How to get rid of love depression. Psychologists' advice on how to experience unrequited love and never return to it again. Constant sleepiness or lack of sleep
Psychology. Love and depression
Love, the pursuit of love, the formation of love relationships is the most important thing in life. depressed individuals... In this direction, the most the best sides their nature, here the greatest danger to their psyche lurks. From the descriptions above, it becomes clear that it is in partnerships that depressed individuals come to a crisis. Tensions, collisions, conflicts in such relationships are painful and intolerable for them, they oppress them more than it follows from objective circumstances, because conflicts activate the fear of loss. For depressed individuals, it is not clear why their efforts can bring a partner to the boiling point, since they find relief in convulsive clinging to him. Depressive individuals react to a crisis in partnership with panic, deep depression; fear sometimes leads them to blackmail their partner by threatening or even attempting suicide. They cannot imagine that a partner does not need intimacy as much as they do, that spiritual closeness does not give him pleasure and joy. They regard the partner's need for distance as a lack of inclination towards them or a sign that they are no longer loved.The ability for intuitive identification, as well as the ability to understand the essence of another person and empathize with him in transcendental participation, is especially characteristic of depressed individuals and is their excellent quality. Authenticity and sincerity of feelings - essential element love and humanity. Their readiness for identification can achieve a mediumistic sensitivity, in which the real boundaries between "I" and "You" are erased - the whole being of a depressed person strives for a loved one, love longing has a mystical character of an unlimited transcendence of divine origin, in which, perhaps, unconsciously reflected not having a bond with her mother in early childhood, found again at the highest level. We see again that in developing our capacity for love, it is crucial early experience communication with the mother.
Have healthy people with a depressive accentuation of personality traits, there is a large and sincere ability to love, a readiness for self-giving and sacrifice. They willingly endure life's difficulties with a partner, their personality inspires a sense of security, sincerity and unreasonable disposition.
With profound disorders in depressed individuals in love relationship fear of loss prevails; it is so intolerable and so significant to them that it actually becomes the most important thing in a partnership. Both parties in the most frequent version of the relationship, loving a partner, seek the most in full identify with him. This, in fact, means achieving the greatest spiritual intimacy. The partner can react to this by refusing to maximize rapprochement, defending his personal sovereignty. What a depressed person thinks about and how she feels can be guessed by the expressed desire to "read in the eyes" - knowing that he interferes with the partner, that he wants to get rid of him, remove him from his path, he accepts his views, shares his opinions - in short, he loves in such a way that in general there is a threat of blurring the distinctions between the existence of a depressed person and a partner. Such a "merger" for a depressed person is like a spell from the fear of loss. He is all in a partner and lives with the consciousness of his sacrifice and self-denial. The truth or untrueness of such love is determined by the fact that depressed individuals decide on love (since it in itself softens the fear of loss), realizing the danger of love for themselves and realizing that the partner must have conditions for the free development of his individuality.
Here the principle "I want what suits you" is absolutized. For a partner, this kind of connection is convenient in many ways, but if depressed individuals expect more from their partner than to be his "echo" or a wordless spirit serving him, then they will be disappointed. The relationship with the child develops in a similar way, when the fear of losing a partner is transferred to the child. Depressed individuals delegate to a partner everything that they themselves want and can do, becoming completely dependent on him and becoming completely helpless without him, believing that their own need for help is satisfied by the partner. It appears that partnerships and marriage are subconscious reflections of a child's connection with a father or mother. For the same reasons, depressed individuals, widowed, soon remarry, although they loved their deceased spouse infinitely: they strive to grab onto a new partner and adapt to him, because the most important thing for them is not to remain lonely.
Thus, depressed individuals strive for symbiosis, for the abolition of the border between "I" and "You". One depressed patient described such a desire to erase the differences between "I" and "You" as follows: "I do not know anymore where I end and it begins." They completely dissolve in love, or love "devours" them so that they seem to forget whether this is themselves or their partner. In both cases, the problem of addiction is that they want to get rid of their own individuality without admitting it to their partner.
Often partnerships among depressed individuals are carried out according to the type "if I love you, then I love everything that concerns you." This is a great attempt to avoid the fear of loss: the partner can behave as he pleases - after all, the depressed person loves his feelings more than himself, and in this sense he is dependent on himself and his love readiness, thus achieving eternal and indissoluble love ...
More severe is another form of depressive partner relationships - the so-called blackmail love, or love-extortion. She willingly disguises herself as heightened solicitude, which hides the prevailing urge to flee from fear of loss. If this is unattainable, depressed individuals resort to more strong methods aimed at awakening the partner's feelings of guilt, for example, to the threat of suicide; if this does not have the desired effect, they fall into a state of deep depression and despair.
The wording “if you don’t love me anymore, then I don’t want to live anymore” prompts the partner to respond in order to free himself from the heavy burden of someone else’s life and change his attachments. Even if the partner is gentle enough, is inclined to feel guilty and does not know about the causes of the tragedy, he is still inclined to withdraw from the tragedy, whereas opposite side more and more entangled in their problems. Thus, in the depths of such ties, where the partner is expected to be released from fear, compassion and guilt, hatred and the desire for death smolder. The disease is also used as a form of blackmail and leads to similar tragedies.
We can again state that the fears and conflicts of depressed individuals have common patterns: the deeper we love, the more we are afraid of being abandoned, and with all the danger human love we hope to find protection in it. We also see that giving up our own individuality does not give us any guarantee of safety from the fear of loss. On the contrary, if we deviate or abandon our essence, then we end up with what we tried to avoid. The existence of a partnership is associated with the creation of a distance, which, if possible, both partners should not only observe, but also develop in relation to themselves. True partnership is possible only between two independent individuals who treat each other as an object of love, and not as an appendage dependent on the other. Not trusting the partner's independence, we thereby increase the risk of loss; dependence and negligible attention to oneself increase the likelihood that the partner will also lose interest and find it on the side where they do not take and give so much.
Even if the partner tries to seduce minor child, a depressed person takes it seriously as an attempt at liberation or as the fact that he overstepped the border of the partner's tolerance and thereby contributed to the transition of love into hate. This situation contributes to the formation of a "neurosis together", in which the relationship between partners is stabilized ("stagnated"), and the relationship with the child does not receive further development.
Sexuality for depressed individuals is less important than love, sympathy and tenderness. In a partner relationship, they can also enjoy sympathy for their partner, while having the attitude that in love there are no boundaries between what is permitted and what is not allowed. In cases of severe dependence on a partner, we meet with all possible forms masochism up to absolute obedience, which is often based on the idea that a complete rejection of one's own desires is the only way keep a partner.
What degree of freedom or affection everyone needs, whether this connection is portable or not, cannot be regulated: everyone seeks and finds his own solution to this problem. Each person, his inclinations, his biography and his social situation so different and unique that the requirements that he puts before a partner can be regarded as deviations from the norm, falsity or indecency. We must show enough understanding and tact to respect various forms manifestations of love, realizing how easy it is to condemn and punish what is mature age is a compensation for the lack of love in childhood.
Why is there depression after a breakup?
In reality, most men and women suffer from depression not so much because of the loss of a loved one, but because of the collapse of plans and hopes associated with lost relationships... Parting can radically change a person's life, for example, due to the need to move to another city or even a country. Such changes are rarely perceived positively.
Women especially suffer in this regard. In a relationship, they dream of a wedding, children born in love, and happiness that will last the rest of their lives. The realization that all these dreams will never come true leads to depression.
During the period of separation, it intensifies energy connection with ex-lover the partner left is not ready for this unexpected turn events. Is developing psychological dependence... I want to return everything, even if by reason the person understands that the relationship was hopeless.
The experiences after parting bring unbearable mental anguish. The person seems to lose touch with the real world... He continues to dream of illusions about the happiness that could be, not realizing that parting was inevitable.
Consolations of loved ones and any attempts to reason with the suffering lover usually do not help. At this moment, it is important to realize that nothing in the world lasts forever. Relationships are not eternal, people's feelings are not eternal, and suffering is also not eternal. At some point, the pain will go away. But when this happens depends on the person himself.
Gradually comes the understanding that exhausting yourself with negative experiences will not lead to anything good. The relationship is over, they cannot be returned. And then the mind begins to look for a way out, how to get rid of depression after parting.
Love depression is not only due to unhappy love. Although if you arrange a survey, then 99% of its participants will name this particular root cause. Really love depressive state can occur at the most different conditions... For example:
- lover or in love, realizing his physical unattractiveness, considers himself unworthy or unworthy of love, which is why he experiences constant fear of being abandoned or ridiculed;
- fear of the loss of love experienced by lonely people who associate the disappearance of feelings with the next long stage of their loneliness;
- constant jealousy experienced by those whose partners are cheating on them, or show signs of sympathy for third parties;
- the uncertainty that arises in an uncertain relationship, when one of the partners - the future carrier of depression - dreams of stability, cohabitation or marriage, and the other is satisfied with a relationship with much less obligations and responsibilities;
- love, in the way of which there are parents who disagree with the choice of a daughter or son;
- material problems, due to which the further development of relations, living together or marriage is not possible;
- a huge difference in age, physical data (a classic example is beauty and the beast), material capabilities, education, intelligence or social adaptation;
- religious differences;
- and much more.
"Untold Secrets": Why Love Is A Disease
About 7 billion people live on our planet, differing in skin color, wealth and temperament. But there is one feeling that unites everyone - this is love. She turns her head and brings happiness, and it also happens that wonderful feeling becomes a dangerous tool that in an instant can break a person's life or cause unbearable pain.
Each of us, probably, asked the question: "Where is love born?" Some answer this question - "in the heart", while others say - "in the brain." Why was it called a disease and is it true that love lives for three years? How do we choose each other and why do we fall in love with the wrong ones? The answers to these and many other questions are in our material.
Symptom one: "tunnel vision"
According to psychologist Ekaterina Stepanova, love is like a fever, a kind of strong emotional outburst. “When people fall in love, they first go through the stage of“ merging ”- the lovers do not notice the differences between themselves, but pay more attention to the similarities. This is how it appears general concept"We" that erodes the individuality of each lover, "she explained.
Psychologists unanimously insist that all love stories begin the same way, but end differently. Among the first symptoms of love, experts distinguish "tunnel vision", when a person is unable to perceive anything that does not directly or indirectly touch his object of love.
Doctor of Medical Sciences, Professor Aleksey Danilov is sure that the fate of the future is decided at the first stage of love. state of mind person: “If a person does not find an answer from the object of love, then depending on his level of culture, his moral values, a person is able to become angry, commit a crime aimed at a partner or circumstances around. Or he can paint a picture, a poem, music, perform a feat in the name of his love. "
Symptom two: flight and mental clouding
Another symptom of love is heightened feelings. So, a person has a certain sensation of flight and a strange clouding of his mind. A lover wants to sing, dance, do something unusual all the time, he wants to move mountains ...
“A person really becomes stupid at this time. And this perception is called limitation. There is an idealization of the image of a beloved, which a person does not want to destroy at all, ”says psychologist Yekaterina Stepanova.
During this stage, experts note the emotional and psychological instability accompanied by insomnia, which does not affect performance in any way, there is no feeling of fatigue. In such a state, a person is not afraid of bacteria and viruses, no illness will take him. However, the person is already sick.
It is worth noting that in 2000, falling in love was officially recognized as a disease and was included in the international classifier of diseases under the code F63.9 - doctors attributed this romantic feeling to psychiatric deviations.
“Love is akin to neurosis. A state that is ready to go to the borderline, if a person does not already direct his attention to other aspects of life. Then it can even turn into a psychotic state, ”continues Ekaterina Stepanova.
Where does love originate - in the heart or in the brain?
Love arises simultaneously in the brain and in the heart. “The brain is the coordinator, and the heart is the motor of love,” notes Aleksey Danilov.
According to him, now science is discovering neurophysical and biological mechanisms that help to understand this connection: "It is already obvious that a person in love has a singing heart and a happy brain." Scientists are convinced that love is nothing more than a chemical reaction, under the influence of which all human systems and organs begin to work differently.
“The expression of love depends on hormonal saturation. The higher the content of hormones in a person, which are responsible for the state of love, the more pronounced the manifestation of love in a person, ”says endocrinologist Svetlana Kalinichenko.
Love begins in the adrenal glands
When a person falls in love, the adrenal glands are the first to respond. They start producing hormones of passion and fear. At the sight of an object of love, thanks to adrenaline, the heart rate increases, blood flow accelerates. The hormone cortisol increases the production of glucose in the pancreas, giving the body more energy.
According to Professor Alexei Danilov, love is a very powerful biochemical explosion, a very structured, beautiful neurochemical concert: “Love is very good workout for the brain, because it is well supplied with blood in this state. "
Butterflies in the stomach
Scientists have compared brain tomograms of couples in love and drug addicted patients. As a result, in both cases, the same zones were active, responsible for the so-called "reward system". Expressed it increased level dopamine - a substance that causes a feeling of pleasure.
Love doesn't come from hormone injections
There were many experiments with different sets of hormones, but nothing worked. It turned out that love causes a surge in hormones, but a surge in hormones cannot cause love.
Love depression is not only due to unhappy love. Although if you arrange a survey, then 99% of its participants will name this particular root cause. In fact, the amorous depressive state can occur under a variety of conditions. For example:
Despite all its certain, albeit rather conventional, romanticism and sublimity, love depression is exactly the same painful, and therefore requiring urgent professional treatment, a condition, like any other mental problem. And like any mental anomaly, under certain conditions, there is not a long solution to the problem constant stress strong psychological conflicts, fears, nervous strain, refusal to help a psychologist or psychotherapist - this type of depression can also lead to all sorts of complications.
For example, it can cause various chronic diseases on physical level affecting the cardiovascular system, and disrupting the normal functioning of the nervous and hormonal system... Or lead to different serious illnesses of a mental nature, some of which, such as psychosis, social phobia, aggressiveness, or chronic fear of love - phylophobia.
Therefore, never treat such depression with a grin or as something that will go away on its own. After all, such a state, experienced even in the very young age, subsequently can become a source of a variety of, sometimes insoluble problems that can have a destructive effect, both on the personality and on the entire fate of a person who today is prone to such a seemingly harmless love depression.
How to get rid of depression
Depression accompanied by a number characteristic symptoms- unwillingness to live, loss of interest in the world around, rapid fatigue and many others. If you find yourself showing signs of a depressed mood, then you need to start fighting this problem as soon as possible.
What is depression
Depression is commonly referred to as mental illness, which is accompanied by a mood disorder.
Types of mental disorder
Mental disorders are very diverse and most often young and old people are exposed to completely different types. Let's list some of them.
Symptoms and signs of depression
1. Depression. Most often you have a very Bad mood, and this has been going on for more than a week. At the same time, there are often no special reasons for such a state of health.
2. Apathy. You have lost interest in activities that previously could seriously captivate you. You do not strive for new knowledge and are indifferent to almost everything that happens around.
3. Closure. You prefer to communicate with other people as rarely as possible, and if possible, avoid their company altogether.
4. Anxiety. This feeling accompanies you quite often, and, as a rule, you are not able to determine its nature.
5. Thoughts about death. From time to time you think that nothing would change in the world if you passed away. And in general, even close people, in your opinion, would not be very worried about your death.
6. Changes in appetite. You have started to eat differently from how it was not long ago, and this affects your weight. Now you eat very little, or vice versa - "sweep away" everything that you see in the refrigerator. Most often, you do not control this process - you simply forget about food or even do not even notice how you regularly chew something.
7. Sleep disturbance. Here, too, there can be two extremes - you either suffer from insomnia and cannot fall asleep for a long time, or you fall into a deep sleep, which usually lasts the main part of the day.
8. Self-doubt. It seems to you that you look bad, uninteresting, not charming, or simply stupid.
9. Tearfulness. A careless word accidentally dropped can bring you to tears. However, from time to time you cry even without someone's "interference", but out of general powerlessness.
The causes of the depressive state
1. Parting with a loved one. You may have experienced significant stress some time ago when you separated from the person you were connected to. serious relationship or marriage. It is possible that directly during the period of separation you were in control, but suppressed emotions still make themselves felt.
2. Non-reciprocal love. Long time you tried to achieve the location and reciprocity of the person with whom you were in love, but in the end you realized that all your attempts do not lead to a positive result.
3. Death loved one. You have experienced a serious emotional upheaval after a loved one passed away.
4. Learning problems. You are a student, and you have problems assimilating the material, many gaps, difficulties in communicating with other students or teachers. Studying gives you more negative emotions than positive ones.
5. Problems in the professional sphere. You feel that you are not fulfilling your profession properly. Perhaps you doubt the correctness of the chosen path, or you do not know at all what type of activity is right for you.
6. Financial difficulties. You have debts, you just recently "got out" of them, or you just barely have enough money, and more often than not you are constantly forced to limit yourself, refusing what you want.
7. Health problems. You may have experienced the loss of a child or are facing some kind of serious illness. Also, we can talk about ailments that have appeared in a loved one.
Family troubles. It is difficult for you to find a common language with your other half, parents, children or other close relatives.
The course of depression and its possible consequences
Accompanied by a change in mood. Nevertheless, you manage to pull yourself together when necessary - to behave at ease in society, to carry out your daily duties, and the like.
In a running form
Accompanied by complete apathy for everything that happens, nervous breakdowns... A person physically cannot exercise business as usual and he will not be able to hide his state. Suicidal thoughts may appear.
The relationship between depression and stress
Stress and depression are directly related to each other, and very often one does not exist without the other. As you know, a stressful state, which can be caused by many factors, is accompanied by nervous exhaustion. Negative emotions that had to be experienced for a long period, as a rule, lead to depression. An exception can be very stress-resistant people who are able to ignore many negative factors.
To prevent stress from turning into depression
If you understand that you are faced with a stressful situation, but do not want it to lead to a depressive state, follow some rules that will help you get out of this situation with the least emotional loss.
How to quickly cure depression
Serious depression cannot be overcome very quickly, but in general, if you start fighting it right now, you will start living a completely different life within a few weeks.
Treating depression yourself at home
How to get rid of severe and prolonged depression
If depression lasts more than a year, and you cannot force yourself to follow any recommendations, then you need to make an appointment with a psychotherapist. Often, people in such a condition cannot physically take advantage of this advice, because they need to look for a specialist, call the clinic, make an appointment, and the like. Share your problem with a loved one, and ask for help - let him find you a psychotherapist, make an appointment and accompany you to him.
How to overcome a disease once and for all
By following the above tips, you can get rid of depression permanently. However, since such a nuisance has already happened to you, then you need to realize that you are in a kind of "risk zone", and another serious stress can once again plunge you into a depressive state. To prevent this from happening, apply these recommendations not only when getting out of depression, but also later - in your daily life.
Is it possible to die from depression
Depression alone is not fatal. That is, apathy, reduced ability to work, tearfulness and other symptoms cannot lead to the death of a person, but there is another problem.
A depressed person thinks very pessimistically. He considers himself unnecessary, superfluous and irrelevant everywhere. The longer and deeper the depression, the more often the patient may think that it would be good to end all suffering in one fell swoop and begins to see his salvation in suicide. This happens only with a very severe form of depression, and in order to get out of it, it is necessary serious help close people or specialists.
What works best for depression
1. If you feel that your emotional condition leaves much to be desired, then you need to switch yourself to other emotions. The fastest way to do this is by simply calling the person with whom you enjoy talking. Even though you don't feel like dialing someone's number now, do it!
2. If your depressed state has no special reason, and does not last for several days, but only arose today, then a cup of delicious can help you. strong tea! Opt for chamomile and lime-tree drinks. Drink it while you're on the run - find a calm and quiet place where you can leisurely sip a soothing tea and think of something good in solitude.
3. Physical work or playing sports can to a large extent relieve you of depression, because your energy will be directed in a completely different direction. And in general, it has long been known that muscle activity provokes the release of endorphins into the human blood, which are also called "hormones of happiness."
Tips for treating depression
How to be treated with antidepressants
If you decide to improve your condition by using antidepressants, keep in mind that this will not completely cure your depression. You can suppress the symptoms of the disease for a while, but not get rid of it. Dosage drugs can only be established by a specialist, in no case do it yourself, otherwise this approach can only harm you.
Wanting to get rid of depression, do not rely only on medicine, because you are overcome by "mental illness". Communicate with loved ones more often, confidentially telling them about your problem.
Therapy and psychotherapy
Many people underestimate the help of psychotherapy, but this industry is actively developing. Specialists use the following types of psychotherapy: cognitive-behavioral, psychodynamic and interpersonal. The first will help to correct your thinking from negative to positive, the second helps to resolve internal conflicts, and the last one makes it clear what became the main source of the problem for you.
As you can see, one visit to a psychotherapist can give you a complete understanding of your condition and identify landmarks by which you can get out of it.
For some, family or group therapy may help - you may find it easier to solve a problem based on positive examples from others or a solution family problems from the inside.
Preventing future depression
To prevent depression from returning, try to limit yourself from the factors that cause it. Many people who do charity work or just an interesting hobby are less prone to depression than others. Find an activity that you enjoy and truly captivate, and in the end it can always distract you from sad thoughts.
Sources:
Depression due to love and its causes
Depression due to love and its causes Love depression is not only due to unhappy love. Although if you arrange a survey, then 99% of its participants will name this particular
http://zdorovat.ru/depressiya/lyubovnaya-prichiny
How to get rid of depression
How to get rid of depression Depression is accompanied by a number of characteristic symptoms - unwillingness to live, loss of interest in the world around, rapid fatigue and many others. If you find
http://konsay.ru/2018/02/02/kak-izbavitsya-ot-depressii/
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I. GENERAL INFORMATION ABOUT DEPRESSION
Depression is a disease of our time
Studies around the world show that depression is like cardiovascular disease, is becoming the most common ailment of our time. It is a common disorder that affects millions of people. According to various researchers, up to 20% of the population of developed countries suffers from it.
Depression - serious illness, which sharply reduces the ability to work and brings suffering to both the patient himself and his loved ones. Unfortunately, people are very little aware of typical manifestations and the consequences of depression, therefore, many patients receive help when the condition takes on a protracted and severe nature, and sometimes it does not appear at all. In virtually all developed countries, health services are concerned about the current situation and are making efforts to promote 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 form of the disease. Let's list the most typical signs of this disorder:
Emotional manifestations
* longing, suffering, depressed, depressed mood, despair
* anxiety, feeling of inner tension, anticipation of trouble
* irritability
* feelings of guilt, frequent self-accusations
* dissatisfaction with oneself, decreased self-confidence, decreased self-esteem
* decrease or loss of the ability to experience pleasure from previously enjoyable activities
* decreased interest in the environment
* loss of the 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 untenable in public
Physiological manifestations
* sleep disorders (insomnia, drowsiness)
* changes in appetite (loss or overeating)
* impaired bowel function (constipation)
* decrease in sexual needs
* decrease in energy, increased fatigue during normal physical and intellectual exertion, weakness
* pains and various discomfort in the body (for example, in the heart, in the stomach, in the muscles)
Behavioral manifestations
* passivity, difficulty in engaging in purposeful activity
* avoidance of contact (tendency to solitude, loss of interest in other people)
* refusal of entertainment
* alcoholism and substance abuse providing temporary relief
Thought manifestations
* difficulty concentrating, concentrating
* difficulty making decisions
* prevalence of gloomy, negative thoughts about yourself, about your life, about the world in general
* gloomy, 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 their own uselessness, insignificance, helplessness
* slow thinking
For the diagnosis of depression, it is necessary that some of the listed symptoms persist for at least two weeks.
Depression needs to be treated
Depression is often perceived by both the patient and others as a manifestation of bad character, laziness and selfishness, promiscuity or natural pessimism. It should be remembered that depression is not just a bad mood (see manifestations above), but a disease that requires the intervention of specialists and responds well to treatment. The earlier the correct diagnosis is made and started correct treatment, the more chances for fast recovery, that depression will not recur again and will not take on a severe form, accompanied by a desire to commit suicide.
What usually stops people from seeking help for depression?
Often people are afraid to see a specialist in mental disorders due to the alleged negative consequences:
1) possible social restrictions (registration, ban on driving vehicles and traveling abroad);
2) condemnation if someone finds out that the patient is being treated by a psychiatrist;
3) fears of the negative impact of medication, which are based on widespread, but not correct ideas about the dangers of psychotropic drugs.
People often do not have the necessary information and misunderstand the nature of their condition. It seems to them that if their condition is associated with understandable life difficulties, then this is not depression, but a normal human reaction that 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 the reason for contacting a general practitioner.
80% of people with depression initially seek medical help general practice, while the correct diagnosis is made about 5% of them. Fewer patients receive adequate therapy. Unfortunately, at a regular clinic appointment, it is not always possible to distinguish between the physiological manifestations of depression and the presence of a true somatic illness, which leads to an incorrect diagnosis. Patients are prescribed symptomatic therapy (drugs "for the heart", "for the stomach", for headaches), but there is no improvement. Thoughts arise about a serious, unrecognized somatic illness, which, according to the mechanism vicious circle leads to worsening of depression. Patients spend a lot of time on clinical and laboratory examinations, and, as a rule, come to a psychiatrist already with severe, chronic manifestations of depression.
II. SCIENTIFIC KNOWLEDGE ABOUT DEPRESSION
The main types of depression
Depression often occurs against a background of stress or long-standing severe traumatic situations. Sometimes they arise without apparent reasons... Depression can accompany somatic diseases (cardiovascular, gastrointestinal, endocrine, etc.). In such cases, it significantly complicates the course and prognosis of the underlying somatic disease. However, with timely detection and treatment of depression, there is a rapid improvement in mental and physical well-being.
Depression can occur in the form of single, different in severity episodes of the disease or proceed for a long time in the form of repeated exacerbations.
In some patients, depression is chronic - it lasts for many years without reaching significant severity.
Depression is sometimes limited mainly to bodily symptoms without distinct emotional manifestations... At the same time, clinical and laboratory examinations may not reveal any organic changes. In such cases, it is necessary to consult a psychiatrist.
Modern ideas about the causes of depression
Bio-psycho-social model of depression
Modern science views depression as a disease contributing to its origin different reasons or factors - biological, psychological and social.
The biology of depression
TO biological factors depressions include, first of all, specific disorders of neurochemical processes (exchange of neurotransmitters such as serotonin, norepinephrine, acetylcholine, etc.). These disorders, in turn, can be hereditary.
The psychology of depression
Scientific research has revealed the following psychological factors depression:
* special style thinking, the so-called negative thinking, which is characterized by a fixation on negative sides life and one's own personality, the tendency to see in a negative light the surrounding life and one's future
* a specific style of communication in the family with an increased level of criticism, increased conflict
* increased number of stressful life events v personal life(separation, divorce, alcoholization of loved ones, death of loved ones)
* social isolation with few warm, trusting contacts that could serve as a source of emotional support
The social context of depression
The growth of depressions in modern civilization is associated with a high pace of life, an increased level of its stressfulness: high competitiveness of modern society, social instability - high level migration difficult economic conditions, uncertainty about the future. V modern society cultivated whole line values that doom a person to constant dissatisfaction with himself - the cult of physical and personal perfection, the cult of strength, superiority over other people and personal well-being. It makes people feel bad about their problems and failures, deprives them of emotional support and condemns them to loneliness.
III. HELP FOR DEPRESSION
The modern approach to the treatment of depression involves a combination different methods- biological therapy (medication and non-medication) and psychotherapy.
Drug treatment
It is prescribed for patients with mild, moderate and severe manifestations of depression. A prerequisite the effectiveness of treatment is cooperation with a doctor: strict adherence to the prescribed therapy regimen, regular visits to the doctor, a detailed, frank report about your condition and life difficulties.
Antidepressants.
Correct therapy can in most cases completely get rid of the symptoms of depression. Depression requires specialist treatment. The main class of drugs for the treatment of depression are antidepressants. Currently, there are various drugs in this group, of which tricyclic (amitriptyline, melipramine) and have been used since the late 50s. V last years the number of antidepressants has increased significantly.
The main advantages of new generation antidepressants are improving tolerance, reducing side effects, reduced toxicity and high safety in case of overdose. Newer antidepressants include fluoxetine (Prozac, Profluzac), Sertraline (Zoloft), Citalopram (Cipramil), Paroxetine (Paxil), Fluvoxamine (Fevarin), Tianeptine (Coaxil), Mianserin (Lerivon), moclobemide (Milxelnauciparanx) (Ixelnarix), , mirtazapine (Remeron), etc. Antidepressants are safe class 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 therapeutic effect antidepressants can manifest slowly and gradually, so it is important to be positive and wait for it to appear.
Antidepressants do not cause addiction and the development of a withdrawal syndrome, in contrast to drugs of the class of benzodiazenine tranquilizers (phenazepam, Relanium, Elenium, Tazepam, etc.) and Corvalol, Valocordin, widely used in our country. In addition, benzodiazepine tranquilizers and phenobarbital, which are part of Corvalol and Valocordin, with prolonged use, reduce sensitivity to other psychopharmacological agents.
The main stages of therapy.
1. Determination of treatment tactics: the choice of an antidepressant taking into account the main symptoms of depression in each patient, the selection of an adequate dose of the drug and an individual treatment regimen.
2. Conducting the main course of therapy aimed at reducing the symptoms of depression up to their disappearance, restoring the patient's previous level of activity.
3. Conducting a maintenance course of therapy for 4-6 months or more after the general normalization of the condition. This stage is aimed at preventing the exacerbation of the disease.
What usually interferes with drug treatment:
1. Misconceptions about the nature of depression and the role of medication.
2. A common misconception about the unconditional harm of all psychotropic drugs: the emergence of dependence on them, bad influence on the state internal organs... Many patients believe that it is better to suffer from depression than to take antidepressants.
3. Many patients interrupt their appointment in the absence of quick effect or taking medication irregularly.
It is important to remember that there have been numerous studies that support high efficiency and the safety of modern antidepressants. The damage done by depression to emotional and material well-being human, in severity is incomparable with the minor and easily eliminated side effects that sometimes occur with the use of antidepressants. It should be remembered that the therapeutic effect of antidepressants often occurs only 2-4 weeks after the start of administration.
Psychotherapy
Psychotherapy is not an alternative, but an important adjunct to the drug treatment of depression. In contrast to drug treatment, psychotherapy assumes a more active role of the patient in the treatment process. Psychotherapy helps patients develop emotional self-regulation skills and later cope more effectively with crisis situations without sinking into depression.
In the treatment of depression, three approaches have proven to be the most effective and scientifically based: psychodynamic psychotherapy, behavioral psychotherapy and cognitive psychotherapy.
According to psychodynamic therapy, psychological basis depression are internal unconscious conflicts. For example, the desire to be independent and the simultaneous desire to receive in large volume support, help and care from other people. Another typical conflict is the presence of intense anger, resentment towards others, combined with the need to be always kind, good and to maintain the location of loved ones. The sources of these conflicts lie in the patient's life history, which becomes the subject of analysis in psychodynamic therapy. Each individual case may have its own unique content of conflicting experiences, and therefore requires individual psychotherapeutic work. The goal of therapy is to recognize the conflict and help in its constructive resolution: to learn to find a balance of independence and intimacy, to develop the ability to express feelings constructively and maintain relationships with people. Behavioral psychotherapy is aimed at resolving the patient's current problems and relieving behavioral symptoms: passivity, refusal of pleasures, monotonous lifestyle, isolation from others, inability to plan and engage in purposeful activity.
Cognitive psychotherapy is a synthesis of both of the above approaches and combines their advantages. It combines work with actual life difficulties and behavioral symptoms of depression and work with their internal psychological sources (deep ideas and beliefs). As the main psychological mechanism depression in cognitive psychotherapy is considered the so-called. negative thinking, which is expressed in the tendency of depressed patients to view everything that happens to them in a negative light. Changing this way of thinking requires careful individual work which aims to develop a more realistic and optimistic outlook on oneself, on the world and on the future.
Additional forms of psychotherapy for depression are family counseling and group psychotherapy (but not any, but specifically aimed at helping depressed patients). Their involvement can be of significant assistance in treatment and rehabilitation.
What usually hinders seeking psychotherapeutic help?
1. Low awareness of people about what psychotherapy is.
2. Fear of initiation of a stranger into personal, intimate experiences.
3. Skeptical attitude to the fact that "talking" can have a tangible healing effect.
4. The idea that you need to cope with psychological difficulties yourself, and turning to another person is a sign of weakness.
In modern society, psychotherapy is recognized, effective method assistance from various mental disorders... Thus, a course of cognitive psychotherapy significantly reduces the risk of recurrence of depression. Modern methods psychotherapy focused on short-term (10-30 sessions depending on the severity of the condition) effective assistance... All information that the psychotherapist receives during the session is strictly confidential and remains secret. A professional psychotherapist is specially trained to work with difficult experiences and difficult life situations of other people, he knows how to respect them and help in coping with them. Every person in life has situations (for example, such as an illness) that he cannot cope with on his own. Learning to ask for and accept help is a sign of maturity and rationality, not weakness.
Helping people close to you to overcome depression
The support of loved ones, even when the patient is not interested in her, is very important in overcoming depression.
In this regard, you can give following tips relatives of patients:
* remember that depression is a disease that requires compassion, but in no case should you plunge into the disease with the patient, sharing his pessimism and despair. You need to be able to maintain a certain emotional distance, all the time reminding yourself and the patient that depression is a transient emotional state
* Studies have shown that depression is especially unfavorable in those families where a lot of critical remarks about the patient are made. Try to make it clear to the patient that his condition is not his fault, but the misfortune that he needs help and treatment
* try not to concentrate on the illness of a loved one and bring positive emotions into your life and into the life of your family. If possible, try to involve the patient in some kind of useful activity, and not remove him from business.
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Ph.D. A.B. Kholmogorova, Ph.D. T.V. Dovzhenko, Ph.D. N.G. Garanyan Moscow Research Institute of Psychiatry, Ministry of Health of the Russian Federation Previous conversation |