In recent years, patients with schizophrenia have become frequently pregnant. This is due to new principles of treatment and care for such patients, as well as the use of atypical antipsychotics.
It is difficult for a psychiatrist to manage such pregnant women, and it is also difficult for gynecologists. There is a risk of complications for the mother and the fetus, and it is due to both the possibility of a relapse of schizophrenia and the effect of psychotropic drugs on the fetus.
It is known that for the first fifteen years after the onset of schizophrenia, a woman leads an active social and sexual life. And pregnancy does not protect and does not prevent the exacerbation of the disease. A woman can refuse to take psychotropic drugs, but the risk of relapse is great.
Schizophrenia can begin during pregnancy, but this is rare. Most often, personality disorders occur. But if schizophrenia occurs during pregnancy, then the further development of psychosis will be unfavorable. In such patients, preterm labor is more often recorded, and the child has a low body weight.
Schizophrenia can cause congenital anomalies and perinatal mortality. Patients with schizophrenia are advised to become pregnant one year after the onset of the disease. Hormonal drugs ( depomedroxyprogesterone ) can be a contraceptive , but relapses of schizophrenia or depression are possible while taking them.
Oral contraceptives can interact with nicotine and psychotropic drugs ( clonazepine ), increasing their serum levels. First-generation antipsychotics such as haloperidol are considered safer than atypical antipsychotics.
Cancellation of antipsychotics in the first 6-10 weeks of pregnancy can only be practiced in patients with mild forms of schizophrenia. Antipsychotics should be used at the lowest effective dose, while monitoring blood levels of the drug. When treated with olanzapine and clozapine, the CYP 1A2 activity of cytochrome P450 is reduced during pregnancy.
What if someone close to you suffers from depression?
The complaints of the depressed patient should not be ignored and prohibited.
Avoid flat, comforting language or trivial encouragement.
Do not try to cheer up the sick person.
Emphasize the immediacy of the depressive state by instilling hope for an end to the depression.
Do not call for manifestations of the patient’s will, do not tell him: “you must pull yourself together,” you could , if you wanted “, etc.
Do not let the sick person feel helpless and guilty .
Don’t invoke virtues like faith or a sense of responsibility.
Free the depressed patient from the need to make decisions, especially the very important ones.
Behave with the patient calmly, evenly and confidently.
Organize your own visit to the doctor and accompany the patient
Relieve the patient from personal and professional contacts.
Do not change the patient’s cardinal habits.
Do not insist on sick leave, especially if there are no signs of severe depression.
Show your compassion and understanding, and support the patient in their own urgent and real tasks.
To draw the patient’s attention to everything that he manages to do, do not allow yourself at the same time to triumphant intonations.
Monitor the regular adherence to the patient’s regimen, the rhythmic distribution of affairs in the daily routine
Do not let the patient lie in bed in the morning , go to bed early and be alone.
Make sure that the patient looks after himself.
Avoid feigned gaiety.
Do not make reproaches and remarks.
Try to stimulate the patient’s breathing.
Don’t mention the patient ‘s past successes.
Do not self-medicate the patient, seek help from a specialist psychiatrist.
How can depression be treated?
Current treatment for depression involves:
The use of biological methods of therapy ( primarily psychopharmacological drugs). A prerequisite for the effectiveness of treatment is cooperation with a doctor: strict adherence to the prescribed therapy regimen, regular visits to the doctor, a detailed, frank report about your condition and life difficulties.
Psychotherapy (individual, group and family) is not an alternative, but an important adjunct to the drug treatment of depression. In contrast to drug treatment, psychotherapy assumes a more active role of the patient in the treatment process. Psychotherapy helps patients to develop skills of emotional self-regulation and in the future to cope more effectively with crisis situations without sinking into depression.
What usually hinders seeking psychotherapeutic help?
Low awareness of people about what psychotherapy is.
Fear of a stranger’s initiation into personal, intimate experiences.
Skeptical about the fact that “talking” can have a tangible healing effect.
The idea that you need to cope with psychological difficulties yourself, and turning to another person is a sign of weakness.
Helping people close to you to overcome depression
The support of loved ones, even when the patient does not express interest in her, is very important in overcoming depression. In this regard, the following advice can be given to relatives of patients:
Remember that depression – a disease in which the need sympathy, but not in koem case can not sink into the disease with the patient, sharing his pessimism and despair. You need to be able to maintain a certain emotional distance, constantly reminding yourself and the patient that depression is a transient emotional state.
Studies have shown that depression is especially unfavorable in those families where a lot of criticism is made about the patient. Try to make it clear to the patient that his condition is not his fault, but a misfortune, that he needs help and treatment.
Try not to focus on the illness of a loved one and bring positive emotions into your life and into the life of your family. If possible, try to involve the patient in some kind of useful activity, and not remove him from business.
“Feminine character” or a special tendency towards illness?
Depression is a painful condition that manifests itself with characteristic symptoms. Depression is not in any way a sign of weakness of character. This is a serious disease, which is accompanied by disorders of all mental and even bodily (sleep, appetite, body weight, etc.) human functions. Loss or decrease in volitional qualities is one of the symptoms of a depressive illness. Therefore, one should not advise a person suffering from depression to “pull himself together” – he will not be able to overcome the disease without medical help. Depression significantly affects performance, study, social life, relationships with others, including loved ones.
There is a relationship of depression with a female?
Doctors are well aware that women are more likely to suffer from depression than men. This fact is confirmed by the results of numerous fairly large epidemiological studies in different countries, including in Russia. The frequency of depression in women 2- 3 fold higher than in men. In modern medicine, the female sex is one of the factors predisposing to the development of depression.
With what is connected with women’s predisposition to depression?
Depression is largely associated with changes in hormonal levels that occur in the female body during childbearing years. The so-called reproductive (childbearing) cycle goes through a number of stages, starting with the appearance of menstruation and ending with their disappearance: the menstrual cycle, pregnancy, childbirth, premenopausal and climacteric periods. At each of these stages , significant changes occur in the composition and quantity of hormones, which are accompanied by physiological changes in all functions of the female body, including the mental sphere. Therefore, such changes in hormonal levels are associated with an increased risk of developing depression.
How does depression manifest in women?
As stated, the risk of depression increases at every stage of the reproductive cycle. In clinical medicine, there are different variants (syndromes) of depression characteristic of each of the stages of the reproductive cycle – premenstrual syndrome, depressive syndrome of pregnant women, sadness in women in labor, postpartum depression and depression in the premenopausal and climacteric periods. The manifestations of depression can be different. A depressive mood can be manifested as depression, depression and apathy, as well as increased irritability, tearfulness, anxiety, and a feeling of inner tension. Changes in mood are usually accompanied by a decrease in activity, a feeling of loss of energy, increased fatigue, and distraction of attention. Depression in women is often accompanied by a variety of somatic disorders: changes in sleep (insomnia or increased sleepiness), appetite (decreased appetite or increased appetite). Unpleasant sensations of tension and a feeling of pain in the mammary glands, headaches, pain in joints and muscles, pain in the heart and periodic palpitations, weakness in the body, fluctuations in blood pressure, etc. may appear . The duration of depression associated with the reproductive cycle may vary. … Premenstrual depressive syndrome is usually short-lived, about 2 weeks (1 week before and 1 week after menstruation), but has a recurrent nature with monthly exacerbations corresponding to the menstrual cycle. Postpartum depression and depression of the climacteric period can be more protracted and last for several weeks or even months.
How can female depression be treated?
Depression is a treatable disease. With the correct choice of the appropriate drug and its dose, complete relief from the symptoms of depression is possible . Depression is treated only with drugs called antidepressants. Treatment for depression should only be prescribed by a doctor. It is necessary to remember that each person’s depression has its own characteristics associated with both disease severity and with its clinical manifestations. The correct choice of treatment in each specific case requires an assessment of many features of the patient’s condition. Only a doctor – psychiatrist or psychotherapist can correctly identify, evaluate and qualify such features . Nor in any way necessary to resort to the advice of relatives or friends, or to choose a treatment on their own, on the basis that one or the other drug to help someone whom you know. This rule must be observed, especially if the change in mood is accompanied by pronounced changes in general well-being, impaired bodily functions and pain, which is most characteristic of depression associated with the reproductive cycle. In such cases, only a doctor can correctly assess the nature of the symptoms, determine the real state of the internal organs and choose a drug that will be not only effective, but also safe. It is strongly discouraged to take antidepressants on your own during pregnancy and lactation. On Today, there are a large number of anti-depressants. All modern drugs of this class are effective and safe means. However, each of the drugs has its own distinctive features associated with both the therapeutic effect and the methods of its administration and dosage. Depression treatment takes time. You should not wait for a complete cure already in the first days of taking the drug. It must be remembered that all modern antidepressants begin to act on depression no earlier than 1-2 weeks after the start of treatment. During this period, the selection of the required dose of the drug is also carried out. Cancellation of the antidepressant, as well as its appointment, should be carried out only by a doctor. Even after the complete disappearance of all symptoms of depression, it is necessary to continue taking the antidepressant for a certain period of time. This is due to the fact that the risk of exacerbation of depression in case of premature discontinuation of therapy is very high – up to 60-80%. Moreover, exacerbation of depression associated with early discontinuation of treatment tends to be more difficult to treat. The duration of such an additional period of treatment, the purpose of which is to prevent exacerbation, is determined only by the doctor based on the individual characteristics of each patient. Remember that even if you decide to stop treatment before the time specified by the doctor, you must always consult with him.
Seasonal depressions are a variant of recurrent (recurrent) depressions. By seasonal depression include that develop in the autumn-winter season with some regularity – every year for at least 3 years. Much less often, depression occurs in the spring and summer.
Seasonal depression can show the same symptoms as depression not associated with a specific season:
depressed mood
feeling of longing or anxiety
decreased interest in the environment
apathy
feelings of joylessness and hopelessness.
Often these symptoms are more pronounced in the first half of the day, while in the evening the condition improves.
There are also a number of season-specific features:
Winter depression
Spring depression
Summer depression
Autumn depression
Other symptoms are considered more specific for seasonal depression. Patients with seasonal depression, along with low mood, anxiety and decreased activity, experience drowsiness during the day and an increase in appetite. During depression, they consume more food rich in carbohydrates, gain weight. As a rule, the general tone decreases, weakness appears, various unpleasant sensations in the body.
Asthenic symptoms of seasonal depressions are as follows: a feeling of weakness, lethargy, weakness, general physical illness. Various pains and unpleasant sensations appear in the body, mental performance decreases, memory and attention deteriorate. It is characteristic that the severity of these symptoms practically does not depend on the external load and they are often more pronounced in the morning hours after waking up.
In the development of seasonal depression, the main role is assigned to the metabolic disorders of serotonin , a biologically active substance that regulates mood. Experimental studies have shown that in winter, the serotonin content in the brain is lower than in summer. An important regulator of serotonin metabolism is melatonin , an active substance, the production of which depends on the amount of light.
Light therapy is the classic treatment for seasonal depression . In addition, the high efficiency of antidepressants with a specific effect on the metabolism of serotonin in the brain has been proven . Long-term use of these drugs allows not only to cure an already developed depressive state, but also to prevent their development in the future. As with other depression, psychotherapy is an important element of effective treatment .
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.
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!
The World Health Organization singles out the problem of suicide as one of the important medical and social problems of modern society. In many countries, suicide is among the top 10 causes of death, and among adolescents and adolescents it is ranked third. Every year, about half a million people die from their own hands, and these figures are undoubtedly underestimated. Over the past decade alone , an increase in the prevalence of suicides has been noted in Russia to 45-56 cases per 100 thousand of the population per year, and in certain regions and population groups – to 90 and more, which is combined with a parallel increase in the frequency of depressive conditions and alcohol abuse. Depression is the cause of 70% of all suicides. Many authors agree that the high number of suicides we have is associated with inadequate treatment for depression. Depressive disorders, in turn, are one of the most common psychopathological conditions. Approximately every tenth inhabitant of the planet carries on throughout their lives depressed, and in each of the twentieth it is repeated.
Thus, for the prevention of suicide, it is necessary to carry out early adequate diagnostic measures in order to timely identify and treat depressive disorders.
Changes in the body’s natural biological rhythms can also contribute to the development of depression.
This refers primarily to the “sleep-wakefulness” rhythm, the rhythms of daily changes in body temperature, blood pressure, and hormone release. The cause of these disorders can be hidden in the nerve centers located in the region of the limbic system of the brain.
Within the framework of the theory of “biological rhythms”, the decrease in the duration of sleep and the disruption of the normal electrical activity of the brain during this period are explained by the desynchronization of the physiological functions of the brain. It is believed that changes in the ratio of sleep phases occur due to a decrease in the activity of brain systems that are sensitive to the neurotransmitter serotonin.
Either way, the normalization of the sleep-wake cycle always reduces the manifestations of depression.
It is also important that the observance of the normal rhythm of food intake and a number of other habitual rhythms of daily life contributes to the restoration of sleep and, as a result, to the improvement of the state. At present, for the treatment of depression with success used drugs that restore the circadian rhythm.
One of the most important factors in the formation of depression is the desire for complete perfection in everything. At the same time, the bar of claims rises to an almost unattainable height, and the assessment of one’s own successes and achievements constantly remains underestimated.
Another fetish for people prone to depression: Fairness with a capital letter. It is of fundamental importance, and undeserved punishment can work like a detonator of explosives. A person prone to depression often compares himself with others and, of course, almost always loses, because in the world there is probably someone better than us, more beautiful, richer, etc. In addition, the nature of future depressive patient plays an important role pride, he of himself in high regard and believes that he is destined to achieve great things. The difference between “pride” and “pride”, I hope, is clear to everyone.
There are many more factors that contribute to the development of depression. The constant search for the meaning of life and the inability to find it. Painful attitude to money , as in fact the only means of pleasure … and money, how much would they not been, always small. That’s really really, people are dying for the metal!
For a person predisposed to depression, typically the desire to do everything myself ( “better because still no one will do”), all control ( “so safe”), to evade responsibility ( “can not do anything to turn”), confusion ( “What is to do? “), categorical judgments, polarity of assessments without halftones (” all or nothing “,” terrible or wonderful “), constant tension due to a sense of duty (” must “,” must “,” must “,” should “) …
An acute need for the support of other people , the desire to fulfill their expectations, and hence frequent misunderstandings and “busting” along the way, play a role . People begin to explain all their problems by insurmountable external reasons, endless blows of fate, from which they cannot be protected. Added to this is the inability to relax. Stubbornness, pride, hot temper make it difficult to seek help. An inclination towards mysticism and painful religiosity, which has nothing to do with true faith based on love for God and neighbor, and has always been condemned by the holy ascetics of the Church.
The experience of the Christian worldview is very important here. The underlying awareness of the original, insurmountable independently, without God’s help, imperfection, sinfulness of a person in itself can cause depression. In many of the works of the holy ascetics said about the danger of wrong “approach” to repentance in sins , and, as a consequence, incorrect understanding of repentance, not without reason called a sacrament.
Meanwhile, the ways worked out by Christian experience to overcome despondency and pride, which have always been considered one of the most dangerous sins, can be useful not only to sincerely and deeply religious people.
Without going into the details of the Christian science of the salvation of the soul, it is worth noting one fundamentally important principle. The resulting depression, according to the Christian understanding, is the result of pride, the complete isolation of a person on himself, on his exclusiveness. It is similar to the phenomenon when one mirror is placed in front of another – and an endless, meaningless corridor is formed, going into darkness. In this corridor, all our own shortcomings and blows from the outside are reflected endlessly and stretch to infinity. One of the outstanding Russian ascetics of the twentieth century, Hieroschemamonk Sampson ( Sivers ), who was the confessor of Academician Pavlov and President of the Academy of Sciences of the USSR Academician Karpinsky, often talked about how important it is to “stop talking with oneself” in time, and constantly reminded gnaw yourself. Self – gnawing is the fruit of demonic ̆. I just realized my sin – and calm down! ”
However, here we are already intruding on the topic of treating depression with the help of non-drug, psychotherapeutic methods. But, by the way, at the everyday, mundane level, many talented clergymen who are highly advanced on the spiritual path can be recognized as “highly qualified psychotherapists” . In particular, not only the Christian denominations. Although, I emphasize, in Christianity, the topic of depression and its psychological causes is “developed”, perhaps, the most deeply.
In today’s academic plan psychotherapists and priests look at the origins of depression and methods of treatment may be different. Usually, a psychotherapist seeks to give a person the opportunity to independently cope with depression, to teach him to control himself, not relying on God’s help.
It is curious that one of the most authoritative doctors of the past century, the founder of psychoanalysis, Sigmund Freud , who held an atheistic position , saw a similar cause of depression at the level of psychological reactions. He believed that it arises from the turning of a person’s anger towards himself . Hence such her symptoms as self-accusation and self-flagellation, which, in the opinion of Freud and his followers, represent anger towards other people repressed into the subconscious .
The main sources of depression and other psychological problems, psychoanalysts call mental trauma received in childhood, even infancy. According to the theory of psychoanalysis, people who are prone to depression develop in the subconscious the confidence in the absence of love from their parents. In particular cases, this, of course, is possible, but it is hardly reasonable to make total generalizations on their basis, as the Freudians do .
The reason is no less weighty than the negative attitude of loved ones, sometimes their loss becomes . So, in clinical studies it was possible to establish that the loss of a mother before the age of 11 years contributes to the subsequent occurrence of frequent depressive episodes. In the circle of depressive patients, one can find people who have suffered serious mental trauma ( mainly, it is precisely the loss of loved ones) during the six months preceding the episode (attack) of depression.
All these factors associated with family relationships can be classified as social.
Acute and especially prolonged stress experienced by a person in his youth, during puberty, is very dangerous . Poor adaptability to difficulties, distorted forms of self-control, the test of loneliness of a person who is accustomed to increased parental care , in many respects ensure the “readiness” for the development of depression.
On the other hand, constant parental reproaches, the tendency to blame the young person for all the failures, frequent insults, and harsh remarks increase the risk of developing depression . All of these “parenting lessons” create feelings of helplessness. Physical abuse and other abusive parenting measures can be obvious reasons . Scandals in the family, quarrels between parents, in which children are involuntarily involved, at least on an emotional level, also contribute to the appearance of depression in adolescents . The presence of a mental disorder in one of the parents, which in fact plays the role of a chronic stressful situation, also has a negative impact .
The child accumulates negative memories, traumatic memories, which in the future will turn into mental vulnerability, a habit of distorted, inadequately interpreting any situation. Another problem at a later age is the inability of a young man to distance himself from the emotions of the people around him, the insecurity of the boundaries of his personality, their blurredness.
An “unhappy childhood” contributes to the early onset of depression, which can manifest itself as early as the age of 18-20. To make matters worse , “childhood in a state of stress” complicates puberty, which, in turn, negatively affects the nervous and endocrine systems of the body.
These factors – psychological and social – always go hand in hand, it is not always easy to separate them , and the system of “mutual guarantee” is understandable here even to a non-specialist. In people whose body is genetically, biologically predisposed to depression, inadequate mechanisms of psychological defense can usually be formed under the influence of upbringing. Very often, the cause of depression can be found in the shortcomings of upbringing ( and is it possible to find a person on Earth who has received an ideal upbringing ?!) and in a multitude of adverse social problems, “whose name is legion.”
Psychologists distinguish personality types among people with a certain character, a set of properties and ways of responding to external influences. Some researchers note that for the most part, three personality types are prone to developing depression :
This is the so-called ” statotimic personality” , distinguished by hard work, accuracy and exaggerated conscientiousness.
Another type is a personality of the “melancholic type” , characterized by a desire (in many respects excessive) for order, constancy, pedantry, increased self -exactingness and conscientiousness in performing the assigned work.
The third type is a “ hypothetical personality” with its tendency to depressed mood, anxiety, feelings of self- doubt and feelings of inadequacy. This personality type usually has a positive quality – a special talent for empathy, which, however, can also be excessive, causing no less harm than good.
