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Depression is defined as a state of depressed mood in combination with mental-speech and motor inhibition, somatic symptoms of the sympathic-tonic series (melancholic depression, melancholy). Allocate endogenous , psychogenic ( reactive ) and somatogenic depression .     

Endogenous depression is characterized by the so-called “ depressive triad ”: asthenic affect (low mood, depression), mental-speech and motor block. 

Diagnosis of depression begins with the detection of manifestation of asthenic affect in the form of a decrease in mood from the hood, sadness, to a physical feeling of longing, localized in the region of the heart or behind the food, which sometimes reach a degree of “physical suffering”: patients declare “unbearable pain”, “breaks the heart ”,“ Squeezes like a vice ”, etc. Thinking and speech are slowed down. The whole world is perceived in a gray light. The patient has delusional ideas of self-accusation and self-humiliation, reaching the point of absurdity: a person recalls minor offenses of many years ago, etc. 

Mental and speech retardation is manifested by lethargy, passivity, lack of initiative, etc.

Motor inhibition is manifested in the fact that patients prefer to lie down, have difficulty trying to attract them to any activity, lose their sense of correctness in the actions they perform. The highest degree of motor inhibition is depressive stupor – a state of complete immobility. 

Depressive conditions are the most common cause of suicide. 

Psychogenic (reactive) depression refers to protracted reactive psychoses that occur after severe mental experiences associated with the death of relatives or close people, a real oufose for the life of the patient or his relatives, a sudden violation of familiar well-being, etc. The patient’s mood is depressed. He constantly thinks about the former incident, often begins to consider himself his culprit. If a loved one died, blames himself for being inattentive to him during his life, treating him badly. All these experiences are vividly demonstrative. Sleep is disturbed, somato-vegetative disorders appear. 

Somatogenic depression occurs with somatic diseases, mainly due to endogenous intoxication (see the topic ENDOGENIC INTOXICATION SYNDROME) and is manifested by a decreased mood in combination with asthenic syndrome: weakness, fatigue, irritability, and vascular reactions. 

Emergency (first) relief for depression

1. The appointment of antidepressants such as imipramine (synonyms: melipramine, imizin, depsonil, etc.) in a dose of 1-2 ml of 1.25% solution or amitriptyline in an amount of 2 ml of 1% solution in oil.  

2. Isolation of the patient in a separate room and careful monitoring to prevent self-harm and suicidal attempts.  

3. The call of the psychiatric team . 

Hospitalization for depression . With manic-depressive psychosis, the patient must be urgently hospitalized in a psychiatric clinic.