Depression
Description:
Depression - the affective frustration which is characterized by emotional, cognitive and somatic disturbances that is shown in decrease in mood, loss of interests and pleasures, decrease in vigor, and as a result, in decrease of the activity and increased fatigue. The expressed fatigue even is noted at insignificant effort. Among additional symptoms are also present reduced ability to concentration and attention; reduced self-assessment and self-reliance; secondary ideas of self-accusation; gloomy and pessimistic vision of the future; the ideas or the actions directed to self-damage or a suicide; the interrupted sleep; reduced appetite.
The depressive episode proceeds not less than 2 weeks.
Depression symptoms:
Patients note decline in the ability to concentration and attention that is subjectively perceived as difficulty of storing and decrease in success in training. It is especially noticeable at teenage and youthful age, and also at the persons who are engaged in intellectual work. Physical activity is also reduced to block (up to a stupor) that can be perceived as laziness. At children and teenagers of a depression can be followed by aggression and a conflictness which mask a peculiar hatred to themselves. It is conditionally possible to divide all depressions into syndromes with a component of alarm and without alarm component.
Rhythmics of changes of mood is characterized by typical improvement of health by the evening. The self-assessment and self-confidence decrease that looks as specific neophobia. The same feelings distantsiirut the patient from people around and strengthen feeling of its inferiority. At the long course of a depression aged after 50 years it leads to the deprivation and a clinical picture reminding dementia. There are ideas of guilt and self-abasement, the future seems in gloomy and pessimistic tones. All this leads to emergence of the ideas and actions connected with an autoaggression (self-damage, a suicide). The dream/wakefulness rhythm is broken, sleeplessness or lack of feeling of a dream is observed, gloomy dreams prevail. In the mornings the patient hardly gets up. Appetite decreases, sometimes the patient prefers carbohydrate food proteinaceous, appetite can be recovered in the evening. Perception of time which seems infinitely long and burdensome changes. The patient ceases to attract attention, he can have numerous hypochiondrial and senestopathetic experiences, depressive depersonalization with negative representation about own I and a body appears. The depressive derealization is expressed in perception of the world in cold and gray tones. The speech is slowed ordinary down with a conversation on own problems and the past. Concentration of attention is complicated, and the formulation of the ideas is slowed down.
At survey patients often look out of the window or on a light source, gesticulation with orientation towards own body, pressing of hands to a breast, at an alarming depression to a throat, a subordination pose, in a mimicry Veragut's fold, the lowered mouth corners. At alarm the accelerated sign object manipulations. The voice is low, silent, with big pauses between words and a low directivity.
Indirectly on depressive an episode such symptoms as expansion of pupils, tachycardia, locks, decrease in turgor of skin and the increased fragility of nails and hair, the accelerated involute changes (the patient seems is more senior than the years), and also somatoformny symptoms, such as can specify: psychogenic asthma, syndrome of uneasy legs, dermatological morbid depression, cardial and pseudo-rheumatic simtom, psychogenic dysuria, somatoformny disorders of digestive tract. Besides, at depressions sometimes weight is not lost, and increases in connection with thirst for carbohydrates, the libido can also not decrease, and raise as the sexual satisfaction reduces alarm level. Among other somatic symptoms uncertain headaches, an amenorrhea and a dysmenorrhea, stethalgias and, especially, specific feeling "a stone, weight on a breast" are characteristic.
Depression reasons:
1. Anomalies in the 11th chromosome though existence of polygenic forms of frustration is supposed can be the genetic reasons.
2. Disturbance of activity of exchange of neurotransmitters is the biochemical reason: deficit of serotonin and catecholamines.
3. The neuroendocrinal reasons are expressed in disturbance of rhythmics of functioning of gipotalamo-pituitary, limbic system and an epiphysis that is reflected in a rhythm of emission of relizingovy hormones and melatonin. These processes are connected with daylight photons. It indirectly influences complete rhythmics of an organism, in particular, on a rhythm of dream/wakefulness, sexual activity, food.
Risk factors is the age of 20 — 40 years, decrease in a social class, a divorce at men, family history of suicides, loss of relatives after 11 years, personal qualities with lines of uneasiness, diligence and conscientiousness, stressorny events, homosexuality, problems of sexual satisfaction, the puerperal period, especially at lonely women. In a pathogeny of depressions along with the genetic factors determining the level of neyrotransmitterny systems the cultivation in a helplessness family in the period of a stress making a basis of depressive thinking, loss of social contacts matters.
Treatment of the Depression:
In treatment antidepressants are applied: mono - bi-, three - and tetracyclic, MAO inhibitors, inhibitors of the return serotonin reuptake, L-tryptophane, hormones of a thyroid gland, monolateral EST on not dominant hemisphere, a dream deprivation. Treats old methods in/in treatment by the increasing eyforiziruyushchy doses of novocaine, inhalation by nitrous oxide. Also phototherapy by cold light lamps, the cognitive psychotherapy and group psychotherapy are applied.
