Long-term depression: causes, diagnosis and treatment

Depression is a condition that can be caused by somatic or nervous disorders, or be a consequence of stress, family troubles, or other problems in personal or social life. It can also develop absolutely without any external reasons, against the background of complete well-being - in this case, the cause, as a rule, is a violation of the level of neurotransmitters in the brain.

To receive quality treatment, the patient must realize that bad moods can occur in absolutely healthy people. While with depression, low mood or depression lasts for at least two weeks and may be accompanied by sleep disturbances, appetite, decreased performance and other symptoms, which we will discuss later.

Depression can occur in people of any age, regardless of gender. The death of a close friend, relative, loved one or child can be a catalyst for progressive feelings of sadness. Sometimes the only beloved child, unexpectedly for those around him, becomes unsociable and withdrawn. We need to try to figure out the reasons as quickly as possible and help him gain faith in himself. A simple misunderstanding among classmates and friends or the appearance of another child in the family can disrupt the psychological balance and become the root cause of depression.

Prediction and distribution of depression

It is safe to say that depression is the most common psychological illness. It has been successfully treated for a long time; a specialist is able to restore the patient’s faith in himself in a few sessions. Most often, women who seek help are those who, due to their mental characteristics, are more susceptible to stress. Of the four ladies, one had to seek specialized medical help at least once in her life. Men are more resilient in this sense; only one in ten bothers psychologists with requests for help with a depressive episode. This prevalence of the disease is compensated by the fact that in 90% of cases, people who consult a doctor completely get rid of the disease.

Prevention

Measures to prevent depressive disorders may include maintaining a healthy lifestyle, giving up bad habits, actively combating stress, normalizing sleep and eating a balanced diet.

Regular exercise is beneficialSource: Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity Aaron Kandola, Garcia Ashdown-Franks, Joshua Hendrikse, Catherine M Sabiston, Brendon Stubbs. Neuroscience & Biobehavioral Reviews, Volume 107, December 2021, being in the fresh air, active communication with family and friends, having a hobby or hobby.

Sources:

1. Depression: find and neutralize. Sosunova N.A. Healthcare of Ugra: experience and innovations, 2015. p. 5-9
2. Depression: from treatment to prevention. Hovsepyan A.A. Difficult patient, 2015. p. 46-49
3. Depression in neurological practice. Romanov D.V., Petelin D.S., Volel B.A. Medical Council, 2021. p. 38-45
4. Depression and antidepressants. Lyubin G.S. Medical news No. 8, 2019. p. 8-12
5. Neural mechanisms of the cognitive model of depression. Seth G Disner, Christopher G Beevers, Emily AP Haigh, Aaron T Beck. Nature Reviews Neuroscience volume 12, pages 467–477(2011)
6. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Aaron Kandola, Garcia Ashdown-Franks, Joshua Hendrikse, Catherine M Sabiston, Brendon Stubbs. Neuroscience & Biobehavioral Reviews, Volume 107, December 2019
7. Circadian regulation of depression: A role for serotonin. Rachel A Daut, Laura K Fonken. Frontiersin Neuroendocrinology, Volume 54, July 2019

Symptoms

The first thing that catches your eye when talking with a person who is depressed is joylessness and pronounced depression. Melancholy and anxiety can be read on the patient’s face. In this state, people feel abandoned and forgotten, it seems to them that friends and relatives have turned their backs, and the world around them wants to get rid of their presence as quickly as possible. When talking with such patients, you can find that they most often complain about:

• A sharply decreased appetite or a complete loss of interest in food (although with the so-called “atypical depression”, on the contrary, the appetite increases and there is a craving for sweet, starchy, and sometimes fatty foods - the person “eats” depression and can gain several kilograms in a relatively short period of time) .
• Having problems sleeping. Constantly haunted by nightmares, night's sleep becomes superficial and light, not bringing a sense of rest. In order to fall asleep, you need to take strong medications. After waking up, such people do not feel relief; fatigue does not leave them.
• The feeling of joy goes away. Even ordinary physiological pleasures become inaccessible.
• Interest in the events happening around is lost, even if they directly concern the person.
• Loss of strength is expressed in the reluctance to do the usual work. A little tension causes an attack of mortal fatigue.
• It is difficult to concentrate on simple life situations.
• Symptoms are often expressed in absolute helplessness and a feeling of uselessness to loved ones.
• A painful feeling of guilt that arises for any reason (or “the beginning of a feeling of guilt” - the feeling “I’m disturbing everyone,” “it would be better without me”) is a very dangerous symptom from the point of view of the risk of a suicide attempt.

From origins to modern times

Depression

- is not at all a phenomenon that suddenly became popular or seemed to be a consequence of superstition. This is a real disease, a problem that began around the time humanity appeared. Proof of this can be a written source that has survived to this day - the Bible. It describes the story of the first king of the Jews, Saul, who lived in the 11th century BC. His condition was a mixture of all negative emotions: Saul was angry and gloomy, angry, depressed. And only playing the lute was able to humble the king and ease his suffering. The brave and valiant David, who performed delightful music, helped Saul get out of his difficult situation. But Saul was not filled with gratitude. Envy of the brave warrior, who so easily gained fame and recognition of the people, burned the heart of the king and drove him into even greater despondency. Depression and anger forever left Saul painfully aware of reality. This story shows signs of depression. The aggravation of the causes of the king’s illness is also caused by his feeling of guilt for his broken promise to God. Being in deep prostration, the king, unable to stand it, kills himself with a sword.

Depression in people from wild tribes occurred in conditions in which the imperfect human psyche could quickly adapt, which allowed them to survive in the future. Ancient Egyptian priests several thousand years ago already knew how to treat patients with constant melancholy. Around 5000 BC, the thinker Pythagoras advised people who fell into a sick state to listen to music. A thousand years later, Democritus recommended reflection, that is, analyzing one’s condition in order to get rid of the causes of suffering. Around the same time, Hippocrates called the mental disorder melancholia and noted that it is the human brain that causes grief, sadness, and poor sleep and nutrition. Madness, anxiety and fear have their origins in the functioning of the brain. Hippocrates tried to “divide” melancholy depending on the reasons for its manifestation. For example, overwork and other external factors led to a semblance of melancholy, while the disease itself arose for no reason.

Today, such conditions are given names, namely, “psychogenic” and “endogenous” depression. Plato viewed disease carriers as creative individuals in comparison with healthy people living their everyday philosophy. Aristotle, by the way, in the 4th century BC wondered about the close connection between the activities of talented people and melancholy. In the 17th century, the English professor R. Barton, the author of “The Anatomy of Melancholy,” himself suffered from depression and in his work outlined everything he knew about the disease. Barton's views on the disease turned out to be close to the views of modern scientists. Thanks to the works of outstanding authors, it is now possible to use modern techniques in the fight against depression.

How depression physically manifests itself

People who are depressed often experience headaches, accompanied by dizziness and sometimes loss of consciousness. Aching pain in the heart area and heaviness in the abdomen may appear. Patients begin to complain of aching muscles and joints. The work of the gastrointestinal tract is accompanied by unsystematic changes in diarrhea and constipation. In women, the menstrual cycle is disrupted, and men may completely lose interest in sexual activity. Many somatic diseases can be a manifestation of depression. It is for this reason that among specialists there is the concept of masked depression. A similar term explains the condition when the disease is hidden behind somatic disorders. Statistics paint an alarming picture, stating that at least a third of patients visiting surgeons, internists, endocrinologists, gynecologists and other specialists, in fact, suffer from depression.

Etiology

To date, the exact causes of depression have not been clarified. But the most widespread and clinically confirmed theory is hereditary disorders of neurotransmitter production. But the impetus for the development of the disease is external reasons:

• serious illness, death of a close relative;
• chronic fatigue;
• constant conflicts in the family and/or at work;
• regular severe stress, etc.

Some experts believe that a predisposition to depression is formed in early childhood, when, due to incorrect upbringing, the child becomes dependent on the opinions of others and fears that his actions will be incorrectly assessed.

Depressive episode and its dangers

In this state, a number of patients have an irresistible desire to commit suicide. Severe depression can lead to suicide. An inexplicable feeling of anxiety or melancholy pushes people between the ages of fifteen and twenty-five to take rash, spontaneous actions. This is the most dangerous period of life, when a lack of worldly wisdom can push you to a terrible point. Every day, about fifteen people die attempting suicide. Experts say that depression most often leads people to suicide. If you are plagued by feelings of anxiety, joylessness, or depression of an inexplicable nature, do not delay visiting a specialist.

Types of depression

Once you see a doctor, you can count on a correct diagnosis and quick treatment results if the specialist can objectively determine the form of the disease. Timely recognition and application of proven treatment methods guarantee a quick exit from an anxious state.

• Neurotic depression is a patient’s condition when he reacts painfully to various problems and becomes withdrawn and depressed for any reason. With neurotic depression, patients have difficulty getting out of a traumatic situation.
• Situational or reactive depression differs from neurotic depression in that the patient responds more quickly to treatment. A correct diagnosis and strict adherence to the specialist’s recommendations make it possible to quickly cope with the disease.
• With endogenous depression, not only personal qualities and people’s reactions to changing situations are involved in the process of formation of the disease state, but also metabolism, genetic characteristics, and heredity. The disease sometimes manifests itself without any reason or pressure from external factors. In this case, the trigger can be not only stress, but also a common cold or a banal change in the weather. Women during menopause should pay special attention to sudden mood changes. Endogenous depression manifests itself most clearly in the morning, and neurotic depression in the evening.
• Bipolar depression has its own dangers. A severe form of the disease leads to a painful, manic, elevated state, when inexplicable joy makes one perform wonderful deeds. Often such an unreasonable rise in mood sharply turns into a feeling of melancholy.
• Unipolar types of depression are not accompanied by sudden mood swings. In this case, joylessness and depression constantly weigh on the patient’s shoulders.

Reasons for development

There are many reasons for long-term depression. The literature describes a group of social causes, physiological and psychological. The focus is on the physiological origins of the disease:

• disruptions of cerebral blood flow;
• drug use, alcoholism;
• traumatic brain injuries;
• disruptions of the hormonal system;
• genetic determination.

The first psychological factor is childhood trauma. They are formed by the pedagogical ignorance of parents and a harsh attitude towards children. In second place among the causes are acute traumatic situations. These are separations, divorces, death of a relative, military actions, etc. The disease often develops against the background of impaired self-esteem and lack of self-esteem. At the same time, there are problems in the perception of one’s own “I”.

Psychological reasons also include unhealthy relationships. A codependent relationship or marriage is a situation where a person desires complete fusion with his partner. In such a situation, the patient begins to “experience himself” through the prism of his partner. The described dependence increases the risks of mental pathologies. The situation is especially dangerous when codependent relationships break up.

Social factors - the presence of emotional experiences that arose due to the impossibility of self-realization in the work or public sphere. The situation is aggravated by social pressure on any issue (for example, gender stereotypes, homophobia, etc.). Social problems initially increase the level of anxiety and worry. Then they gradually lead to mental illness.

In a social environment, the danger comes from cultivating success. A sensitive person watches successful people, but for some reason such achievements are impossible for him to realize. Women are more likely to pay attention to achievements in the area of ​​physicality. But the image of a slim body is not achievable for everyone. The mechanism of social comparison of oneself with others is activated, and the risks of depression increase.

How to identify depression

If a person close to you is constantly gloomy and sheds tears for any reason or without it, he is overcome by thoughts about the imminent end of his life, he constantly looks at everyone as enemies, take him to the doctor or invite a specialist to your home. Treatment will be more effective if you start fighting the disease in a timely manner. This is the case when it is impossible to play it safe. It is easier to fight the disease if a person is aware of the danger and is ready to listen to the doctor’s recommendations. A severe form of the disease requires hospital treatment. If you notice frequent mood swings, lethargy, lack of appetite, or the appearance of unexplained pain in different parts of the body, do not delay, visit a doctor as soon as possible.

Diagnostics

The doctor determines the diagnosis based on typical complaints, assessment of lifestyle, medical history and special tests to determine the level of depression. To make a diagnosis, a doctor needs to assess the level of depressive disorders, the presence of at least two symptoms included in the depressive triad, as well as the presence of additional indicators. These are pessimistic moods, constant feelings of guilt, problems with decision-making, serious difficulties with concentrating, low self-esteem, suicidal thoughts, sleep disorders, severe fluctuations in appetite.

To exclude somatic diseases, an examination is carried out with consultation from specialized specialists.

Where to look for help

Remember that even though the disease may seem unserious, only a highly qualified psychiatrist with sufficient practical experience can cure it. If you find these symptoms in yourself or your loved ones, we recommend that you contact a specialist.

It is important to convince the patient that help will be effective if the specialist’s recommendations are fully followed. CELT employs doctors who will help you quickly cope with any manifestation of depression. Treatment will always give a positive result if you start working with the patient in a timely manner.

Depersonalization-derealization syndrome is a fairly serious mental disorder that can easily be corrected. If you find these symptoms in yourself or your loved ones, we recommend that you consult a specialist. To clarify the diagnosis and receive qualified medical care, you can contact CELT. This is one of those conditions in the treatment of which our psychoneurologists achieve good results.

Make an appointment through the application or by calling +7 +7 We work every day:

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Treatment

Only a doctor can determine ways to get out of depression. Thus, depressive disorders that occur in a mild form can be corrected through psychotherapy and supportive treatment. You need to visit the doctor about twice a week, he can determine, together with the patient, ways to get out of a depressive state. Consultations can be either face-to-face or by telephone or video conference. The doctor will explain that these are not problems of mood and character, but a serious illness, will tell you how this or that variant of its course is treated, will help you understand what is happening, and will advise ways to correct your mood.

Moderate to severe depression requires medication in combination with psychotherapy and complementary treatments. All antidepressant drugs are selected individually, taking into account existing manifestations and additional factors, they are used for at least 6-12 months in a row, also identifying possible signs of recovery from depression. Source: Depression and antidepressants. Lyubin G.S. Medical news No. 8, 2021. p. 8-12. If necessary, the doctor will supplement the treatment with other medications - antipsychotics, anticonvulsants or tranquilizers.

Unfortunately, it is difficult to answer how to get rid of depression forever. Often, against the background of provoking factors, the disease can return. Phototherapy, the use of powerful light sources, is often used in combination with other methods to combat seasonal disorder.