What is depression? What are the signs of depression? Find out from this article!
What you should know about depression?
Depression - a disease of our time
Studies worldwide show that depression, like cardiovascular disease, it is the most common disease of our time. It is a common disorder that affects millions of people. According to various researchers, it affects up to 20% of the population of developed countries.
Depression - a serious disease that dramatically reduces the ability to work and brings suffering to both the patient and his relatives. Unfortunately, very few people are aware of the typical manifestations and consequences of depression, so many patients are assisted, when the state takes a long and severe, and sometimes - and is not. In almost all developed countries, health services are concerned about the situation and make efforts to promote information about depression and how to treat it.
Depression - a disease of the whole organism. Typical signs of depression
The manifestations of depression are very diverse and vary according to the form of the disease. Here are the most common symptoms of the disorder:
* Anguish, suffering, depression, depressed mood, despair
* Anxiety, inner tension, the expectation of trouble
* Feelings of guilt, self-blame frequent
* Dissatisfaction, decreased self-confidence, self-esteem decline
* A reduction or loss of ability to experience pleasure in previously enjoyable activities
* Decline of interest in the surrounding
* Loss of the ability to experience any feelings (in cases of major depression)
* Depression is often associated with anxiety about health and the fate of loved ones, as well as the fear seem untenable in public places
* Sleep disorders (insomnia, sleepiness)
* Changes in appetite (its loss or overeating)
* Violation of bowel function (constipation)
* Reduction in sexual needs
* Decreased energy, increased fatigue during normal physical and mental stress, fatigue
* Various pain and discomfort in the body (for example, the heart, the stomach, muscle)
* Passive, involving difficulties in purposeful activity
* Avoidance of contacts (the propensity for solitude, loss of interest to other people)
* Rejection of entertainment
* Alcoholism and substance abuse, giving temporary relief
* Difficulty in concentrating
* Difficulty making decisions
* Predominance gloomy, negative thoughts about yourself, about your life, about the world in general
* Gloomy, pessimistic vision of the future with the lack of perspectives, thoughts of meaninglessness of life
* Thoughts of suicide (in severe cases of depression)
* The existence of thoughts about his own uselessness, insignificance, helplessness
* Slow thinking
For the production of "depression" diagnosis requires that a portion of these symptoms persisted for at least two weeks.
Depression needs to be treated
Depression is often perceived both by patients and by others as a manifestation of bad character, laziness and selfishness, immorality or natural pessimism. Keep in mind that depression - not just in a bad mood (see display above.), And disease, which requires the intervention of professionals and is well treatable. The earlier the correct diagnosis and proper treatment started, the better the chances for a quick recovery, that depression does not happen again and will take a severe form, accompanied by a desire to commit suicide.
What usually prevents people from seeking help for depression?
Often people are afraid to see a specialist in mental disorders because of the alleged negative consequences:
1) the possible social restrictions (registration with the ban on driving vehicles and travel abroad);
2) condemnation if someone finds out that the patient is treated by a psychiatrist;
3) fear of the negative impact of drug treatment of depression, based on what are widely used, but not the correct idea about the dangers of psychotropic drugs.
Often, people do not have the necessary information and properly understand the nature of his condition. They think that if their condition is due to the understandable difficulties in life, it is not depression, but a normal human reaction, which takes place on their own. Often it also happens that the physiological manifestations of depression contribute to the formation of beliefs about the presence of serious systemic diseases. It is an occasion to refer to the general practitioner.
80% of depressed patients initially seek help from general practitioners, and the correct diagnosis is about 5% of them. Adequate therapy gets even fewer patients. Unfortunately, the usual reception in the clinic is not always possible to distinguish between physiological manifestations of depression and the presence of a true medical condition that leads to the formulation of misdiagnosis. Patients prescribed symptomatic therapy (medicines "to the heart", "stomach", the headache), but the improvement does not occur. There are thoughts about the difficult, unrecognized somatic disease, that the mechanism of the vicious circle leads to a weighting of depression. Patients spend a lot of time on the clinical and laboratory tests, and, as a rule, get to a psychiatrist already heavy, chronic manifestations of depression.
Scientific knowledge about depression
The main types of depression
Depression frequently occurs on the background of stress or long-existing severe traumatic situations. Sometimes they occur for no apparent reason. Depression can be accompanied by somatic diseases (cardiovascular, gastrointestinal, endocrine, etc.). In such cases, it is much heavier main course and prognosis of medical condition. However, with early detection and treatment of depression has been a rapid improvement in mental and physical health.
Depression can occur as single, different severity disease episodes occur continuously or in repeated relapses.
In some patients, the depression is chronic - lasts for years without reaching a considerable gravity.
Sometimes depression is limited mainly to bodily symptoms without distinct emotional expressions. At the same clinical and laboratory tests can not detect any organic changes. In such cases, you need to consult a psychiatrist.
Modern ideas about the causes of depression
Bio-psycho-social model of depression
Modern science considers depression as a disease in the origin of which contribute to different reasons or factors - biological, psychological and social.
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Biology of depression
The biological factors include depression, above all, the specific violation of neurochemical processes (metabolism of neurotransmitters such as serotonin, norepinephrine, acetylcholine, etc.). These disorders are, in turn, may be genetically determined.
Psychology of depression
Scientific research has revealed the following psychological factors of depression:
* A special way of thinking, the so-called negative thinking, which is characterized by a fixation on the negative aspects of life and self, the tendency to see in a negative light surrounding the life and future
* Specific style of communication in the family with a high level of criticism of heightened conflict
* Increased number of stressful life events in his personal life (separation, divorce, alcoholism family, the death of loved ones)
* Social isolation with a small number of warm, confidential contacts that could serve as a source of emotional support
The social context of depression
Growth depressions in modern civilization is associated with a high rate of life, an increased level of stress it: the highly competitive modern society, social instability - a high level of migration, difficult economic conditions and uncertainty in the future. In modern society, cultivated a number of values that doom a person to a permanent dissatisfaction - the cult of personality and physical perfection, the cult of power, of superiority over others, and personal well-being. It makes people hard to survive and hide their problems and failures, deprives them of emotional support and doomed to solitude.
The modern approach to depression treatment involves a combination of various methods - biological treatment (medication or medication) and psychotherapy.
Appointed in patients with mild, moderate and severe symptoms of depression. A necessary condition for the effectiveness of the treatment is to cooperate with the doctor: strict adherence to the prescribed treatment regimen, regular visits to the doctor, a detailed, candid account of his condition and life difficulties.
Proper treatment in most cases, to get rid of the symptoms of depression. Depression requires treatment by specialists. A major class of drugs for the treatment of depression are antidepressants. Currently, there are various products of this group, of which aptidepressanty tricyclic (amitriptyline, imipramine) and have been used since the late 50s. In recent years a number of antidepressant drugs has increased significantly.
The main advantages of the new generation of antidepressants are improved tolerability, reduction of side effects, decrease toxicity and high safety in overdose. To new antidepressants are fluoxetine (Prozac, profluzak), sertraline (Zoloft), citalopram (tsipramil), paroxetine (Paxil), fluvoxamine (Luvox), tianeptine (tianeptine), mianserin (lerivon), moclobemide (auroriks), milnacipran (Ixel) , mirtazapine (Remeron), and others. Antidepressants are safe class of psychotropic drugs, if properly used according to doctor's recommendation. The dose is determined individually for each patient. You need to know that the therapeutic effect of antidepressants can manifest itself slowly and gradually, so it is important a positive attitude and wait for it to appear.
Antidepressants are not addictive, and withdrawal of, unlike the class of tranquilizers benzodiazeninovyh drugs (Phenazepamum, Relanium, elenium, tazepam et al.) And widely used in our country korvalola, valokordin. In addition, benzodiazepine tranquilizers and phenobarbital, are part of korvalola valokordin and long-term use reduces the sensitivity to other psychopharmacological agents.
The main stages of therapy.
1. Determination of the treatment tactics choice of the antidepressant with the main symptoms of depression in each patient, the selection of adequate dose and individual treatment regimens.
2. Provide a basic course of therapy aimed at reducing the symptoms of depression up to their disappearance, the old restoration, peculiar to the patient activity level.
3. Conduct supports the course of therapy for 4-6 months or more after the general normalization of the state. This step is aimed at the prevention of exacerbations of the disease.
What usually impedes drug treatment:
1. The misconception about the nature of depression and the role of drug treatment.
2. A common misconception about the dangers of unconditionally all psychoactive drugs: the occurrence of dependence on them, the negative impact on the internal organs. Many patients believe that it is better to suffer from depression than taking antidepressants.
3. Many patients interrupted reception in the absence of a rapid effect or take medication regularly.
It is important to remember that conducted numerous studies confirming the high efficiency and safety of modern antidepressants. Damage depression emotional and material well-being of man, not comparable in severity with minor and easily avoidable side effects that sometimes occur with the use of antidepressants. It should be remembered that the therapeutic effect of antidepressants often comes only after 2-4 weeks after starting.
Pychotherapy is not an option, but an important addition to the medical treatment of depression. Unlike drug treatment therapy involves a more active role of the patient in the treatment process. Psychotherapy helps patients develop skills in emotional self-regulation in the future to cope with the crisis more effectively, without sinking into a depression.
In the treatment of depression as the most effective and science-based proven three approaches: psychodynamic psychotherapy, cognitive behavioral therapy and psychotherapy.
According to psychodynamic therapy, psychological basis of depression are internal unconscious conflicts. For example, the desire to be independent and at the same time a desire to receive a large amount of support, help and care from other people. Another typical conflict is the presence of intense anger, resentment on others, coupled with the need to always be kind and good, and keep the location of the family. The sources of these conflicts lie in the history of the patient's life, which is the subject of analysis in psychodynamic therapy. In each individual case, it may be its unique content of conflicting emotions, and therefore requires an individual psychotherapeutic work. The goal of therapy - understanding the conflict and help in its constructive resolution: learn to find balance closeness and independence, develop the ability to constructively express their feelings and to maintain at the same relationships with people. Behavioral therapy aims to resolve the current problems of the patient and the removal of behavioral symptoms: passivity, renunciation of pleasures, monotonous lifestyle, isolation from others, planning and engaging in purposeful activity of impossibility.
Cognitive therapy is a synthesis of the two above-mentioned approaches and combines their advantages. It combines work with the current life difficulties and behavioral symptoms of depression and work with their internal psychological sources (deep ideas and beliefs). The main mechanism of psychological depression, cognitive therapy is considered the so-called negative thinking, which is reflected in the tendency of depressed patients consider everything that happens to them in a negative light. Changing this way of thinking requires careful individual work, which aims to develop a more realistic and optimistic view of ourselves, the world and the future.
Additional forms of depression are psychotherapy, family counseling and group psychotherapy (but not any, and specially designed to help depressed patients). Their involvement can be of great help in the treatment and rehabilitation.
What usually prevents treatment for psychological help?
1. Low awareness of people about what is psychotherapy.
2. Fear of a stranger initiation into personal, intimate experience.
3. The skeptical attitude to the fact that "conversations" can provide significant therapeutic effect.
4. The notion that psychological difficulties need to handle yourself, and appeal to another person is a sign of weakness.
In modern society, psychotherapy is an established, effective method of care for a variety of mental disorders. Thus, cognitive psychotherapy significantly reduces the risk of recurrence of depression. Modern methods of psychotherapy focused on short-term (10-30 sessions depending on the severity of the condition) effective assistance. All the information that the therapist gets in the session is confidential and remains confidential. A professional therapist is specially prepared to work with heavy emotions and difficult situations of other people, he knows how to respect and assist in coping with them. Every person in life there are situations (such as illness), with which it can not cope on their own. The ability to ask for help and accept it is a sign of maturity and rationality, not weakness.
Help loved ones overcome the depression!
Support for loved ones, even when the patient does not express interest in it is very important to overcome depression.
In this regard, we can give the following advice to relatives of patients:
* Remember that depression - a disease in which the need sympathy, but in no case can not be koem dive into disease together with the patient, sharing his pessimism and despair.
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