What is anxiety-depressive disorder: symptoms, causes and treatment

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Troubles in personal and social life, the loss of a loved one or health problems often provoke the development of mental illness. Many disorders are short-term and can be dealt with on your own. But, there is a more severe depressive state, which is characterized by a lingering effect. Experienced psychologists help you get rid of depression.

• What is depression?
• Disease statistics
• Causes of the condition
• Biological
• Psychological
• Social
• Signs of clinical depression
• Physiological
• Psychological
• Behavioral
• Stages of development of depression
• First stage
• Second stage
• Third stage
• Complications of depression
• Sleep disturbance
• Apathy
• Lack of interest in life
• Biochemical processes in the brain
• Types of depression in psychiatry
• Classical
• Psychiatric
• Moderate
• Heavy
• Expressed
• Chronic
• Acute
• Black
• Behavioral
• Resistant
• Consequences of prolonged depression
• Prevention of depression
• How to get rid of depression on your own?
• Treatment methods for depression in Moscow
• Diagnostics
• Drug therapy
• Treatment at home
• Psychological help
• When should you go to the hospital?

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Course of the disease and its prognosis

Based on current clinical information, it appears that patients may initially be equally likely to have predominant anxiety symptoms or predominant depressive symptoms, or a proportional mixture of the two.

During the course of the disease, anxiety and depressive symptoms may alternate in their predominance. The prognosis is still unknown.

However, individually, depressive and anxiety disorders tend to become chronic without adequate psychological treatment.

Disease statistics

Depression is the most common mental disorder in the world. According to statistics, 280 million people experience depression, which is as much as 4 percent of the total world population. In our country, according to the Ministry of Health, every tenth person suffers from depression. This is about 15 million people of different ages and genders. Experts say that the female half of humanity is most susceptible to the development of mental disorders of a depressive nature.

Prognosis for depressive disorders

If the patient continues the course of treatment properly and follows all the specialists’ instructions, the prognosis is very favorable. It is important to note that in 50% of cases, patients show independence and stop taking medications, without fully curing depression. As a result, a relapse occurs, which worsens the patient's condition.

It is extremely important to stop the disease after the first manifestation, otherwise the likelihood of reoccurrence increases. After repeated onset of depression, a third attack occurs in 75% of cases.

Causes of the condition

Disturbances in neurotransmitter activity in the neurons of the brain system play an important role in the development of depression. Serotonin deficiency manifests itself in increased irritability, sleep disturbances, and decreased libido. Lack of dopamine leads to disruption of mental and motor activity. Mental and physical symptoms include loss of interest in life, apathy, and muscle weakness.

Biological

Experts have proven that women are most susceptible to developing depression. Emotional instability caused by pregnancy, postpartum, menopause, provokes endocrine changes in the body. Biological reasons include:

• Immune.
• Neurobiological.
• Asthenia of the body against the background of severe infectious diseases.

Psychological

Psychological reasons include the inability to find the right strategy in solving problems. A person does not understand how to act correctly in a given situation. Against this background, he seems to be stuck in a problem with all the ensuing consequences. Also susceptible to depression are people who, due to their temperament, have a tendency to worry for a long time about any reason.

What is this

A depressive episode is an affective disorder that is characterized by certain cognitive, emotional and somatic disturbances. In the patient, it manifests itself in the form of a bad mood, loss of vital interests, decreased energy, activity, increased fatigue and a general loss of joy in life. In other words, a person gets tired even after a slight effort, he does not want to do anything, since all activities seem boring, monotonous, and the outside world and human relationships seem unsightly and gray.

Additional symptoms of a depressive episode include decreased attention and concentration, low self-esteem, loss of self-confidence, gloomy pessimistic moods, loss of faith in a “bright future,” poor sleep, and decreased appetite. The most serious consequences are self-flagellation and thoughts of suicide.

The duration is determined by specialists for a period of more than 2 weeks.

How to get there

Social

Perhaps these are the most common reasons that lead to the development of depression. The following factors negatively affect the human psyche:

• Acute and chronic stress. For example, the loss of a loved one, divorce, betrayal, violence.
• High work loads.
• Job loss and change.
• Retirement.

Older people do not adapt well to changes in life. Therefore, any change, even positive, can lead to the development of stress or depression.

At-risk groups

These categories of people are not immune from both a moderate depressive episode and more severe manifestations:

• People aged 20-40 years of both sexes.
• Those who have low social status.
• People who have experienced a divorce, a breakup with a loved one, family, friends.
• Those who had relatives in their family who committed suicide (“family suicide”).
• Anyone who was very worried about the death of loved ones.
• Having characteristic personal qualities: a tendency to empty experiences, melancholy, anxiety at the slightest provocation, etc.
• Overly responsible and conscientious people.
• Persons prone to homosexuality.
• Postpartum period in women.
• Having sexual problems.
• People suffering from chronic loneliness.
• Lost social contacts for some reason.
• Having experienced a stressful situation for a long time.
• With certain moods cultivated in the family: a feeling of one’s own helplessness, worthlessness, uselessness, etc.

Signs of clinical depression

A key sign of clinical depression is low mood. A person loses the ability to receive joy from anything. There is a negative assessment of others and oneself. The person experiences psychological inhibition and decreased physical tone.

Physiological

Physical activity decreases due to a lack of desire to do work or household chores. A person becomes lazy and gloomy, unable to start and finish any activity. Sleep is disturbed, appetite is lost or increased, libido decreases.

Psychological

In a state of depression, the functioning of the brain and central nervous system is disrupted. A person becomes indifferent to everything, his memory deteriorates, and his self-esteem decreases. In a severe stage, it is impossible to cope with this condition on your own.

Behavioral

A person has passivity, it is difficult to involve him in active activity. He begins to avoid contact with other people and refuses entertainment. Often, when people are depressed, they begin to abuse alcohol and drugs.

Symptoms on examination

Both a severe depressive episode and a moderate one, a qualified specialist can determine by direct examination of the patient:

• A person constantly looks out the window or at another light source.
• Gesticulation is directed towards one's own body. The person often presses his hands to his chest.
• With alarming manifestations, the patient constantly strives to touch his own throat.
• Characteristic pose of submission.
• The Veragut fold is visible in his facial expressions, the corners of his mouth are downturned.
• In case of alarming symptoms, gestures are accelerated.
• The person's voice is low and quiet. Puts long pauses between words.

Stages of development of depression

Depending on the cause and individual characteristics of the individual, the development of depression can be divided into three main stages.

First stage

Performance decreases significantly, mood deteriorates for no reason, and interest in what is happening is lost. If a person tries to entertain himself and get rid of problems, he can easily get out of this state.

Second stage

Negative symptoms increase, in addition to psychological discomfort, physical discomfort is involved - sexual desire decreases, sleep is disturbed, and appetite is lost. There is a complete loss of work activity.

Third stage

There is a pronounced agitated state or complete inhibition. The mood is always bad, there is low self-esteem and a feeling of guilt. During the third stage, suicidal tendencies may appear.

Important points in diagnosis

To correctly determine the severity of a depressive episode, a specialist should first pay attention to the following manifestations:

• The ability to focus attention and switch it from subject to subject.
• Self-esteem, degree of self-confidence.
• Self-flagellation, thoughts of one’s own guilt.
• Gloomy and pessimistic mood.
• Ideas or even actions that relate to self-harm or suicide attempts.
• Sleep and appetite disturbances.
• Duration of the condition (a depressive episode lasts more than two weeks).
• The patient has organic brain damage.
• The fact of taking psychotropic drugs or drugs.
• There is no history of conditions that could directly lead to such a manifestation.

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Diagnostic Basics

On what basis does a specialist identify the development of a depressive episode? Important components here will be the collected anamnesis, the patient’s immediate complaints, the clinical picture that emerges during the examination, during a conversation with the patient.

In some cases (depressive syndrome is extremely similar to Alzheimer's disease in older people), examinations are also of great importance: neuropsychological, computed tomography, EEG.

Complications of depression

If a person suffers from chronic diseases such as hypertension, heart disease, asthma, gastritis or ulcers, oncology, then with the development of a depressive state the course of these pathologies becomes more severe. At the same time, the severity of the pain syndrome increases. The patient's sleep is disturbed, he becomes indifferent, and loses interest in life.

Sleep disturbance

With depression, a person is in an anxious, confused state. He can't sleep at night and then falls asleep during the day. The biological rhythm goes astray, and negative changes begin to occur in the functioning of other organs.

Apathy

Indifference or apathy is a consequence of prolonged stress or depression. A person’s desires disappear, he lacks the motivation to take care of loved ones and do household chores. Apathy fetters a person who becomes self-absorbed, while internal anxiety grows.

Lack of interest in life

A depressive state is characterized by a loss of interest in what is happening around. Complete apathy and indifference are the body’s protective reaction to a stressful situation. You can cope with this condition on your own only at the initial stage of development of the disorder. In the chronic form, you need to consult a psychologist.

Biochemical processes in the brain

In patients with depression, biochemical processes in the brain are disrupted. The balance of hormones is disrupted, making the condition even worse. If drug treatment is not started in time, this will lead to irreversible consequences.

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Types of depression in psychiatry

Based on the nature of its course, mental disorders are classified into several types, each of which poses a danger to the human psyche.

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• Classic
  Characterized by depressed mood and lack of pleasure from previously enjoyable activities. Negative changes in cognitive functions occur, memory deteriorates. Motor activity decreases, and loss of strength often occurs.
• Psychiatric
  A mental disorder is observed in which a decrease in mood occurs and indifference to everything that happens. A person is often sad and depressed. To treat this condition, doctors prescribe effective antidepressants.
• Moderate
  Characterized by a depressed state for two weeks. However, it does not improve under the influence of external factors. Sleep and eating behavior are disturbed; a person may sleep little, but at the same time experience hyperactivity in the morning, which is then replaced by apathy.
• Severe
  A serious mental disorder that combines mental, physical, and behavioral symptoms. It is characterized by a persistent pessimistic mood, depression and melancholy. A severe form of depression develops as a result of severe stress or a traumatic situation.
• The severe
  severe stage of the development of the disease includes all negative manifestations. A depressed depressed state, a constant feeling of mental pain and guilt coexist with a loss of strength and indifference. Particularly emotional people begin to have thoughts of suicide.
• Chronic
  Symptoms in the chronic course of the disease persist for about two years. A prolonged form of depression is accompanied by constant apathy, decreased mood, and anxious thoughts. A person’s self-esteem decreases, he moves less, and his mental abilities decrease. Chronic depression requires qualified treatment in a clinic.
• Acute
  Genetic factors lead to an acute form of depression. Gene mutations predetermine congenital deficiency of serotonin, dopamine and norepinephrine. As a result of a lack of these substances, depression develops, manifested by rapid fatigue, bad mood, and apathy.
• Black
  Black depression is characterized by a hopeless negative state. A person begins to feel guilty in all situations that do not even depend on him. He always has anxiety, a gloomy mood, and for all troubles he blames himself and those around him.
• Behavioral
  Depression is often perceived by others as a character trait. With a mental disorder, a person’s behavior changes for the worse. He becomes indifferent to social affairs, avoids communication and entertainment, and often begins to use alcohol or drugs.
• Permanent
  Depression is often perceived by others as a character trait. With a mental disorder, a person’s behavior changes for the worse. He becomes indifferent to social affairs, avoids communication and entertainment, and often begins to use alcohol or drugs.
• Resistant
  is a mental disorder that has not responded to treatment by specialists in one or two courses. Resistant depression includes severe depression and partial remission. To achieve the effect of treating such a disorder, a long period of hospital stay and complex treatment, including with the participation of a psychologist, are necessary.

Treatment methods for depression in a clinic in Moscow

Each aspect of treatment includes pharmacotherapy and psychotherapy. Therapeutic measures are selected on an individual basis: they actively resort to art therapy, yoga, massage... The most effective method of treating depression in Moscow is combined. A comprehensive, modern approach is what helps achieve remission.

Diagnostics

The main method for diagnosing depression is interviewing the patient. There are several main manifestations of the disease:

• Depressed psycho-emotional background for several weeks;
• Anhedonia (the inability to experience positive emotions even from things that previously brought joy);
• Apathy (lack of motivation to perform daily activities).

An extensive range of diagnostic measures is also prescribed. They examine brain activity, study analyzes of the thyroid gland and sex hormones to exclude endocrine and hormonal pathologies.

Drug therapy

Depression is a disease that is often accompanied by organic pathologies. Due to disruption of the biochemical processes of the brain, severe depression of mood and apathy are observed. To stabilize sleep, sleeping pills are used, and antidepressants are prescribed without fail, but the exact treatment regimen depends on the specific case.

Treatment at home

Treatment for depressive disorder cannot be done at home. Traditional recipes for treating depression do not help in any way to get rid of this disease. Depression is often caused by bereavement. This means that psychotherapy is simply necessary: ​​only a professional will help a person work through the problem.

Psychological help

This disease requires the participation of a psychologist. Several types of psychotherapy are used:

• Cognitive - aimed at changing thinking patterns that support a depressive state;
• Gestalt therapy - support in difficult life situations, working through underlying problems, feelings of loneliness. abandonment;
• Psychodynamics - awareness of the root cause of the problems that have arisen. Working through childhood traumas and grievances, being in an unfavorable environment.

Together with a psychologist, a person with depression changes their way of thinking, fights traumatic memories of the past, and correctly experiences the stages of grief. Thanks to high-quality psychotherapy, a person quickly returns to normal life.

Need for a hospital

This mental disorder should be treated in a clinical setting. People suffering from depressive disorder are prone to suicide. This means that a person in deep depression, left alone, can commit rash actions that can lead to death.

In a hospital setting, the patient is under constant supervision of medical personnel. Due to compliance with safety rules, the risk of committing suicidal acts is practically absent. It is impossible to achieve the same high effectiveness of treatment and safety of the environment at home.

Consequences of prolonged depression

With chronic depression, not only the functioning of the brain is disrupted in a person. Due to a mental disorder, the immune system malfunctions. As a result, the body’s protective functions weaken, and the risks of developing diseases, including infectious ones, increase. It is difficult for a person after depression to socialize in society. If treatment is not started, depression becomes severe.

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Anxiety depressive disorder symptoms and signs

Since depressive disorder has acquired the status of a modern international problem, a whole classification of symptoms and signs has been compiled in medicine. It is important to note that we can only talk about a disorder if a person has symptoms on an ongoing basis for at least 1 month. To make a diagnosis, as a rule, 4-5 signs of the following must appear:

1. Difficulty concentrating. To solve at least one task, a person has to make enormous efforts, since increased absent-mindedness prevails
2. Lack of a normal sleep cycle. Sleep does not occur immediately; intermittent sleep is often observed (waking up after a short period of time), resulting in constant fatigue.
3. Feeling as if strength is leaving the body. As a rule, with increased attention, the patient begins to feel anxiety and irritation.
4. Increased irritability. Most often it manifests itself in an ordinary reaction to external stimuli in the form of tears, screams, even if the person is asked an ordinary question
5. Groundless worry. Accompanied by a feeling of unreasonable fear and lack of self-confidence
6. A tearful state. The patient begins to cry under any circumstances: observing a touching moment, an ordinary meeting with friends and relatives
7. The emergence of unfounded fears. Any event, even one without any danger, seems suspicious to a person
8. Constantly prepared for the worst. The patient develops a strong belief that the future does not promise him anything positive and the situation will only get worse every day
9. A state of hopelessness. When any action seems completely ineffective, luck has turned away from the person and one should not hope that something good will happen in the future
10. Low self-esteem. As a result, one’s own importance is devalued.

Any of the symptoms must be present for a month to indicate the occurrence of a depressive disorder.

Prevention of depression

To avoid the development of depression, you must follow the following recommendations:

• Properly distribute workload and rest. Sleep should be full for at least eight hours.
• Maintain a daily routine. The day is for being awake and the night is for resting.
• Proper nutritious nutrition will strengthen the body.
• Lead a healthy lifestyle. To feel good, you need to play sports, you can just go jogging every morning.
• Avoid stressful situations.

You should try to find interesting hobbies that bring joy and satisfaction. Positive emotions are the main prevention against depression.

Severe depressive episode without psychotic symptoms

During a severe depressive episode, a person's consciousness is completely filled with painful sensations. A characteristic feature of endogenous depression is precardiac melancholy - a physical feeling of melancholy in the chest, heart or solar plexus - is constantly felt. This melancholy is similar to physical pain and can be described as a feeling of compression, petrification, as a feeling of unbearable suffering. These sensations are very intense and due to this intensity and severity they attract all attention. Thinking rushes about in a vicious circle of painful sensations. The diurnal mood swings characteristic of lighter stages disappear.

Along with melancholy, anxiety can also be felt, and there is also a loss of the ability to feel and communicate normally.

Outwardly, a person in such a state is not difficult to recognize. They rarely get out of bed, move slowly, speak quietly, lips are dry, facial expressions are either absent or reflect suffering, quiet speech or no speech at all.

Hypochondriacal ideas may develop.

“This stage of the attack can imperceptibly turn into delusional melancholy , when a tragic “clarity” sets in in the patient’s mind. The distance between the patient’s former “I” and the experienced state has disappeared. Melancholic delusional states in their integrity and their multiple manifestations express the ensuing revolution in the patient’s self-awareness. The former “I” does not exist either now, or in the past, or in the future. The external world registered by perception is inaccessible to the patient. Any standard (health, usefulness, ability to live among people) is unattainable. With his presence among people, he can only interfere; he was already inferior, unhealthy, and sinful. Death from disease, isolation or punishment is the only natural prospect.”

People who have experienced a major depressive episode remember it as one of the worst events in their lives:

During a severe episode, people are typically unable to carry out home, social, and work activities. Suicides are especially dangerous in cases of severe depression or at the end of it, when the mood is still depressed, but the strength has already appeared.

How to get rid of depression on your own?

People with depression rarely go to the clinic for help. If you experience a depressive reaction to a stressful situation or mild depression, it is not necessary to consult a doctor, since the consequences will not lead to serious consequences. A person can cope with the disorder on his own. It will be enough to get carried away by something interesting and learn to let go of problems. The condition will improve if loved ones provide psychological support. At a more severe stage, all measures will be ineffective; here the help of a psychologist and psychotherapist will be required.

Indirect symptoms

Nonspecific manifestations of a moderate, severe, or mild depressive episode are as follows:

• Dilated pupils.
• Constipation.
• Tachycardia.
• Reduced skin turgor.
• Increased fragility of hair and nails.
• Acceleration of involutive changes (a person seems older than his age).
• Restless legs syndrome.
• Psychogenic shortness of breath.
• Hypochondria dermatological.
• Pseudoreumatic, cardiac syndrome.
• Psychogenic dysuria.
• Somatic disorders of the digestive tract.
• Dysmenorrhea and amenorrhea.
• Chest pain (the patient complains of “a stone in the heart, in the soul”).
• Vague headaches.

Frequently asked questions about depression

How to get rid of depression on your own?

Attempts to deal with depression on your own usually end in failure and the appearance of signs of a deeper disorder. Only an experienced doctor will be able to determine the type of disease and select the optimal treatment tactics. Folk remedies, uncontrolled use of antidepressants “on the advice of friends,” withdrawal into oneself only tighten the problem and can cause deeper mental disorders with a simultaneous deterioration in physical health.

Why is depression dangerous?

Voluntary refusal of treatment with the intention of independently overcoming the disease can have the most severe consequences: the appearance of suicidal thoughts, deep mental disorders, increased frequency of attacks, personal degradation in professional and family terms, and the emergence of addiction to alcohol and drugs. It is useless to treat all of these symptoms with conventional treatment methods, and taking potent drugs can cause side effects.

How to overcome depression?

It is important to understand that depression is not a temporary deterioration in mood, but a serious mental disorder. And it will be possible to cope with it only after completing a course of complex treatment with the mandatory use of prescribed medications and additional methods for correcting the psycho-emotional state. Treatment under the supervision of an experienced specialist will help to completely cope with the disease and reduce the risk of relapse even when exposed to negative factors.