Depressive neurosis (dysthymia, neurotic depression)

A disease such as depression can belong to the following types (forms):
- neurotic depression, which is caused by external or internal conflicts, that is, psychogenic factors,

- endogenous depression, which is based on hereditary predisposition and biological (neurotransmitter) changes.

Although in the medical literature, mild endogenous depression is sometimes called “depression of a neurotic, non-psychotic level.” The division of depression into types is intended, first of all, for convenience, which helps to better understand the issues of diagnosis and clinical manifestations of depression, as well as prescribe the correct treatment.

Neurotic depression

Depression of a neurotic nature is one of the possible manifestations of psychogenic, neurotic, stress-related and somatoform disorders according to the ICD 10 classification of mental disorders. This is a depressive adaptation reaction that occurs to negative events for a person, as well as a depressive syndrome in the structure of various neurotic and somatoform disorders.

Neurotic depression is also considered typical of the second stage of development of neurotic disorders (neurotic reaction - neurotic state - neurotic development).

How to get there

Social

Perhaps these are the most common reasons that lead to the development of depression. The following factors negatively affect the human psyche:

• Acute and chronic stress. For example, the loss of a loved one, divorce, betrayal, violence.
• High work loads.
• Job loss and change.
• Retirement.

Older people do not adapt well to changes in life. Therefore, any change, even positive, can lead to the development of stress or depression.

Symptoms of neurotic depression

The structure of the neurotic depression syndrome is distinguished by some features, among which are the reflection in the statements of patients of the psychogenic situation and the absence of the affect of melancholy, which is aimed at the future. A characteristic depressive decrease in the level of activity and a decline in the manifestation of initiative, during neurotic depression, partially manifests itself for a long time. Sometimes there is also a kind of “flight” to work, when the patient tries to “cure” from depressive symptoms by becoming even more involved in work tasks.

If we talk about the main clinical manifestations, then neurotic depression is distinguished by a combination and even coincidence of symptoms of a mental and somatic nature.

The results of clinical observations in neurotic depression show the absence of characteristic daily mood fluctuations. In this case, in the morning during and after they wake up, patients with neurotic depression do not experience pronounced melancholy and hopelessness, early awakenings, as with endogenous depression, but may experience lethargy and weakness.

People suffering from neurotic depression do not have sadness and a gloomy outlook on the future. They are not characterized by hopeless, sad reflections, as well as a pessimistic assessment of the present and past.

Techniques

There are many techniques that help get rid of degradation. How to highlight the most effective:

• Cognitive behavioral therapy. Today it is considered one of the most promising areas. Includes lectures and trainings. Keeping a personal diary, analyzing your behavior. It is aimed at making the patient aware of his own behavior, taking control over it and measuring it.
• Art therapy. Relaxing art activities allow you to release emotions and express your feelings in a safe way. Includes modeling, drawing, fairytale therapy, in the form of creative activities that allow you to repress your experiences.
• Body-oriented diagnostics. Through body language, work is carried out under the patient’s suppressed experiences.
• Breathing exercises, meditation.
• Psychoanalysis – helps to identify the cause, associated psychological problem.
• Existential-humanistic therapy helps to understand your life style and build correct behavior.
• Gestalt therapy allows you to get rid of the means of experiencing and the burden of the past.
• Neurolinguistic programming – promotes normal communication.
• Hypnotherapy is an effective way to combat the result of fear and obsessive states.

The attending physician selects the methods. Psychotherapeutic, where there is an individual program and a reasonable price for each patient, you just need to call the site and read the reviews. Sometimes it is not possible to find them right away, but consistent work with a psychotherapist is sure to give results in the end.

Manifestations of neurotic depression

The manifestations of neurotic depression are quite varied. These include sleep disorders, which can manifest as difficulty falling asleep, frequent awakenings and shallow sleep. Also, people with neurotic depression are quite tearful. Even if a person was previously restrained, during illness he often cries for the slightest reason. Patients complain of weakness, decreased general activity and weakness. Often there are manifestations of self-pity along with blaming others for all the troubles, which is not typical for endogenous depression, when the vector of guilt is directed only at oneself.

The above features of the manifestations of neurotic depression syndrome help to effectively distinguish and differentiate it from depressive states of other origins.

Kinds

Clinical practice distinguishes several forms of development of this disease. Each of the neuroses can differ in a number of features of the course and requires an individual approach:

• Neurasthenia is characterized by increased fatigue, decreased performance and concentration, increased vulnerability, all of which is accompanied by frequent headaches.
• Hysterical - nervousness and irritability are noted, there is a tendency to convulsions or paresis. The reaction to the most ordinary phenomena may be inadequate.
• A sad mood is depression, accompanied by apathy, increased fatigue, decreased performance, and a negative emotional background. There may be suicidal thoughts or tendencies.
• Obsessiveness – a person develops uncharacteristic thoughts or actions, self-control decreases, impulses are not restrained.
• Hypochondriacal – characterized by a fear of being subjected to a serious illness or getting into an insoluble situation.

Specialists also study and note such forms of manifestation of cerebral psychoneurosis at an early stage, such as:

• Tics - even imperceptible, but constant muscle contractions are often caused by developing neurosis.
• Insomnia - sleep disturbances are one of the most obvious signs of blues.
• Fears and anxieties - unreasonable and obsessive fears indicate the development of a neurotic coma.
• Apathy is indifference to favorite activities, decreased activity most often accompanies neurotic well-being and a sad mood.

Neurotic depression syndrome

The emergence of neurotic depression occurs due to a variety of internal conflicts (“I want, but I can’t”, “I want, but they don’t give me”, “I want both”), as well as external factors that adversely affect the personality (emotional factors). Of course, in each specific case, these factors will differ. It is unlikely that there are many people who will be depressed because they did not receive the gift they wanted. But those who experience depression due to the death of a loved one are much more numerous. If you pay attention to the influence of the genetic factor on the development of neurotic depression, then it is minimal. As a rule, no affective illnesses are found in immediate relatives, although this is not entirely necessary. But if changes in genes characteristic of depression exist, then neurotic depression in the form of a depressive adaptation reaction to a triggering stress factor may be the beginning of endogenous depression, which, unfortunately, is characterized by a course independent of external causes with subsequent repeated attacks.

The main characteristic feature of the depressive adaptation reaction (neurotic depression) is that it occurs after a traumatic event. The incident does not have to be related to military action, a man-made disaster, or rape. Its intensity can sometimes be just a little greater than other events we encounter every day. Only its subjective significance is important. A place of honor among such factors belongs to old accumulated problems that weigh on a person every day like a dead weight. The range of such situations is quite large: a spouse’s alcoholism, a child’s chronic illness, the inability to contact a loved one, or the need to constantly restrain one’s emotional reactions at work or in the family due to established foundations and traditions.

On the other hand, if you do not have personal vulnerability to a certain external stimulus, then it will not lead you to depression. There are a certain number of features by which one can determine a person’s “susceptibility to a nervous breakdown.” Such people may be characterized by rapid mood changes, strong emotional reactions, and at the same time a bad habit of focusing on the negative aspects of life. As researchers Roth and Mountjoy point out, individuals at risk are those who are very easily infected by emotions, encouraged by good events, but also very easily upset, despondent, and focused on defeat and failure.

As already mentioned, in the clinical picture of neurotic depression there are no manifestations of melancholy and hopelessness, motor retardation, slowing down of the pace of thinking, ideas of self-blame and other characteristic manifestations of endogenous depression. The depressive state in such patients manifests itself to a greater extent in words and statements, practically not manifesting itself in actions and appearance. The condition of patients with neurotic level depression changes depending on the degree of resolution of traumatic events.

Main factors of occurrence

The etiology of depressive neurosis is always psychogenic (stress due to external or internal factors), and contains the causes of neurosis and depression, as well as part of their symptoms, which often complicates diagnosis in the early stages of development. In addition, the clinical picture of the disorder is complemented by somato-vegetative symptoms, which further complicates diagnosis and differentiation with other pathologies.

Neurotic depression can occur in groups of people with directly opposite psychotypes. The first of them is people who are confident in their beliefs, distinguished by categorical statements, setting new goals and achieving them. At the same time, they hide their inner world from others. A large place in it is given to concerns and worries about personal leadership and the assessment of their actions by those around them.

The second group of people susceptible to neurotic depression includes individuals who poorly adapt to various life complications and even natural changes. They are characterized by low self-esteem, inability to make decisions, daydreaming in the absence of action.

Factors that can cause neurotic disorders such as depression in both groups can be long-term psychotraumatic circumstances: personal failures in professional activities, failures in personal life, social relationships. Among these factors, the most influential are:

• constant suppression of real feelings and emotions, hiding true feelings from others;
• inability to distance yourself from a situation, not to get involved, not to take it to heart;
• an overly heightened sense of responsibility and desire to be the best;
• conflict between the goal and the means to achieve it;
• emotional hunger - the absence of like-minded people, loved ones, friends, relatives, the inability to do what you love, to communicate with the people you want.

The accumulation of these unfavorable factors gives a person the impression that it is impossible to correct the situation; he does not even try to look for ways to solve problems, directing all efforts to hiding the internal conflict. As a result, the nervous system cannot withstand such stress, and the first visible sign of depressive neurosis appears - autonomic-somatic disorders.

Treatment of neurotic depression

In the treatment of neurotic depression, it is important to adhere to certain rules, one of which is the mandatory use of psychotherapy. Drug treatment with anti-anxiety drugs and antidepressants is no less important in this case. But psychotherapy plays a leading role in cases where the severity of depressive symptoms is mild and cognitive functions are not reduced. This makes it possible to conduct psychotherapeutic sessions, which is quite justified, since it is known that these disorders are of a psychogenic or psychogenic-personal nature.

But what can be done to minimize the occurrence of neurotic disorders, including neurotic depression? In our complex and traumatic world, it is necessary to regularly protect and take care of yourself, not forgetting about healthy rest and the joys of life. It’s so easy to get sucked into a life routine that doesn’t suit you at all and only causes negative emotions. Don't forget about yourself and appreciate your feelings! Perhaps then there will be no need to visit a specialist and subsequent treatment.

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Prevention of depression

To avoid the development of depression, you must follow the following recommendations:

• Properly distribute workload and rest. Sleep should be full for at least eight hours.
• Maintain a daily routine. The day is for being awake and the night is for resting.
• Proper nutritious nutrition will strengthen the body.
• Lead a healthy lifestyle. To feel good, you need to play sports, you can just go jogging every morning.
• Avoid stressful situations.

You should try to find interesting hobbies that bring joy and satisfaction. Positive emotions are the main prevention against depression.