Probably, each of us has our own ideathe answer to the question of what depression is. Some people consider it an imaginary problem, others - a serious illness requiring medical intervention, and for others, depression is just bouts of bad mood and melancholy. Be that as it may, without a true understanding of this phenomenon, it is very difficult to fight it, and it is necessary to do so, because it is not for nothing that depression is called the “disease of the twenty-first century”. Almost every resident of a large city has encountered manifestations of depression in one way or another - including you, and that is why information about it will be interesting and useful to you.

Depression as a disease

It all started, as usual, with Hippocrates.As many people know, he described four temperaments, one of which was called melancholic. So, the description of the condition “melancholia” (which in translation from ancient Greek means “black bile”) is very close to the modern concept of depression. By the way, Hippocrates even made a scheme for its treatment, which, of course, will surprise a person living in the twenty-first century: opium tincture, long warm baths, massage, cleansing enemas and, of course, psychological support. Modern medicine calls depression a disease. Just like with any other disease, depression disrupts a person’s normal life, their ability to work, their desire to interact with other members of society, the quality and duration of life and the ability to adapt to a changing world. It belongs to the class of mental disorders and is characterized by the so-called “depressive trinity”:

• Decreased mood and loss of ability to experience joy;
• Changes in the thinking process: pessimism, negative judgments, negative predictions for the future, etc. ...
• Motor and mental retardation, lethargy and apathy.

Depression refers to emotional disordersspheres. According to the World Health Organization, at least ten percent of the population of civilized countries have suffered from depression at least once in their lives. Most likely, people in undeveloped countries also suffer from it, but no one writes about it - you must agree that in places like Africa, the problems of hunger and vaccination against infections are much more acute than the diagnosis and treatment of depression. It is necessary to say a few words about the diagnosis of depression. Often it is very difficult due to the fact that many patients keep silent about the first symptoms of this disorder. Someone is afraid of being considered a psycho, someone is afraid of the prescription and dependence on drugs, someone believes that depression does not exist at all. But the fact remains: in almost half of the percent of cases, depression is diagnosed late. Depression does not develop overnight: yesterday it was not there, and today it knocks a person off his feet and blossoms in full bloom. As a rule, at first a person has a single depressive episode. It can be of varying severity: mild, moderate and severe. In some cases, depression becomes chronic: episodes recur with a certain frequency. Treatment of depression is a separate story. Indeed, in many cases, patients are prescribed antidepressants. But a good doctor prescribes them after weighing all the pros and cons of such treatment, assessing all the risks and possible consequences. For people suffering from clinical depression, they are necessary, because without appropriate treatment, the quality of life of these patients is extremely low. The treatment of depression almost always includes an element (and sometimes the main part) of psychotherapy. This is correct, since it is necessary to eliminate the psychological causes of depression and to consolidate the result obtained during treatment. This is the point of view of official medicine on the problem of depression. But you should not assume that you are dealing with a sick person if you hear him say “I have depression”. Many people use this term not in the medical sense, but only to describe bouts of bad mood. It is necessary to understand that clinical depression is always something more than just melancholy. It includes a number of symptoms, which we wrote about above and will write about below, and only a doctor can make an appropriate diagnosis - we must not forget about this.

Types of depression

It just so happens that in Russia there is depressionthey call it anything - blues, melancholy, melancholy, apathy, sadness, grief, and just a bad mood. No one cares that depression is actually a mental disorder with its own symptoms. It is in the case of such a disorder that a person should be examined by a doctor and sometimes prescribed antidepressants. There are a huge number of types of depression. They differ from each other in symptoms, causes and course of the disease. If a person is really sick with depression, then one of the tasks of a psychiatrist is to determine its type in order to prescribe appropriate medication and psychotherapeutic treatment. Of course, readers of our magazine do not need to know them all, but we think you will be interested in the most common types

Endogenous depression This is one of the most severe of itstypes. Translated from Greek, “endogenous” means “coming from within.” The development of such depression is not influenced by psychological or any other factors — the disease simply suddenly manifests itself in all its glory: patients have “a pain in the soul,” “melancholy squeezes the chest as if in a vice,” “the heart is breaking,” etc. … Some scientists associate the development of this type of depression with an imbalance of chemicals in the body, which is why antidepressants are used as the main medicine for it. Endogenous depression is unpleasant because its attack cannot be predicted or somehow prevented — it occurs on its own, and this significantly reduces the quality of life of the person suffering from it. We will tell you a short story so that you can better understand the state of a person who is depressed. Maria was twenty-two years old when she first encountered this problem. After graduating from university and starting to work, she began to realize that nothing made her happy anymore, as before. The world was painted not even in black and white, but in dirty gray colors. Communication with friends, which until recently caused a storm of positive emotions, now did not make her happy. More than anything in the world, Masha wanted to sit at home and stare at one point, not going anywhere else. The saddest thing is that the realization of what was happening came to Masha suddenly. At first, it seemed to her that all this was just bouts of bad mood. But when one far from wonderful day she could not find the strength to go to work, she had to see a psychotherapist. After listening to Masha, he diagnosed her with depression. She did not understand - how so, because everything in her life was fine! Where did such negative experiences come from? But the doctor explained to her that in some cases depression appears as if out of nowhere, and you need to learn to live with it and fight it.

Reactive depression This is the optionmost readers probably imagine: something terrible, out of the ordinary, happens to a person in his life, and he can’t take it anymore and goes crazy. This happens because the power of the psychotraumatic event is so great that the person’s psyche reacts to it with a decline in mental activity: joylessness, apathy and melancholy. Such events usually include the loss of a loved one, divorce, dismissal, retirement, illness, etc. - In some cases, psychotherapy alone is enough to treat reactive depression. A psychotherapist (or psychologist) discusses the negative circumstances with the client and together they find ways out of the depressive state. Various techniques are used, as a result of which the person’s condition improves, and the ability to enjoy life gradually returns to him. Let us tell you a real story. Irina, a thirty-five-year-old woman from Moscow, has what they call a good life: a job she loves, a caring husband, a smart daughter, a home full of joy. What more could you wish for! And then one day, picking up the phone, Irina heard a stern voice: “Your husband was in an accident.” The events that followed were a blur: the hospital, intensive care, sleepless nights. A week later, Irina’s husband was gone. She didn’t know how to live with it: one moment she had everything, and then suddenly — bam! — she was losing it all. She didn’t want to get out of bed and go to work, and suicide seemed like the best way out. It was in this state that Irina was found by her sister, who later took her to a psychotherapist. Then, during the sessions, there were tears, anger and grief, but after some time, the strong emotions that had found an outlet began to let go of Irina, and she began to accept her loss.

Latent (larval) depression Oh-oh-oh, this kinddepression has caused a lot of trouble for therapists! It manifests itself in the form of numerous physical illnesses: headaches, heart pain, muscle pain, insomnia, gynecological and other problems. The patient is subjected to numerous examinations and check-ups, as a result of which the doctor often shrugs his shoulders: well, she has no physiological basis for this kind of symptoms! And in this case, he should think carefully and refer the girl to a psychotherapist or psychiatrist. Hidden depression is a very dangerous thing. It does not manifest itself in the form of typical low mood and depression. Its target is the human body. Yes, most likely, a person will experience periodic attacks of apathy and sadness, but in his mind they will be associated with a painful state of health, and not vice versa. After all, he is not a doctor to know about all the connections! The most interesting thing is that with adequate treatment, physical symptoms go away on their own or with minimal intervention. An example of this is the story of Larisa, a forty-six-year-old accountant. She was constantly complaining about something: pounding in her heart, wheezing in her lungs, a stiff back, heartburn, and something else. The list of her illnesses was so long that it would be enough to stretch along the Great Wall of China. Larisa's regular therapist treated Larisa for all these ailments for a very long time, regularly prescribing pills and procedures. But they had no effect, or the effect was short-lived. And everything continued like this until the doctor went on vacation, and Larisa was sent to another therapist. Having quickly studied the patient's medical history, he immediately wrote her a referral to a psychiatrist. Larisa was surprised at first, but she still went to the specialist, and imagine her surprise at the diagnosis of depression! She didn't want to believe it, but like an obedient patient she took a course of antidepressants, worked through her personal problems with a psychologist - and lo and behold! - her physical symptoms noticeably decreased.

Postpartum depression Unfortunately, it happenssuch. It would seem that what could be more joyful for a woman than the moment of her child's birth! But in some cases, discord sets in in the mother's body, and after giving birth, she does not want to see her child, does not experience any positive feelings either towards herself or towards the world in general. To all this is added a huge feeling of guilt, because the woman's brain has the attitude: "I am a bad mother". This feeling must be immediately gotten rid of. Postpartum depression is associated with the fact that the cocktail of hormones and other chemicals that was in the woman's body "bombarded" her nerve receptors, forcing her to experience joy and other emotions. After giving birth, this cocktail gradually leaves, and the woman, in contrast, feels bad and empty. To this are added fatigue, abrupt changes in life and some unpreparedness - these are the reasons for the depressive state that arises. Something must be done about this - this condition will not go away on its own. It must be said that all women experience a mental decline after childbirth, but in five percent of cases it goes beyond the norm, and the woman needs the help of a specialist. This is exactly what happened to Marina - a young mother who gave birth to her first child at the age of twenty-three. She was always anxious, emotional and sensitive to life's troubles. But Marina always wanted a child and went through childbirth quite easily. But left alone with the baby in the postpartum ward, the young mother realized that she did not feel anything for him. More precisely, no, she felt anger and irritation. She was irritated by the baby's crying, the need to take care of him, feed him and change his diapers. Sometimes Marina could not bring herself to go to the baby for hours, and then the nurses took him away. The neonatologist, who was told about this condition of the young mother, immediately recommended that she see a doctor. From him Marina learned that she is not a bad mother. She just needed help to cope with the problems that had arisen. A month later, Marina was proudly walking in the park with a stroller and could not understand how her heart could never have burst with tenderness for this sweetly snoring baby.

Seasonal depression Probably each of usare familiar with bouts of melancholy in autumn and winter. Lack of sunlight and vitamins, a lot of warm and unattractive clothes, dry skin - aren't these reasons enough to fall into depression? For some, alas, they become critical. These are the people who experience negative experiences associated with a certain season. For some, it's autumn, for others, winter, and some manage to "be melancholy" in the spring. Unfortunately, it is unlikely that you will be able to eliminate the cause of such depression - unless you move to the south. And even then, no one can guarantee that a radical change in climate will not result in something more serious. Olya was sad every autumn, as long as she could remember. And if the great Russian poet called it "the charm of the eyes", then for Olya, autumn was and remained a source of melancholy, apathy, lethargy - in general, everything that people called depression. And for a long time she dealt with this problem herself, until her twenty-fifth autumn came. Olya absolutely did not want to communicate with friends, leave the house, work. At that moment, when she began to think about quitting, she turned to a psychologist. But he was an adequate specialist, and seeing the first signs of depression in the girl, he immediately sent her to a psychiatrist. Now every autumn Olya takes mild antidepressants - this does not cause serious harm to her health, but now Olya is no longer afraid of this time of year.

Depression in Psychology

Major clinical depression is inсфере компетентности врача-психотерапевта и должна лечиться именно им, однако большинство состояний, которые мы привыкли называть депрессией, имеют психологические корни. Разными учеными они понимаются по-разному, и мы хотим предложить вашему вниманию самые интересные и правдивые факты. Старейшим и классическим направлением в психологии является психоанализ. Некоторые ученые называют его “отцом” всех других течений, а имя Зигмунда Фрейда, основателя психоанализа, давно стало нарицательным. Психоаналитики считают, что корень всех бед, в том числе и депрессии, лежит в подсознательном. В жизни каждого человека имеют место быть психотравмирующие события, а наиболее подвержены их влиянию мы в глубоком детстве. Например, мать редко брала своего сына на руки в младенчестве, из-за чего ему не хватило ее любви и ласки. Вполне возможно, что во взрослом возрасте он будет мучиться депрессиями из-за этого. Осознав суть своих проблем и их источник, достав их из подсознательного, человек получает возможность побороть свою меланхолию. Как правило, источником депрессии оказывается нарушенное из-за конфликтов и бессознательных фантазий развитие, вследствие чего человек оказывается неспособен на нормальные отношения с окружающими людьми и средой. В качестве возможной причины депрессии психоаналитики также указывают потерю любимого объекта, которым может быть все что угодно, например, грудь матери. Как обычно, идеи психоаналитиков весьма причудливы — что, естественно, вовсе не говорит о том, что они не работают. Из анализа вышла масса других психологических направлений, одно из которых называется гештальт-терапия. Одним из ее постулатов является здоровое приспособление человека к миру: понимание своих потребностей, себя, своей манеры взаимодействовать с другими и с окружающей средой. Главным признаком депрессии в этом подходе является отсутствие потребностей. Чаще всего оно бывает связано с тем, что человек просто не знает себя, не умеет понимать свои желания и состояния. Психотерапия в данном случае направлена на получение нового опыта, способствующего встрече с самим собой, умению вглядываться, вслушиваться и понимать себя. Человек учится строить жизнь по своим потребностям, понимать, что происходит вокруг и наслаждаться этим, отпускает ситуации, которые невозможно контролировать, и несет ответственность за то, что зависит от него, а именно за свою жизнь. Звучит довольно гуманистично, не так ли? Гештальт-терапия отличается вниманием и любовью к человеку, а именно это зачастую оказывается нужным в депрессивном состоянии. Есть еще психологи-экзистенциалисты, которые имеют свой взгляд на происхождение депрессии. Они связывают ее возникновение с потерей человеком жизненного смысла. Многие представители вида Homo sapiens хотя бы раз в жизни да задумывались о том, в чем смысл жизни. С точки зрения экзистенциалистов смысл имеет не только вся жизнь в целом, но и каждое событие, присутствующее в ней, в том числе и страдание. Однако человек так устроен, что потери, лишения и боль кажутся ему бессмысленными, и когда они случаются в его жизни, то начинается депрессия. Но как только человек находит в этих страданиях хоть какой-либо смысл (например, муж жены, умершей от рака, находит в ее смерти такое послание: она умерла раньше и не мучилась в одиночестве, как если бы раньше умер он), ему сразу же становится легче, и депрессия отступает. Есть и менее философские концепции. Например, в поведенческой психологии депрессия считается результатом состояния длительного угнетения человека. Он хочет или пытается что-то сделать, но у него это не получается из-за каких-либо непреодолимых препятствий, стоящих у него на пути. И если такая ситуация сохраняется в течение долгого времени, у человека может начаться депрессия. Когнитивная психология утверждает, что источником депрессии являются неправильные установки, усвоенные человеком. Примером такой установки может быть “я неудачница” или “я плохая”. Любое событие своей жизни человек воспринимает через призму этих установок, и такое негативное мнение о себе, разумеется, вызывает лишь самые неприятные и негативные переживания. Психология говорит о том, что печаль — это нормальное явление в жизни человека, а депрессия — это уже что-то неправильное. Необходимо уметь отличать одно от другого, и мы расскажем вам об этой разнице. Депрессивный синдром имеет следующие психологические признаки:

• a person loses interest in everything around him;
• he lacks the desire and strength to do anything, and a constant sense of fatigue does not allow even a hint of the slightest activity;
• a person can not concentrate on anything, even in the simplest situations of life: he only looks at everything with a superficial glance;
• feelings of guilt, hopelessness, own uselessness and helplessness become predominant in the emotional sphere of the sufferer;
• sleep and appetite disorders;

Depression and psychosomatics

The soul and body of a person are closely and continuously connectedwith each other. This speaks of two facts: firstly, the mental state can influence the course of physical illnesses, and secondly, sensations in the body can cause certain changes in the soul. We all know that if you maintain cheerfulness, a good mood and faith in recovery, the body will fight the disease better. For chronic diseases, this means an improvement in the patient's physical condition, and for severe ones - an increase in the likelihood of recovery. Unfortunately, when a person is depressed, his body becomes much less resistant to all kinds of bacteria and viruses, all processes in it begin to proceed less harmoniously, which, naturally, negatively affects his well-being. By the way, depression can manifest itself not only in the form of mental experiences, but also in the form of physical symptoms. In some cases, they accompany a low mood, and in some they even come to the fore - then we can talk about latent or larval depression. Such symptoms include:

• feeling of squeezing when eating, nausea;
• a feeling of pressure in the head, headaches;
• tension and pain in the limbs;
• pain and sensation of pressure in the area of ​​the stomach;
• difficulties and discomfort during breathing;
• feeling of squeezing in the heart;

The sad fact is that in these cases the doctor is verymay chase an “imaginary enemy” for a long time - a physical cause of physical ailments, prescribe a bunch of unpleasant and expensive examinations, but do not take into account the presence of depressive syndrome in the patient. You understand that there can be no talk of any effectiveness of treatment in this case. In some cases, the body and its suffering become a trigger for mental suffering. Usually in these circumstances we are talking about a long and serious illness, often accompanied by severe pain. For example, cancer: cases of depression are not uncommon for people suffering from this disease. When it comes to fatal diseases and a disappointing prognosis, depression is one of the stages that a person must go through in order to accept and come to terms with the circumstances. Of course, in this case, a consultation with a good psychologist would not be superfluous. Sometimes mental and physical illness are very closely intertwined. There is a so-called psychosomatic seven - a list of diseases that, as scientists believe, come "from the nerves": ulcers, colitis, ischemia, hypertension, rheumatoid arthritis, neurodermatitis and thyrotoxicosis. Such patients experience alternating phases of exacerbations of the physical disease itself and depressive states. In this case, joint management of the patient by the attending physician and psychologist is necessary.

Conclusion

As every adult knows, life— it is not an amusement park. It has black and white stripes, through which any person passes. Accordingly, there is more or less equal amounts of sadness and joy in our destinies, and sadness is an absolutely normal reaction to failures and disappointments. But we live in an “anesthetized society” — a society where any pain is incomprehensible and seems unnecessary. If you don’t want to feel pain — get an injection or take a pill, and mental pain is no exception to this rule. Thus, people forget about the “normality” and “importance” of sadness, and any of its occurrence is called depression, although in fact depression — it is something more. It is always more or less long-lasting and noticeably interferes with a person’s life. Many describe depressive experiences as living with a sense of hopelessness and doom, or “living with emptiness inside and outside.” Depression invades a person's daily life and prevents him from eating, drinking, sleeping, communicating and working. If all this is absent from your life, if you just feel sad and lonely - you do not have depression, but just a difficult period. And this is joyful, because you can cope with all this yourself and gain important and useful experience in overcoming life's difficulties. We recommend reading:

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