What is depression? A detailed breakdown of the disease.

Depressive disorderA.K.A. depressiondepression is a common mental illness often accompanied by low mood, inability to enjoy life (feelings of longing, hopelessness and despair), impaired thinking and slowness of movement. One of the main dangers for people suffering from depression is that as their condition worsens, the likelihood of suicide attempts increases. To date, the mortality rate indirectly related to depression is only slightly lower than that of diseases affecting different organs (e.g., cancer and cardiovascular disease).

 It should be noted that depression is twice as common in women as in men.

Main causes of depression

Depression can occur regardless of age category or social status. It most often appears in stressful and negative situations, especially with prolonged setbacks, when a person feels helpless to change the course of events.

In addition to social factors, the development of depression can be caused by severe psychological traumaDepression is often referred to as depression, such as family breakdown, bereavement, or serious illness that affects not only the patient but also their loved ones. In such cases, depression is often referred to as reactive.

The likelihood of depression increases hormonal changesThese changes can affect both emotionally and physically. These changes can affect both emotionally and physically.

Traditionally, psychogenic, endogenous and somatogenic forms of depression are distinguished.

• Psychogenic depressive disorders are associated with the development of conditions caused by psychological or stressful factors. These forms of depression can result from the impact of various stressful events on a person's psyche.
• Endogenous depression are associated with psychiatric disorders such as schizophrenia, manic-depressive psychosis and involutional melancholia. They occur internally, without apparent external causes, and are often associated with changes in brain chemistry.
• Somatogenic depressive disorders are caused by somatic illnesses. They can arise as a result of the effects of physical illnesses on the mental state.

Another factor is brain lesions and somatic pathologies.

People who have had a stroke, suffer from chronic impaired blood flow to the brain, or have undergone a brain injury are often susceptible to depression.

Depression can also be caused by side effects of certain medications such as benzodiazepines and corticosteroids. Often this condition improves after discontinuation of the respective drug. An additional cause of depression is intoxication of the body, which can be a consequence of infectious diseases, as well as alcohol and drug abuse.

Symptoms of the disease or how to identify the presence of depression?

Pathology can occur after experiencing stressful situations. When the problem is resolved, the person's good mood returns. However, if the cause is eliminated, but the person does not leave apathy, depression and loss of strength, then he should already seek help from a specialist. There may also be a decrease in performance.

You can try to determine the presence of depression on your own, but self-treatment, even at an early stage of the disease is not worth it. This should be handled by a psychologist or psychotherapist. Today, I can easily conduct online therapy at a convenient time for you and in the comfort of your home, which will contribute to a quicker cure.

Depression in women often manifests itself postpartumAs their lives change dramatically, sleepless nights increase fatigue, which can cause breakdowns and apathy.

Symptoms of a neglected form of depression:

1. Bad moods and powerlessness: There is not only a constant bad mood, but also a feeling of complete powerlessness.
2. Persistent nervous system disorders: there are persistent disorders of the nervous system.
3. A significant drop in self-esteem: there's a pronounced drop in self-esteem.
4. Social maladaptation: the person has difficulty adapting to society, a sense of inadequacy.
5. Despondency: there is a constant gloom and a sense of futility.
6. Loss of interest in all events: the person loses interest in all the events and activities around them.

These symptoms indicate severe depression and require professional medical attention for effective treatment.

Physiologic changes in depression:

1. Changes in appetite: there may be a change in appetite, either increased or decreased.
2. Decreased intimate needs and energy: There is a decrease in the desire for intimacy and companionship, as well as in energy levels.
3. Sleep disturbance: may have trouble falling asleep, insomnia, or the opposite - excessive sleepiness.
4. Intestinal dysfunctions: constipation and other disorders of intestinal activity may occur.
5. Physical weakness and fatigue: There is general weakness and rapid fatigue with physical and intellectual exertion.
6. Pain in various parts of the body: can manifest pain in various areas including the heart, muscles and stomach area.

These physiologic changes are frequent manifestations of depressive states and can affect the patient's overall physical well-being.

Signs of depression in the patient:

1. Loss of interest: there's a loss of interest in the people around him.
2. A penchant for solitude: a desire to avoid society, a preference for solitude.
3. Refusal to be entertained: the patient shows no interest in entertainment and pleasures.
4. Substance Use: There may be an increase in the use of alcohol and psychotropic substances.

The mental signs of depression:

1. Difficulty concentrating: has trouble concentrating.
2. Focus: decreased ability to focus on tasks.
3. Decision Making: there are difficulties in making decisions.
4. Slow thinking: there's a slowing down of the thought process.
5. A pessimistic view of the future: a negative vision of the future with a lack of perspective prevails.
6. Thoughts of the meaninglessness of existence: the patient experiences thoughts of the meaninglessness of his existence.
7. Suicide attempts: Sometimes these thoughts can lead to suicide attempts due to feelings of irrelevance, helplessness and insignificance.

What types of depression are there?

There are many different types of depression, each of which manifests itself in a unique way. The nature of signs and symptoms vary in terms of amount, duration, severity and frequency, although they generally have a similar pattern. Since the treatment methods for different forms of depression are different, accurately identifying the type becomes an important aspect. People of different gender, age and cultural contexts may experience symptoms and severity of depression in different ways.

Neurotic and reactive (mild) depression can be successfully treated with psychotherapy. While somatic and psychotic forms may, rarelyrequire medical intervention.

Research suggests that depression develops in phases, with periods of normal mood alternating with episodes of depression. Occasionally, a manic phase may occur, with irritability and elevated mood, however, indicates bipolar disordera more serious condition, not just depression.

1. Depressive episode: This is the most typical form of depression, lasting from a few weeks to a year, with more than 2 weeks. A single episode is called unipolar. Without treatment, the risk of recurrent episodes increases, affecting performance.
2. Recurrent depressive disorder: Characterized by recurrent episodes, beginning usually in adolescence or young adulthood. Episodes of depression alternate with phases of normal mood. It is a form of unipolar depression that has a serious impact on performance.
3. Dysthymia: Manifested by less severe symptoms, lasting more than 2 years, called "chronic depression". Can progress to a more severe form known as double depression.
4. Bipolar depression, type I: Includes alternating depressive, normal moods and manic phases. Mania is characterized by elevated moods, hyperactivity, and risky behavior. Symptoms of depression after the manic phase.
5. Bipolar depression, type II: Similar to recurrent depressive disorder, alternating between depressive phases and mania phases, but with less euphoria.
6. Anxiety-depressive disorder: Clinically similar to depression, but with an even mix of anxiety and depressive symptoms.
7. A psychotic depressive episode: Includes psychotic elements such as hallucinations and delusions. Requires inpatient psychiatric treatment.
8. Atypical depression: Characterized by hypersensitivity, mood swings, overeating, and sleepiness. Can be bipolar.
9. Seasonal depressive disorder: Appears seasonally, most often in the fall or winter, with a return to normal function after the season is over (described in more detail below).
10. Brief depressive disorder: A mild form of depression, often affecting young people, with short episodes lasting less than 2 weeks.

Types of depression

1. Neurotic depression: Characterized by frequent suffering of people with low self-esteem, insecurity. The feeling of injustice often leads to apathy.
2. Clinical depression: It is manifested by low mood, loss of energy, appetite and sleep problems. It can be accompanied by suicidal tendencies and lasts for at least 2 weeks.
3. Vegetative depression: It appears with symptoms such as tachycardia, blood pressure drop and tinnitus.
4. Psychogenic depression: Develops after severe psychological trauma, such as divorce, loss of a loved one, or dismissal. It is accompanied by mood swings and sensitivity.
5. Masked (hidden) depression: It manifests itself covertly. Apathy and loss of interest in life may accumulate gradually.
6. Asthenic depression: Accompanied by fatigue, sleep disturbance and emotional instability due to difficulty, stress and strain.
7. Postpartum depression: It usually appears 10-14 days after delivery. It is associated with anxiety about the baby, lack of sleep and hormonal effects.
8. Somatogenic depression: Caused by disorders in the endocrine system or the presence of neoplasms, both benign and malignant.
9. Alcoholic depression: It is accompanied by excessive alcohol consumption. Post-alcoholic state is characterized by craving for alcohol and withdrawal syndrome when giving up alcohol.
10. Bipolar depression: Characterized by alternating euphoria, depression, and manic disorders. Symptoms may be latent in the periods between the phenomena.

Seasonal (fall, winter, summer) depression

Seasonal depression, most often a period of fall or winter, is an affective disorder that encompasses both the psychological and physical state of a person with a characteristic seasonality and periodicity.

There are three patterns of seasonal disorder: fall depression - the onset of colder weather and rains, winter depression, beginning in mid-October to early November and continuing into the warm spring, and the rarer summer depression, manifesting from late May through the fall cold spells.

Seasonal affective disorder is a serious psychological illness that requires diagnosis and treatment. It is important to pay attention to it and not ignore its symptoms to prevent the situation from getting worse.

There are ways to mitigate seasonal aggravation at home:

1. Lengthen the daylight hours artificially by changing the activity for the morning and avoiding long periods of time in dark rooms.
2. Raise the level of vitamin D in the body through short walks in the fresh air.
3. Increase physical activityby playing sports, dancing or walking.
4. Stabilize the dietInclude more fruits and vegetables, and consult with doctors about nutrition.
5. Monitor temperature conditionsavoid hypothermia and excessive warm clothing.

Diagnosis and treatment of depression:

1. Screening tools: Short questionnaires are used to identify symptoms of anxiety, anhedonia and suicidal tendencies. These instruments help to determine the presence of chronic depression, the form and severity of the disease.
2. Symptom Definition: To fully understand the picture of the disease psychologist, psychotherapist familiarizes with the symptoms peculiar to depression.
3. Choosing a specialist: Treatment for depression may include online counseling with a psychologist or psychotherapist. It is also recommended to make an appointment with a neurologist, especially if depression is associated with neurological disorders.
4. Treatment of mild forms: Psychologists are involved in the therapy of mild forms of depression that require attention but are less dangerous compared to severe forms.
5. Pharmacotherapy and social therapy: Treatment may include not only counseling, but also pharmacotherapy and social therapy. Effective treatment requires cooperation and trust in the physician, as well as strict adherence to the prescribed therapy regimen.
6. Regular counseling: It is important for the patient to attend regular online counseling or appointments in the psychologist's office and provide a detailed report of their condition for effective monitoring and adjustment of therapy.

Medications to treat depression

Used in rare cases (*in my practice, I try to avoid the use of medication.) if the depression is prolonged or severe.

1. Antidepressants:
   • Used for anxious depression or with lethargy.
   • They are prescribed by a doctor and taking them on their own is not recommended.
   • Many antidepressants take two weeks to take effect and can be addictive.
   • The dosage and type of drug is determined individually for each patient.
2. Treatment of bipolar depression:
   • It is used to treat depression accompanied by insomnia.
   • In patients with bipolar disorder, sleep deprivation can lead to mental normalization.
3. Natural-based preparations:
   • A moderate or mild form of depression is perfectly treatable with light, natural-based (herbal) medications.
   • These medications may be prescribed for gentler and safer effects on the body.
4. Individual Assignment:
   • Treatment of depression involves an individualized approach to each patient.
   • It is necessary to determine the best choice of medications, taking into account the specifics of the condition and the patient's needs.

Types of treatment for depression:

There are several common approaches to treating depression, including counseling with a psychotherapist (psychotherapy) and the use of antidepressant medications (medication).

There are several types of antidepressants, including those that stimulate action to treat apathetic states.

If depression is accompanied by anxiety and irritability, antidepressants with a sedative effect are prescribed.

It is important to remember that antidepressants with sedative effects used to treat apathetic states have serious side effects.

Herbal-based preparations with magnesium are often recommended for mild forms of depression.

Unfortunately, medication is of little effectiveness without therapy. Medications can relieve symptoms or significantly reduce their occurrence only in 40-60% cases. If antidepressant treatment is not appropriate or is not accepted by the patient, online psychotherapy sessions are provided. Compared to medication, psychotherapy has similar efficacy but is harmless and safe for the patient and includes cognitive and interpersonal techniques.

Cognitive Psychotherapy:

Cognitive psychotherapy is a method of psychology that aims to Identifying and modifying a person's thought processes. During the course of communication with the therapist, the patient becomes aware of and analyzes a number of problems, including:

• The impact of negative thoughts on the course of life and behavior.
• Skills for managing negative thoughts, eliminating them and channeling them in a more constructive direction.
• Distinguishing between correct and destructive judgments affecting depressive state.
• Help with the challenges of coping with depression.

Interpersonal Psychotherapy:

Interpersonal psychotherapy is one of the most successful methods of short-term therapy, originally developed to treat depressive conditions. This method is based on the assumption that a person sinks into despair because of difficulties in relationships with people around him. Problems arise because of misperception of others and difficulties in communication. This method is widely used, including, to treat postpartum depressionwhen the mother isolates herself and refuses to communicate even with loved ones.

There are also non-traditional therapies such as hypnotherapy, acupuncture, meditation, and music or drawing therapies. All of these approaches are aimed at better self-knowledge and identifying internal problems that are interfering with the enjoyment of life and socialization. Any form of therapy offers the individual the opportunity to heal and regain confidence in their abilities.

Contraindications for the treatment of depression

Contraindications for psychotherapy in the treatment of depression are similar to those that exist with any other form of pathology:

1. Lack of desire for recovery and acceptance of psychological help:
2. Failure to recognize or categorical denial of the psychological cause of illness in the presence of multiple complaints and symptoms:
3. Lack of interest in exploring one's own problem and shifting responsibility for therapy to the psychologist or blaming others:
4. Patient concerns about intolerance to psychological pain that may be disclosed in therapy:
5. Failure of the patient to accept psychological help during the first sessions:

Prevention of the state of depression

In a medical field that often emphasizes the treatment of disease, it is important not to lose sight of prevention, especially in the context of prophylaxis. It is prevention that occupies a key position in addressing issues related to prolonging quality of life. To reduce the risk of depression, it is recommended that:

1. Mastering stress management and relaxation skills:
   • Developing the ability to effectively control stressful situations.
   • Learning relaxation techniques to reduce the negative impact of stressors on mental health.
2. Maintaining a healthy lifestyle:
   • Proper nutrition as a factor in reducing the risk of depression.
   • Regular physical activity and its effect on endorphin levels, which have a positive effect on mood.
   • Sleep adherence as an important aspect of maintaining mental health.
3. Avoiding social isolation:
   • Active participation in community events.
   • Joining clubs or groups with common interests to maintain emotional well-being.
4. Seeking help in a timely manner:
   • Responding to the first signs of depression or noticeable mood changes.
   • Counseling with a psychotherapist, psychiatrist, or other qualified professional.
5. Making time for creative and favorite activities:
   • Engage in things that bring pleasure and promote joyful experiences.
   • Develop creative interests to liberate and enhance mood.
6. Teaching effective problem solving and coping skills:
   • Developing rational and effective coping skills.
   • Reducing feelings of helplessness and anxiety through systematic training.

Frequently Asked Questions

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