Psychologist.

Depression is one of the most significant health problems in the 21st century. Depression is now the leading cause of disability worldwide. Mental health experts estimate that more than a quarter of working-age citizens suffer from depression.

We all feel sad, cranky or depressed at times, but there are people who experience these feelings intensely for long periods of time (weeks, months or even years), sometimes without any apparent reason. Depression is not just a bad mood - it is a serious illness that affects your physical and mental health. When something unpleasant or upsetting happens, such as the end of a relationship or the loss of a job, it is normal that discomfort and depression arises and continues for a while, but these feelings eventually disappear, and you continue to live. But if it's depression, the feelings don't go away even when the situation improves.

The essence of depression is not what kind of depression you have, but that it is a disease! About depression, a depressed person, etc. A lot of material has been written, but we still don’t fully understand that there is no state “after depression”, it does not go away at once, like SARS, for example, and it is impossible to determine the time of depression. Depression is such a thing that it is impossible to feel, but it spoils life very seriously. The state of depression is experienced by absolutely all people at different periods of life and even children “suffer” from depression.

The World Health Organization has published statistics on studies of depression. Depression now ranks first in the world among the causes of absenteeism, in second place among all illnesses that lead to disability. There is a possibility that by 2020, that is, in a year and a half, depression will paralyze economic life most countries. Depression overtakes cancer cardiovascular diseases.

Also, WHO says about 350 million people who today have depression. The highest prevalence of depression according to statistics is the Baltic countries, Korea and Japan. Residents of megacities are more likely to get sick. The number of suicides is also much higher in metropolitan areas. In our country, general practitioners know almost nothing about depression and this diagnosis will be made in the last case. Whereas in the US everyone family doctor or the therapist is very knowledgeable about all things depression and is willing to offer treatment.

In our country, with depression, you need to contact a psychiatrist and psychologist. What is the difference? If the cause of depression is external, for example, a conflict at work, then a psychologist will be able to help and a psychiatrist will not be required. If reactive depression is caused by loss loved one, then a psychiatrist is needed, because only he can prescribe drugs. If depression is caused by a mental illness, then nothing will work without a psychiatrist. Don't be afraid of psychiatrists! This is an ordinary doctor, who is often the only one who can help you.

The definition of depression is given in the ICD - 10. Mood disorders [affective disorders] (F30-F39).

This block includes disorders in which the main disturbance is a change in emotions and mood towards depression (with or without anxiety) or towards elation. Mood changes are usually accompanied by changes in overall activity levels. Most of the other symptoms are secondary or easily explained by changes in mood and activity. Such disorders most often tend to recur, and the onset of a single episode can often be associated with stressful events and situations.

Sadness and melancholy, as a reaction to an event, is not depression at all. How to suspect depression?

Here are those symptoms, which are the most common and observed for a long time.

• Appetite disorders;
• Weight fluctuations with a large amplitude;
• Lack of motivation in principle;
• Apathy;
• Reluctance to communicate with people and leave the house;
• Postponing things, even those that you used to like;
• Feelings of helplessness and confusion;
• Thoughts of death as salvation;
• Suicide attempts.

Not all of these symptoms may be present, but if a person has some of them for three months or even a month, then most likely this is already depression.

Stages of depression

The first stage is the rejection stage. A person rejects all symptoms and shifts the blame to fatigue, feeling unwell and even in bad weather. The second stage, when the body begins to work offline, the work of the whole organism changes. All chronic diseases are waking up. The third stage (corrosive) is the most dangerous. The body is still working offline. Mental problems begin. Aggression is added to detachment from the world. There is a danger of harm not only to yourself, but also to others. It is believed that the third stage, without appropriate treatment, can lead to schizophrenia or manic-depressive psychosis. At this stage, a person is registered in a psychiatric clinic.

Types of depression

Major depression (clinical)

Major depression is sometimes referred to as clinical depression, unipolar depression, or simply "depression". This is severe depression. Symptoms occur on most days and last for at least two weeks.

Persistent depressive disorder (dysthymia)

Persistent depressive disorder is a long-term but less severe type of depression. It's a milder but chronic depression, and it keeps you from living. normal life. The symptoms of dysthymia are similar to those of major depression, but are less pronounced and not sufficient to diagnose major depressive disorder.

Endogenous and exogenous (reactive) depression

Endogenous depression occurs without the presence of stress or trauma. In other words, she has no visible external cause. Exogenous depression occurs after a stressful or traumatic event. This type of depression is more commonly referred to as "reactive" depression.

Psychogenic depression

Depressive disorder caused acute injury.

Neurotic ("nervous") depression

This is depression in an emotionally unstable person.

Melancholy

One of the main changes is that the person begins to move more slowly, completely loses the pleasure of everything or almost everything.

Psychotic (clinical) depression

Sometimes people with a depressive disorder can lose touch with reality and experience what psychosis is like. This condition may include hallucinations.

Perinatal (antenatal, postpartum) postnatal, hormonal) depression

In the first days after birth, many women experience so-called "infantile melancholy", which is a common disease associated with hormonal changes and affects up to 80 percent of women.

Somatogenic depression

This depression is provoked by the presence of a disease (brain tumor, enlargement of the thyroid gland, fibroids, etc.), is secondary in nature and disappears after recovery from the underlying disease.

bipolar depression

Bipolar disorder was commonly referred to as " manic depression because the person goes through periods of depression and periods of mania, with periods of normal mood in between.

Cyclothymic disorder

Cyclothymic disorder is often described as a milder form of bipolar disorder.

Pseudo dementia

This decline intellectual activity(problems with concentration of attention, with orientation in space, with memorization).

seasonal affective disorder

This type of depression usually starts in early winter and rises in the spring and can be treated light therapy or artificial lighting.

Masked (somatized) depression

Masked depression has been a proposed form of atypical depression in which somatic symptoms or behavioral disturbances dominate clinical picture and mask the underlying affective disorder.

Atypical depression: the wrong type of depression

Unlike major depression, common feature atypical depression is a feeling of heaviness in the arms and legs - like a form of paralysis. However, drowsiness and overeating are considered to be the two most important symptoms for diagnosing atypical depression.

Alcoholic depression

There is a link: self-harm and suicide are much more common in people with alcohol problems.

panic depression

Depression is sometimes accompanied by panic attacks.

Suicidal depression

Suicidal depression is a terrible, deep, lingering depression that, if not treated on time. Leads to the death of a person.

situational depression

Also called adjustment disorder, situational depression is caused by a stressful or life-changing event such as job loss, death of a loved one, trauma, etc...

depression without depression

The symptoms are only of a physical nature, without loss of interest in life. Heart-like pains, headache in other parts of the body.

home depression

Such people are active at work, but do nothing at home. If this is not just laziness, but a depressing state, then it may be depression.

Latent depression

A person with hidden depression is a person who struggles with his inner demons and tries not to show them to anyone. Sometimes they can show their pain and give a little hint that they need help.

Children's depression

Manifested in children under 18 years of age by lack of interest, sadness, bad behavior and academic performance, etc.

Treatment for depression

It is very important to find the "right" specialist. It is important to determine whether your symptoms of depression are due to a health problem. Finding the treatment and support that works best for you may require trying several treatment options through trial and error. For example, if you decide to go into psychotherapy, it may take several attempts to find a therapist with whom you really get along. Same with antidepressants. Don't rely on drugs alone. Although the drug may relieve the symptoms of severe depression, it will not solve all problems.

The more you improve your social connections, the more protected you are from depression. Lifestyle changes are simple yet effective tools for treating depression. Even if you need other treatments, making lifestyle changes can help relieve depression faster and keep it from coming back. Psychological treatment depression is dealt with by a psychologist working with depression. Psychological therapy can help you identify and change destructive thoughts and behaviors. The main drug for depression are antidepressants. There is a lot of misinformation about antidepressants, however, this method can be of great help in the treatment of moderate to severe depression and some anxiety disorders.

How to deal with depression on your own?

Treatment for major depressive disorder usually requires professional intervention, but there are ways you can manage your condition.

• Good, long sleep;
• Eat enough and healthy food;
• Keep acting and looking for exits;
• Take care of your hygiene;
• Avoid psychoactive substances;
• Find out what makes you happy;
• Be kind to yourself;
• Try something new;
• Try to help;
• Set realistic goals;
• Keep a mood diary;
• Try self-help;
• Keep in touch with friends and family;
• Join a support group for people who are depressed;
• Learn as much as you can;
• Practice coping skills;
• Look for reputable, trusted doctors and therapists;
• Explore alternative medicine.

depression in women

Here's what contributes to female depression:

Puberty

Hormone changes during puberty may increase the risk of depression in girls;

premenstrual problems

A small number of women have severe symptoms that disrupt their learning process, jobs, relationships, or other areas of their lives. At this point, PMS can turn into premenstrual dysphoric disorder (PMDD), a type of depression that usually requires treatment.

Pregnancy

Hormonal changes occur during pregnancy and this can affect mood.

postpartum depression

New mothers can be sad, angry and irritated. These feelings, sometimes called childhood blues or childhood melancholy, are normal and usually subside within a week or two.

Premenopause and menopause

The risk of depression may increase during the transition to menopause, a stage called premenopause, when hormone levels can fluctuate unsustainably.

Life circumstances and culture

Life circumstances and cultural stressors can also play a role.

• Unequal status;
• Working overload;
• Sexual or physical abuse.

postpartum depression

Postpartum depression affects up to 15 percent of mothers after birth and up to 9 percent of women during pregnancy, more often it is depression on maternity leave. Depression can occur any time during pregnancy or up to a year after the baby is born. This can happen after a miscarriage, and depression almost always occurs after an abortion.

depression in men

There are several reasons why the symptoms of male depression are not usually recognized. For example, men tend to deny having problems because they have to "be strong". And the culture suggests that the expression of emotions is largely feminine trait. As a result, depressed men are more likely to talk about the physical symptoms of their depression, such as feeling tired, rather than about emotional symptoms. Some of common factors risks for men may include:

• physical injury;
• Relationships, difficulties and conflict in relationships;
• Major life changes, such as becoming a dad;
• Problems at work;
• Unemployment, especially if it lasts for a long time;
• Overweight;
• Retirement;
• Financial difficulties;
• No close friends, no one to talk to;
• Divorce;
• Drugs and alcohol.

Depression in children and adolescents

Less than three decades ago, depression was seen as the predominant disorder in adults: children were considered too immature to develop depressive disorders, and teenage low moods were seen as part of the "normal" teenage mood swings. depression in children and teen depression are quite real.

What teens and their parents need to know about depression. If one or more of these signs of depression persist, seek help:

• Frequent sadness, tearfulness and directly crying;
• Decreased interest in favorite activities;
• Hopelessness;
• Persistent boredom; little energy;
• Social isolation from friends and family;
• Low self-esteem and guilt;
• Extreme sensitivity to failure;
• Increased irritability, anger or hostility;
• Difficulty with relationships;
• Frequent complaints about physical illness such as headaches and abdominal pain;
• School truancy or poor academic performance;
• Poor concentration;
• Major changes in eating and/or sleep;
• Talk about running away or actually trying to run away from home;
• Suicidal talk or self-harming behavior (selfharm).

depression and age

Young people between the ages of 19 and 29 sometimes get depressed due to major life changes, lack of support in a new environment, lack of coping skills, relationship problems, poverty, trauma, work problems, and so on. Adults between the ages of 30 and 60 tend to have a lot in common that can trigger depression: caring for children as well as older parents; financial stress, isolation, problems at work and relationships, illnesses and many responsibilities. With no relief in sight. The age of 40 is considered a midlife crisis and this is also a period of depression. There is a reassessment of values ​​and all life, and not everyone likes the results. After the age of 50, many begin to regret missed opportunities and dreams that are not destined to come true. Symptoms in older adults include trouble sleeping, fatigue, sadness and anxiety, trouble focusing or making decisions, and mood changes that do not subside (for example, grieving the loss of a loved one should subside over time).

Causes of depression

How diverse depression itself is, so is the huge number of reasons that cause it or contribute to its development. Depression usually results from a combination of recent negative events and other antecedent factors, often much earlier, rather than from just one negative event. Research shows that long-term difficulties, such as long-term unemployment and subsequent depression, living in abusive, toxic relationships, long-term isolation or loneliness, prolonged stress are more likely to cause depression than recent fights. About a person then they say that he "fell into a depression." Before depression, as a rule, a person simply stays in a sad mood for a long time and does not notice when he can no longer get out.

Effects of depression

The problems with depression are that when depressive feelings develop into a chronic, life-destroying disorder that interferes with daily functioning, the clinical diagnosis of major depressive disorder ( short name- depression).

If you are depressed and left untreated, the effects of depression will not only cost you a very high personal cost and drastically affect your health, but will also affect your quality of life. The effect of depression may be that your depression can cause anxiety to your family and friends, affect your ability to reproduce, and often make it difficult for you to do your job. Depression also increases the risk of suicide, but treatment also drastically reduces this risk.

depression of loved ones

Here are some tips on how to help with depression, how to help a person come out of depression.

• Do not ask your loved one to "ignore". Depression is a real illness;
• Listen. Right now, what your loved one with depression might need is to be heard;
• Encourage your loved one to be more active;
• Don't push too hard. Be reliable, but not too pushy;
• Encourage your loved one to stick with the treatment;
• Create a stable environment. Reducing stress at home can help a person with depression;
• Emphasize that your loved one will feel better for sure. Encourage him, but subtly and not insistently;
• Educate yourself, your family and friends about mental health issues and depression in particular;
• Make sure you notice and praise any significant improvement. Be real;
• Leave time for yourself and your own needs;
• Consider family or marital therapy (if this is your spouse);
• Consider reaching out to support groups, both for the depressed person and for you as his or her family member.

depression In medicine, a mental disorder is called, which is characterized by three main features:

• decreased mood, inability to experience joyful feelings;
• pessimistic moods in thinking;
• decrease in motor activity.

People suffering from depression do not perceive the joys of the world around them, like everyone else, their thinking is aimed at aggravating the negative manifestations of reality, they perceive any minor troubles exaggeratedly. Due to depression, people with a weak psyche and will are easily susceptible to alcoholism, drug addiction, and suicidal thoughts.

Causes of depression and risk factors

Mental illnesses are one of the most complex categories in medicine, since their manifestations are multifaceted, and the apparent causes are quite difficult to establish. Doctors have long studied the causes of depression and argued about what is the decisive factor in the development of this severe mental illness. To date, several hypotheses have been formed in science regarding the causes of depression:

• biochemical hypothesis, based on the assertion that depression is primarily due to the malfunctioning of the limbic system. The limbic system is a functionally integrated brain structure that is responsible for the behavioral activity of an individual. Thanks to the limbic system, a person has such reactions as fear, maternal instinct, affection, sexual arousal. Part of the limbic system is the hypothalamus, which is involved in the regulation of physiological needs - feelings of hunger, body temperature, thirst, etc. The limbic system is also actively involved in changing the daily activity of a person - observing the sleep and wakefulness regimen. All components of the limbic system are interconnected through the transmission of certain chemical substances namely dopamine, norepinephrine and serotonin. Serotonin has a big impact on performance gastrointestinal tract. With the help of this substance, a person feels appetite, a feeling of satiety from food, a feeling of hunger, etc. Serotonin also regulates the state of sleep, impulsive behavior. Norepinephrine is primarily turned on in stressful situations - with its help, blood pressure rises, the work of the heart accelerates, respiratory acts become more frequent, and blood sugar levels rise. Dopamine provides a person with physical activity, coordination of movements, emotions.
• biological hypothesis based on the idea that depression is the result of serious somatic diseases- Crohn's disease oncological diseases. Diabetes, rheumatoid arthritis, inflammatory diseases intestines. Such diseases not only accompany a person for long years, and even throughout his life, but also significantly limit him in society, can lead to partial or complete disability, premature death. Feeling their inferiority in this world, patients with such diseases are prone to depression, low mood, etc.
• genetic hypothesis depression is based on the fact that the tendency to such conditions is inherited, but they manifest themselves to one degree or another depending on the influence environment.
• environment hypothesis sees first social factors in the onset of depression. So, people who have lost their jobs, have problems in marriage, are experiencing loneliness, the death of a loved one are susceptible to depression. It is not necessary that these reasons must necessarily cause depression - if people have a stable psyche, then they find compensatory moments in life. However, with a weak will and psyche, the situation can surpass the individual and he will begin to suffer from depression.

Depression does not select patients by sex, age, social status. However, among risk factors worth noting heavy life situations presence in the family of people suffering from depression, serious illnesses in the patient himself. As doctors notice, women are more susceptible to depression, which is due to their greater emotionality, dependence on sex hormones, changes in the hormonal background (climax, postpartum period), greater social responsibility(for example, for children, elderly parents, etc.). Also, some drugs, head injuries, and infectious diseases can affect the occurrence of depression.

The appearance of stress factors in a person's life can also lead to depression. This is especially true if the stress factor persists for a long time - then depressive states occur much more often. At the same time, stress factors do not always have to be associated with negativity. According to studies by American scientists, the majority of their respondents noted the wedding as a stress factor in the first place, and only then problems with work, etc. And the point here is not so much in the coloring of stress - negative or positive, but in the need for the body to look for adaptations to a new situation, rebuild its physiological cycles, etc. All this can lead to serious psychological disorders.

Symptoms and course of depression in humans

Depression is a very individual disease and each patient manifests differently. Some people say that they are constantly haunted by failures and a black streak has come in life, they do not try to deal with troubles and overcome them. Such people feel physically tired, they try to sleep more, they like to spend time alone.

Other patients, on the contrary, may exhibit symptoms of depression violently - such patients are harsh in judgments, too critical of themselves and see shortcomings in others. They are constantly not satisfied with the level of attention to themselves, they try to attract it with extraordinary actions - tantrums, demonstrative withdrawal into themselves, provocations.

emotional symptoms:

• most of the time they are sad;
• deprived of pleasure from what used to bring them joy;
• prolonged sadness can be replaced by a feeling of irritability, internal emotional stress;
• feel guilty for doing something;
• fear of something, anxiety and anxiety over trifles.

Physiological symptoms:

• after sleep there is no feeling of cheerfulness, a feeling of an active start to the day;
• there is pain all over the body;
• feeling of fatigue, lack of sleep, weakness;
• permanent headache;
• pain behind the sternum, a feeling of compression in the region of the heart;
• sleep disturbances in the form of insomnia, inability to get up, sleep intermittently;
• loss of appetite or vice versa - uncontrolled consumption of foods;
• incorrect perception of sounds, colors;
• weak potency;
• dry mouth;
• increased feeling of thirst.

Thinking Symptoms:

• feel different from society;
• do not see the meaning in their lives;
• slowing down of thought processes;
• difficulty concentrating;
• inability to make decisions at the right time;
• avoidance of responsibility, fear for one's actions;
• obsessive return to the same thoughts;
• thoughts of suicide.

behavioral symptoms:

• difficulty doing the usual thing;
• privacy;
• violation of sexual instincts (unwillingness of intimacy, etc.);
• isolation, unwillingness to see relatives, friends;
• abuse of alcohol, psychotropic substances;
• propensity to leave home;
• unwillingness to fulfill the requests of loved ones, etc.

A combination of some of these symptoms may indicate some form of depression. It is not necessary to make a diagnosis based on one-stage facts that are not a systemic disorder in the patient. At the same time, it is also not worth skipping the first symptoms - it is better to cure the disease on early stage. The final choice of treatment methods remains with the doctor, who will determine the type of depression and prescribe the appropriate therapy.

An additional way to diagnose depression is tests, the results of which are compared with tables. Such tests are carried out additionally, since a diagnosis cannot be made on the basis of a single test.

Insomnia with depression

Insomnia is diagnosed in eighty percent of patients who suffer from depression. With insomnia, patients cannot fall asleep on time, toss and turn, and cannot find a sleeping position. All this time, patients return to what they experienced during the day, and not positive moments are remembered, but negative ones, to which the patient's consciousness returns again and again. If patients fall asleep, then such a dream is not deep, they wake up from nightmares. After that, it is not possible to fall asleep for some time. In the morning, patients get up with a headache, a feeling of fatigue, weakness.

The cause of insomnia during depression, doctors call the transferred stress. Against the background of this stressful state, depressive neurosis, anxiety, and excessive overexcitation occur. It is for these reasons that a person cannot fall asleep. The main symptoms of insomnia are:

• fatigue during the day;
• irritability;
• distraction;
• difficulty going to sleep;
• frequent nocturnal awakenings.

Restoring normal sleep patterns priority doctor. Against the background of a normal sleep and rest regimen, it is much easier to treat the disease. Your doctor may prescribe a drink to treat insomnia. herbal preparations(melissa, valerian, chamomile); folk methods- honey at night, etc.; exercises that promote falling asleep - a warm shower at night, airing the room, rest from the TV, active games, computer.

Classification and severity

Depression is diverse in its manifestation, causes, course of the disease. Consider the most frequent species depression:

• endogenous depression. The cause of endogenous depression is the lack of hormones that control the emotional sphere of a person, namely dopamine, serotonin and norepinephrine. With a lack of these hormones, a person has an increased feeling of anxiety, apathy, and emotional depression. The cause of this condition can be any stress, even the most insignificant. The risk group includes people who have already suffered from a similar disease and those who have a heightened sense of duty and justice. Symptoms of endogenous depression: general depression, slowing down of movements, slowing down of thought processes, chronic fatigue, constant feeling guilt, phantom pain, appetite problems, suicidal thoughts.
• dysthymia- chronic depression. Most often, dysthymia does not have severe forms, so it is quite difficult to diagnose it. Symptoms of dysthymia: low mood, problems with appetite, sleep, low self-esteem, feeling of impasse, hopelessness, panic attacks, overuse alcohol, psychotropic drugs. In order to make a diagnosis of dysthymia, a patient must be diagnosed with a decrease in mood for two years or more. Antidepressants are usually not prescribed for the treatment of dysthymia. The doctor only draws up a special treatment plan and supervises the patient until complete recovery.
• reactive depression- arises as a response to severe stressful situations (car accident, loss of loved ones, dismissal from work, unfounded accusations from others, etc.). In addition to the influence of these factors as causes reactive depression, scientists have established a hereditary link in the occurrence of the disease. Reactive depression is divided into two types - short-term and prolonged. Brief depression is associated with catastrophic events for the patient. Before the symptoms of reactive depression developed, patients reported anxiety, tantrums, withdrawal, etc. On the background acute development disease patients can not only consider the idea of ​​suicide, but also try to commit it. Prolonged depression is noted in patients who are exposed to a stress factor for a long time. It can be nitpicking on the part of the boss, problems transitional age in children, difficulties with adaptation to a new place. Patients do not feel the symptoms of depression so acutely, but they return to experiences much more often, they cannot let go of pessimistic thoughts. Any reminder can throw the patient off balance. Over time, such depressive disorders go away on their own, but it is better to control this process with a doctor. Treatment can consist of both medication and psychotherapy sessions.
• postpartum depression- in the world ranges from ten to fifteen percent of all mental disorders. This is a serious indicator that indicates the insufficient development of maternal instincts in women in labor. Subsequently, postpartum depression and the children themselves suffered from mental disorders. Most often, postpartum depression occurs in those women who did not have close contact with their own mother, because of which they did not form a model of behavior in relation to the child. Also, depression can be found in those who are overly worried about any changes in their lives, depression does not happen to them for the first time. It should be noted that mild postpartum depression occurs in more than half of women in labor, however, after discharge from the hospital, such moods disappear, the woman is included in the care of the child, and the symptoms of depression no longer visit her. Severe postpartum depression requires medical supervision so that the young mother gets out of this state as quickly as possible without harming the child. Causes of subsequent depression: hormonal surge, dissatisfaction in marriage, difficult childbirth, the need to care for a newborn, which may seem too difficult, lack of support from her husband, relatives, moral exhaustion, social isolation. Symptoms of postpartum depression: anger, desire to cry, anxiety, irritability, fatigue, negative thoughts about the child, fatigue, loss of strength, refusal to visit relatives, lack of interest in the child (unwillingness to feed him, come when he cries), drops mood, loss of interest intimate life, presenting your life without a child in a positive way. The treatment of postpartum depression should be provided as much as possible by the relatives of the woman in labor - to take on part of the household duties, help in caring for the child, and, if necessary, provide material assistance. The doctor draws up a treatment plan, according to which the young mother will attend psychotherapy sessions.
• manic—depressive disorder- a disease characterized by the occurrence of bouts of depression or manic episodes. It is characteristic that such a disorder is not long-term - patients feel quite normal during periods of remission, lead a normal life and are no different from healthy people. The causes of the development of the disease are seen in heredity and a violation of the linkage of the genes responsible for the pathology with the X chromosome. The first signs of the disease appear at the age of twenty and older. Most seizures are preceded by trauma. Manic-depressive psychoses last from two to six months, the peak of exacerbation of the disease occurs in autumn and spring. Patients report anxiety, a sense of overwhelming negative power, and other symptoms of depression. In patients, disorders such as increased pressure, constipation, headache, and joint pain can also be connected. With manic attacks, the symptoms of depression are erased - patients become helpful, help others, their appetite normalizes, hypersexuality can be noted.
• seasonal affective disorder occurs at the end of October and lasts differently in all patients. Typically, patients noted a breakdown, irrepressible cravings for sweets, making food, weight gain, increased drowsiness, decreased sexual activity, and irritability. special treatment there are no seasonal disorders, the patient needs support from loved ones, understanding. As a result of establishing a microclimate in the family, depression will recede, and its manifestations will be minimized.
• depression in menopause associated with change hormonal background, vegetative disorders, menopause. Most women during menopause become irritable, rude. Doctors see the reason here in competition with the younger generation, which is only taking the place of pensioners. Women already feel like they are losing social role- Possibility of childbearing. Against the background of these changes, insomnia, an increase or decrease in pressure, a feeling of anxiety occurs. To treat this condition, the doctor prescribes light antidepressants to the patient, which she cancels after menopause.
• depression due to low magnesium in the body, has the same symptoms as seasonal disorder. Scientists have found that a person loses magnesium in stressful situations for the body, for example, with myocardial infarction and other diseases. The treatment of this type of depression consists in vitamin therapy, psychological rehabilitation, etc.

Degrees of depression

Previously, three degrees of depression were distinguished in medicine, but modern science has developed a new gradation of the severity of this disease, in which there are now 4 degrees of depression:

• 1 degree - mild - manifested by rare, almost imperceptible symptoms to others. At the same time, the patient can control his emotions, switch from depressive thoughts to positive ones. Decreased mood and other symptoms of depression are subjective; if desired, the patient can easily overcome the onset of the disease.
• 2 degree — moderate- more visible to others. The patient is sad all the time, closes in his experiences, goes to work under duress, productivity is not high. Often there may be dark thoughts, crying, provocative behavior with colleagues. At this stage, there are already interruptions in sleep, the head is occupied with unpleasant thoughts.
• 3 degree- severe - a person tries to communicate less with people, does not leave the room, loses interest in what is happening around, eats poorly, does not observe basic hygiene.
• 4 degree- very severe - a person is close to suicide, intends to commit suicide, or constantly talks about it. There may be hallucinations and other severe mental and somatic disorders. Treatment of this stage is mandatory in a hospital, under the supervision of a doctor and with a wide range of methods.

depression in men

According to studies, men are two and a half times less depressed than women. However, this does not mean that this disease does not overtake men. In men, the symptoms of depression are somewhat different from those of women, however, women's depression can also have elements of a man's. So, the main signs of depression in men are:

• feeling tired;
• constant drowsiness or vice versa - lack of sleep;
• weight changes;
• pain in the back, in the abdomen;
• digestive disorders;
• irritability;
• distraction;
• aggressiveness, anger;
• stress;
• alcohol abuse;
• sexual problems;
• self-doubt.

Research scientists have shown that women think about suicide more often than men, however, in terms of mortality, men outnumber women because they choose more reliable ways to take their own life. One more salient feature male depression - the difficulty of diagnosis, unwillingness to cooperate with the doctor, considering depression to be the lot of the weak.

Diagnostics

The most effective way to make a diagnosis is to talk to the patient. The doctor draws attention to what disorders disturb the patient, how he evaluates them. Particular attention is paid to the patient's mood during the day, his behavior and life habits.

Diagnosing depression is not easy because Not all patients go to contact with the doctor. Some fall into apathy, others become too excited, irritable. When establishing trusting communication with the patient, the doctor first of all pays attention to the following markers of depression:

• feeling of anxiety, sadness, mental emptiness;
• indifference to favorite activities;
• feelings of guilt, worthlessness;
• pessimism, increased tearfulness, feeling of hopelessness;
• fast fatiguability;
• inability to concentrate, forgetfulness, distraction;
• excessive irritability, provocativeness;
• the presence of insomnia, short-term intermittent sleep, superficial sleep;
• low self-esteem, constant condemnation of oneself and one's actions;
• phantom pains;
• thoughts of suicide;
• loss of appetite, weight loss.

Next, the doctor will evaluate the symptoms that he was able to establish. Thus, to diagnose depression, it is necessary that five indicators in a patient last for several weeks, since short-term affects do not signal depression at all. These symptoms may increase, decrease, change into chronic stage. Most often, severe depression is combined with somatic disorders.

Externally, depression also has its manifestations that need to be noticed. Patients suffering from depression have a preoccupied look, try to avoid direct looks, are unable to connect simple judgments, facts, make long pauses in conversations, as if they are forgetting something. The movements of such patients are slow, smooth, as if they are doing them through force. The facial expression is sad, tearfulness is possible, as a reaction to petty troubles, memories, a way of manipulating others.

Today, this diagnostic method remains the main one in detecting depression in patients, however, in medical science, studies of the brain ventricles and hormonal levels are being conducted to link these indicators with depression.

Treatments for depression

Treatment of depression is carried out by two main methods - medication with the appointment of antidepressants, and non-medication, based on a series of psychotherapy sessions with specialists. Since depression is both very difficult to diagnose and treat, only a doctor should prescribe drugs.

Treating depression with deprivation

This method is currently very popular. Especially in Western countries. According to the effect achieved, it can be compared with an electric shock, which quickly brings a person out of depression.

Previously, human sleep was considered the main type of recreation, the adjustment of the work of all systems and organs, the “turning off” of the brain, etc. Indeed, the impact of sleep on human health is enormous. The method of deprivation works on the principle of "knocking out a wedge with a wedge" - the patient is deprived of sleep so that his body receives even more stress than during depression. Exactly half a century ago, this theory was proposed by the Swiss psychiatrist W. Schulte, who discovered the healing properties of insomnia to the world. With the help of research by this scientist, sleep disorders, depression and other diseases are treated with deprivation. As a result of prolonged insomnia, a person finally gets the opportunity to fall asleep and the emotions from sleep prevail in his mind, displacing depression.

Patients with depressive disorders have disturbances in their normal circadian rhythm. In the morning they are lethargic, lethargic, want to sleep, and in the evening their activity may increase. Deprivation is designed to restore normal biological rhythm patient, in which his physiological and biochemical processes in the body will be coordinated. Deprivation works best on patients with manic psychosis, schizophrenia, neurotic depression.

During deprivation treatment, the patient is not allowed to sleep for about thirty-six to thirty-eight hours. This is followed by sleep and again the same period of wakefulness. Many patients experience improvement after the first deprivation session, but usually doctors perform six sessions or more of the procedure. V initial stage treatment, patients may feel a deterioration in their condition, but the maximum positive changes await patients in the morning after the second and third sessions.

Medical method

The method is based on the prescription to the patient special preparations- antidepressants, antipsychotics, mood stabilizers, etc. All drugs should be prescribed strictly according to the doctor's prescription, which evaluates the patient's condition, takes into account the characteristics of the course of the disease, possible complications, etc. This method is the main one in the treatment of most types of depressive conditions. To date, a large number of proven antidepressants with whom physicians have been working for decades. These are amitriptyline, melipramine and others. With intravenous administration of these drugs, the therapeutic effect occurs within a few days, but they also have side effects. Among other drugs that are no less effective, one can name selegiline, moclobemide, cipramil, paroxetine, sertraline, fluoxetine. Despite the fact that the drugs are easily tolerated, they should not be taken on their own, without consulting a doctor. In some cases, the use of these drugs may not only not bring the expected result, but also contribute to the worsening of the course of the disease.

Speaking of neuroleptics, it is worth noting that these drugs can successfully replace antidepressants, which for some reason are contraindicated in patients. Mostly drugs are used to treat short-term depression associated with metabolic disorders in the brain, organic lesions of the central nervous system, etc. The drugs are not addictive and have fewer side effects than antidepressants. The most commonly prescribed drugs are haloperidol, chlorpromazine, fluspirilene.

Another group of drugs normothymic drugs- able to stabilize mood in patients with affective disorders (quetiapine, risperidone, clozapine). Such patients become less irritable, short-tempered. With the help of these drugs, recurrent phases are softened and shortened, and the progression of the disease is inhibited. Since this group of drugs is marked by high activity, doctors carefully make combinations with this group of drugs.

Additionally, in the treatment of depression are used vitamins and amino acids that improve the action of the main drugs. This makes it possible to accelerate the effect of the onset of antidepressants and antipsychotics. For each drug, its own vitamins and amino acids are selected, the use of which, after the withdrawal of the main drug, continues for some time.

Psychotherapeutic methods
Psychotherapeutic methods consist of a complex of individual techniques (psychodynamic, trance, etc.), which the doctor uses in combination with each other. As practice shows, the use of methods separately gives poor results, but combined psychotherapy can achieve high results. Psychotherapeutic methods are aimed at influencing the central nervous system, while sometimes the effect is so much beyond expectations that for mild depressive disorders, psychotherapy is used as the only method of treatment, without medication. With severe depression, it is used along with drug treatment. Psychotherapy is often combined in the treatment of depression with biotherapy.

Methodology rational psychotherapy is the most common and most proven to date. The treatment system was first outlined over a hundred years ago by a Swiss neurologist. During this time, the experience of treating depression by this method has undergone some changes and has been enriched with experimental results. The therapy consists in convincing the patient that his assessments of reality are erroneous, and that the source of depression is a distorted, unreal world.

Method psychodynamic psychotherapy consists in the formation of a certain standard of behavior that is necessary for the doctor.

Interpersonal Psychotherapy is aimed mainly at solving current problems, is short-term and highly effective. It is used for depression over deceased relatives, with interpersonal conflicts, changing the role of the patient in society, loneliness.

Not directive therapy includes other types of psychological assistance, in which the doctor's actions are minimized - the patient is set up to solve his problems on his own, goes to psychological assistance groups, individual consultations, etc.

Physiotherapy methods

These methods are used as additional methods in the treatment of depression, since as such medicinal properties do not have, however, for patients of this category are extremely important in terms of rehabilitation. These techniques include music therapy, light therapy, healing sleep and other methods.

shock technique

The shock technique is based on the theory that the body should receive a shock that is greater in weight for the body than a depressive state. It is taken into account that the effect of shock should not bring complications for the patient and aggravate his situation - shock techniques, as a rule, are short-term and dosed, selected for a particular patient, depending on the characteristics of the course of the disease. These methods include therapeutic fasting, medical shock therapy, electroconvulsive therapy, treatment of depression by depriving the patient of sleep.

During electroconvulsive therapy, an electric current is passed through the patient's brain, which provokes a seizure. This intervention is equivalent to small surgical operations therefore, it requires special preparation of the patient.

The initial symptoms of depression do not have pronounced manifestations. At first, they look like temporary increased irritability, but gradually such conditions occur more and more often. And now the problems with sleep begin, and the depressed state practically does not go away. Depression is not uncommon in today's society. Every tenth person over 40 suffers from this type of disorder, and this percentage is constantly growing.

At the same time, the disease “gets younger” from year to year. Often, even children with serious depressive disorders are recorded for an appointment with a psychologist. The disease brings suffering not only to the sick person, but also to his entire environment. During an exacerbation, the character of the patient often becomes unbearable. Some try to alleviate their condition with the help of alcohol or drugs and this only aggravates the situation. At the same time, the people around, and even the person himself, are often simply unaware that he is sick and needs help.

depression syndrome

The symptoms of depression can vary from person to person. It depends on the individual characteristics psyche. However, the first signs of depression can be identified:

• decreased mood;
• feeling of depression and oppression;
• severe irritability, anger;
• feeling of abandonment and uselessness;
• apathy, loss of interest in life;
• fast fatiguability.

If at least three of these symptoms are observed, then we can talk about the presence of depression. Before determining depression, observations are made for two weeks. Only then can a diagnosis be made. Over time, the disease progresses, and the subsequent stages of depression are characterized by new manifestations: communication decreases, the desire to communicate disappears. There is a change in appetite, both in one direction and in the other. There may be complete indifference to food and, conversely, sudden bouts of hunger. This results in a change in weight.

With severe depression, obsessive thoughts about suicide, one's own uselessness and uselessness arise. Objective self-esteem and self-confidence are falling. There is constant self-torture, experiencing the past, while the future is seen only in a gloomy light. Against the background of a constant decline in strength and fatigue, psychomotor retardation appears, which can be replaced by a sudden short-term excitement. All this negatively affects performance, which only exacerbates the situation. In addition, persistent depression most often leads to sexual disorders in humans.

In medicine, it is customary to distinguish the following types depressions:

• dysthymia;
• dysphoria;
• hypothymia;
• hypokinesia.

Dysthymia is characterized by an unreasonable depressed state, a decrease in interest in what is happening. The general tone decreases and desires become dull. With dysphoria, bouts of unreasonable aggression, irritation and anger often occur. Increased sensitivity to external stimuli.

A person suffering from hypothymia, as it were, withdraws into himself, becomes withdrawn and uncommunicative. There is a feeling of deep sadness and longing, a premonition of impending misfortune. There may be a feeling of heaviness or tightness in some organs. With hypokinesia, the syndrome of slowness of movements is pronounced, the general tone drops significantly and the physical condition worsens. There may be weakness and a complete lack of desire to do anything.

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Where did sadness come from?

The causes of depression can be objective, for example, some personal tragedy (loss of a loved one, divorce, financial collapse, etc.). But sometimes it seems that the disease comes for no apparent reason. However, nothing happens just like that, and the disease can be the result of certain factors.

The causes of depression are divided into several main types:

1. Biological.
2. Genetic.
3. Psychogenic.
4. Social.

Biological (organic) depression occurs in half of the cases. Most often they are caused by insufficient blood circulation in the vessels of the brain. As a rule, in this case, the patient is constantly in a depressed-anxious state and constantly complains about his illness. Such depressions even received a separate name - “complaining” or “aching” depressions.

The cause of poor blood supply can be a chronic disease or stroke. After a stroke, during the recovery period, the depressed state of the patient is far from uncommon. Traumatic brain injuries can manifest themselves even a year after the event and cause prolonged depression.

Depression can be inherited. If at least one of the parents suffers from such a disorder, then with age there is a high probability of developing this disease in the child. The disease can also come adolescence, and the reason for this is often the increased vulnerability of the psyche. In addition, there are frequent cases of depression in women in the postpartum period and with menopause.

Among the causes of depression, alcohol and drug addiction can be highlighted. Systematic poisoning of brain cells with toxic substances leads to a malfunction of the entire organ and the onset of depression. Sometimes a person tries to “treat” already shattered nerves with alcohol or drugs. In this case, a vicious circle is created, because the use of "amusing helpers" only aggravates the course of the disease.

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Psychogenic states

Most often found, which is divided into two types:

• reactive;
• neurotic.

happens due to objective facts that actually happened to a person and caused severe psychological trauma. Events can be different - from really serious losses to trifles, to which a person, however, may be too reverent. Moreover, illness can be the result of even a joyful event. This is the so-called goal achieved syndrome, when a person has been striving for something for a long time, and now it has come true! But further comes soul emptiness to be filled with something. If this does not happen, there is a feeling of loss of the meaning of life and there are mild symptoms depression that quickly grows into a serious problem.

Neurasthenic manifestation of depression occurs due to chronic stress. Most often, this form of disorder affects very active people who overload themselves with their activities. In this case, there is no tragic event in the patient's life. The disease originates in psychological fatigue, which is sometimes accompanied by a chain of small failures and disappointments.

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How to get rid of the disease

Therapy for depression in most cases ends successfully, provided that adequate treatment is used. How to cure depression? Like most others, this disease is much more amenable to complex treatment. Moreover, the disease not only affects internal state but also leads to difficulties in social adaptation. Therefore, the way out of depression should be under the supervision of a psychologist. What is required for quality treatment?

1. Psychotherapy.
2. Medicines.
3. Physiotherapy.

The therapist has a wide range of techniques and knowledge of how to get rid of depression. An excellent effect of combating depression is cognitive-behavioral psychotherapy, which helps the patient to tune in to a more optimistic vision of the world and cope with internal problems. It is used in combination with psychodynamic and existential psychotherapy. They are complemented by various trance techniques and hypnosis.

Medical treatments for depression:

• antidepressants;
• neuroleptics;
• normotimics;
• neurometabolic drugs;
• vitamins;
• amino acids.

Medications must be selected by the attending physician on a strictly individual basis.

You can't self-medicate because effective treatment possible only if it is prescribed in accordance with the diagnosis. Without being a specialist, it is almost impossible to diagnose yourself and choose treatments for depression. Moreover, many of these drugs are sold only by prescription. It is advisable to use even medicinal herbs only after consulting a doctor who will give recommendations on how to get out of depression.

Physiotherapy includes procedures such as light therapy and color therapy. Light therapy can be done independently. To do this, you need to purchase special device, often referred to as a "lightbox". The essence of the treatment is that you need to look at the light emitted by the device. How to deal with depression, what is the duration of the sessions and their frequency, is detailed in the instructions for use of the device. This type of treatment can be prescribed by a doctor and carried out on an outpatient basis.

Treatment of depression may include music therapy, mesodiencephalic modulation (exposure to a weak electric current on the brain), therapeutic sleep, etc. Physiotherapy alone cannot give a strong therapeutic effect, but can be an excellent addition to the main treatment, lead to the speedy disposal of depression and full recovery.

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Depression(from Latin deprimo - “pressure”, “suppress”) - a mental disorder characterized by a “depressive triad”: a decrease in mood and a loss of the ability to experience joy (anhedonia), impaired thinking (negative judgments, a pessimistic view of what is happening, and so on), motor retardation. With depression, self-esteem is reduced, there is a loss of interest in life and habitual activities. In some cases, a person suffering from it may begin to abuse alcohol or other psychotropic substances. Represents a variety affective disorders(mood disorders). Depression is treatable, but depression is currently the most common mental disorder. It affects one in ten over the age of 40, two-thirds of them are women. Depression is three times more common among people over 65 years of age. Also, about 5% of children and adolescents aged 10–16 years are affected by depression and depressive states. According to the World Health Organization, depression is the leading cause of adolescent illness and disability. The overall prevalence of depression (of all varieties) in adolescence ranges from 15 to 40%. Many studies emphasize that the greater prevalence of affective disorders at this age corresponds to a higher frequency of suicides.

Types of depressive illnesses

• People with major depression (sometimes called unipolar or clinical depression) experience some or all of the following symptoms for at least two weeks, most often for several months or longer. Episodes of this disease may occur 1-2 times or several times during a lifetime.
• People who have dysthymia experience the same symptoms, but they are not as severe and last for at least two years. These people are often devoid of "thirst" for life and enthusiasm, their existence is bleak and tiring, and this seems to be a natural extension of their character. In addition, they may experience episodes of major depression.
• Manic-depressive psychosis (or bipolar disorder) is not as common as other forms of depression, episodes of depression come in fits and starts and alternate with episodes of mania. During episodes of mania, people may be overly active and talkative, may enjoy everything for no reason, get irritated, spend money frivolously, and become embroiled in sexual misadventures. And for some, mild episodes of mania, or hypomania, alternate with episodes of depression. Unlike other cases of mood disorders, men and women are equally susceptible to bipolar disorder, although, on the other hand, women in such cases experience more episodes of depression and fewer episodes of mania or hypomania.

Causes of depression

Depressive disorders can appear at any age and in any social group. This is explained, first of all, by the fact that the values ​​of modern society put a significant pressure on a person.

People strive for social well-being, professional success, external attractiveness. If this is not achieved, a person may fall into despair, it is hard to experience failures, and, as a result, depression develops. TO depressive disorder severe psychological trauma can also result, such as the death of a loved one, the breakup of a family, a break in relations with a loved one, a serious illness.

V rare cases depression occurs without any obvious cause. Scientists suggest that in similar situations play a role features of neurochemical processes, in particular, the exchange of neurotransmitters (serotonin, norepinephrine, etc.).

Symptoms of depression

Depression negatively affects every aspect of a person's life. Inadequate mechanisms psychological protection, in turn, have a destructive effect not only on psychological, but also on biological processes.

The first signs of depression - apathy, independent of circumstances, indifference to everything that happens, weakening of motor activity - are the main clinical symptoms depression. If their combination is observed for more than two weeks, it is necessary urgent help specialist.

Mental symptoms:

• depressed mood, joylessness;
• loss of interest, decreased motivation, loss of energy;
• self-doubt, guilt, inner emptiness;
• decreased speed of thinking, inability to make decisions;
• anxiety, fear and pessimism about the future;
• daily fluctuations;
• delirium is possible; suicidal thoughts.

Somatic symptoms:

• vital disorders;
• sleep disturbances (early awakening, the ability to wake up);
• appetite disorder;
• constipation;
• sensations of compression of the skull, dizziness, a feeling of pressure;
• vegetative symptoms.

When talking with a patient, a psychologist or psychotherapist identifies the following criteria:

• Depressed mood.
• Feeling tired.
• Rising concern.
• Lack of desires and interests.
• Decreased sexual interest.
• Frequent nervousness and photophobia.
• Careless attitude to personal hygiene and daily duties.
• Constant need for rest.
• Irritability, restlessness and nervous tension.

The above symptoms are starting. If they last long, they lead to mania.

Early warning symptoms of depression

• Fatigue, feeling of exhaustion, lack of energy
• Depressed mood, depression
• Increased need for rest
• Decreased self-confidence, self-doubt
• Increased sophistication and concern
• Lack of interest and desire
• Sleep disturbances and sleep maintenance
• Careless attitude to daily duties
• Attention disorder (thinking is difficult)
• Decreased sexual interest
• Fear, nervousness
• Decreased resistance to stress, decreased performance
• A person takes everything personally, believes that others talk badly about him
• Changes in the daily routine
• physical ailment
• Increased alcohol consumption
• Tension, anxiety
• Irritability

Various parameters of depression in women

Studying depression in women, scientists pay attention to Special attention the following questions:

adolescence

There is very little difference in depression levels between boys and girls before they enter adolescence, but between the ages of 11 and 13, girls' depression rates skyrocket. By the time they are 15, girls are twice as likely as boys to experience episodes of major depression, and this is happening at a time when teen assignments and expectations are undergoing significant changes. Formation of personality, awakening sexuality, separation from parents and the time when for the first time it is necessary to make independent decisions, as well as physical, mental and hormonal changes- all this causes stress in adolescents. Stressful situations of this kind usually affect boys and girls differently and may be more commonly associated with depression in girls. Studies show that, compared with boys, who are more likely to experience aggressive behavior, high school students have significantly higher rates of depression, anxiety disorder, eating disorder, and adjustment disorder.

Coming of Age - Relationships and Responsibilities

Usually, stress contributes to depression in cases where people are biologically susceptible to this disease. There is an opinion that the high level of depression in women is not due to the fact that they are more vulnerable, but to the fact that women face certain stressful situations. Such stressful situations can be basic responsibilities at home and at work, raising a child without a father, and caring for children and aging parents. It is not yet entirely clear how all these peculiar factors affect women. Major depression is high in both men and women who are divorced or separated from their spouse, and low in married people, although women also have higher rates of major depression. One way or another, and the quality of marriage can significantly contribute to the disease of depression. Relationships that lack intimacy and trust, as well as repetitive quarrels between spouses, are now known to be associated with depression in women. So, it turned out that among women who are unhappy in marriage, there is the highest level of depression.

reproductive period

The reproductive period in women includes the menstrual cycle, pregnancy, post-pregnancy, infertility, menopause, and sometimes the decision not to have children. All of these events can cause mood swings and, in some women, depression. Scientists have confirmed that hormones affect chemical elements brains that control emotions and mood, but they do not know the specific biological mechanism that explains the effects of hormones.

Many women experience certain changes in mood as well as physical changes associated with different phases of the menstrual cycle. For some women, these changes can be abrupt, occur regularly, and cause feelings of depression, irritability, and other emotional and physical changes. Called premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), these changes usually begin after ovulation and continue to worsen until menstruation begins. Scientists are investigating how the cycling up and down levels of estrogen and other hormones can affect brain chemistry associated with depressive illness.

Pregnancy, if desired, rarely leads to depression, and the same is true of abortions - they do not lead to widespread depression. Women suffering from infertility may experience feelings of extreme anxiety or sadness, but it is not known whether infertility leads to increased levels of depressive illness. Motherhood, in turn, can be a time when the risk of depression increases due to the stress and responsibilities of motherhood. As for menopause, it is usually not associated with the risk of depression. So, although depression was once considered a unique illness, studies have shown that depression that occurs during menopause is no different from depression during other periods. life periods. Women who are more susceptible to life-changing depression are women who have had depression before.

Circumstances associated with a particular culture

In terms of depression per se, rates are twice as high among African American and Hispanic women as among men, but there are some indications that major depression and dysthymia

may be found less frequently in African American women and somewhat more frequently in Hispanic women than in white women. Information about the spread of this disease in other racial and ethnic groups is not conclusive.

Possible differences in how symptoms manifest may affect how depression is defined and diagnosed among minorities. African-American women, for example, may be the most likely to complain of somatic symptoms, such as changes in appetite and body aches. In addition, people different cultures may interpret episodes of depression in different ways. Such factors should be taken into account in cases involving women who represent certain population groups.

Victimization

Research shows that women who have been molested as children are more likely to develop clinical depression at some point in their lives than those who have not. In addition, according to some studies, among women who were raped in adolescence or in adulthood, the level of depressive illnesses is higher. Since the seduction of young girls happens much more often than the seduction of boys, insofar as such conclusions are directly related to this issue. Women who experience other common forms of abuse, such as physical abuse or sexual harassment at work, may also experience higher levels of depression. Violence leads to depression because it contributes to low self-esteem, feelings of hopelessness and guilt, and causes social isolation. The risk of depression is associated with biological factors and environmental factors and may be the result of growing up in a dysfunctional family. More research is needed to understand whether victimization is specifically related to depression.

Poverty

Women and children represent 75% of the US population considered poor. heavy economic situation leads to stress, isolation, insecurity, frequent adverse events and poor access to support services. Feelings of anguish and depressed morale are common among people with low income and disadvantage social assistance However, scientists have not yet established whether depressive illnesses are actually more common among people living in such conditions.

depression in old age

It was once believed that women were especially prone to depression when their children moved away, they were seized by the "empty nest syndrome", and they began to feel that they had lost their purpose in life and their individuality. However, studies show that there is no increase in depressive illnesses at this stage of life.

As with younger people, rates of depressive illness are higher among older women than among older men. And, as with all age groups, the unmarried (this includes widowhood) are also at risk of depression. Most importantly, depression should not be treated as a natural consequence of people's physical, social, and economic problems. old age. On the contrary, studies show that most older people are satisfied with their lives.

Every year, approximately 800,000 people become widows or widowers, most of them older women who varying degrees experience some of the symptoms of depression. Many of them do not require regular treatment, although for those who experience moderate to severe bouts of depression, attending self-help groups or various psychotherapy sessions may seem to be helpful. beneficial effect. One way or another, but during the first month after the death of a spouse (s), the condition of a third of widows and widowers meets the criteria for major depression, and half of them continue to experience clinical depression a year later. The various forms of this disease are amenable to conventional antidepressant treatment, but research on when to start treatment or how to combine medication and psychotherapy sessions is at an early stage.

Clinical Research on Symptoms of Depression

As a result clinical research depression is caused by a disease that cannot be treated on its own. Due to psychological disorders, a person cannot cope with it by a simple effort of will. The main symptom of pathology is the oppression of the spirit and the ability to self-heal. Feelings of sadness and constant anxiety indicates psychological problems. If depression is triggered by a tragic event, such as a loss of loved ones, a divorce, or being fired from a job, the person often becomes addicted to alcohol. However, in some cases, the symptoms of pathology occur without expressed cause. They affect the daily activities of a person. Gradually, he becomes aggressive towards the people around him.

One of the frequent signs of pathology is a violation of concentration. A person focuses on inner experiences, so it is difficult for him to complete the necessary production or home task. Severe depression causes a person to stop responding normally to ordinary things.

Problems such as the inability restful sleep, high pressure, sudden weight loss are common symptoms of the disease. The cause of their appearance is unknown, but they must be treated. When patients with depressive disorders lose interest in life, they stop taking care of themselves. In this case, only the help of relatives and friends will lead to the return of a person to the social environment.

Diagnostics

Diagnosis of depression “I was “attacked” by depression, what should I do?” is a question that is widespread among young people. Yes, most people can already identify themselves with depression and are trying to find ways to get rid of it. But is depression really depression? In order to find out whether a person really suffers from depression, it is necessary to undergo a diagnostic course. Diagnosis of the disease is carried out by an experienced doctor, who, at the first complaints, begins with simple questions about the mood and thoughts of the patient. Next, they move on to tests, on the basis of which the doctor becomes

known picture of the disease. If, nevertheless, the doctor reveals a suspicion of depression, then a series of procedures are carried out to examine the patient, which make it possible to exclude other similar diseases. So, the diagnosis includes: Checking the physical condition: weight, height, pressure and pulse. Laboratory tests: it is necessary to donate blood for analysis to detect abnormalities. Psychological research: a visit to a psychotherapist who talks about the symptoms and finds out the cause of the disease. Also, based on this, the doctor finds out the presence of thoughts about suicidal tendencies, which is important in diagnosing depression. After an appropriate diagnosis is made, it is necessary to immediately proceed to the treatment of depression.

How to get rid of depression?

First steps in treating depression

1. Learn more about depression and how to treat it on our website. Check what symptoms you have, read about existing methods treatment, you can read about what you might discuss with your doctor.
2. Contact a specialist - a psychotherapist. It will help you determine if you have depression and how you can manage it.
3. Talk to relatives or friends. Depression could alienate you from them. Close people can support you during this period and help you find a specialist for the disease. You don't have to be alone with depression. After talking with loved ones, you will feel better.

Contacting a specialist

Depression distorts a person's perception of life and can cause shame, fear, and guilt that a person suffers from it. Many people silently suffer through depression. Some are ashamed or afraid to admit their feelings; others deceive themselves by downplaying the symptoms, treatment of the disease is delayed.

Remember that one of the manifestations of depression is a feeling of hopelessness. It may be hard for you to believe that anything can help you, but in the vast majority of cases, depression is treatable.

After you tell what is happening to you, you can ask a psychotherapist:

• "Do you think I have depression?" (after all, even if you have some of the symptoms described above, only a doctor can make an accurate diagnosis)
• What do you think causes depression?
• What should be done to get rid of depression?
• Do I need to consult with any other specialists? (depression is often combined with neurological pathology) If yes, could you recommend someone?
• Do I need to take a vacation, relieve some of my responsibilities, somehow change my lifestyle?
• How long can depression last?
• What are the consequences if you do not start treatment right now?
• What is the preferred treatment method? drug therapy, psychotherapy or their combination (combination therapy)?

What else can you do to get rid of depression?

1. Don't make big decisions. Depression can prevent you from making an informed decision, because in depression a person perceives himself and the world around him biased.
2. Try to avoid stress. For a person suffering from depression, even a small load can seem like a heavy burden. Do not overwork yourself even when you feel that you have strength - this can cause a worsening of the condition.
3. Take care of your body. In a state of depression, a person often loses physical strength, feels exhausted. If you feel that you have physical strength - give your body a little physical activity, but do not overdo it - start walking a little or take care of the flowers.
4. Eat regularly and enjoy. If you have an appetite - do not deny yourself delicious food. This will help you bring back the taste for life. When depression is impaired immunity, so try to eat more vitamins.
5. Avoid negative thoughts. If you have a negative thought - try to think of something pleasant, distract yourself with some action - make a cup of tea, listen to the radio or call a friend.
6. Communicate with friends and relatives, even overcoming yourself. Your loved ones can be a source of support. They can help you make decisions or solve problems that you are afraid of not coping with, help with household chores.
7. Feel free to let your therapist know about any concerns or changes in how you feel. The doctor will help to cope with any problem if he knows about it.
8. Do not take alcohol and drugs - they can provoke a worsening of the condition. Try not to abuse sleeping pills

Talk to your loved ones about what is bothering you - they will support you.

Most often, depression develops against the background of stress or a long-term traumatic situation. Often depressive disorders are hidden under the mask bad mood, character traits. In order to prevent severe consequences it is important to understand how and why depression.

Causes of depression

Depressive disorders can appear at any age and in representatives of any social groups. This is explained, first of all, by the fact that the values ​​of modern society put a significant pressure on a person. People strive for social well-being, professional success, external attractiveness. If this is not achieved, a person may fall into despair, it is hard to experience failures, and, as a result, depression develops. Severe psychological trauma can also lead to a depressive disorder, such as the death of a loved one, the breakup of a family, a break in relations with a loved one, and a serious illness.

Rarely, depression occurs without any apparent cause. Scientists suggest that in such situations, the features of neurochemical processes play a role, in particular, the exchange of neurotransmitters (, norepinephrine, etc.).

Symptoms of depression

The emotional manifestations of depression are very diverse. These include feelings of anxiety, despair, reduced self-esteem. A person suffering from depression is experiencing constant fatigue, sadness. He ceases to be interested in what used to bring him joy, becomes indifferent to others.

The behavior of patients also changes. Depression can be suspected if a person loses the ability to purposeful actions, cannot concentrate. A sociable and cheerful person by nature, falling into depression, begins to avoid contact with friends, relatives, "locks himself in four walls." Often there is attachment to alcohol, drugs.

Patients with depression also have some peculiarities of thinking. Thoughts about oneself become negative, a person fixes on negative sides his life, considers himself unnecessary, worthless, burdensome for relatives. It is difficult for the patient to make decisions independently.

Beyond change emotional sphere, physiological (somatic) manifestations are also characteristic of depression. Most often, sleep and wakefulness is disturbed, it occurs. Appetite may disappear completely or, on the contrary, increase and lead to overeating. Patients complain of pain in the region of the heart, stomach, suffer. The energy reserve of the body is noticeably reduced, patients quickly overwork even with slight physical and mental stress. Often there are disorders of the sexual sphere.

Complications

Unfortunately, drug addiction is very often caused by depressive states. Alcohol and drugs create a false sense of well-being in the patient. Depression also underlies a variety of social phobias (fear of losing a loved one, fear of being in public place), and in severe cases can lead to suicidal thoughts and attempts.

What can you do

First of all, you need to know that depression can and should be fought.

If you notice that one of your loved ones has become too often critical of himself, conflicts with family members, work colleagues, experiences an inexplicable feeling of fear, you should consult a doctor. If the patient is diagnosed depression, he needs to be supported, try to cheer him up, even if he himself is not interested in this. Relatives of the patient should understand that depression is a transient condition in which it is necessary to provide psychological help without plunging into the disease itself. Try to convince the patient that it is not his fault that he had depression. Together you will get through this difficult situation.

What can your doctor do

Without treatment, depression can linger for months or even years. The basis of treatment is the use of medications and psychotherapy.

Drugs for the treatment of depression (antidepressants) are selected individually for each patient and are taken for a long time, for several months. Medical treatment will be successful if the patient strictly adheres to the recommended drug regimen.

The goal of psychotherapy is to help a person learn to regulate their own emotions. This method of treatment implies the active participation of the patient himself, his willingness to talk about his problems. All information received by the doctor during a psychotherapy session remains a secret.

Prevention of depression

In order to hinder the development of depression You need to learn how to deal with stressful situations. healthy image life, regular exercise, the correct mode of work and rest - that's what will help you deal with and maintain peace of mind!