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What is depression?

Depression is a disease that affects 15% of the population of all countries of the world. The causes of depression are not fully understood. There are many theories explaining this or that aspect of the disease, but only the factors leading to the disease have been identified.

According to the international classification of diseases ICD-10, depression is divided into:

• depression in bipolar disorder;
• depressive episode;
• recurrent depressive disorder;
• depression with cyclothymia and dysthymia.

Depression also occurs: postpartum, child, adolescence, old age, female and male.

Depression occurs when:

• strokes;
• encephalopathy;
• brain tumors;
• bronchial asthma;
• rheumatoid arthritis;
• diseases of the endocrine organs;
• tumors of other organs.

Symptoms of depression can occur with self-medication and poor-quality therapy for various human diseases.

Depression is caused by drugs that lower blood pressure, some antibiotics, oral contraceptives, some drugs for cancer, and drugs that lower blood cholesterol. Depression can throw a person out of emotional balance for a long time and significantly worsen the quality of his life (work activity, personal relationships, leisure). 70% of patients with depression have suicidal thoughts, 15% attempt suicide.

Causes of depression

Depression can be a response to a previous psychological trauma or negative event – the loss of a job, the death of a loved one.

But depression does not arise only due to external causes, genetic, biochemical factors, imbalance of neurotransmitters, hormones provoke the development of symptoms of depression.

Depression symptoms

Symptoms of depression are manifested in various areas of the human psyche and somatics.

Emotionally, the signs of depression are:

• yearning;
• suffering;
• despair;
• irritability;
• anxiety;
• low self-esteem;
• guilt;
• loss of interest in favorite activities;
• lack of emotional closeness with loved ones;

At the physiological level, depression manifests itself:

• body pain;
• headache, migraines;

• weakness, fatigue;
• decreased appetite;
• decreased libido;
• dry mouth;
• incorrect perception of colors and sounds;
• pain in the heart;
• thirst.

In behavior, depression is characterized by:

• privacy;

• passivity;
• alcohol abuse;
• drug use;

The mental sphere in depression is disturbed in the form of:

• slowing down the thought processes;
• a sense of alienation and dissimilarity in comparison with other people;
• decreased concentration of attention;
• avoiding decision making;

In men, depression is difficult to recognize and is manifested by the following symptoms:

• aggressive and hostile behavior;

• alcohol addiction;
• burnout syndrome;
• impulsive behavior;
• passion for extreme sports;
• attempted suicide.

Female depression

Female depression is more common than male depression. The exact reasons for this are difficult to determine. Although, according to most psychiatrists who study the problem of the onset of depression, gender is not at all a biological prerequisite for the development of depression. Experts tend to attribute a greater percentage of the prevalence of female depression to those social prerequisites that exist in almost any society. Women are more likely to find themselves in stressful situations, and they are more inclined to seek medical help, which explains the statistical picture.

Diagnosing depression

Psychiatry remains a branch of medicine in which the diagnosis of any disease, including depression, remains subjective, based on complaints, signs, and the doctor’s experience. In recent years, special diagnostic questionnaires have been used to assess symptoms and prescribe treatment for depression – the Sung scale, the Beck questionnaire, the Hamilton scale, the Montgomery-Asberg scale, the geriatric depression scale, and the multidisciplinary personality test.

Subjective Depression Scale (Depression Diagnosis)

Has your behavior changed in your opinion or the opinion of others in the last month? If so, how?

Signs of depression	Not at all	To a weak degree	Pretty strong	Very much
Decreased stress tolerance	0	one	2	3
More aggressive, outwardly directed behavior, difficulty with self-control	0	one	2	3
Feeling empty	0	one	2	3
Burnout syndrome	0	one	2	3
Persistent unexplained fatigue	0	one	2	3
Irritation, worry, tension	0	one	2	3
Indecision in everyday situations	0	one	2	3
Sleep disturbance: waking up early, falling asleep with difficulty, restless sleep, overwhelming daytime sleepiness	0	one	2	3
Impatience, anxiety, feeling awkward, especially in the morning	0	one	2	3
To relieve stress: alcohol (or medication) abuse, increased activity, exhausting work, increased sports, abundant or poor nutrition	0	one	2	3
The future looks black, gloomy, hopeless	0	one	2	3
Self pity	0	one	2	3
Previously observed in the family: alcohol, drug or drug abuse, depression or suicidal behavior, engagement in risky activities	0	one	2	3

• 0-13 points : in all likelihood, there is no depression.
• 14-26 points : initial symptoms of developing depression.
• 27-39 points : obvious depression, you should consult a doctor.

This scale is intended to help the clinician identify depression in patients and save time. The patient fills out the scale on his own, circling the number corresponding to his condition in each of the listed items. The scores are then added up.

You can take depression tests online:

• Zung scale
• Beck’s questionnaire

Treatment of depression and therapy of other mental illnesses in modern clinics is based on objective and accurate diagnostic methods. Treatment regimens are not prescribed without assessing the state of human organs at the micro level using a visceral test, determining the immune status, diagnosing diseases:

• of cardio-vascular system;
• lungs;
• kidney;
• stomach and intestines;
• thyroid gland;
• nervous system;
• the state of insulin receptors.

Treatment regimens prescribed by doctors by trial and error, without objective criteria, can harm the patient and not cure depression. Diagnostic methods based on objective data allow you to individually select a medicine, predict and eliminate the side effects of treatment. To diagnose depression and prescribe the right treatment, the following are carried out:

• general blood analysis;
• diagnostics of the condition of the thyroid gland;
• identification of traces of alcohol and drugs;
• dexamethasone test, which determines the level of cortisol;
• tests for viruses and bacteria, so fatigue, malaise caused by infections can be similar to symptoms of depression;

• electroencephalography;
• neuropsychological testing;
• neuroimaging – diffuse tensor image of the brain, near infrared spectroscopy, functional magnetic resonance imaging.

Also used – measurement of body weight, blood pressure, electroencephalography, assessment of sexual health, the state of bone density, the functional activity of the liver.

Depression treatment

Of all mental illnesses, depression is the most difficult condition that requires intervention in all areas of a person’s life. According to the WHO, depression is the leading cause of disability and disability. Depressive states often do not respond to therapy, and even depressed patients from wealthy countries may not receive adequate therapy.

That is why you cannot independently purchase antidepressants at the pharmacy, use them uncontrollably. Qualitative treatment regimens involve careful selection of the drug, control of its effectiveness and side symptoms. Moreover, non-drug, instrumental methods, physical therapy and psychotherapy may be more effective in treating depression.

Treatment by psychotherapy methods

For the treatment of depression are used:

• cognitive behavioral psychotherapy;
• psychoanalysis;

• gelstat therapy;
• group, individual, family psychotherapy;
• existential psychotherapy;
• interpersonal psychotherapy;

Instrumental treatment

Instrumental therapy for depression is sometimes more effective than antidepressant therapy. The methods of instrumental therapy that help with the disease are as follows:

• transcranial magnetic stimulation – the effect of a magnetic field on the brain;
• Biofeedback – Teaching Emotion Control Skills
• light therapy – exposure of the eyes to a source of artificial light,

Treatment with new technologies

In modern depression therapy centers, new technologies are available that allow treatment taking into account new developments by scientists. Treatment regimens using:

• focused ultrasound;
• light therapy in the near infrared range;
• optogenetic stimulation (exposure to photons of light of neurons), can enhance the effect of drug therapy.

Intranasal ketamine treatment

Many antidepressant regimens act on depression symptoms after several weeks or months during which people continue to suffer from depressive symptoms. This delay leads to a high risk of suicide. Ketamine therapy allows you to get a quick effect, and the introduction of the drug intranasally (through the nose) leads to the flow of the drug directly into the brain, bypassing the blood-brain barrier. Ketamine, unlike other antidepressants, does not affect the mediator serotonin, but glutamate.

Ketamine treatment regimens can improve the patient’s condition in a few minutes, and the introduction of the drug through the nose avoids the toxic effects of antidepressants on the organs of the gastrointestinal tract and the liver.

Treatment with non-traditional methods

Non-traditional methods of treatment, methods adopted in oriental medicine, time-tested and modern science, can be an adjunct to drug treatment, and used in the treatment of the disease. Treatment with music, art therapy (art), Bible reading, yoga, acupuncture, physical exercise, Pilates, swimming, communicating with nature, hippotherapy allow a person to relax, change their attitude towards themselves, the world around them, change their worldview and develop skills to behave in a stressful situation

Treatment with medicinal plants and nutrition

The fact that many plants have antidepressant effects cannot be ignored. They were used before the era of pharmacology. Many ancient doctors treated mental illness with food and herbs. So the doctor from Ancient Greece Hippocrates wrote: “Your food should be medicine, and your medicine should be food.”

The introduction of oily fish, nuts, chocolate, legumes, liver, fish oil into the diet prevents depression.

The use of turmeric in a variety of foods can reduce the symptoms of the disease. Kalanchoe leaves give vigor and good mood for the whole day.

Treatment for prenatal depression

Treatment for this type of depression is carried out by a psychotherapist who changes a woman’s mind about many contrived difficulties and problems. Relieves mental stress, reduces anxiety and fear.

Motivation gives strength and improves mood. But in some cases, psychotherapy does not help, therefore medication therapy is carried out. Drugs are prescribed only on strict indications, taking into account the consequences for the child. For depression of pregnant women, omega-3 fatty acids, folic acid, S-adenosylmethionine are prescribed.

Antidepressant treatment

When treating with antidepressants, it is important to know that:

• the effect of treatment usually occurs in 2-3 weeks;
• in the case of the use of antidepressants of the SSRI group, there are no side effects such as blurred vision, urination, weight gain. Sometimes there may be nausea, increased sweating, drowsiness;
• to achieve a stable effect, treatment in most cases should be continued for at least 4-6 months.
• with repeated depression and suicide attempts, a longer course of treatment is necessary.

Treatment with tricyclic antidepressants

Treatment with tricyclic antidepressants is prescribed individually according to strict indications. They are effective in sleep disorders, migraines, accompanying depression; selection of an effective dose is carried out using a neural test and pharmacogenetic study of cytochrome P450 isoforms.

Tricyclic antidepressants – imipramine, mianserin, doxilin, lofepramine are prescribed in small doses under the control of their concentration in the blood. The decision on their appointment, dosage, cancellation is the competence of a psychiatrist. Currently, treatment with tricyclic antidepressants is fading into the background, as a new class of drugs has appeared – serotonin reuptake inhibitors.

Treatment with serotonin reuptake inhibitors (SSRIs).

Treatment with drugs acting on the reuptake of serotonin affects the level of this neurotransmitter in the brain. It is the lack of serotonin that is one of the mechanisms for the development of depression.

The advantages of treatment with SSRI antidepressants are:

• minimal dependence on them;
• prescribing immediately in a therapeutic dosage, without increasing concentration;
• efficiency.

List of SSRI drugs used in the treatment of depression

Derivative	Tradename
fluoxetine	fluxen, prozac, deprex
paroxetine	paxil, luxotil, xet
sertaline	zoloft, emoton, depralin
fluvoxamine	deprivox, fevarin, sandoz
citalopram	oropram, citalam, auropram
eccytalopram	escitam, tsipralex, tsipram, pandep

Treatment of depression with psychotropic drugs of other groups

Treatment with tranquilizers is prescribed for anxiety, sleep disturbances, irritability. Benzodiazepine derivatives are used:

• relanium;
• gidazepam;
• grandaxin;
• alprozalam.

Tranquilizers of other chemical groups are also used: atarax, afobazole, phenibut, buspirone.

Treatment with neuroleptics is used for suicidal thoughts and delusions, and treatment with nootropic drugs – for fatigue and weakness, impaired concentration.

Depression treatment is the prerogative of the psychiatrist. You cannot use medicines on your own, following the advice of friends, recipes on the Internet, self-medication. Almost all drugs have side effects, and the treatment consists of using different methods and an integrated approach:

Depression prevention

To avoid depressive disorders, one must understand that a person is integrated into nature, that many environmental factors can prevent the disease.

First of all, these are:

• Light. Solar is not electric!
• Fresh air. Walks in the open air!
• Movement. After all, movement is life!
• Communication. Turn off cell phones and chat live!
• Nice images. Do not watch TV that broadcasts political debates, wars, squabbles and any negative things! Don’t waste time on horror movies, thrillers, computer games. Enjoy music, art, nature!

Make plans and get creative.

Remember! Life is not a debt to loved ones, relatives, children, the pursuit of finances. Life is pleasure, it is the realization of oneself, one’s potential and pleasure!