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Very depressed and unmotivated


SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

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    It's Not Your Fault (NACoA) (PDF | 12 KB)
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    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

Alcohol, Tobacco, and Other Drugs

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Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present estimates from the 2021 National Survey on Drug Use and Health (NSDUH).

Alcohol

Data:

  • Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million people (or 45.1%) were past month binge drinkers. The percentage of people who were past month binge drinkers was highest among young adults aged 18 to 25 (29.2% or 9.8 million people), followed by adults aged 26 or older (22.4% or 49.3 million people), then by adolescents aged 12 to 17 (3.8% or 995,000 people). (2021 NSDUH)
  • Among people aged 12 to 20 in 2021, 15.1% (or 5.9 million people) were past month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.3% (or 3.2 million people) and 1.6% (or 613,000 people), respectively. (2021 NSDUH)
  • In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
  • Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44.4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
  • The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31. 4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
  • Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily

Programs/Initiatives:

  • STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Talk. They Hear You.
  • Underage Drinking: Myths vs. Facts
  • Talking with your College-Bound Young Adult About Alcohol

Relevant links:

  • National Association of State Alcohol and Drug Abuse Directors
  • Department of Transportation Office of Drug & Alcohol Policy & Compliance
  • Alcohol Policy Information Systems Database (APIS)
  • National Institute on Alcohol Abuse and Alcoholism

Tobacco

Data:

  • In 2020, 20. 7% of people aged 12 or older (or 57.3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH)
  • Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
  • Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
  • The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes

Electronic cigarette (e-cigarette) use data:

  • In 2021, 13.2 million people aged 12 or older (or 4.7%) used an e-cigarette or other vaping device to vape nicotine in the past month. The percentage of people who vaped nicotine was highest among young adults aged 18 to 25 (14.1% or 4.7 million people), followed by adolescents aged 12 to 17 (5.2% or 1.4 million people), then by adults aged 26 or older (3.2% or 7.1 million people).
  • Among people aged 12 to 20 in 2021, 11.0% (or 4.3 million people) used tobacco products or used an e-cigarette or other vaping device to vape nicotine in the past month. Among people in this age group, 8.1% (or 3.1 million people) vaped nicotine, 5.4% (or 2.1 million people) used tobacco products, and 3.4% (or 1.3 million people) smoked cigarettes in the past month. (2021 NSDUH)
  • Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey. Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
  • E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals

Resources:

  • Tips for Teens: Tobacco
  • Tips for Teens: E-cigarettes
  • Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
  • Synar Amendment Program

Links:

  • Truth Initiative
  • FDA Center for Tobacco Products
  • CDC Office on Smoking and Health
  • National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
  • National Institute on Drug Abuse: E-Cigarettes

Opioids

Data:

  • Among people aged 12 or older in 2021, 3. 3% (or 9.2 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 9.2 million people who misused opioids in the past year, 8.7 million people misused prescription pain relievers compared with 1.1 million people who used heroin. These numbers include 574,000 people who both misused prescription pain relievers and used heroin in the past year. (2021 NSDUH)
  • Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
  • According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose

Resources:

  • Medication-Assisted Treatment
  • Opioid Overdose Prevention Toolkit
  • TIP 63: Medications for Opioid Use Disorder
  • Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
  • Opioid Use Disorder and Pregnancy
  • Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
  • The Facts about Buprenorphine for Treatment of Opioid Addiction
  • Pregnancy Planning for Women Being Treated for Opioid Use Disorder
  • Tips for Teens: Opioids
  • Rural Opioid Technical Assistance Grants
  • Tribal Opioid Response Grants
  • Provider’s Clinical Support System - Medication Assisted Treatment Grant Program

Links:

  • National Institute on Drug Abuse: Opioids
  • National Institute on Drug Abuse: Heroin
  • HHS Prevent Opioid Abuse
  • Community Anti-Drug Coalitions of America
  • Addiction Technology Transfer Center (ATTC) Network
  • Prevention Technology Transfer Center (PTTC) Network

Marijuana

Data:

  • In 2021, marijuana was the most commonly used illicit drug, with 18. 7% of people aged 12 or older (or 52.5 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (35.4% or 11.8 million people), followed by adults aged 26 or older (17.2% or 37.9 million people), then by adolescents aged 12 to 17 (10.5% or 2.7 million people).
  • The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34.5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
  • Marijuana can have significant health effects on youth and pregnant women.

Resources:

  • Know the Risks of Marijuana
  • Marijuana and Pregnancy
  • Tips for Teens: Marijuana

Relevant links:

  • National Institute on Drug Abuse: Marijuana
  • Addiction Technology Transfer Centers on Marijuana
  • CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

  • Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
  • Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
  • Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.

Resources:

  • Tips for Teens: Methamphetamine
  • Tips for Teens: Cocaine
  • National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.

Last Updated: 01/05/2023

Depression

Russian Academy of Medical Sciences
SCIENTIFIC CENTER FOR MENTAL HEALTH









DEPRESSION (from hope to certainty).
(INFORMATION FOR PATIENTS AND THEIR FAMILIES)









nine0003




MOSCOW
2008


Oleichik I. V. - Candidate of Medical Sciences, Leading Researcher of the Department for the Study of Endogenous Mental Disorders and Affective States

© 2008, Oleichik I.V.
© 2008, NTsPZ RAMS

The vast experience accumulated by mankind and reflected in many literary works convincingly shows that sadness (sadness, spleen) has always gone side by side with people, being one of the natural human emotions. None of us is immune from failures, illness, breakups, loss of loved ones, financial collapse. Each person can face something inevitable and inevitable, when it seems that life loses its meaning, and despair becomes boundless. However, normally, sadness, sadness and melancholy, as natural reactions to traumatic events, weaken over time and the person's condition returns to normal without special treatment. The situation is different with depressions, which are mental disorders that differ from natural physiological reactions in greater intensity, special severity of experiences and persistence of manifestations. True depression rarely goes away on its own, requiring persistent, sometimes long-term treatment. nine0003 A depressive state (from the Latin word depressio - suppression, oppression) is a disease that concerns not only an individual specific sick person, but is also a significant burden of modern society, since it is spreading more and more widely in the world, causing enormous damage to the health of the population and the state. economy. And this applies to all countries, regardless of their level of social development. Every year, at least 200 million people in the world fall ill with depression. Perhaps these figures are even higher, since most victims of depression do not seek help because they are not aware of the painfulness of their condition. Scientists have calculated that almost one in five people who have reached adulthood will experience at least one episode of depression during their lifetime. nine0003 In the most general sense, a depressive state is one of the possible forms of a person's response to the impact of stress factors. In some cases, depression can be triggered by external negative influences, for example, mental trauma, excessive educational or work overload, infection or other serious somatic disease, traumatic brain injury, changes in the hormonal background, which is especially important for the female body, regular certain medications, such as hormones, blood pressure medications, alcohol or other drug abuse. In other cases, depressive states develop as a manifestation of such mental illnesses, in which the main influence is heredity or characteristics of the nervous system (cyclothymia, dysthymia, manic-depressive psychosis, schizophrenia, etc.). If, based on the description of depressive symptoms set out later in our brochure, you realize that you have indeed developed a depressive state, do not fall into despair, do not “try to control yourself”, remember that depression is not a manifestation of weakness of will or character, on the contrary, weakening of volitional qualities is one of the main symptoms of depression. Depression is a disease like rheumatism, arthritis or hypertension, it responds well to treatment, resulting in almost always a full recovery. You should not blame yourself for the occurrence of depression, it does not indicate either your fault, or your weakness, or the possible development of a more severe mental pathology. Below we will tell you about the symptoms of depression, which can be extremely diverse. nine0018

Manifestations of depression

Manifestations of depression can be very different. Depressive states can be manifested by a violation of almost all aspects of mental life: mood, memory, will, activity, which is expressed in the appearance of sadness, sadness, mental and muscle retardation, lasting at least 2 weeks. Depressed mood during depression can manifest itself as mild sadness, sadness, and boundless despair. Often it is accompanied by a feeling of melancholy, unbearable heaviness in the soul, with excruciating pain behind the sternum, a feeling of hopelessness, deep depression, hopelessness, helplessness, despair and uncertainty. At the same time, the patient is completely immersed in his gloomy experiences, and external events, even the most joyful ones, do not affect him, do not affect his mood, and sometimes even worsen the latter. A constant "companion" of a depressive mood is also anxiety of varying severity: from mild anxiety or tension to violent excitement, riot. Anxiety and bad mood arise at the mere thought of the need to make some kind of decision or change your plans due to suddenly changed circumstances. Anxiety can also manifest itself on the physical (bodily) level in the form of belching, intestinal cramps, loose stools, frequent urination, shortness of breath, palpitations, headaches, increased sweating, etc.
The picture of depression is complemented by the disappearance of desires, interests, a pessimistic assessment of everything around, ideas of one's own low value and self-blame. Deficiency of vital impulses is manifested in patients with a variety of symptoms - from lethargy, physical weakness to a state of weakness, loss of energy and complete impotence. Where an important decision is required, a choice between different options, human activity is sharply hampered. Depressed people are well aware of this: they complain that insignificant everyday tasks, small issues that used to be solved almost automatically, take on the significance of complex, painful, insoluble problems. At the same time, a person feels that he began to think, act and speak slowly, notes the suppression of instincts (including food and sexual instincts), the suppression or loss of the instinct of self-preservation and the lack of the ability to enjoy life up to complete indifference to what used to be liked evoked positive emotions. nine0003 People suffering from depression often feel "stupid", "mentally retarded", "feeble-minded". Thinking in depression becomes viscous, painful, requires special efforts, one mental image is hardly forced out by the next. The sick person is oppressed by the feeling of his own intellectual insolvency, professional collapse. Depressed patients can hardly describe their painful experiences to the doctor. Only after getting out of depression, many of them say that the mood at that moment was lowered, thinking was slow, all undertakings (including treatment) seemed in vain, and the years lived were empty and useless. However, at the time of the first visit to the doctor, they could not explain this because of the almost complete absence of thoughts in their heads, “para-lich of thinking”. With depression, there are also often complaints of memory loss, which is why those suffering from it assume that they have "Alzheimer's disease", "schizophrenia", "senile dementia", which is not true. Especially often these complaints are found in depressions that develop in adolescence. nine0003 Typical story
Aleksey, 18 years old, 1st year student of a technical university, describes his condition during depression as follows:
“From childhood, I was fond of technology and modeling, I could read special literature for hours, won school and regional olympiads in mathematics and physics. After graduating from school, my dream came true - I brilliantly passed the exams to a prestigious university. Then it seemed to me that the whole world was at my feet, I flew with happiness "as if on wings." In September, I happily began to study. At the beginning, everything worked out well, but after 2 months I began to notice that it was becoming increasingly difficult for me to absorb what I read, I did not remember the simplest text, I could not solve problems that I used to “click like nuts”. Trying to achieve success through many hours of brainstorming or drinking a few cups of coffee led to the fact that I completely stopped thinking about anything. It seemed to me that I was "finally and irreversibly stupid." At night I sobbed, wrapped in a blanket and thought about how best to commit suicide. Luckily, I met a senior in the library and shared my problems with him. My new acquaintance said that he experienced something similar and advised me to contact the psychiatrist of the student clinic. After the examination, I was diagnosed with juvenile depression and sent for treatment to a specialized medical center. After 2 months, I felt completely healthy, returned to my studies and caught up with my classmates. nine0018

Depression can also be accompanied by real setbacks: for example, a decrease in academic performance, the quality of work, family conflicts, sexual disorders and their consequences for personal relationships. As a rule, the significance of these failures is exaggerated and as a result there is a false sense of the irreparability of what happened, "the collapse of all hopes."
Another generally recognized danger of depression is the possibility of suicidal thoughts, which often lead to suicide attempts. The condition of a person suffering from depression can suddenly deteriorate sharply, which happens either without clear external causes, or under the influence of traumatic situations, unpleasant news. It is during these hours, and sometimes even minutes, that a fatal decision is made. Factors that increase the risk of suicide in depression are past suicide attempts, the severity and duration of the depressive state, the presence of anxiety in its structure, prolonged insomnia, loneliness or alienation in the family, alcohol and drug abuse, loss of work and a sharp change in lifestyle, as well as relatives commit suicide. nine0003 Typical story
Eugene E., 35 years old, leading manager of the company.
Almost all my life, my career went “on the ascending”, the goals set were clear, clear and achievable. The marriage was extremely harmonious, two beloved children grew up. He devoted almost all the time to the affairs of the company, occasionally, once every 1-2 months, he escaped with his family out of town, to the country. He often lacked sleep, stayed late at work, took home assignments, and was deeply worried about the affairs of the company. Gradually, irritability, fatigue, insomnia, difficulty concentrating appeared, more and more often he suffered a “fiasco” in intimate life. Thoughts appeared that life was lived in vain, that it is a "chain of tragic mistakes" that led to a dead end. He began to believe that the choice of work, friends, family was wrong, for which now "retribution has come." Analyzing the past years for a long time, he found more and more evidence and examples of his "duplicity, hypocrisy, insincerity, etc. " I realized that the only way to solve all problems is to voluntarily leave this life. At the same time, he believed that by this act he would free the family from the “burden”, “loser”, “loser”. I decided, having locked myself in the garage, to get poisoned by the exhaust gases of the car. However, by chance, in a semi-conscious state, he was discovered by an employee of a garage cooperative. He explained what happened as an "accident". The thought of leaving life did not leave the patient. I decided to shoot myself with a gas pistol, which I had long ago acquired for self-defense. After a shot in the mouth, in a serious condition, he was taken to the Research Institute. Sklifasovsky, from where he was discharged a week later. The alarmed wife, suspecting something was wrong, decided to consult her husband with a psychiatrist. He was admitted to the clinic. He agreed to this only out of respect for family relations, he himself believed that treatment by psychiatrists was completely useless, because. his situation is hopeless and no medicines will help here, but will only "stupefy" his psyche. However, after two weeks of taking a modern antidepressant, the patient's point of view changed. Everything began to look not so bleak and hopeless, interest in work and life in general returned, I began to feel more cheerful, more energetic, interest in intimate life appeared. He took work to the clinic, called up colleagues. After two months of treatment, he fully returned to his usual life. With bewilderment, he recalled his thoughts about insolvency, the collapse of life, suicide. He took the drug prophylactically for about six months, then, on the recommendation of a doctor, he gradually reduced the dose and stopped taking it. Over the next two years, the condition remained stable, career growth continued, another child was born. nine0018

Depression is also characterized by sleep disturbances, occurring in approximately 80% of patients. As a rule, these are early awakenings with the inability to fall asleep, lack of a sense of sleep, difficulty falling asleep. These disorders, as well as restless sleep with unpleasant dreams, are often the very first symptoms of incipient depression.
If the depression is not deep, it is sometimes difficult to recognize it. This is due to the fact that people are ashamed to tell others about their problems, to admit to "weaknesses". Quite often, especially in Russia, depressive states are masked by alcohol abuse (“vodka heals”). In addition, often patients suffering from depression, in order to "shake themselves up", "throw into all serious", engage in casual sex, are fond of gambling or extreme sports, leave to serve on a contract in "hot spots", lead an idle lifestyle with constant attendance at entertainment events. Surrounding people, relatives who do not have psychiatric knowledge, often accuse them of debauchery, drunkenness, riotous lifestyle, parasitism. Meanwhile, this behavior is a kind of “cry for help”, an attempt to fill the spiritual emptiness brought by depression with new acquaintances and impressions. nine0003 Depressive conditions can occur in shallow forms that are easily treatable, but at least a third of depressions are more severe. Such depressions are characterized by:
- ideas of guilt, sometimes reaching the degree of delirium, i.e. unshakable conviction in their sinfulness, low value (patients consider themselves great sinners, believe that because of them all relatives and Mankind will die, that they are “moral freaks” from birth, supposedly deprived of the foundations of morality and a sense of empathy for other people that they have no place on earth They find in their past numerous "confirmations" of what has been said above, they believe that the doctor and other patients are aware of these transgressions and express contempt and indignation with their facial expressions and gestures, but in the words “they hide, deny the obvious.” Both the patients themselves and their relatives must remember this in order to prevent the impending threat in time: remove all firearms, piercing and cutting objects, ropes, potent drugs and poisonous close household fluids, close windows or shutters, do not let the patient go anywhere alone. If these ideas become persistent and cannot be dissuaded, it is urgent to seek advice from a psychiatrist. neurological institution or call a psychiatrist at home. nine0003 - mood swings during the day: in typical cases, the patient, waking up, immediately feels longing. Sometimes, even before full awakening, through a dream he experiences a painful premonition of a heavy coming morning. In the evening, the state of health improves somewhat.
- the patient may experience a feeling of unmotivated hostility towards relatives, friends, constant internal discontent and irritation, which makes him unbearable for the family.
- in a number of people suffering from depression, constant doubts, fear for the health and well-being of loved ones, obsessive ones, come to the fore. arising against the will, ideas about the misfortunes and troubles of family members. nine0018

Typical story
Dmitry Petrovich, 58 years old, teacher.
“After minor troubles at work, I began to feel incomprehensible anxiety and agitation. Unpleasant thoughts came into my head that I did something wrong at work, because of which I double-checked everything many times and went home later than everyone else. But even at home, the anxiety did not let go: as soon as the daughter or wife lingered for at least half an hour, terrible pictures of traffic accidents or violence were drawn in the imagination. I fell asleep only in the morning, got up broken and felt sleepy all day. I took Valerian, Corvalol, but it practically did not help. At work, they hinted whether I should take a vacation. Friends advised me to consult a neuropathologist, but he did not find his pathology and sent me to a psychiatrist. I was diagnosed with anxiety depression. After a course of outpatient treatment, I completely recovered.” nine0018

- in many cases, depression is characterized by unpleasant sensations in the body, disturbances in the activity of internal organs in the absence of objective signs of true somatic, i.e. non-mental illness. At the same time, many patients constantly report pain, internal discomfort. Some complain of headaches, pains in the stomach, joints, lower back, others - of disorders in the intestines: constipation, indigestion, irritation of the colon, others pay attention to a decrease in sexual desire and potency. In women, menstruation often becomes painful and irregular. Approximately 50% of depressed people at the doctor's office complain of such physical ailments, without mentioning the depressed mood or state of mind underlying the depression. Experiencing chronic pain or other unpleasant sensations in the body, patients may not realize that they are suffering from depression, even with severe melancholy, considering the latter a reaction to painful bodily discomfort. nine0003 - some patients are convinced that they have some rare and difficult to diagnose disease and insist on numerous examinations in general medical institutions. Doctors call this condition masked (hidden) depression, in which a person may experience pain in the head, in the limbs, behind the sternum, in the abdomen and in any other parts of the body, he may be haunted by anxious fears, he may suffer from insomnia or, on the contrary, too much sleep. nine0003 - Patients may experience disturbances in the cardiovascular system, skin itching or lack of appetite. All of these are manifestations of depression.
- the pathological sensations that patients experience during such depressions are quite real, painful, but they are the result of a special mental state, and not an internal disease. It must be remembered that the frequency of latent depressions exceeds the number of explicit ones many times over.
- with such depression, patients, as a rule, also have a changed attitude towards food: they can go without food for a long time and not feel hungry, and sitting down at the table, eat only 1-2 spoons - they have neither strength nor desire for more . nine0003 - a sign of depression can serve as a weight loss of more than 5 kg. within a month. In some people, especially women, the appetite for depression, on the contrary, increases, sometimes reaching the level of excruciating hunger, accompanied by severe weakness and pain in the epigastric region. In some cases, food is taken in excess due to an increased craving for sweets or attempts to distract oneself from painful thoughts by frequent eating.
Thus, we see that depression is a disease with many different manifestations that do not go away on their own, requiring special, sometimes long-term, medical intervention. Therefore, when the symptoms described above appear, it is necessary to seek help from a psychiatrist who will prescribe and monitor antidepressant treatment. nine0018

TREATMENT OF DEPRESSIVE DISORDERS


To date, it can be argued that the vast majority of cases of depression respond well to treatment. According to modern views, effective treatment of depression consists of a combination of pharmacotherapy, psychotherapy and, if necessary, other types of treatment. At the same time, the main role in therapy, of course, belongs to antidepressants - drugs specially designed for the treatment of various types of depression. nine0003 The creation of antidepressants is based on the discovery of scientists that depression develops as a result of a violation of the mechanism of biochemical transmission of nerve impulses in the brain regions responsible for mood, behavior, response to stress, sleep and wakefulness, appetite and some other functions. To ensure the coordination of the work of all these functional divisions, the brain sends special "commands" to them in the form of chemical impulses transmitted from the processes of one nerve cell (neuron) to the processes of another. This transmission is carried out with the help of chemical mediators (neurotransmitters), which, after transmitting a signal, partially return to the original neuron. This process is called neurotransmitter reuptake. Thanks to him, the number of mediators in the microscopic space between the processes of neurons (in the so-called synaptic cleft) decreases, which means that the necessary signals are transmitted worse. Numerous studies have shown that mediators of various structures, in particular, norepinephrine and serotonin, are involved in the transmission of signals that ensure the normal functioning of the nervous system. The first of them has a general activating effect, maintains the level of wakefulness of the body and takes part in the formation of adaptive reactions, and the second has the main antidepressant effect, controls impulsive actions, anxiety, aggressiveness, sexual behavior, falling asleep, feeling of pain, therefore serotonin is called sometimes a "good mood" regulator. A decrease in the number of mediators in the synaptic cleft causes symptoms of depression, while an increase, on the contrary, prevents their appearance. The ability of some drugs in one way or another to increase the concentration of mediators in the synaptic cleft allows them to be used as antidepressants. nine0003 Now antidepressants are used in Russia, which can be conditionally divided into 4 generations according to the time of creation.
The first antidepressants to find wide clinical use were tricyclic drugs: amitriptyline and imipramine. They have a fairly powerful effect on most depressive states by blocking the reuptake of both norepinephrine and serotonin. However, the real clinical effect of these drugs is significantly offset by their undesirable side effects, which drastically reduce the quality of life of patients during treatment. Side effects of tricyclic antidepressants arise due to the nonspecificity of their effect on receptor structures. Acting in addition to the serotonin and norepinephrine system and other neurotransmitters (acetylcholine, histamine, dopamine), these antidepressants cause side effects such as urinary retention, dry mucous membranes, constipation, palpitations, fluctuations in blood pressure, confusion, tremor, sexual dysfunction. functions, weight gain. In such cases, it is necessary to prescribe other drugs to correct side effects or reduce the therapeutic dose of drugs, which naturally affects the effectiveness of the antidepressant action. It has been observed that up to 50% of patients refuse to take tricyclic antidepressants due to severe side effects. For the same reason, physicians are less likely to prescribe these drugs to patients on an outpatient basis. nine0003 The situation was somewhat improved by the introduction into practice of drugs of the second generation - tetracyclic antidepressants, which, along with the ability to block the reuptake of norepinephrine and serotonin, could also affect some other receptors. Being analogues of tricyclic compounds, these drugs have antidepressant activity comparable to them, but unlike their predecessors, they are safer, since they cause unwanted side effects much less often. In addition to the antidepressant, mianserin (lerivon) has a clear sedative, anti-anxiety and hypnotic effect. Maprotiline (Ludiamil) has a mild balanced antidepressant effect. In general, these drugs are able to cure mild to moderate depression, but are ineffective in patients with severe depression. nine0003 To date, antidepressants of the 3rd generation, such as fluoxetine (Prozac), fluvoxamine (Fevarin), paroxetine (Paxil), sertraline (Zoloft), citalopram (Cipralex) and some other drugs that selectively (selectively) affect the serotonin metabolism system, have received widespread recognition today. , preventing its reuptake in the synaptic cleft. Based on the mechanism of action, these antidepressants are combined into a group of selective serotonin reuptake inhibitors. In addition to treating depression, they are used to correct eating disorders, level panic disorders, so-called social phobias, various obsessive-compulsive disorders and chronic pain symptoms. These drugs have gained popularity due to the possibility of a once-daily intake, concomitant anti-anxiety effect, the presence of a psychostimulant component and a small number of side effects. In addition, they have low toxicity and are well tolerated by elderly patients. However, some researchers note their lack of effectiveness in the treatment of severe forms of depressive states, probably associated with selective activity in relation to only one neurotransmitter - serotonin. It should be noted that in recent years, some American scientists have associated the use of these drugs with an increased risk of suicide, which, however, is not proven. nine0003 Considering the high frequency of side effects in some of the above drugs and the insufficient antidepressant activity in others, psychopharmacologists have taken the path of developing more effective antidepressants - IV generation drugs that selectively block the reuptake of both serotonin and noradrenaline, without affecting other mediators. system and with minor side effects. Currently, 3 drugs meet these requirements: milnacipran (Ixel), duloxetine (Cymbalta) and venlafaxine (Effexor). Their antidepressant activity in the treatment of patients with severe and moderate depression has been confirmed in a number of specially conducted studies, which at the same time showed that these drugs are well tolerated. nine0003 It should be noted that antidepressants of plant origin (negrustin, gelarium hypericum, deprim, etc.) can be effective in mild depressive states, but there are no reliable data guaranteeing their effectiveness. The opinion of a number of doctors that all depression can be treated with herbs or, say, acupuncture, should be recognized as unfounded.
For extremely severe depressions that do not improve despite the use of the most powerful antidepressants, electroconvulsive therapy (ECT) can be effective, but this situation is extremely rare and requires careful justification by the commission of doctors and the consent of the patient. nine0003 An important additional role in antidepressant therapy, especially with concomitant anxiety, is played by tranquilizers - anti-anxiety drugs, such as Xanax, phenazepam, diazepam, nitrazepam, atarax, etc. Drugs that can, when taken systematically, prevent mood swings in various depressive disorders include so-called mood stabilizers or mood stabilizers - lithium preparations, carbamazepine, valproic acid salts, lamotrigine, topiramate. With their systematic intake in most patients, the clinical manifestations of depression either completely disappear or become rare and mild, requiring no hospitalization and not significantly affecting the ability to work. nine0003 Antipsychotics play a significant role in the treatment of certain forms of depression. These include both traditional drugs - fluanxol, triftazin, eglonil, teralen, neuleptil, sonapax, and atypical antipsychotics that are gaining more and more recognition among doctors: seroquel, solian, zeldox, rispolept, abilify, serdolect and others.
In drug therapy of depressive conditions, an unconventional, strictly individual approach is used, with the obligatory provision of fruitful cooperation between the patient and the doctor. Otherwise, there may be a violation of medical recommendations regarding doses and regimens for taking medications. The patient's faith in the possibility of recovery, the absence of prejudice against the "harm" caused by psychotropic drugs, the systematic observance of the prescriptions prescribed by the doctor largely contribute to the achievement of therapeutic success. nine0003 Drug treatment of depression takes time. You should not expect a complete cure already in the first days of taking the drug. It must be remembered that all modern antidepressants begin to act on depressive symptoms no earlier than 1-2 weeks after the start of treatment. Cancellation of an antidepressant, as well as its appointment, should be carried out only by a doctor. Cancellation is usually made no earlier than 6 months from the normalization of the mental state. Even after the complete disappearance of all symptoms of depression, do not rush to stop taking the drug yourself, as there is a risk of an exacerbation of the disease. Therefore, doctors recommend continuing to take the antidepressant for a certain period of time. A common mistake is the premature withdrawal of drugs soon after a significant improvement in the condition or due to "forgetfulness". To avoid this, try to include the drug in the list of daily urgent matters - for example, store it in the bathroom and take it after hygiene procedures. When planning a trip, calculate exactly how many tablets you need for the entire period of absence from home. Breaking therapy is fraught with serious troubles. nine0003 Conducted along with drug treatment, psychotherapy of patients with depressive states implies various systems of influence, including individual conversations, family and group therapy, etc. An important element of social rehabilitation is participation in the work of mutual support groups for patients who have experienced depression. This allows other patients to feel help in understanding their problems, to realize that they are not alone in their misfortune, to see the possibilities of personal participation in rehabilitation activities and in public life. nine0018

diagnosis, condition, severity, attacks, treatment, depressive mood, psychiatric treatment.

Depression is a certain form of disappointment in the world and people. In more scientific terms, a mental disorder, accompanied by apathy (anhedonia, or melancholy), as well as destruction of thinking and motor static.

According to statistics, every second at least once in his life experienced a set of symptoms characteristic of a depressive state. What kind of disease is this and is it really a neurotic disorder or simply the result of a licentious character. What is depression: sin or disease? Let's figure it out. nine0018

The history of depression goes back not only to ancient times, but sends us back a couple of centuries. After all, in fact, this is a well-known disease among the intelligentsia; in the days of tsarist Russia it was even fashionable to suffer from this disease. If there is no depression, then it seems like blood is not blue. From time immemorial, the Russian intellectual and bohemian characters have been accustomed to suffering, even getting a certain pleasure from experiencing their grief. The decadent moods of depression are also vividly represented in the literature of the "golden age". Just remember Onegin, who falls into asthenia and apathy, Chatsky, who is always looking for the truth, the nihilist and anarchist Bazarov, who, perhaps, dissected frogs not out of great zest for life. And there is no need to talk about Oblomov - the brightest patient! By the way, in the case of Oblomovism, the depressive despondency of the hero is certainly presented as a significant “fall into sin”. And all because in a state of despondency and apathy, a person often derives quite a lot of "secondary benefits", because any of his actions, or rather even inaction, can be justified by the legendary - "I'm depressed." nine0018

What is this “secondary benefit” and how is it possible, you ask.

Choosing such a sadomasochistic state, a person simultaneously gets time for himself to think, reevaluate his life, take a break from the haste and the boring routine of life. And finally, a person does not owe anything in everyday terms, because he is depressed. And many, by the way, enjoy it. The other side of the coin is increased attention from loved ones. After all, sometimes, indeed, the state in question allows you to disrupt your share of love, affection and attention. In general, in anhedonia, the patient can afford any feelings (pain, resentment, jealousy, sadness) and even actions. nine0018

Nevertheless, from the point of view of clinical psychology, depression is still a mental illness, most often characteristic of neurotics suffering from obsessive-compulsive disorder or anxiety. It is she who helps patients with the above diagnoses to get rid of fear, and sometimes, indeed, grants purification and mental renewal. But be that as it may, a depressive state destroys the body at the neurological and even hormonal levels; it does not pass without a trace and is a rather dangerous condition, including suicidal outcomes. nine0018

Main symptomatology

Any sign of this disease is manifested either excessively or absent altogether. For example, either a person suffers from insomnia, or constantly sleeps, or there is no appetite, or vice versa, overeating is observed, and so on.

The standard set of symptoms is as follows, on an emotional level the patient may experience:

Loss of strength and permanent sadness bordering on guilt, along with aggression and nervousness, loss of former interests, as well as deconcentration, absent-mindedness and difficulty making decisions, causeless anxiety and fear, sociopathy. Of course, the mental state described above also manifests itself at the level of physiology. The patient may experience fatigue, asthenia, headaches, problems with sleep and appetite, tightness in the chest or "lump in the throat". Sometimes there is a distorted perception of taste and color, violations of the intimate sphere, dry mouth, tachycardia, disorders of the intestinal tract. As noted above, in the serious stages of the patient, thoughts of a suicidal nature may occur. nine0018

Causes of depression

Specialists distinguish psychotrauma or psychotraumatic stress factor as the root cause . In the background lies infantilism or, in other words, the inability of a person to take responsibility and cope with difficulties, which leads to such a mental phenomenon as cognitive dissonance or frustration (a discrepancy between a person’s expectations and reality, leading to reflection). It is worth noting that the fundamental trigger is the problem situations that have arisen in the “here and now”, but in the background, in any case, there are childhood traumas and an upbringing model. Other reasons may be: an organic factor (disturbances in the work of neurotransmitters, neurochemical processes), as well as the use of psychostimulants or other chemicals. But most often the development of depression is due to the complex influence of psychological, biological and social factors. nine0018

Psychological factor is associated with the type of person at risk. These can be people of a statotimic nature, who are characterized by exaggerated conscientiousness and accuracy, for example. Melancholics, distinguished by scrupulousness, pedantry and high demands on themselves, as well as hyperthymic individuals with low self-esteem and constantly experiencing anxiety and worries.

Biological factor includes a genetic predisposition, any brain injury, as well as hormonal disorders, seasonal disorders associated with weather changes, the use of certain drugs or vitamin deficiency of various pathogenesis. nine0018

And finally, the social (fundamental) factor in the development of depression includes stressful situations, mental trauma (loss of a loved one, bad relationships in a family or other team, lack of attention or affection from parents, sudden changes, violence.

Types depression

The psychiatric community distinguishes a fairly wide range of depressive conditions.One of the key types is reactive or situational depression, which is caused by psychogenic (predominantly social) factors.In the aspect of this type, it is just "infantilism", the child's reaction of an individual to a psycho-traumatic Thus, the reactive state is caused by a traumatic situation, which, as noted above, is the root cause.0018

What lies in the basic beliefs of the patient? Most often, this is an incorrect children's attitude: “the world owes me”. Whatever it was: a divorce, loss of a loved one, dismissal from work or another situation ... It seems to a depressed person that another person owes him. Such behavior or expectation is dictated by the cry of the “inner child”. Unjustified expectations cause a deep state of frustration, when reality does not converge with the patient's desires. Reactive - is a disorder of a neurotic nature, and the reason for its occurrence is the irrational belief that the happiness of a particular person depends on other people. When something does not go according to the planned scenario, the patient has an accusatory factor. nine0018

On the other hand, this is one of the methods of demonstrative behavior, the purpose of which is to attract attention to oneself. From childhood, such people have a reflex that resentment or frustration leads to increased attention from parents or other close people, for example.

Other common forms are:

  • Dysthymia . Also referred to as minor or subthreshold depression . It is a prolonged despondency, aggravated sleep and appetite disorders, as well as chronic fatigue syndrome. May refer to moderate postpartum depression or manic-depressive psychosis. It has a chronic mild form, but a very long-term character (up to 2.5 years). By the way, in modern psychiatry the term "dysthymia" is used to classify neurasthenia and psychasthenia. In the context of the depressive syndrome, "dysthymia" affects the psychological and somatic status of the individual, making changes in his quality of life. May occur in childhood or adolescence, is more common in women and causes difficulty in diagnosis due to "blurred" and chronic symptoms. nine0174
  • Manic-depressive psychosis - a phase of depression in dysthymia, which is also characterized by a depressed mood, impaired thought processes, and increased anxiety.
  • Masked form . It differs in latent (hidden) course of the disease. Diagnosis is very difficult.
  • Bipolar disorder . A separate neurotic disorder caused by constant sharp mood swings: from euphoria to decline. nine0174
  • Anesthetic form . The problem here is the lack of any emotions and feelings. The world is losing its colors and sounds.
  • Adynamic shape . The main symptom is longing, which the patient may not pay attention to. The volitional factor is weakened, everyday problems and difficulties in communication appear.
  • Anxiety depressive disorders (agitated). The main symptom is unmotivated anxiety and unreasonable fears. This includes panic attacks and other anxiety states. nine0174
  • Atypical depression . A person with this form sleeps and eats a lot, and also overreacts to events.
  • Childhood mood disorder . A chronic condition that manifests itself under certain circumstances. It is due to severe deprivation that the child faced in childhood.
  • Pseudo-dementia . It is observed in the elderly and is characterized by amnesia, bad mood, deconcentration. This condition is often confused with dementia. More about this condition is described in the article depression in the elderly

  • Special attention deserves " Postpartum depression ", which is one of the most dangerous, since in this case, the most powerful hormonal imbalance that a woman experiences after childbirth and during lactation joins the social and psychological factors.

    It is logical that this form occurs only in women and develops immediately or in the first months after childbirth. Moreover, this state can last for quite a long time up to a year or more. It is worth considering such physiological situations as miscarriage or stillbirth, which are the most powerful trigger for the development of depression. The basic symptoms of this type of disorder include a deep sense of hopelessness, a feeling of sadness, a loss of joy in life. Physical manifestations are added to psychological manifestations, provoked by fatigue, lack of sleep and general exhaustion of the body. However, one should not confuse the usual female fatigue caused by changes in life and depression. There is only one difference between them - the presence or absence of joy from the appearance of the baby. Fatigue usually resolves within a few weeks or at most months after childbirth, while depressive disorder, as noted, can drag on for a longer period. In a depressed state, a woman is in dire need of support and understanding, classic, but in fact “cruel” phrases: “everyone gave birth”, “she wanted to” and others will only aggravate the condition. It is important to note that under the circumstances, not only the woman herself is in danger, but also the child. According to statistics, it is postpartum depression that has the maximum number of suicidal outcomes, and this is the type that requires mandatory monitoring by a specialist. nine0018

    Risk factors for the development of postpartum depression are: adolescence of the woman in labor; genetic prerequisites, the presence of psychopathy, a dysfunctional family situation, prolonged stress, as well as problems in the prenatal period.

  • Seasonal depression . Quite an interesting form, as it occurs regularly at certain times of the year. According to statistics, this species begins in autumn or winter and ends by summer. Although there are many cases when the main manifestations occur precisely in the early spring. Among the reasons are considered such as a lack of solar energy, which leads to a decrease in the level of serotonin in the brain, which has a calming and analgesic effect. Another theory takes into account the development of beriberi, which explains the spring depressive syndrome. In any case, the result is fatigue and spleen due to carbohydrate deficiency. nine0174
  • Depression due to traumatic brain injury or prolonged traumatic psychosis occurs against the background of mechanical damage to the brain, which can lead to not only health problems, but also mental disorders. Depending on the severity of the trauma itself, psychopathy may appear immediately, or it may take some time. Among the main symptoms of depression on the background of TBI can be identified: asthenia and amnesia, aggressive behavior and irritability, deconcentration, hallucinosis, mania of a different nature, euphoria, or vice versa, mental and motor retardation. Neurasthenia of this type can very often be accompanied by affective psychosis, complicated by manic attacks. Unlike depression of a psychogenic nature, caused by a psychotrauma, in this case, the course and symptoms depend on the type of physical injury to the head. A pronounced stage of this form may be Korsakov's syndrome, in which consciousness is disturbed. When burdened with alcohol addiction, the patient may generally cease to navigate in space. nine0174

Severe depression. Causes and signs

This is how the stage of depression, which has passed into the form of a mental disorder, is indicated. It is also called clinical depression or major depressive disorder (major depression). In contrast to moderate depression, the fundamental symptom here is a long period of the course of the disease, during which a bad mood, apathy, pessimism, and a decrease in self-esteem are observed. In the physiological aspect, symptoms such as sleep and appetite disorders, asthenia, and lethargy may be present. In extreme cases, it paralyzes the mental, mental, and motor spheres of human activity. In fact, the causes of the development of severe depression remain the same and are endogenous in nature: these are stress or psychotrauma, changes in living conditions, abuse in childhood or adolescence, a serious illness, medication, as well as a number of biological factors. Against the background of these symptoms, with major depression, a person's immunity decreases, which is a prerequisite for the development of infectious diseases. In general, there is an imbalance in the functioning of the whole organism. By and large, major depression is the main symptom of melancholic psychosis, which also belongs to the cluster of mood disorders. It is not subject to independent regression and is the form that requires the mandatory intervention of specialists and the appointment of drug therapy. nine0018

How to treat severe depression

The first thing to do when you notice severe symptoms of depression is to see a specialist. An important function in overcoming this syndrome is played by relatives and friends of the patient, who are able to show understanding, provide support and help in maintaining everyday social stability. Unfortunately, it is impossible to overcome this disease without mezhikamentozny therapy. The specialist will definitely prescribe a course of antidepressants, and if the situation is aggravated by endogenous factors (family situation), then drugs from the group of normotimics will be connected in order to increase efficiency and create a preventive effect. nine0018

Prognosis for success

With the right therapy and support from the immediate environment, the chances of a full recovery in the "here and now" are quite high. With the help of specialists, depression, even its pronounced syndrome, can be overcome without any global consequences. The sad news is that no temporary therapy is guaranteed to relapse.

Classification of depression according to ICD 10

According to the international classification of diseases, depressive syndrome is assigned codes F30-F39, and no matter how surprising, but it belongs to the section that specifically includes disorders of the human mental sphere. The main criterion for this cluster are diseases that affect a person's mood and emotions in the direction of depression. Also, the diseases of this block are recurrent in nature and difficult to predict, since they mainly depend on the person himself, and not on the environment. By the way, this section also includes: Bipolar disorder and manic episodes, affective and other mood disorders. nine0018

Stages of depression

Like many psychopathic conditions, depression has certain developmental stages.

  • The first stage is called denial, and at this stage a person continues, as it were, to live an ordinary life, as if nothing had happened. For example, in the event of the loss of a loved one, in denial it is common to talk about them in the present tense, to keep their things and photographs, as if this person is about to return. In general, the patient is not able to accept reality due to the operation of compensatory mechanisms of the psyche. nine0174
  • In the second stage, along with the understanding that it is pointless to deny what happened, feelings of resentment and anger come. Often, the patient begins to look for those responsible for what happened and throw out his negative emotions on them.
  • The third stage is called “bargaining”, at which the negative is dulled, and the person begins to look for ways to get out of this state, listens to loved ones, goes to a specialist if necessary. In general, they are trying to improve the situation.
    • nine0169 And only at the fourth stage comes the "depression" itself, as it is. This is the most dangerous period, because in it a person becomes fully aware of the situation and falls into despair, called depression. The pain during this period is felt in full force.
  • The final stage is acceptance, at which comes the realization that the past must be left in the past. Many begin to take a fresh look at their lives and loved ones, finding solace in the family or work. Having passed all the previous stages, a person accepts life as it is, realizing that it is pointless to fight what cannot be corrected. nine0174

Women's and men's depression

For a long time it was believed that only women were susceptible to depression, and there is a significant amount of truth in this, since the very mental and physical constitution of a woman causes more opportunities for the occurrence of this type of disorder. According to statistics, women suffer from depression three times more often than men. Nevertheless, modern medicine has revealed the prerequisites for the development of this syndrome in men, which most often manifests itself in combination with other diseases of the psychopathic sphere. The masculine form can be observed in bipolar, affective or obsessive-compulsive disorders, in anxiety neuroses, for example. Why is the weaker sex much more prone to this disease? In addition to the clinical general causes that were discussed above, in this aspect, it is worth paying attention to such female prerequisites as right-brain thinking, a pronounced functioning of the emotional sphere (the ability to experience events and things more deeply), but above all, it is the hormonal background and the presence many factors influencing it. Women constantly have to experience fluctuations in the level of hormones in the body, which, of course, has a certain impact on the mental, emotional, and, as a result, somatic spheres. It is also worth noting a longer period of female recovery from depression, which is also due to changes in hormonal levels in stressful situations. That is why in the treatment of female depression it is very important to pay attention to hormonal stabilizing therapy. nine0018

Screening for depression

Only a specialist can make such a diagnosis: psychotherapist or psychiatrist .

There are a number of tests - questionnaires for a deeper specialized understanding of the mental and emotional state of the patient.

One of these tests is called - PHQ-9 , it includes questions about mood, appetite, sleep patterns. It is also interesting to note that for the screening of depressive conditions, American scientists have developed a unique blood test that determines the level of nine RNA markers that affect the development of the disorder. nine0018

Treatment of depression

As in the treatment of any other neurotic disorder, in the case of depression, an integrated approach is used, including psychotherapeutic and medication methods. If the situation is not running, then the chances of avoiding the use of drugs are quite high.

Non-pharmacological methods of treatment

Prevention and self-help methods

Mindfulness, lifestyle and mental state of a person are those components that significantly affect his ability to withstand stress factors and independently prevent the development of such conditions. Depression is often called the disorder of infantilism, the prevention of which requires accepting the fact that each of us is responsible for our own condition, and we choose to be happy or unhappy. As soon as the patient manages to take responsibility for himself and his condition, depression recedes by itself. nine0018

Psychotherapy of depressive states

The primary task of psychotherapy is to help a person realize that he himself has led himself into depression. One of the popular methods is “drawing”. The patient is asked to draw what exactly his depressed mood looks like (it can be visualized as a closet, a door to nowhere, a black hole, and other images). And then decide for yourself where he wants to go. Whether he goes into a black hole or not is his choice. A depressed mood does not actually happen by itself, and it is not the world that has led a person to depression - all these realizations are accepted with the help of a specialist. The next well-known method is to help the patient maintain social status and household activity. The therapist usually works out a program to create automatic actions to return to normal life: clean up, go to the gym, meet friends, cook food. Sometimes the patient cannot and does not want to perform these simple routine manipulations, but they trigger physiological processes in the body that contribute to the production of the hormone serotonin and the establishment of chemical processes. nine0018

Types of psychotherapy
  • Cognitive-behavioral - changing the initial wrong attitudes that led to destruction.
  • Interpersonal - change in the patient's perception and style of communication with other people. Determines the form of social participation of a person in society.
  • Psychodynamic . It defines the intrapersonal conflict as the root cause, and is aimed at resolving it by bringing it to the plane of consciousness. nine0174

Treatment of depression with folk remedies

At certain undeveloped stages, in addition to psychotherapeutic methods, phytotherapy can also be connected, it will definitely not be worse. Still, the wisdom of the ages does not pass without a trace, and it is worth noting that our ancestors did not particularly suffer from neuroses. Herbal medicine, indeed, offers a large number of natural preparations that have a general strengthening effect on a person.

So, as we found out, a depressive state is largely caused by disturbances in the functioning of the brain, which needs vitamins, microelements, proteins and amino acids to power it. Most of these important substances are found in herbal preparations such as St. John's wort, Schisandra chinensis, chamomile, oregano root, lavender flowers, and many others. You can use these herbs in the form of tinctures and decoctions, both individually and in combination. Another great remedy is evening soothing baths with the addition of string or myrtle flowers. By the way, many of these products are sold in pharmacies and cosmetic stores in a ready-to-use form. nine0018

Remember that a healthy lifestyle and a balanced diet that includes fruits, vegetables and grains is also an excellent way to prevent stress and depression.

Drug therapy

If all the proposed methods do not have the desired effect or the stage is already quite advanced (major depressive or bipolar disorder), then a course of medications is indispensable. Only a specialist can prescribe antidepressant drugs. At a certain stage of equalization, taking drugs can be canceled, but to withdraw from the peak, if it has occurred, you need to start with them. Medicines in severe cases serve as an auxiliary tool, but not the main one, this must be remembered. nine0018

What drugs are prescribed for depression?

Antidepressants essentially stabilize the amount of neurotransmitters in the brain, thereby improving mood.

Learn more