Depression - causes, types, stages, symptoms, signs, diagnosis, treatment in women and men

Depression is a common mental disorder, the main features of which are a persistent decline in mood, problems with memory and concentration, and minimal motor activity.

The causes of such a painful condition for a person in the majority of cases are neuropsychological distress or chronic stress. Depression can be accompanied by severe illnesses, sudden changes in life.

Treatment is based on the use of psychotherapeutic techniques. In some cases, it is supplemented by the administration of medications.

Reasons

Depending on the form, the illness is associated with external or internal factors. Psychogenic reactive depression can be caused by severe emotional distress, or by an acute psychologically traumatic situation. It is not uncommon for the disorder to develop after the loss of a loved one, job loss, divorce, moving, or injury.

Positive events, such as finally gaining wealth or popularity, can also cause a disorder. In this case, the mental disorder is explained by the realization of a dream followed by a loss of meaning in life, provided there are no other goals.

Neurotic depression is a consequence of chronic stress. In this condition, it is usually not possible to establish a concrete cause of experiences. The person finds it difficult to name a particular psychologically traumatic circumstance and sees his or her life in general as a series of losses and disappointments.

Depression in men more often develops with regular use of alcoholic beverages and psychoactive substances.

Other risk factors for affective disorder in patients of either sex are:

• a very high or extremely low financial position;
• Impressionism, mistrustfulness, poor stress tolerance;
• low self-esteem, a tendency to self-injury;
• pessimistic outlook on life;
• high psycho-emotional stress in professional activities;
• difficult childhood, psychologically traumatic situations at a young age;
• divorce or loss of one of the parents, growing up in a single-parent family or orphanage;
• presence of mental or neurotic disorders, addictions in relatives;
• loneliness, lack of support in the family and social environment;
• economic and political instability in the country;
• physiologically determined changes in hormonal background - the process of puberty, postpartum period, menopause.

Endogenous depression develops due to neurochemical abnormalities caused by a genetic mutation or aging of the body. This group of disorders includes involutionary melancholy and senile depressions. This form of pathology is also found in manic-depressive psychosis, characterized by alternating phases of mania, depression and mental stability.

The likelihood of depression in women is higher during postpartum and menopausal periods, when there are changes in the level of sex hormones, which is stressful for the body. In a young mother, neuropsychiatric disorders can occur in case of complicated childbirth, problems with breastfeeding or the baby's health, or excess weight.

Depression can also be accompanied by illnesses of various organs. They are divided into the following groups:

1. Abnormalities of the cardiovascular system - myocardial infarction, hypertension, circulatory insufficiency, heart rhythm disorders.
2. Brain damage from stroke, neuroinfection or head trauma.
3. Endocrine disorders - diabetes mellitus, hyper- or hypothyroidism.
4. Digestive disorders - cirrhosis of the liver, colitis.
5. Rheumatic diseases with long-term pain syndrome - rheumatism, systemic connective tissue lesions, arthritis.
6. Cancer, especially malignant neoplasms.

Classification

Depending on the severity and nature of its manifestations, depression is of the following types:

• large or clinical
• Postpartum
• atypical
• recurrent
• small
• dysthymia

Latent or "masked" depression is characterized by the absence of signs of neuropsychiatric disorders and symptoms typical for somatic diseases. The following variants are distinguished:

• Cardiology
• abdominal
• skin

Conditioned by an acute psychologically traumatic situation, reactive psychogenic depression proceeds in several stages:

1. Denial. The psyche makes an attempt to isolate itself from the negative events that are occurring, and the patient stubbornly refuses to believe in what has happened.
2. Anger. A feeling of injustice creates anger, and the search for the guilty begins.
3. Bargaining. A person tries to bargain to avoid consequences. This indicates an active attempt to find a way out of the situation.
4. Depression. There is a sensation of loss of control over what is going on, a feeling of powerlessness and impossibility to correct anything. This is accompanied by a depressed mood, apathy, laziness, sadness, pessimistic judgments.
5. Acceptance. After a realistic assessment of the situation and the prospects opened up, the person accepts his fate and morally prepares himself for the consequences.

Symptoms

The main manifestations of the disease are grouped under the name "depressive triad" and include:

• persistent low moods, despair, melancholy, hopelessness for weeks or even months
• slowed thinking, problems with remembering and analyzing information, fixation on your own experiences
• decreased motor activity, sluggishness, lethargy, prolonged stay in a monotonous posture

The patient ceases to enjoy activities that used to bring positive emotions, becomes withdrawn and taciturn, and may spend most of the day lying in bed or sitting, slouching, with his head bowed and his elbows propped on his knees. There is a feeling of guilt, low self-esteem and suicidal ideation. Rapid fatigability is characteristic, solving simple household tasks requires great effort.

In some cases of depression, the following symptoms may be present:

• nocturnal insomnia, often combined with sleepiness during the day
• decreased appetite and weight loss
• pulse rate
• constipation
• pupil dilation
• loss of libido
• menstrual disorders
• intense pain in different parts of the body for no objective reason
• aggressive behavior, attacks and accusations against others
• Dry and loose skin, wrinkles
• increased hair loss, brittle nails

In endogenous depression, the intensity of symptoms peaks in the morning, gradually weakening during the day, and manifestations of psychogenic affective disorders intensify in the evening. A peculiarity of postnatal depression is the mother's decreased interest in the child, irritation from the necessity to care for him or her.

Clinical depression is severe, including all the manifestations of the triad and many additional symptoms. The minor form is characterized by only a couple of signs of the illness persisting for two weeks or more. The atypical variant proceeds with increased appetite, somnolence, emotional agitation, and anxiety.

Recurrent depression is characterized by a short duration of a few days with monthly recurrences. Seasonal affective disorder is associated with the change of seasons, with symptoms beginning and ending around the same time interval. In dysthymia, mood is persistently low for several years, but negative emotions and experiences do not reach the intensity characteristic of clinical depression.

Complications

The greatest danger comes from suicidal thoughts arising from the illness. They can provoke appropriate actions and lead to tragic consequences. With postpartum depression, a woman is able to harm not only herself, but also the baby. In order to alleviate the symptoms, the patient may resort to taking alcohol, drugs.

Diagnosis

In somatogenic or latent forms of the illness, a person may seek help from a general practitioner, cardiologist, neurologist, gastroenterologist and other physicians. In the case of psychogenic affective disorder, self-referral to a psychologist is possible. It is important that the patient is timely referred by these specialists to a psychotherapist, who deals with the diagnosis of depression. He identifies the illness by interviewing the patient, during which the complaints and existing symptoms, and possible causative factors are clarified. Based on the findings, the doctor will advise on how to get out of depression as quickly as possible and make a treatment plan.

Special depression tests are administered to determine the severity of the process. They include standardized tasks developed and validated by specialists. Thus, personal needs, character traits, emotional response, level of intelligence, anxiety and stress are studied. The Beck Depression Scale with a test questionnaire is often used to identify and assess symptoms.

Treatment

With a mild course of the disease, it is possible to undergo only a course of psychotherapy without the use of medication. Additionally, massage, hydrotherapy and therapeutic physical training can be recommended. Moderate and severe affective disorders also require the prescription of medications.

The essence of drug therapy of depression is reduced to taking drugs that affect the production of biologically active substances, conditioning the transmission of the neurochemical impulse along the neurons of the limbic system of the brain. For this purpose, antidepressants are used. Major clinical form of the disease usually requires hospitalization. Under indications for severe depression, insomnia and anxiety pills are also prescribed - sedatives, tranquilizers.

Psychogenic reactive disorders are successfully treated, and soon after the onset of the illness there is a recovery from depression. The clinical picture of the somatogenic form of the illness depends on the severity of the organic pathology. Endogenous disorders are not amenable to psychotherapy, but it is often possible to achieve prolonged remission with medication. Neurotic depression tends to have a long-term, chronic course.