Depression

Global studies show: depression, like cardiovascular disease, is becoming the most common disease in today’s world. This is a common disorder that affects millions of people. According to different researchers, up to 20% of the population of developed countries suffer from this nervous disorder.

Depression is a severe disease that dramatically reduces working capacity. It brings suffering to both the patient himself and his relatives. Unfortunately, people are very little aware of the typical manifestations and consequences of depression, therefore, many patients receive help when the condition becomes long-lasting and severe. In almost all developed countries, health services are preoccupied with this situation and are making efforts to disseminate information about depression and how to treat it.

Depression is a disease of the whole organism.

Typical signs of depression

The manifestations of depression are very diverse and vary depending on the disease’s form. We list the most typical signs of this disorder:

• emotional manifestations;
• longing, suffering, oppressed, depressed mood;
• despair;
• anxiety;
• a feeling of inner tension;
• the expectation of trouble;
• irritability;
• guilt;
• frequent self-incrimination;
• dissatisfaction with oneself;
• decreased self-confidence;
• decreased self-esteem;
• decreased or lost the ability to enjoy the pleasure of previously enjoyable activities;
• decreased interest in the environment;
• loss of ability to experience any feelings (in cases of deep depression);
• depression is often combined with anxiety about the health and fate of loved ones, as well as fear of appearing insolvent in public places.

Physiological manifestations

• Sleep disturbances (insomnia, drowsiness);
• Changes in appetite (loss or overeating);
• Intestinal dysfunction (constipation);
• Reduced sexual needs;
• Reduced energy;
• Increased fatigue during normal physical and intellectual stress;
• Weakness;
• Pain and various unpleasant sensations in the body (for example, in the heart, in the stomach, in the muscles).

Behavioral manifestations

• Passivity;
• Difficulty engaging in targeted activity;
• Avoiding contacts (a tendency to solitude, loss of interest in other people);
• Giving up entertainment;
• Alcohol abuse and substance abuse giving temporary relief.

Mental sings

• Difficulty concentration;
• Decision-making difficulties;
• The prevalence of gloomy, negative thoughts about yourself, your life, the world;
• The pessimistic vision of the future with a lack of perspective;
• Thoughts about the meaninglessness of life;
• Thoughts of suicide (in severe cases of depression);
• the presence of thoughts about one’s own uselessness, insignificance;
• Helplessness;
• The slowness of thinking.

For the diagnosis of depression, it is necessary for a part of these symptoms to persist for at least 2 weeks.

What usually prevents people from seeking help for depression?

Often people are afraid to see a mental health professional because of the negative consequences:

• possible social restrictions (registration, a ban on driving vehicles and traveling abroad);
• conviction in the event that someone finds out that the patient is being treated by a psychiatrist;
• fears of the negative impact of drug treatment for depression, which are based on widespread, but not true, ideas about the dangers of psychotropic drugs.

Often people do not possess the necessary information and misunderstand the nature of their condition. It seems to them that if their condition is connected with understandable life difficulties, then this is not depression, but a normal human reaction. They believe this condition will pass on its own. It often happens that the physiological manifestations of depression contribute to the formation of beliefs about the presence of serious somatic diseases. This is an occasion to consult a general practitioner.

80% of patients with depression initially seek the help of general practitioners, while approximately 5% of them are diagnosed correctly. Even fewer patients receive adequate therapy. Unfortunately, at the usual appointment in the hospital, it is not always possible to distinguish between the physiological manifestations of depression and the presence of true somatic disease. It leads to an incorrect diagnosis. Symptomatic therapy is prescribed for patients (medications “for the heart”, “for the stomach”, for headache), but no improvement occurs. Thoughts arise about a severe, unrecognized somatic disease, which leads to depression aggravation. Patients spend a lot of time on clinical and laboratory examinations. As a rule, they get to the psychiatrist already with severe, chronic manifestations of depression.

A modern approach to the treatment of depression involves a combination of various methods – biological therapy (drug and non-drug) and psychotherapy.

Drug treatment

It is prescribed for patients with mild, moderate and severe symptoms of depression. A necessary condition for the treatment effectiveness is cooperation with a psychiatrist. The patient should follow strict adherence to the prescribed treatment regimen, regular visits to the doctor, a detailed, frank report on your condition and life difficulties.

Antidepressants

Proper therapy allows in most cases to completely get rid of the symptoms of depression. Depression requires treatment by specialists. The main class of drugs for the treatment of depression are antidepressants. Currently, there are various drugs in this group, of which tricyclic antidepressants (amitriptyline, melipramine) have been used since the late 50s. In recent years, the number of antidepressants has increased significantly.

The main advantages of new-generation antidepressants are improved tolerability, reduced side effects, toxicity and high safety in case of overdose. New antidepressants include fluoxetine (Prozac, Proflacz), sertraline (Zoloft), citalopram (Cipramil), Paroxetine (Paxil), Fluvoxamine (Fevarin), Tianeptine (Coaxil), Mianserin (Lerivon), Moclobemide (Aurorix) and Milcelip, mirtazapine (Remeron), etc.

Antidepressants are a safe class of psychotropic drugs when used correctly according to the doctor’s recommendation. The dose of the drug is determined individually for each patient. You need to know that the therapeutic effect of antidepressants can manifest itself slowly and gradually, so it is important to be in a positive mood and wait for it to appear.

Antidepressants do not cause addiction and the development of withdrawal syndrome, in contrast to drugs of the class of benzodiazepine tranquilizers (Phenazepam, Relanium, Selenium, Temazepam, etc.). In addition, benzodiazepine tranquilizers and phenobarbital reduce sensitivity to other psychopharmacological agents.