negativity is dulled, and the person begins to look for ways to get out of this state, listens to loved ones, and goes to a specialist if necessary. In general, they are trying to correct the situation.
And only at the fourth stage does “depression” itself come, as it is. This is the most dangerous period, because in it a person begins to fully understand the situation and falls into despair, called depression. The pain during this period is felt in full force.
The final stage is acceptance, at which comes the realization that the past must be left in the past. Many begin to look at their lives and loved ones in a new way, finding solace in family or work. Having gone through all the previous stages, a person accepts life as it is, realizing that fighting what cannot be corrected is pointless.

Other drugs for depression

To treat depressive disorders, medications from a variety of psychopharmacotherapy groups can be used. Thus, mood stabilizers are used to treat bipolar affective disorder; for alcoholic depression, doctors often prescribe anticonvulsants; nootropic drugs can be added to the treatment of organic and senile depression. In addition, restoration of the nervous system often requires the use of B vitamins, essential amino acids and anti-anxiety drugs. It all depends on the type of depression and concomitant diseases.

Acupuncture for depression

Depression is responsive to many types of therapy. Neurological reflexologists widely use acupuncture and other types of acupuncture to treat this type of disorder. But you need to be patient to complete the full course of procedures and constantly inform the reflexologist about your current health.

Physiotherapy for depression

Color therapy is most suitable for depressed patients. Everyone knows the Luscher test for actual emotion. So, this procedure is capable, using colors of certain tones, to change a person’s sensory state.

Light therapy - white light around: walls, linen, tiles can actively reflect ultraviolet and infrared rays of the sun. The patient is placed in such a room and spends some time there. This may be accompanied by aromatherapy with brain-activating scents and music therapy. The effect of this procedure is noticeable immediately - a smile on your face and a light head.

For a long time in Rus', the blues were banished by using a broom in the steam room and diving into an ice hole. Therapeutic baths, showers and saunas help restore a person’s taste for life.

Massage for depression

Depending on the condition, an experienced rehabilitation therapist influences the reflex zones with different strengths. A course of massage accelerates the blood, stimulates the brain indirectly through the active zones of the body, and returns the body to its former tone and elasticity.

Depression test

The psychological tools that psychiatrists, psychologists and psychotherapists use in their work have certain specifics. These can be tests, questionnaires, questionnaires, projective techniques. The difficulty lies in the correct interpretation of the material received from the patient.

It is strictly not recommended for patients to use their own intuition and information on the Internet. The patient may misdiagnose himself and prescribe medications that are not required in his case.

Moreover, most tranquilizers, antidepressants and other strong drugs are available only with a doctor's prescription. The use of dubious remedies will not only not help, but will also aggravate the situation and increase the level of intensity of symptoms.

In addition to tests, Dr. Isaev’s clinic performs diagnostics using modern equipment, which can be used to determine the presence of concomitant diseases. In some cases, treatment must begin with them, since such pathologies complicate the clinical picture.

Clinical depression

well described for major depressive disorder. The latter is characterized by three main features:

a decrease in mood that occurs without an external reason - hypothymia;
inhibition of intellectual activity - bradyphrenia;
weakening of the urge to activity, decreased activity, motor retardation, stupor - hypobulia.

When a person is depressed, he is in a constant struggle with utter despair - as if crawling along a long endless black corridor in complete darkness: forgotten by everyone, without meaning, light, feelings and hopes.

Diagnostics

As mentioned earlier, one of the difficulties in diagnosing depression is separating its symptoms from signs of various psychosomatic diseases. It is also necessary to determine the form of depressive disorder and separate it from the symptoms of other mental illnesses in order to correctly determine the treatment strategy. Diagnosis begins with the study of the “depressive triad”:

Motor retardation is detected in slowness, which can reach stupor and stiffness of movements. Slowness of thinking and speech is manifested in difficulty comprehending events happening around, difficulty in making decisions, and the virtual absence of spontaneous speech. These signs are usually observed with ideomotor retardation. Decreased mood during depression is long-lasting. Under normal conditions, melancholy and depression go away when the source of stress is eliminated. This does not happen with depression.

Diagnosis usually includes a conversation with the patient, the use of various tests and questionnaires. They allow you to identify the presence of depression in general and assess the severity of its various symptoms, such as anxiety or anhedonia (a decrease or loss of the ability to experience pleasure). A comprehensive clinical assessment of depression is performed. Also, to exclude somatic (physical) causes of the disease, additional tests may be prescribed. For example, it is important to evaluate the functioning of the thyroid gland, which is often associated with mood disorders.

You can complete the first part of the diagnosis yourself - fill out the Zung scale and find out how severe your depression is.

Find out how severe your depression is by completing the Zung scale (20 questions, 10 min.)

Myth #7: “Are you depressed? Go work!”

With exactly the same success, one can advise a person with diabetes to go unload a wagon of bricks.

Is so-called “occupational therapy” necessary at all? Yes, it is needed by workers in hospitals, boarding schools and rehabilitation centers who force people with depression or alcoholism to dig up beds, clean wards or help prepare food.

At the same time, patients often also pay money for this, and considerable money at that. This takes the workload off the staff, which I think is well settled.

In my opinion, occupational therapy cannot help people suffering from depression or alcoholism. Among my patients with depression or alcohol addiction, many are real workaholics.

There is also such a problem as doctors being predisposed to depression. It is explained by the fact that people in this profession work a lot and hard, they have a high level of responsibility and stress, and they experience a lack of approval from others. Any mistake will result in a scolding from the chief physician, and in a difficult situation he may not support his subordinate. And if a doctor works at one and a half or two rates, which often happens, he cannot be called a slacker. He doesn't need occupational therapy; he works too much without it. One of the recent American scientific papers reports the results of a survey of young medical trainees for the period from 1963 to 2015. And every third young doctor who is still learning his profession shows signs of depression.