Depression is a serious illness that not only causes psychological pain to the patient, but also to the people around him. Social contacts are cut off, and the person is left alone with the disease.
It is important to always remember this and provide all possible psychological support to the patient. At the same time, you need to remain at the level of professional relationships, because there is always the possibility of developing a personal transfer of the role of “parent” to the doctor, which can harm successful treatment.
People with depression are reluctant to go to specialists, and they may refuse treatment, even when the disease is already in a severe and protracted form, so prompt assistance and informing the patient are very important.
Unfortunately, many people think of depression as just a low mood, which is a misconception. The doctor is required to carefully, without affecting the sensitive state of the patient, debunk these misconceptions at the very beginning of treatment.
It must be made clear that depression as a disease does not depend on gender or season, and that it does not indicate a person’s weakness. This is especially worth remembering because depressed people are often in a state of self-blame.
Symptoms of depression and features of its manifestation
The patient must come to an awareness of the disease. This can be achieved by demonstrating a range of symptoms of clinical depression.
Emotional manifestations
- melancholy, depressed, depressed mood, despair
- increased anxiety
- irritability
- excessive guilt
- decreased self-esteem
- decreased or lost ability to experience pleasure
- decreased interest in surroundings
- loss of the ability to experience any feelings
Cognitive manifestations
- difficulty concentrating
- difficulty making decisions
- predominance of dark, negative thoughts
- suicidal thoughts (in severe cases of depression)
- thoughts of one's own helplessness
- slow thinking
Physiological manifestations
- sleep disorders (insomnia, drowsiness)
- changes in appetite (loss or overeating)
- bowel dysfunction (constipation)
- decreased sexual needs
- decreased energy, increased fatigue during normal physical and intellectual activity, weakness
- pain and various unpleasant sensations in the body (for example, heart, stomach, muscles)
Behavioral manifestations
- passivity
- avoidance of contacts (tendency to solitude, loss of interest in other people)
- refusal of entertainment
- alcoholism and substance abuse
Causes (etiology)
Depression can be the result of dramatic experiences, such as the loss of a loved one, a job, or a social position. In such cases we are talking about reactive depression. It develops as a reaction to some external event or situation. According to some theories, depression sometimes occurs when the brain is overtaxed as a result of stress, which can be based on both physiological and psychosocial factors.
But if the psychological or somatic causes of depression are absent or not obvious, such depression is called endogenous, that is, as if “coming from within” (the body, the psyche). In approximately one third (about 35%) of cases, manifest depression occurs autochthonously, that is, without any external influences. In structure, such depressions are endogenous from the very beginning.
Many people in sunless weather or those who are in darkened rooms show signs of depression, which can occur due to the lack of bright light. This type is called seasonal depression, because it is most often observed in patients in the fall and winter.
Signs of depression can result from side effects of many medications (eg, levodopa, corticosteroids, benzodiazepines). Most often, such depression quickly goes away on its own or is cured after discontinuation of the corresponding drug. Neuroleptic depression (arising as a result of taking antipsychotics) can last from several months to 1.5 years and are often vital in nature. The cause of depression in some cases is the abuse of sedatives or hypnotics, alcohol, cocaine and other psychostimulants. Depression can also be somatic or, more precisely, somatogenic, that is, manifest itself as a consequence of somatic diseases (for example, Alzheimer's disease, atherosclerosis of the cerebral arteries, traumatic brain injury, or even the common flu). Factors that could presumably underlie somatogenic depression are numerous.
As a recent study showed, identifying cases of depression by general practitioners is difficult because in almost half of the cases patients try to remain silent about symptoms of depression. Many people are afraid of being prescribed antidepressants and their side effects; some believe that keeping emotions under control is their own business, and not the doctor’s concern; there are also concerns that a mention of a case of depression will end up in the medical record and somehow become known to the employer; finally, some are afraid of being referred for treatment to a psychiatrist, psychotherapist or psychological consultant. This suggests that therapists should make greater use of early detection tools, including brief questionnaires, in cases where depression is not excluded.
Types of Depression
Depending on the number of symptoms and their severity, a depressive episode may be classified as mild, moderate or severe.
One of the main distinctions is also made between depression in people who have previously had manic episodes and depression in people who have not previously had such episodes.
Each type of depression requires its own approach to the patient. This is important when it comes to stable, long-term treatment and successful treatment outcome.
Unipolar depression
During typical depressive episodes, a person is depressed, loses interests and does not experience a sense of joy, and a decrease in vital energy leads to a decrease in his activity for at least two weeks.
This affects his motivation to recover. In some cases, a person may consider himself weak and flawed, and the phrases may sound: “Serves me right!” or “I deserve it!” In this case, you need to show some authoritarianism when discussing treatment. The patient should not be given the opportunity to choose. It is necessary to draw the patient’s attention to his serious condition with the words: “I see that you feel bad, it’s hard for you.”
Then, in an affirmative form, indicate the treatment: “Once a day you will take...”. This approach is usually received well, as it creates the illusion that the responsibility of choice is being removed from the person. In subsequent appointments, the patient should be supported and praised for following instructions.
Bipolar disorder
This type of depression usually consists of both manic and depressive episodes, interrupted by periods of normalcy.
In this case, it is important to convince the person that this is really depression, because during periods when the attacks go away, the disease is not felt.
Once contact has been established and a person has begun treatment, special care should be taken in their emotional expressions and verbal language so as not to provoke a manic episode, which may lead to interruption or complete abandonment of treatment.
— Methods of prevention
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To prevent any type of depressive disorder, it is necessary to follow a number of simple recommendations:
1) learn to relax (the ability to relax is necessary in a world of haste and constant stress),
2) eat healthy (not only proper nutrition is important, special foods that improve your mood are also important: the most prominent representatives of these are bananas and carrots), (Read the article “List of foods for proper nutrition”)
3) normalize your sleep (go to sleep at the same time, don’t spend time in bed if you don’t want to sleep, master relaxation techniques to consciously free yourself from all obsessive thoughts before going to bed),
4) spend more time in nature (fresh air works wonders),
5) do physical exercise (you don’t need to set any special records, but keeping yourself in good shape, taking care of yourself and your health is vital), (Read how to force yourself to play sports).
6) do not harm yourself (smoking and alcohol will not solve problems and will not improve depressed mood, no matter how you may think otherwise at first),
7) communicate with people (close connections with loved ones, support from friends and good relationships with others will help avoid depressive disorder).
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Consequences of depression
Problems in the family and with loved ones
Due to lack of awareness, depression is often mistaken for a bad mood. At a time when the patient needs support and love, they turn away from him. Against the backdrop of depression, a large number of divorces occur, relationships are broken, and social connections are lost.
Deterioration in appearance
During prolonged depression, more brittle hair and nails and a pale complexion are observed. A person may stop taking care of himself. The desire to buy new clothes, get a new hairstyle, or, in severe cases, wash, disappears.
Sleep disturbance
Depression is often associated with lack of sleep, lack of mobility and worsening bad habits. All this leads to an increased risk of complications for patients with cardiovascular diseases and complicates treatment.
Diabetes and obesity
During depression, the secretion of stress-dependent hormones increases. It becomes difficult for a person to regulate his diet and lifestyle. This can lead to complications in people with diabetes and obesity.
Deterioration of brain function
Patients with depression, especially in severe forms, experience deterioration in cognitive activity, as well as structural and functional changes in the brain. In addition to psychological factors, it becomes physiologically difficult for a person to cope with his work, studies and social problems.
Dependencies
Due to increased stress, people often turn to alcohol and drugs to relieve symptoms of depression. In severe and prolonged cases of depression, it can lead to alcohol or drug addiction in a person, making treatment even more difficult.
Tumors and cancers
There is an increased risk of malignancy for patients with severe depression. The overall immunity of the body is weakened and healthy brain function is disrupted. Depression also often develops in cancer patients due to the existing disease.
Suicide
In some cases, depression can be fatal. According to statistics, more than 60% of people who commit suicide have depression. Without the necessary treatment with antidepressants and cognitive psychotherapy, people are left alone with a serious illness and cannot always cope with it.
— 3 negative ideas that you should get rid of
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There are some ideas that make it very difficult to cure attacks of mental blues. I’ll say right away that these ideas are false and need to be gotten rid of.
Idea 1 - I feel depressed because I am such a person (nervous, sensitive, subtle mental organization), this is how I am built and I can’t do anything about it.
There is no more destructive misconception for personal development! You suffer from depression, not because you are who you are, but because you haven't done anything to change! Every person is capable of changing himself; every personality has enormous potential for positive metamorphoses.
Idea 2 - I’m depressed because some circumstances of my life are to blame for this (I live in a bad country, I don’t have money to buy myself everything I want, I’m surrounded by idiots, I don’t have a girlfriend/boyfriend , my parents didn’t love me, etc.).
This is also a rather dangerous misconception. When you feel bad, you are overcome by despondency, your brain tries at all costs to find the reason for the current situation. The search for a reason precedes the determination of a way out of the current situation, so many people cling to these imaginary reasons as life preservers. This helps them realize that they know why they suffer and know how to stop this suffering.
Idea 3 - Depression is exclusively a psychological illness. This is wrong. Depression is also related to the condition of your body. Bad habits, fatigue, stress can lead to the appearance of this disease. And exactly the opposite: playing sports, keeping your body in good shape, and regular rest can help prevent depression.
Stop looking for the reasons for your unhappiness only in some lofty matters: in a feeling of existential emptiness, loss of Faith, etc. Also pay attention to how your body feels, whether it is healthy enough and whether it is getting all the vitamins it needs to function.
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Hypotymia in the acute period of concussion
Affective (subaffective) disorders are detected in 68% of patients in the acute period after a concussion and are characteristic of disorders of the neurotic level. Hypotymia is most fully represented in the psychopathology of the acute period of concussion and occurs in 50% of cases. The most commonly observed are anxious subdepression (36% of patients in the acute period of concussion) and asthenic subdepression (11%).
- When a pathological focus (for example, a tumor) is localized in the temporal lobe of the right hemisphere, melancholy depression is observed, including the classic depressive triad: melancholy, motor slowness and ideational inhibition. Melancholy depression, which occurs when the right temporal region is affected, can be combined with olfactory and gustatory hallucinations, as well as autonomic disorders. Patients are oriented, critical of their condition, have a clear understanding of their illness, and experience it hard. Self-esteem is reduced. They look worried, dejected, sad. Speech is slow, the voice is quiet, patients quickly get tired and make forced pauses in conversation. They present active complaints of memory loss, but they correctly reproduce dates and events; often pronounced memory impairments are not detected in experimental psychological examinations.
- When the pathological focus is localized in the left temporal lobe, anxious depression is observed, characterized by anxiety, irritability (dysphoria), tearfulness and motor restlessness. Symptoms of anxious depression can be combined with aphotic disorders (such as sensory and acoustic-mnestic aphasia), verbal auditory hallucinations, and delusional ideas of a hypochondriacal nature. Patients constantly change position, stand up, sit down and get up again; they sigh, look around in bewilderment, and peer into the face of their interlocutor. They express fears that something is going to happen to them. Patients cannot relax voluntarily and sleep poorly.
