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Description of clinical depression


Overview - Clinical depression - NHS

Depression is more than simply feeling unhappy or fed up for a few days.

Most people go through periods of feeling down, but when you're depressed you feel persistently sad for weeks or months, rather than just a few days.

Some people think depression is trivial and not a genuine health condition. They're wrong – it is a real illness with real symptoms. Depression is not a sign of weakness or something you can "snap out of" by "pulling yourself together".

The good news is that with the right treatment and support, most people with depression can make a full recovery.

How to tell if you have depression

Depression affects people in different ways and can cause a wide variety of symptoms.

They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety.

There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.

The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.

Most people experience feelings of stress, anxiety or low mood during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression.

When to see a doctor

It's important to seek help from a GP if you think you may be depressed.

Many people wait a long time before seeking help for depression, but it's best not to delay. The sooner you see a doctor, the sooner you can be on the way to recovery.

What causes depression?

Sometimes there's a trigger for depression. Life-changing events, such as bereavement, losing your job or giving birth, can bring it on.

People with a family history of depression are more likely to experience it themselves. But you can also become depressed for no obvious reason.

Read more about the causes of depression

Treating depression

Treatment for depression can involve a combination of lifestyle changes, talking therapies and medicine. Your recommended treatment will be based on whether you have mild, moderate or severe depression.

If you have mild depression, your doctor may suggest waiting to see whether it improves on its own, while monitoring your progress. This is known as "watchful waiting". They may also suggest lifestyle measures such as exercise and self-help groups.

Talking therapies, such as cognitive behavioural therapy (CBT), are often used for mild depression that is not improving, or moderate depression. Antidepressants are also sometimes prescribed.

For moderate to severe depression, a combination of talking therapy and antidepressants is often recommended. If you have severe depression, you may be referred to a specialist mental health team for intensive specialist talking treatments and prescribed medicine.

Living with depression

Many people with depression benefit by making lifestyle changes, such as getting more exercise, cutting down on alcohol, giving up smoking and eating healthily.

Reading a self-help book or joining a support group are also worthwhile. They can help you gain a better understanding about what causes you to feel depressed. Sharing your experiences with others in a similar situation can also be very supportive.

Information:

Social care and support guide

If you:

  • need help with day-to-day living because of illness or disability
  • care for someone regularly because they're ill, elderly or disabled – including family members

Our guide to care and support explains your options and where you can get support.

Video: clinical depression - Lawrence's story

In this video, Lawrence talks about his experience of clinical depression.

Media last reviewed: 1 June 2021
Media review due: 1 June 2024

NIMH » Depression

Overview

Depression (also called major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.

To be diagnosed with depression, the symptoms must be present for at least two weeks.

There are different types of depression, some of which develop due to specific circumstances.

  • Major depression, which includes symptoms of depression most of the time for at least 2 weeks that typically interfere with one’s ability to work, sleep, study, and eat.
  • Persistent depressive disorder (also called dysthymia), which often includes less severe symptoms of depression that last much longer, typically for at least 2 years.
  • Perinatal depression, which occurs when a woman experiences major depression during pregnancy or after delivery (postpartum depression).
  • Seasonal affective disorder, which comes and goes with the seasons, typically starting in late fall and early winter and going away during spring and summer.
  • Depression with symptoms of psychosis, which is a severe form of depression where a person experiences psychosis symptoms, such as delusions (disturbing, false fixed beliefs) or hallucinations (hearing or seeing things that others do not see or hear).

Individuals with bipolar disorder (formerly called manic depression or manic-depressive illness) also experience depressive episodes, in which they feel sad, indifferent, or hopeless, combined with a very low activity level. But a person with bipolar disorder also experiences manic episodes, or unusually elevated moods in which the individual might feel very happy, irritable, or “up,” with a marked increase in activity level.

Examples of other types of depressive disorders newly added to the diagnostic classification of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD).

Signs and Symptoms

The Centers for Disease Control and Prevention (CDC) has recognized that having certain mental disorders, including depression and schizophrenia, can make people more likely to get severely ill from COVID-19. Learn more about getting help and finding a health care provider on NIMH's Help for Mental Illnesses webpage.

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Feelings of irritability, frustration, or restlessness 
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy, fatigue, or feeling "slowed down"
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early morning awakening, or oversleeping
  • Changes in appetite or unplanned weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not ease even with treatment
  • Suicide attempts or thoughts of death or suicide

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment as well. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.

Risk Factors

Depression is one of the most common mental disorders in the United States. Research suggests that genetic, biological, environmental, and psychological factors play a role in depression.

Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present, and research suggests that people who have depression and another medical illness tend to have more severe symptoms of both illnesses. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.

Risk factors include:

  • Personal or family history of depression
  • Major life changes, trauma, or stress
  • Certain physical illnesses and medications

Treatment and Therapies

Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.

Quick Tip: No two people are affected the same way by depression and there is no "one-size-fits-all" for treatment. It may take some trial and error to find the treatment that works best for you.

Medications

Antidepressants are medicines commonly used to treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.

Antidepressants take time – usually 4 to 8 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before deciding whether it works.

If you begin taking antidepressants, do not stop taking them without talking to your health care provider. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your health care provider have decided it is time to stop the medication, usually after a course of 6 to 12 months, the health care provider will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.

Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.

If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding, talk to your health care provider about any increased health risks to you or your unborn or nursing child.

To find the latest information about antidepressants, talk to your health care provider and visit the FDA website.

Psychotherapies

Several types of psychotherapy (also called “talk therapy” or "counseling") can help people with depression by teaching new ways of thinking and behaving and how to change habits that contribute to depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). More information on psychotherapy is available on the NIMH Psychotherapies webpage.

Brain Stimulation Therapies

If medications do not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research:

  • ECT can provide relief for people with severe depression who have not been able to feel better with other treatments.
  • Electroconvulsive therapy can be an effective treatment for depression. In some severe cases where a rapid response is necessary or medications cannot be used safely, ECT can even be a first-line intervention.
  • Once strictly an inpatient procedure, today ECT is often performed on an outpatient basis. The treatment consists of a series of sessions, typically three times a week, for two to four weeks.
  • ECT may cause some side effects, including confusion, disorientation, and memory loss. Usually these side effects are short-term, but sometimes memory problems can linger, especially for the months around the time of the treatment course. Advances in ECT devices and methods have made modern ECT safe and effective for most patients. Talk to your doctor and make sure you understand the potential benefits and risks of the treatment before giving your informed consent to undergoing ECT.
  • ECT is not painful, and you cannot feel the electrical impulses. Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant. Within one hour after the treatment session, which takes only a few minutes, the patient is awake and alert.

Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). Other types of brain stimulation treatments are under study. You can learn more about these therapies on the NIMH Brain Stimulation Therapies webpage.

Natural Products

FDA has not approved any natural products for depression. While research is ongoing, some people find natural products, including vitamin D and the herbal dietary supplement St. John’s wort, to help depression. Do not use St. John’s wort or other dietary supplements for depression before talking to your provider. For more information, visit the National Center for Complementary and Integrative Health website.

How can I find help?

If you think you may have depression, start by making an appointment to see your health care provider. This could be your primary care practitioner or a health provider who specializes in diagnosing and treating mental health conditions. Visit the NIMH Find Help for Mental Illnesses webpage if you are unsure of where to start.

Beyond Treatment: Things You Can Do

Once you begin treatment, you should gradually start to feel better. Here are other tips that may help you or a loved one during treatment for depression:

  • Try to get some physical activity. Just 30 minutes a day of walking can boost mood.
  • Try to maintain a regular bedtime and wake-up time.
  • Eat regular, healthy meals.
  • Do what you can as you can. Decide what must get done and what can wait.
  • Try to connect with other people, and talk with people you trust about how you are feeling.
  • Postpone important decisions, such as getting married or divorced, or changing jobs until you feel better.
  • Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.

Join a Study

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may receive better help in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials have uncovered. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

  • NIMH’s Clinical Trials webpage: Information about participating in clinical trials
  • Clinicaltrials.gov: Current Studies on Depression: List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country
  • Join a Study: Depression – Adults: List of studies currently recruiting adults with depression being conducted on the NIH Campus in Bethesda, MD
  • Join a Study: Depression – Children: List of studies currently recruiting children with depression being conducted on the NIH Campus in Bethesda, MD
  • Join a Study: Perimenopause-Related Mood Disorders: List of studies on perimenopause-related mood disorders being conducted on the NIH Campus in Bethesda, MD
  • Join a Study: Postpartum Depression: List of studies on postpartum depression being conducted on the NIH Campus in Bethesda, MD

Learn More

Free Brochures and Shareable Resources

  • Chronic Illness and Mental Health: Recognizing and Treating Depression: This brochure provides information about depression and mental health for people living with chronic illnesses, including children and adolescents. It discusses symptoms, risk factors and treatment options.
  • Depression: This brochure provides information about depression including the different types of depression, signs and symptoms, how it is diagnosed, treatment options, and how to find help for yourself or a loved one.
  • Depression in Women: 5 Things You Should Know: This brochure provides information about depression in women including signs and symptoms, types of depression unique to women, treatment options, and how to find help.
  • Men and Depression: Men and women may experience depression very differently. This brochure describes common signs and symptoms, and treatment options for depression in men.
  • Perinatal Depression: This brochure provides information about perinatal depression including how it differs from the “baby blues”, causes, signs and symptoms, treatment options, and how you or a loved one can get help.
  • Seasonal Affective Disorder: This fact sheet includes a description of seasonal affective disorder (SAD), signs and symptoms, how SAD is diagnosed, causes, and treatment options.
  • Seasonal Affective Disorder: More Than the Winter Blues: This infographic provides information about how to recognize the symptoms of SAD and what to do to get help.
  • Teen Depression: More Than Just Moodiness: This fact sheet is intended for teens and young adults and presents information about how to recognize the symptoms of depression and how to get help.
  • Shareable Resources on Depression: Help support depression awareness and education in your community. Use these digital resources, including graphics and messages, to spread the word about depression.

Federal Resources

  • Depression (MedlinePlus - also en español)
  • Moms’ Mental Health Matter: Depression and Anxiety Around Pregnancy (National Institute of Child Health and Human Development)

Research and Statistics

  • Journal Articles: This webpage provides information on references and abstracts from MEDLINE/PubMed (National Library of Medicine).
  • Statistics: Major Depression: This webpage provides information on the statistics currently available on the prevalence and treatment of depression among people in the United States.

Multimedia

  • NIMH Experts Discuss the Menopause Transition and Depression: Learn about the signs, symptoms, treatments, and latest research.
  • Mental Health Minute: Depression: Take a mental health minute to watch this video on depression.
  • NIMH Expert Discusses Seasonal Affective Disorder (SAD): Learn about the signs, symptoms, treatments, and latest research on SAD.
  • Discover NIMH: Personalized and Targeted Brain Stimulation Therapies: Brain stimulation therapies can be effective treatments for people with depression and other mental disorders. NIMH is supporting studies exploring how to make brain stimulation therapies more personalized while reducing side effects. This video describes transcranial magnetic stimulation and electroconvulsive therapy for treatment-resistant depression.
  • Discover NIMH: Drug Discovery and Development: One of the most exciting recent breakthroughs from research funded by the NIMH is the development of a fast-acting medication for treatment-resistant depression based on ketamine. This video shares the story of one of the patients participating in a NIMH clinical trial, and how ketamine infusions changed her life and gave her a sense of purpose. In addition, Dr. Carlos Zarate, a senior clinical investigator in NIMH’s Intramural Research Program, describes his groundbreaking research on ketamine.

Last Reviewed: September 2022

Unless otherwise specified, NIMH information and publications are in the public domain and available for use free of charge. Citation of NIMH is appreciated. Please see our Citing NIMH Information and Publications page for more information.

symptoms, causes in men and women, remedies

Lack of vitality, unwillingness to get out of bed, bad mood for a long time, and even unwillingness to live are all signs of depression. Depression has a negative effect on the health and general well-being of a person. That is why it is so important to get medical help from a specialist in time.

How to determine the presence of depression?

Pathology can appear after experienced stressful situations. If there is no disorder, after the problem is resolved, a good mood returns to the person. But when the cause is eliminated, and apathy, depression and loss of strength do not leave the person, it is necessary to seek help from a specialist. It may also decrease performance. nine0003

You can determine the presence of depression on your own, but you should not self-medicate even at an early stage of development. This should be done by a doctor, since self-medication can only aggravate everything.

Depression in women is often postpartum, as their lives change dramatically, and sleepless nights add fatigue. This is where frustration and apathy come in.

When the pathology is in advanced form, then a person has the following symptoms of depression - not only a bad mood and impotence, but also persistent disorders of the nervous system. There are also symptoms such as: a significant decrease in self-esteem, disadaptation in society, despondency and loss of interest in any events. nine0003

In physiological terms, appetite changes, intimate needs and energy decrease, sleep and bowel function are disturbed (constipation, weakness, fatigue during physical and intellectual stress are observed), pain in the body (in the heart, in muscles, in the stomach area).

The patient shows signs of depression such as loss of interest in other people, a tendency to frequent solitude, refusal of entertainment, use of alcohol and psychotropic substances. nine0003

Mental signs of depression include difficulty in concentrating, concentrating, making decisions, slowness of thinking, a pessimistic view of the future with a lack of perspective and thoughts about the meaninglessness of one's existence, suicide attempts, due to their uselessness, helplessness, insignificance.

Causes of depression

The appearance of the disorder is not influenced by age category or social class. Most often, depression appears against the background of stressful negative situations, with constant failures - then a person falls into despair from the inability to somehow influence the course of events. nine0003

But in addition to the social factor, severe psychological trauma can also lead to the development of depression, for example: family breakup, death of a loved one, a serious illness that affects not only the patient himself, but also his relatives. In this case, depressions are referred to as reactive.

The likelihood of depression increases with changes in hormonal levels: during adolescence, after delivery, with the onset of menopause, and also in old age. It can affect the emotional and physical level. nine0003

Another factor is brain damage and somatic pathologies. Often depression affects patients who have had a stroke, suffering from a chronic lack of blood circulation in the brain, after a traumatic brain injury.

The causes of depression can manifest themselves as a result of the side effects of drugs (benzodiazepines, corticosteroids). Often this condition disappears on its own after the drug is discontinued.

Types of depression

  • Neurotic - people with low self-esteem, insecure, straightforward people often suffer. They constantly feel a sense of injustice, and apathy arises from this.

  • Clinical - bad mood, loss of energy, problems with appetite and sleep. Often there is a tendency to suicide. This clinical picture can last at least 2 weeks.

    • nine0035

    Vegetative - manifested by such signs as tachycardia, a drop in blood pressure, tinnitus.

  • Psychogenic - develops after severe psychological trauma - divorce, loss of a loved one, dismissal from work, betrayal, etc. Accompanied by mood swings, anxiety, excessive sensitivity.

  • Masked - often the disease manifests itself secretly. Apathy, solitude and a decrease in interest in life can only appear as negativity and fatigue accumulate. nine0003

  • Asthenic - the condition is manifested by fatigue, sleep disturbance, emotional imbalance due to accumulated difficulties, stress, physical and psychological stress.

  • Postpartum - usually occurs 10-14 days after delivery. A young mother shows an increased sense of excitement for the baby, and constant lack of sleep and fatigue worsen the situation even more. In addition, the hormonal background also affects the state of the mother. nine0003

  • Somatogenic - attacks occur due to disturbances in the endocrine system, the formation and growth of neoplasms, both benign and malignant.

  • Alcoholic - depression is accompanied by excessive consumption of alcoholic beverages. The post-alcohol state is accompanied by an uncontrolled craving for alcohol and the growth of withdrawal syndrome when alcohol is refused. nine0003

  • Bipolar - the patient is changing euphoria depressive, manic disorder. But in the period between these phenomena, caused by various factors: stress, loss of means of popularity, etc., a person lives an ordinary life and does not show symptoms of the disease.

How does depression develop in stages?

First, the patient has a depressed state, which he himself attributes to fatigue, a hard working week, drinking alcohol and other reasons. At the same time, he wants to retire from others and at the same time is afraid to be alone. nine0003

Then the stage of acceptance arises: the awareness of the dangerous state comes, the problem worsens, the intensity of negative thoughts grows, the body and the immune system fail.

The third stage - in the absence of adequate therapy, the patient loses control over himself, aggression increases.

Diagnosis and treatment of depression

-

To identify the disease, experienced specialists use short questionnaires - screening tools to identify symptoms: anxiety, anhedonia (loss of pleasure from life), suicidal tendencies. Thanks to this, it is possible to determine whether the patient has chronic depression, symptoms and treatments for depression, what form and severity it is. nine0003

To fully understand the picture of the disease, the doctor needs to familiarize himself with the symptoms that indicate depression, and not another psychological disorder.

For the treatment of depression, you can contact the following specialists:

  • Psychiatrist - treatment of depression with hypnosis, drugs for acute mental pathologies - schizophrenia, mental retardation, epilepsy, as well as other less severe ailments - neurosis, depression, alcoholism, drug addiction, etc. nine0003

  • Psychotherapist – treatment is carried out through special therapy, which provides for explanations, conversations, search for solutions to problems together with the patient.

  • Psychologist - consults the patient, cannot prescribe drugs and examinations. Clinical psychologists use modern test methods to identify problems that caused a psychological disorder. nine0003

The main directions of therapy in treatment are psychotherapy, pharmacotherapy, social therapy.

A necessary condition for the effectiveness of treatment is cooperation and trust in the doctor. It is important to strictly follow the prescription of the therapy regimen, visit the doctor regularly, and give a detailed account of your condition.

Preparations for the treatment of depression

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For the treatment of the disorder, antidepressants are used for anxious depression or when the pathology is accompanied by lethargy. Antidepressants are prescribed directly by a doctor and are not recommended for self-administration. The action of many antidepressants manifests itself two weeks after administration, their dosage for the patient is determined individually. nine0003

In bipolar depression, depression is treated with insomnia. While it has a negative effect on a healthy person, in a patient with a psychological disorder, sleep deprivation, on the contrary, brings the psyche back to normal.

Moderate or mild depression requires the appointment of drugs on a light, natural basis (herbal).

Where to get tested and treated for depression in Krasnoyarsk?

If you or your loved ones show signs of an emotional disorder, you should immediately contact a specialist. Since depression can lead to dangerous consequences: nine0003

  • isolation from society

  • deterioration in appearance

  • relationship problems

  • low performance or its complete absence

  • sexual problems

Contact the private clinic "Medunion" in Krasnoyarsk, get examined and treated for depression. Our phone number for appointment +7 (391) 202-95-54.

causes, types, stages, symptoms, signs, diagnosis, treatment in women and men

Causes

Classification

Symptoms

Complications

Diagnosis

Treatment

Depression is a common mental disorder, the main features of which are a persistent decrease in mood, problems with memory and concentration, and minimal physical activity.

The causes of such a painful condition for a person in most cases are neuropsychic shock or chronic stress. Depression can be accompanied by severe illness, sudden changes in life. nine0003

Treatment is based on the use of psychotherapeutic techniques. In some cases, it is supplemented by taking medications.

Causes

Depending on the form, the disease is associated with external or internal factors. The causes of psychogenic reactive depression can be severe experiences, an acute psychotraumatic situation. Often, a violation develops after the loss of a loved one, loss of a job, divorce, relocation, injury.

Positively colored events, for example, finally gained wealth or popularity, can also cause upset. In this case, mental deviations are explained by the realization of a dream with the subsequent loss of the meaning of life, provided there are no other goals.

Neurotic depression is a consequence of chronic stress. In this state, it is usually not possible to establish a specific cause of experiences. A person finds it difficult to name any specific psycho-traumatic circumstance, sees his life as a whole as a series of losses and disappointments. nine0003

Depression in men often develops with regular use of alcoholic beverages, psychoactive substances.

Other risk factors for affective disorder in patients of either sex are:

  • very high or extremely low financial status;
  • impressionability, suspiciousness, poor resistance to stress;
  • low self-esteem, a tendency to self-flagellation;
  • pessimistic outlook on life; nine0038
  • high psycho-emotional stress in professional activities;
  • difficult childhood, psychotraumatic situations suffered at a young age;
  • divorce of parents or loss of one of them, upbringing in an incomplete family, orphanage;
  • the presence of mental or neurotic disorders, addictions among relatives;
  • loneliness, lack of support in the family and social environment;
  • economic and political instability in the country; nine0038
  • physiologically determined changes in the hormonal background - the process of puberty, the postpartum period, menopause.

Endogenous depressions develop as a result of neurochemical abnormalities due to genetic mutation or aging of the body. This group of disorders includes involutional melancholia and senile depression. This form of pathology also occurs in manic-depressive psychosis, characterized by a change in the phases of mania, depression and mental stability. nine0003

The likelihood of depression in women is higher in the postpartum and menopause periods, when there is a change in the level of sex hormones, which is stressful for the body. In a young mother, neuropsychic disorders can occur with complicated childbirth, problems with breastfeeding or the health of the baby, and the appearance of excess weight.

Diseases of various organs can also be accompanied by depression. They are divided into the following groups:

  1. Pathologies of the cardiovascular system - myocardial infarction, hypertension, circulatory failure, heart rhythm disturbances. nine0038
  2. Brain damage due to stroke, neuroinfection or head trauma.
  3. Endocrine disorders - diabetes mellitus, hyper- or hypofunction of the thyroid gland.
  4. Violation of the digestive system - cirrhosis of the liver, colitis.
  5. Rheumatic diseases with prolonged pain syndrome - rheumatism, systemic lesions of the connective tissue, arthritis.
  6. Oncological processes, especially malignant neoplasms. nine0038

Classification

Depending on the severity and nature of manifestations, depression is of the following types:

  • major or clinical;
  • postpartum;
  • atypical;
  • recurrent;
  • small;
  • dysthymia.

Latent or "masked" depression is characterized by the absence of signs of neuropsychiatric disorders and symptoms characteristic of somatic diseases. The following options are distinguished:

  • cardiology;
  • abdominal;
  • dermal.

Caused by an acute psycho-traumatic situation, reactive psychogenic depression proceeds in several stages:

  1. Denial. The psyche makes an attempt to isolate itself from the ongoing negative events, the patient stubbornly does not believe in what happened.
  2. Anger. Anger arises from a sense of injustice, and the search for the guilty begins.
    3. nine0035 Trade. A person tries to negotiate in order to avoid consequences. This indicates active attempts to find a way out of the situation.
  3. Depression. There is a feeling of loss of control over what is happening, a feeling of powerlessness and the impossibility of correcting anything. This is accompanied by a depressed mood, apathy, laziness, sadness, pessimistic judgments.
  4. Acceptance. After a real assessment of the situation and the prospects that have opened up, a person resigns himself to his fate and mentally prepares for the consequences. nine0038

Symptoms

The main manifestations of the disease are united under the name "depressive triad" and include:

  • a persistent decrease in mood, despair, melancholy, a sense of hopelessness for several weeks and even months;
  • slowing down of thinking, problems with memorizing and analyzing information, fixation on one's own experiences;
  • decreased motor activity, slowness, lethargy, prolonged stay in the same position. nine0038

The patient ceases to enjoy activities that previously brought positive emotions, becomes withdrawn and taciturn, can spend most of the day lying in bed or sitting, hunched over, bowing his head and resting his elbows on his knees. Feelings of guilt appear, self-esteem falls, suicidal thoughts arise. Fatigue is characteristic, the solution of simple everyday tasks requires great effort.

In some cases, depression may present with the following symptoms:

  • nocturnal insomnia, often associated with drowsiness during the day;
  • decreased appetite and weight loss;
  • increased heart rate;
  • constipation;
  • dilated pupils;
  • loss of sexual desire;
  • menstrual disorders;
  • intense pain in different parts of the body without objective causes;
  • aggressive behavior, attacks and accusations against other people; nine0038
  • dryness and flabbiness of the skin, the appearance of wrinkles;
  • increased hair loss, brittle nails.

With endogenous depression, the intensity of symptoms peaks in the morning, gradually weakening during the day, and the manifestations of psychogenic affective disorders increase in the evening. A feature of postnatal depression is a decrease in the mother's interest in the child, irritation from the need to take care of him.

Clinical depression is severe, including all of the triad and many additional symptoms. The small form is characterized by only a couple of signs of the disease that persist for two or more weeks. The atypical variant proceeds with increased appetite, drowsiness, emotional arousal, and anxiety. nine0003

Recurrent depression is characterized by a short duration of several days with a monthly recurrence. Seasonal affective disorder is associated with the change of seasons, the symptoms begin and end at about the same time interval. With dysthymia, the mood is steadily reduced for several years, but negative emotions and experiences do not reach the intensity characteristic of clinical depression.

Complications

The greatest danger is suicidal thoughts arising from the disease. They can provoke appropriate actions and lead to tragic consequences. With postpartum depression, a woman can harm not only herself, but also the child. In order to alleviate symptoms, the patient may resort to taking alcohol, drugs. nine0003

Diagnostics

With somatogenic or latent forms of the disease, a person can seek help from a general practitioner, cardiologist, neurologist, gastroenterologist and other doctors. In the case of psychogenic affective disorder, self-referral to a psychologist is possible. It is important that these specialists promptly refer the patient to a psychotherapist who diagnoses depression. It detects the disease by questioning the patient, during which complaints and symptoms are clarified, possible causative factors. Based on the data received, the doctor will tell you how to get out of depression as soon as possible and draw up a treatment plan. nine0003

Special tests for depression are carried out to determine the severity of the process. They include standardized tasks designed and tested by experts. Thus, personal needs, character traits, emotional responses, intelligence levels, anxiety and stress are studied. The Beck Depression Scale with a test questionnaire is often used to identify and assess symptoms of the disease.

Treatment

With a mild course of the disease, it is possible to undergo only a course of psychotherapy without the use of medications. Additionally, massage, hydrotherapy and exercise therapy may be recommended. Moderate and severe affective disorders also require medication. nine0003

The essence of drug therapy for depression is to take drugs that affect the production of biologically active substances that cause the transmission of a neurochemical impulse through the neurons of the limbic system of the brain. For this purpose, antidepressants are used. A large clinical form of the disease, as a rule, requires hospitalization. According to indications for severe depression, pills for insomnia and anxiety are also prescribed - sedatives, tranquilizers.

Psychogenic reactive disorders are successfully treated, and soon after the onset of the disease comes the way out of depression. The clinical picture of the somatogenic form of the disease depends on the severity of the organic pathology. Endogenous disorders are not amenable to psychotherapy, but medication can often achieve long-term remission. Neurotic depression is prone to a long, chronic course. nine0003

The author of the article:

Ivanova Natalya Vladimirovna

therapist

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Clinic

m. Sukharevskaya

Services

  • Title
  • Primary appointment (examination, consultation) with a general practitioner2100