How to get out of severe depression

Medical information is reliable Checked by Shaidullin Renat Flyurovich

Depression is a disease of our time, as the disorder is called at the everyday level. Every day the number of recorded cases is growing; according to statistics, about 20% of the population of countries with a good standard of living suffers from it. The disease is serious; when the first signs appear, you should contact a specialist. Treatment of depression will help you return to normal life, get rid of apathy and bad mood, and increase your ability to work.

The difficulty of therapy is that patients are very little aware of the causes of the disorder and its consequences. Prolonged mental and physical illness is often mistaken for bad character, whims, and constant dissatisfaction, so they do not pay attention to it. The condition does not go away on its own; you need the help of a specialist. At Dr. Isaev’s Clinic, the patient is not only prescribed a therapeutic course, but also relapse prevention is carried out, information is provided about the preconditions for the disorder and ways to avoid them.

Signs of Depression

Under certain circumstances, this condition can occur in every person, regardless of gender, age and social status. Depression is a type of mental illness accompanied by a persistent decrease in mood. A person remains in this state for more than two weeks continuously; he experiences a decrease in memory and concentration, loss of interest in life, and retardation of movements. In the absence of timely treatment, the patient loses the ability to live and work fully for many months and even years, and the possibility of attempting to commit suicide cannot be ruled out.

Types of depression

First, you need to figure out whether depressive symptoms have reached the level of a disease or whether this is a manifestation of a secondary depressive syndrome within the framework of the underlying condition.

Depressive syndrome has less pronounced manifestations, the cause of these disorders is clearly visible, the manifestation of symptoms is not stable: short “light” and “dark” periods replace each other.

When depression itself is felt by a person as a painful state of loss of strength, lack of interest in life and has a persistent decrease in mood.

Depression causes

According to statistics, about 90% of diagnoses are made to people who are in a state of chronic stress or experiencing acute psychological trauma. The body cannot cope with this influence of external factors on its own, the psyche fails, depressive episodes are a kind of defensive reaction.

Conditions arising due to severe psychological trauma are considered reactive. They can be triggered by the following events in the patient’s life:

• disability due to health and absence of serious illnesses;
• detection of a malignant tumor;
• conflicts at work, constant tension in relationships with colleagues;
• serious illness of a close relative;
• death of a loved one;
• divorce from your beloved spouse;
• retirement;
• rapid decline in financial levels;
• moving to another city and other factors that can be a real shock for a person.

Depression is not always formed on the basis of negative events. Sometimes the disease occurs when an important life goal is achieved, when a person experiences great success. The patient gets what he wanted. He suddenly loses the meaning of life, he no longer needs to make every effort for a specific result. The situation is aggravated if there are no other life goals at this moment.

A separate category includes depressive neurosis, which develops against a background of constant stress. In this case, it is not always possible to establish the specific cause that became the trigger for the pathology. The patient describes his life as a chain of constantly recurring failures that haunt him every day.

A depressive state of the psychogenic type is more typical for women, while older people suffer from the disease more often than young people. In our society, there are two extreme poles of financial well-being - poverty and wealth. This social scale causes a person to feel dissatisfied with himself if he constantly approaches the first category.

Additional provoking factors will be:

• pessimistic outlook on life;
• low self-esteem, constant self-flagellation;
• loss of parents, loved ones, friends;
• emotional violence against a person;
• physical aggression that the child experienced at an early age;
• predisposition to drug addiction and alcoholism;
• lack of support from others, their indifference towards the person.

Each of these factors in itself is not dangerous; if desired, a person can easily ignore it or seek help from a psychotherapist. If there are several of them, the situation becomes more complicated, the experiences become more intense and acute. In this case, drug treatment may be required.

For example, in a teenager, the period of growing up is associated with intensive growth of all organs and systems; pregnancy and menopause in women are accompanied by hormonal storms. This is fertile ground for the development of a melancholic mood and ever-increasing dissatisfaction with oneself. During these periods, experiences take on a negative connotation; the world around often seems hostile and indifferent.

Organic brain lesions, as well as physical diseases, are classified into a separate category. Cerebrovascular accidents, strokes and heart attacks, traumatic brain injuries, coronary heart disease, and stomach ulcers are also among the sources of depression listed by experts. Against the backdrop of the development of such diseases, depression manifests itself clearly and clearly.

Depression

In approximately 90% of cases, the cause of the development of an affective disorder is acute psychological trauma or chronic stress. Depression that occurs as a result of psychological trauma is called reactive. Reactive disorders are provoked by divorce, death or serious illness of a loved one, disability or serious illness of the patient himself, dismissal, conflicts at work, retirement, bankruptcy, a sharp drop in the level of financial support, moving, etc.

In some cases, depression occurs “on the wave of success,” when an important goal is achieved. Experts explain such reactive disorders as a sudden loss of meaning in life due to the lack of other goals. Neurotic depression (depressive neurosis) develops against the background of chronic stress. As a rule, in such cases, the specific cause of the disorder cannot be established - the patient either finds it difficult to name the traumatic event, or describes his life as a chain of failures and disappointments.

Women suffer from psychogenic depression more often than men, older people more often than young people. Other risk factors include the “extreme poles” of the social scale (wealth and poverty), insufficient resistance to stress, low self-esteem, a tendency to self-blame, a pessimistic view of the world, an unfavorable situation in the parental family, physical, psychological or emotional experiences suffered in childhood. violence, early loss of parents, hereditary predisposition (presence of depression, neurotic disorders, drug addiction and alcoholism in relatives), lack of support in the family and in society.

A relatively rare type is endogenous depression, accounting for approximately 1% of the total number of affective disorders. Endogenous affective disorders include periodic depression in the unipolar form of manic-depressive psychosis, the depressive phase in bipolar variants of the course of manic-depressive psychosis, involutional melancholia and senile depression. The main reason for the development of this group of disorders are neurochemical factors: genetically determined disorders of the metabolism of biogenic amines, endocrine shifts and metabolic changes resulting from aging.

The likelihood of endogenous and psychogenic depression increases with physiological changes in hormonal levels: during adolescence, after childbirth and during menopause. The listed stages are a kind of test for the body - during such periods the activity of all organs and systems is restructured, which is reflected at all levels: physical, psychological, emotional. Hormonal changes are accompanied by increased fatigue, decreased performance, reversible deterioration of memory and attention, irritability and emotional lability. These features, combined with attempts to accept one’s own growing up, aging, or a woman’s new role as a mother, become an impetus for the development of depression.

Another risk factor is brain damage and somatic diseases. According to statistics, clinically significant affective disorders are detected in 50% of patients who have suffered a stroke, in 60% of patients suffering from chronic cerebrovascular insufficiency and in 15-25% of patients with a history of traumatic brain injury. In case of TBI, depression is usually detected in the long term (several months or years after the injury).

Among the somatic diseases that provoke the development of affective disorders, experts indicate coronary heart disease, chronic cardiovascular and respiratory failure, diabetes mellitus, thyroid disease, bronchial asthma, gastric and duodenal ulcers, cirrhosis of the liver, rheumatoid arthritis, SLE, malignant neoplasms , AIDS and some other diseases. In addition, depression often occurs with alcoholism and drug addiction, which is due to both chronic intoxication of the body and numerous problems caused by taking psychoactive substances.

Depression symptoms

For each person, signs of depression can manifest themselves differently, it all depends on the stage and form of the pathology. Symptoms occur at different levels, affecting all aspects of the emotional sphere and behavioral reactions of the patient.

Emotional manifestation:

• deep depression is accompanied by a loss of the ability to experience simple human feelings (anger, joy, surprise, fear);
• there is no interest in surrounding events and people;
• those activities that previously evoked pleasant emotions are of no interest to the patient at all;
• a person is dissatisfied with himself, his appearance;
• lack of self-confidence, low self-esteem;
• constant feeling of guilt, even if the objective reason for this is not determined;
• the patient often blames himself for everything, without necessarily saying it out loud;
• increased irritability, nervousness;
• depressed and depressed mood;
• often falls into despair;
• the patient is characterized by melancholy and suffering;
• the feeling of internal tension increases;
• a subconscious expectation of trouble arises;
• increased anxiety even in the absence of any reason.

Fears about the health of loved ones are constantly present in depressed patients. They understand that they cannot do or change anything in this situation. Anxiety is also associated with fears of appearing stupid or ineffective in the eyes of the public. Going to a psychiatric clinic is the first step on the path to recovery.

The manifestation of the disease at the physical level is expressed in the following:

• sleep disturbance (constant daytime sleepiness or insomnia);
• complete loss of appetite or uncontrolled eating;
• decreased libido, sexual needs cease to interest the patient;
• disruption of the functioning of the gastrointestinal tract (constipation or diarrhea);
• increased fatigue and chronic fatigue;
• decreased energy level, exhaustion, feeling of lack of strength.

Even with ordinary physical or intellectual stress, general weakness of the body, unpleasant sensations in the body and pain of varying intensity occur.

Behavioral symptoms of depression:

• it is impossible to involve a person in any activity that involves the implementation of a certain algorithm of actions;
• he refuses entertainment;
• There is a tendency towards solitude and avoidance of social contacts.

A depressed state can change the intensity of cognitive processes:

• there are difficulties when trying to concentrate on any subject;
• concentration suffers;
• the patient experiences problems if he needs to make some decision and cannot rationally “weigh” the risks;
• he constantly doubts whether he is doing the right thing, turning over the situation in his head, and in the end he never comes to a definite opinion;
• constantly thinks about his own helplessness, insignificance for others;
• thinking is slow, which is very noticeable to others;
• in severe cases, thoughts of suicide occur, and the likelihood of committing it is high.

If there are two or more symptoms from this list, and they are observed in the patient for 2 weeks or more, the doctor may diagnose depression. The selection of effective treatment depends on which type of disorder the patient has:

• Dysthymia.

This is a mild variant of the disease, which begins in adolescence and is formed against the background of intrapersonal conflicts, problems with parents, and constantly changing hormonal levels. People around him believe that this is a manifestation of a difficult character; such a person is called a melancholic or a pessimist.

• Depressive episode.

This condition arose in the patient for the first time in his life; it did not have time to develop into a severe form. A short-term but memorable case of total sadness, exhaustion, lack of interest in everything that was happening.

• Bipolar affective disorder.

Characterized by alternating moments of bad mood and pathological joy, the patient’s life is constantly between these two poles. He seems to float on the waves of mood, constantly moving from one peak of emotions to another.

• Recurrent depressive disorder.

These episodes recur every few years, after which they may go away on their own. The pathology must be treated in a psychiatric center for a long time with the help of psychotherapy and periodic courses of medications.

Symptoms and signs of clinical depression

Among the symptoms of clinical depression (or, in scientific medical terms, major depressive disorder) are:

• Bad mood during the day
• Loss of interest in life
• Lethargy and fatigue
• Inattention and indecisiveness
• Low self-esteem, self-flagellation,
• Thoughts of suicide
• Sleep and appetite disturbances
• Weight loss.

Among the causes of this disease are the acceleration of the pace of life, overcrowding in large cities, an increase in the level of social demands, stress, predisposition, and educational methods.

Many people are afraid to go to the doctor and voice the symptoms of their disease, because they think that this will negatively affect their future personal life and career. Patients believe that an official diagnosis will be like a sentence that will classify them as crazy. But this is not true at all!

And the experienced doctors of our clinic: psychotherapists, psychologists, psychiatrists will help you get rid of torment and prevent the negative consequences of the development of the disease. After all, the development of depression can cause great harm, and in particular, connections with other people will be destroyed, work will be lost, and a person can also commit suicide in this state.

During illness, changes occur at the brain level. It is sometimes very difficult for the patient himself to do anything to improve his condition.

The specialists of the Rehab Family center will not only prescribe the correct medication treatment, but will also conduct psychotherapeutic activities aimed at working through mental states. If treatment is started on time, the outcome of this treatment is usually quite successful.

Don’t wait for the person close to you to “come to his senses” and start acting. Help him make a decision and see a doctor. And the knowledgeable doctors of the Rehab Family clinic will already be able to establish successful interaction with the patient.

Depression scale

If a patient has doubts about the state of his health, and he is sufficiently informed in matters of mental disorders, it will not be difficult during self-diagnosis to determine the presence of a depressive episode.

The 21-item Beck Depression Inventory is used for this purpose. It contains several statements, in each of them you need to select only one option. This phrase should reflect the thoughts and feelings of a person at the current moment as accurately as possible.

You need to answer questions as truthfully as possible and be sincere with yourself. As a result, it is necessary to calculate the total number of points; the lower their number, the lower the likelihood of depression.

If you have alarming results on the Beck scale, you should contact a specialist; you can make an appointment at Dr. Isaev’s Clinic any day. This should be done immediately if you are experiencing panic attacks due to nervous exhaustion.

Diagnostic features

To date, there are no hardware techniques that allow diagnosing dysthymia in a person. Chronic depression is not visible on an x-ray, nor can it be detected by a blood test or other body fluid. The only thing that helps in making a diagnosis is a conversation with the patient and the people around him. The doctor also carefully studies the medical history of not only the person suffering from dysthymia, but also all of his relatives. This approach allows us to determine the hereditary prerequisites for the development of mental problems.

Diagnostics will include the following activities:

1. General examination to exclude malfunction of the thyroid gland. Its hypofunction can provoke symptoms similar to the clinical picture of dysthymia. You will also need to exclude the presence of other diseases or addictions (alcohol, drugs).
2. Identification of symptoms characteristic of a depressive disorder - they do not have to appear over a long period of time. However, they should not be pronounced, otherwise we will be talking about other types of depression.

Despite the seriousness of a disease such as dysthymia, timely treatment can significantly improve well-being and lead to complete healing. To do this, you need to seek specialized medical help. Even an ordinary local doctor can relieve mild forms of depression, but if the symptoms do not go away for a long time, it is better to make an appointment with a psychotherapist.

Depression in men

Constitutional differences between the male and female body lead to the fact that mental disorders have different manifestations. This condition in a man is often unnoticeable to those around him; the patient tries to appear joyful and cheerful, telling everyone about the absence of problems.

The depressive triad, characteristic of men, is expressed as follows:

• anhedonia – the ability to experience pleasure and joy is reduced or absent;
• changes in thinking processes - new, sometimes absurd, judgments arise, negativism and pessimism predominate;
• motor retardation, slowness.

One of the reasons for the development of the disease in the stronger sex is erectile dysfunction. Decreased libido, lack of attraction to the opposite sex, fear of being ridiculed by a partner causes a feeling of slight dissatisfaction with oneself, and then turns into a severe form, accompanied by a feeling of one’s own helplessness and insignificance, the man does not feel strong and self-confident.

Depression in women

There are several factors that lead to the development of depression in women. Among them are the following categories:

• Biological

The disorder develops slowly and gradually under the influence of changes in the body. Increased nervous excitability, decreased levels of norepinephrine or serotonin, and hormonal imbalance lead to pathology. The situation is aggravated if the body lacks vitamins, microelements and other useful substances.

• Social

This group of factors is associated with frequent stress, bad habits, polluted environment, increased physical and emotional activity. The female body is weaker than the male; it is not able to withstand such loads for a long time. The psyche is depleted, various unfavorable states arise, including depressive ones.

• Interpersonal relationships

Psychotraumatic events that occur in a woman's life can cause this disorder. Among them are:

• death of a loved one;
• long-term separation or complete breakup of relationships;
• lack of understanding on the part of relatives;
• constant dissatisfaction with your appearance, excess weight or physical characteristics;
• professional dissatisfaction.

The combination of these factors threatens an increase in symptoms and a gradual deterioration in a woman’s health.

The lack of joy in life radically changes the patient’s character; he becomes melancholic, constantly dissatisfied with himself and his loved ones, and makes complaints about everyone, even if there is no reason for this.

Postpartum depression

After the pregnancy period has been successfully overcome and a woman gives birth to a child, she may experience a different range of feelings and sensations on the physical level. Postpartum depression is an atypical mental disorder that can be dangerous for the new mother and her environment.

It is important to understand that childbirth represents enormous stress for the psyche and a great test for the body. Psychological assistance is necessary for the patient in case of serious deviations from the norm. This condition occurs during the first 3 months after birth and can be mild or severe.

Among the provoking factors, experts identify:

• excessive physical exertion associated with caring for a newborn;
• the pregnancy was difficult or unwanted;
• inability to breastfeed;
• financial difficulties;
• dysfunction of the nervous system, which began even before birth;
• conflicts with a partner (separation, quarrels, infidelity);
• moral exhaustion of the body;
• unjustified expectations of a young mother;
• lack of help at home from close relatives.

This disorder can be distinguished from others by a number of specific signs. The doctor diagnoses and prescribes medications; self-medication in this case threatens to worsen the condition. Among the symptoms characteristic of women are:

• Regular complaints of excessive fatigue, lack of energy, loneliness. This is accompanied by mood swings, euphoria is often replaced by causeless sadness, and outbursts of anger occur that the woman is unable to control. She often cries, becomes hysterical, and does not respond to attempts to calm her down.
• Panic fear. Usually it concerns the health of the newborn, the mother has fears that he may suddenly die or something will happen to him. A gloomy vision of the future becomes dominant, the imagination draws terrible pictures of events that could happen in a few hours or days. Articles about accidents and illnesses read on the Internet are automatically “tried on” to oneself.
• The feeling of guilt does not leave a woman; even the smallest failure plunges her into a world of fear and self-flagellation.
• Provoking conflict. Often a young mother throws tantrums every day for any reason, she becomes grumpy, and she herself looks for reasons to quarrel with her husband or loved ones. People around them attribute these symptoms to whims and bad character, so they do not respond to them in a timely manner.

Depression test

The psychological tools that psychiatrists, psychologists and psychotherapists use in their work have certain specifics. These can be tests, questionnaires, questionnaires, projective techniques. The difficulty lies in the correct interpretation of the material received from the patient.

It is strictly not recommended for patients to use their own intuition and information on the Internet. The patient may misdiagnose himself and prescribe medications that are not required in his case.

Moreover, most tranquilizers, antidepressants and other strong drugs are available only with a doctor's prescription. The use of dubious remedies will not only not help, but will also aggravate the situation and increase the level of intensity of symptoms.

In addition to tests, Dr. Isaev’s clinic performs diagnostics using modern equipment, which can be used to determine the presence of concomitant diseases. In some cases, treatment must begin with them, since such pathologies complicate the clinical picture.

How to get out of depression

Psychologists advise to be attentive to your body, at the first signs of depressive episodes, try to help yourself before visiting a doctor. It is important to follow these rules:

1. There is no need to avoid a bad state and mood and hate yourself for it. The patient must accept himself as he is at a particular moment. This is a normal phenomenon that occurs under the influence of external and internal factors. Depression must be fought, but this must be done gently, without putting strong pressure on the psyche.
2. Redirecting focus to another activity. Reading books, riding a bike, going to the gym, swimming, and changing the environment helps a lot. If finances and time allow, you can go on a trip, see many interesting and new places, in this case the apathy often goes away on its own. Perhaps the person simply lacked impressions.
3. You need to get rid of the fear of losing your positive emotions. Manifestations of joy, euphoria, and pleasure should be enjoyed at the moment they appear, and not constantly replay bygone times in your thoughts.
4. Communication with new people, interesting contacts. You can go to an exhibition, cinema or theater, meet interesting interlocutors, let others help. There is no need to be afraid of being rejected or not needed; in most cases, such experiments end successfully.
5. The psychotherapist will recommend meditations that can be used when the first symptoms of depression approach. Such techniques help develop a sense of inner integrity.
6. Normalization of sleep and rest patterns. An exhausted body needs help first. A full eight-hour sleep helps restore its reserves and promotes inner peace.

Treatment of depression

If a person cannot cope with his condition on his own, he needs the help of a psychotherapist. Treatment of depression involves the use of various techniques aimed at relaxing the nervous system, calming down, and increasing self-esteem.

If the patient does not realize what is happening to him, hypnosis sessions are recommended. Immersion in a trance and precise adherence to the doctor’s commands makes it possible to travel back to childhood or adolescence, to determine the place and time when the psychological trauma was inflicted. In some cases, the patient requires consultation with a neurologist or psychiatrist if he develops other pathologies against the background of a depressive disorder.

Why is prolonged depression so dangerous?

Imagine that you have known a person for a long time. And suddenly, out of the blue (or as a result of a specific situation), he becomes depressed, demonstrates indifference to things that he used to love, and sleeps poorly. Of course, you will understand that something is wrong with him. What if a person has been behaving this way for as long as you can remember?

Often the symptoms of prolonged depression are regarded as character traits, especially if it began at a young age or even in childhood. After all, neither relatives nor the patient himself have anything to compare the demonstrated behavior with.

In general, the following symptoms can be observed with prolonged depression:

• feeling of weakness;
• sadness;
• loss of positive emotions (love, joy, compassion);
• a feeling of general bodily immutability, physically experienced melancholy;
• frequent headaches;
• deterioration of digestion;
• sleep disturbance;
• loss of interest in life up to suicide attempts;

All these symptoms of prolonged depression may be mild or blurred. Getting used to discomfort, a person is in no hurry to change anything. And often the patient seeks help only when depression causes specific problems: it affects academic performance or productivity at work, worsens family relationships, etc.

Questions and answers

Is it possible to get rid of a bad mood on your own with the help of antidepressants?

We categorically do not recommend prescribing medications yourself. This is done by the doctor based on examination of the patient. Many medications have a number of contraindications, which the patient himself may not be aware of.

How long does it take to treat depression?

This is an individual indicator, it all depends on the form of the disease and its stage.

Chronic depression: treatment

How to get rid of prolonged depression? There is no universal answer; it is different for each patient, since everything depends on his personality and mental hygiene of life, the cause of the disease, the therapy used before, etc. It is important to set yourself up for a smooth exit from protracted depression. You can objectively monitor the dynamics of healing using the Zhang, Hamilton, Beck scales, and the WHO Major Depression Questionnaire.

In the “treatment of chronic depression,” the basis is individually selected antidepressant therapy in an adequate dosage.

To the question “How to deal with chronic depression?” a course of psychotherapy will help you answer and teach you how to act: cognitive, behavioral (behavioural), psychodynamic, etc. Competent psychotherapy changes the way of thinking in a positive direction, helps to identify true psychotrauma, removes negative behavioral symptoms such as refusal of pleasure, eating disorders, monotonous lifestyle, desire for excessive solitude.