Depression is a mental disorder, which is characterized by a depressive triad, which includes a decrease in mood, a disturbance in thinking (a pessimistic view of everything that is happening, a loss of the ability to feel joy, negative judgments), and motor retardation.
Depression is accompanied by reduced self-esteem, loss of taste for life, as well as interest in habitual activities. In some cases, a person experiencing a depressive state begins to abuse alcohol, as well as other available psychotropic substances.
Depression, as a mental disorder, manifests as a pathological affect. The disease itself is perceived by people and patients as a manifestation of laziness and bad character, as well as selfishness and pessimism. It should be borne in mind that the depressive state is not only a bad mood, but often a psychosomatic illness that requires the intervention of specialists. The sooner an accurate diagnosis is established and treatment is initiated, the more likely it is to succeed in recovery.
Manifestations of depression are effectively treatable, despite the fact that the disease is very common among people of all ages. According to statistics, 10% of people who have reached the age of 40 suffer from depressive disorders, two thirds of them are women. People over 65 are worried about mental illness three times more often. Among adolescents and children, 5% suffer from depressive conditions, and adolescence accounts for 15 to 40% of the number of young people with a high incidence of suicides.
It is a mistake to believe that the disease refers to the common only in our time. Many famous doctors from antiquity studied and described this ailment. In his works, Hippocrates gave a description of melancholy, very close to a depressive state. For the treatment of the disease, he recommended opium tincture, cleansing enemas, long warm baths, massage, fun, drinking mineral water from the sources of Crete rich in bromine and lithium. Hippocrates also noted the effect of weather and seasonality on the occurrence of depressive conditions in many patients, as well as improvement after sleepless nights. Subsequently, this method was called sleep deprivation.
There are many reasons that can lead to the occurrence of the disease. These include dramatic experiences associated with losses (a loved one, social status, a certain status in society, work). In this case, a reactive depression occurs, which occurs as a reaction to an event, a situation from an external life.
Causes of depression may manifest themselves in stressful situations (nervous breakdown) caused by physiological or psychosocial factors. In this case, the social cause of the disease is associated with a high rate of life, high competitiveness, increased levels of stress, uncertainty about the future, social instability, and difficult economic conditions. Modern society cultivates, and therefore imposes, a number of values that condemn humanity to constant discontent with itself. This is the cult of physical as well as personal perfection, the cult of personal well-being and strength. Because of this, people are experiencing hard, begin to hide personal problems, as well as failures. If the psychological and somatic causes of depression do not reveal themselves, then endogenous depression is manifested.
Causes of depression are also associated with a lack of biogenic amines, which include serotonin, norepinephrine, and dopamine.
Causes may be triggered by sunshineless weather, darkened rooms. Thus, seasonal depression manifests itself, which manifests itself in autumn and winter.
Causes of depression can manifest themselves as a result of the side effects of drugs (benzodiazepines, corticosteroids). Often this condition disappears on its own after the withdrawal of the drug taken.
The depressive state caused by taking neuroleptics can last up to 1.5 years with a vital character. In some cases, the reasons lie in the abuse of sedatives, as well as sleeping drugs, cocaine, alcohol, and psychostimulants.
Causes of depression can be triggered by somatic illnesses (Alzheimer’s disease, influenza, traumatic brain injury, atherosclerosis of the arteries of the brain).
Researchers in all countries of the world note that depression in our time exists along with cardiovascular diseases and is a common ailment. Millions of people suffer from this disease. All manifestations of depression are different and are modified by the form of the disease.
Signs of depression are the most common. These are emotional, physiological, behavioral, mental.
Emotional signs of depression include anguish, suffering, despair; depressed, depressed mood; anxiety, feeling of internal tension, irritability, expectation of misfortune, feeling of guilt, self-accusation, dissatisfaction with oneself, loss of self-esteem and confidence, loss of ability to experience, anxiety for loved ones.
Physiological signs include a change in appetite, a decrease in intimate needs and energy, disturbed sleep and intestinal functions – constipation, weakness, fatigue during physical as well as intellectual stress, pain in the body (in the heart, in the muscles, in the stomach).
Behavioral signs include refusal to engage in purposeful activity, passivity, loss of interest in other people, propensity for frequent solitude, refusal from entertainment, use of alcohol and psychotropic substances.
Thoughtful signs of depression include difficulty concentrating, concentrating, making decisions, slow thinking, the prevalence of dark and negative thoughts, a pessimistic view of the future with a lack of perspective and thought about the meaninglessness of one’s existence, attempted suicide, because of its uselessness, helplessness, insignificance .
All the symptoms of depression, according to ICD-10, were divided into typical (major) and additional. Depression is diagnosed when there are two main symptoms and three are additional.
Typical (main) symptoms of depression are:
– depressed mood, which does not depend on external circumstances, lasting from two weeks or more;
– Persistent fatigue during the month;
– anhedonia, which is manifested in the loss of interest from previously enjoyable activity.
Additional symptoms of the disease:
– a sense of worthlessness, anxiety, guilt or fear;
– inability to make decisions and focus;
– thoughts of death or suicide;
– reduced or increased appetite;
– sleep disorders, manifested in insomnia or peresypani.
The diagnosis of depression is made when the duration of the symptoms, starting with a two-week period. However, the diagnosis is established with a shorter period with severe symptoms.
With regard to child depression, then according to statistics, it is much less common than adult.
Symptoms of childhood depression: loss of appetite, nightmares, problems at school on academic performance, the emergence of aggressiveness, alienation.
Unipolar depressions are distinguished, which are characterized by the preservation of mood within the lower pole, as well as bipolar depressions, accompanied by bipolar affective disorder with manic or mixed affective episodes. Depressive states of minor severity can occur during cyclothymia.
Such forms of unipolar depression are distinguished: clinical depression or major depressive disorder; resistant depression; minor depression; atypical depression; postnatal (postpartum) depression; recurrent transient (autumn) depression; dysthymia.
It is often possible to find an expression in the medical sources, such as vital depression, which means the vital nature of the disease, with anxiety and anxiety, felt by the patient on the physical level. For example, melancholy is felt in the region of the solar plexus.
It is believed that the vital depression develops cyclically and does not arise from external influences, but without cause and inexplicable for the patient himself. Such a course is characteristic of bipolar or endogenous depression.
In the narrow sense of the vital is called melancholy depression, in which melancholy and despair manifest.
These types of diseases, despite their severity, are favorable, as they are successfully treatable with antidepressants.
Vital depressions are also considered to be depressive states with cyclothymia with manifestations of pessimism, melancholia, despondency, depression, dependence on the circadian rhythm.
The depressive condition is initially accompanied by weakly expressed signals, manifested in problems with sleep, refusal to perform duties, and irritability. If symptoms increase in two weeks, depression develops or it recurs, but it fully manifests itself in two (or later) months. There are one-time bouts. If left untreated, depression can lead to suicide attempts, rejection of many vital functions, alienation, disintegration of the family.
Depression in Neurology and Neurosurgery
In the case of localization of the tumor in the right hemisphere of the temporal lobe, there is a dreary depression with motor slowness and lethargy.
Sad depression can be combined with olfactory as well as vegetative disturbances and taste hallucinations. Those who are sick are very critical of their condition, they are seriously going through their illness. People suffering from this condition have lowered self-esteem, their voice is quiet, they are in a depressed state, their speech speed is slow, patients quickly tire, talk with pauses, complain of memory loss, but accurately reproduce events as well as dates.
The localization of the pathological process in the left temporal lobe is characterized by the following depressive states: anxiety, irritability, motor restlessness, tearfulness.
Symptoms of anxiety depression are combined with aphasic disorders, as well as delusional hypochondriacal ideas with verbal auditory hallucinations. The diseased constantly change their position, sit down, rise, and rise again; look around, sigh, gaze into the faces of the interlocutors. Patients talk about their fears of foreboding troubles, can not arbitrarily relax, have a bad dream.
Depression with traumatic brain injury
When a traumatic brain injury occurs, a depressing depression occurs, characterized by delayed speech, an impaired speech rate, attention, and the appearance of asthenia.
When a moderate craniocerebral injury occurs, anxious depression occurs, which is characterized by motor anxiety, anxious statements, sighs, throwing around.
When bruises of the frontal frontal brain regions, apathetic depression occurs, which is characterized by the presence of indifference with a touch of sadness. Patients are characterized by passivity, monotony, loss of interest in others, and in themselves. They look indifferent, lethargic, hypomimic, indifferent.
Concussion of the brain in the acute period is characterized by hypotension (steady decline in mood). Often, 36% of patients in the acute period have an alarming subdepression, and asthenic subdepression in 11% of people.
Early detection of cases of disease makes it difficult for patients to keep silent about the onset of symptoms, since most people are afraid of prescribing anti-depressants and side effects from them. Some patients mistakenly believe that it is necessary to control emotions and not to transfer them onto the shoulders of the doctor. Individuals fear that information about their condition will be leaked to work, others are terribly afraid of being referred for counseling or treatment to a psychotherapist, as well as to a psychiatrist.
Diagnosis of depression includes tests for the identification of symptoms: anxiety, anhedonia (loss of life pleasure), suicidal tendencies.
Scientific studies have psychological factors that help stop subdepressive states. To do this, you need to remove negative thinking, stop dwelling on negative moments in life and begin to see good things in the future. It is important to change the tone of family communication to a benevolent one, without critical condemnations and conflict. Maintain and build warm, trusting contacts that will be your emotional support.
Not every patient needs to be hospitalized, effective treatment is carried out on an outpatient basis. The main directions of therapy in treatment are psychotherapy, pharmacotherapy, social therapy.
A prerequisite for the effectiveness of treatment is noted cooperation and confidence in the doctor. It is important to strictly observe the prescription of the treatment regimen, regularly visit the doctor, give a detailed account of your condition.
It is better to entrust treatment of depression to a specialist, we recommend professionals from the mental health clinic “Alliance” (//
It is important to support the immediate environment for a speedy recovery, but you can not dive into depression with the patient. Explain to the patient that depression is only an emotional state that will pass with time. Avoid criticism of patients, engage them in useful activities. With a protracted course, spontaneous recovery occurs very rarely and as a percentage is up to 10% of all cases, with a very high return to a depressive state.
Pharmacotherapy includes treatment with antidepressants, which are prescribed for a stimulating effect. Imipramine, Clomipramine, Tsipramil, Paroxetine, Fluoxetine are prescribed in the treatment of melancholy, deep or apathetic depression. In the treatment of subpsychotic states, Pirazidol and Desipramine are prescribed, which remove anxiety.
Anxiety depressed with sullen irritability and constant anxiety are treated with antidepressants of sedative action. A pronounced anxious depression with suicidal intentions and thoughts is treated with Amitriptyline. Insignificant depression with anxiety is treated by Ludiomil, Azefen.
In case of poor tolerance of antidepressants, as well as with high blood pressure, Coaxil is recommended. For mild as well as moderate depressive conditions, herbal preparations are used, for example, Hypericin. All antidepressants have a very complex chemical composition and therefore act in different ways. On the background of their intake, the feeling of fear is weakened, the loss of serotonin is prevented.
Antidepressants are prescribed directly by the doctor and they are not recommended to be taken alone. The effect of many antidepressants appears two weeks after administration, their dosage for the patient is determined individually.
After the cessation of symptoms of the disease, the drug should be taken from 4 to 6 months, and on the recommendations of a few years to avoid relapse, as well as withdrawal syndrome. Incorrect selection of antidepressants can cause deterioration. Combination of two antidepressants, as well as a potentiation strategy, including the addition of another substance (lithium, thyroid hormones, anticonvulsants, estrogens, Buspirone, Pindolol, folic acid, etc.) can be effective in treatment. Research in the treatment of affective disorders Lithium has shown that the number of suicides is reduced.
Psychotherapy in the treatment of depressive disorders has successfully established itself in combination with psychotropic drugs. For patients with a mild as well as moderate depressive state, psychotherapy is effective for psychosocial as well as intrapersonal, interpersonal problems and associated disorders.
Behavioral psychotherapy teaches patients to perform pleasant activities and eliminate unpleasant as well as painful ones. Cognitive psychotherapy is combined with behavioral techniques that identify cognitive distortions of a depressive nature, as well as thoughts that are too pessimistic and painful, which impede useful activity.
Interpersonal psychotherapy refers to depression as a medical disease. Her goal is to teach patients social skills, as well as the ability to control mood. Researchers have noted the same efficacy in interpersonal psychotherapy, as well as in cognitive versus pharmacotherapy.
Interpersonal therapy as well as cognitive-behavioral therapy provide prevention of relapse after an acute period. After the use of cognitive therapy, patients with depression are much less likely to experience recurrences of the disorder than after the use of antidepressants and resistance to a decrease in tryptophan, which precedes serotonin, is observed. However, on the other hand, the effectiveness of psychoanalysis itself does not significantly exceed the effectiveness of drug treatment.
In the treatment of depression, physical activity is recommended, which is effective for mild or moderate manifestations of the disease, as well as instead of psychotropic or in combination with them.
Treatment of depression is also carried out by acupuncture, music therapy, hypnotherapy, art therapy, meditation, aromatherapy, magnetic therapy. These auxiliary methods should be combined with rational pharmacotherapy. An effective treatment for all types of depression is light therapy. It is used in seasonal depression. The duration of treatment includes from half an hour to one hour, preferably in the morning. In addition to artificial lighting, it is possible to use natural sunlight at the moment of sunrise.
In severe, prolonged and resistant depressive states, electroconvulsive therapy is used. Its purpose is to cause regulated seizures that occur by passing an electric current through the brain for 2 seconds. In the process of chemical changes in the brain, substances that boost mood are released. The procedure is performed using anesthesia. In addition, to avoid injury, the patient receives funds that relax the muscles. The recommended number of sessions is 6-10. Negative moments – this is a temporary loss of memory, as well as orientation. Studies have shown that this method is 90% effective.
A non-drug method of treating depression with apathy is sleep deprivation. Full sleep deprivation is characterized by spending no sleep all night and the next day.
Deprivation of a partial night sleep includes awakening the patient between the 1st and 2nd hour of the night, and then waking until the end of the day. However, it was noted that after a single procedure of sleep deprivation, there are relapses after the establishment of normal sleep.
The end of the 1990s – the beginning of the 2000s was marked by new approaches to therapy. These include transcranial magnetic stimulation of the vagus nerve, deep brain stimulation, and magneto-convulsive therapy.