This affects 300 million people in the world. The psychologist named the main signs of depression

Symptoms of severe depression

Major depression has the following manifestations:

• apathy;
• chronic fatigue syndrome;
• depressed mood;
• lack of interest in people around you, work, hobbies, previous interests;
• increased anxiety, restlessness, internal tension;
• guilt, low self-esteem;
• memory impairment, decreased ability to concentrate;
• obsessive thoughts of suicide.

Prolonged depression entails not only mental disorders, but also health problems:

• sleep disturbance;
• sudden change in body weight;
• loss of appetite;
• anorexia or bulimia;
• dizziness;
• headache;
• muscle pain:
• disruption of the functioning of the cardiovascular system;
• constipation;
• disorders in the functioning of the gastrointestinal tract;
• pain in the abdominal area;
• erectile dysfunction in men;
• menstrual disorder and anorgasmia in women;
• impairment of psychomotor functions (slow thinking, speech, motor coordination disorder).

Long-term depression often entails the development of alcoholism and drug addiction, which allow one to temporarily get rid of internal discomfort and depressing thoughts.

Severe depression is also manifested by a change in the patient’s behavioral model. A person strives for solitude, avoids communication with others, refuses walks and various types of entertainment, and his ability to work decreases.

Decreased interest in hobbies and usual activities

Along with a pervasive feeling of sadness, a sure accompaniment of major depressive disorder is a decreased interest in activities that previously gave you pleasure. According to recent scientific data, about 37 percent of people with MDD have anhedonia. There are two main types of this condition - social anhedonia (lack of pleasure from communication, desire to be alone) and physical anhedonia (decreased libido, loss of interest in sex, loss of appetite, etc.). Because there is no cure for this condition, anti-depression medications can help relieve symptoms.

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Causes of deep depression

Psychotherapists identify several groups of factors that cause severe depression.

Psychological factors

This category includes:

• suffered stress;
• problems in the family, at work or at school;
• disorders in the functioning of the central nervous system;
• severe mental trauma (death of loved ones, disability, physical or sexual violence);
• violation of internal harmony;
• lack of life goals and aspirations;
• frustration - the discrepancy between life realities and a person’s hopes and ideas;
• personal conflicts;
• loss of meaning in life.

Biological factors

Severe depression can develop due to health problems and the following biological factors:

• hormonal imbalances;
• lack of regular, fulfilling sex life;
• unbalanced diet;
• alcohol abuse;
• drug overdose or prolonged use;
• severe physical, mental, psycho-emotional fatigue;
• prolonged and uncontrolled use of hormonal and psychotropic drugs;
• severe form of intoxication of the body;
• insufficient physical activity, sedentary lifestyle;
• traumatic brain injuries;
• cardiovascular pathologies;
• disruption of cerebral circulation processes;
• Parkinson's disease;
• dysfunction of the thyroid gland.

Social factors

Depression can be triggered by:

• destruction of family relationships (divorce, loss of parents);
• change in social status;
• protracted conflicts in the family or team;
• destruction and failure of previous life strategies;
• social isolation.

Depression is more than a chemical imbalance in the brain

Our brain is the most mysterious organ that still surprises scientists. Depression is more than just the result of a chemical imbalance in the brain, it results from a combination of biological, genetic, psychological and social factors. For many people, this may be due to a bereavement, a traumatic experience, or a major life change.

Permanent stress, insomnia and poor lifestyle play an important role in the formation of mental disorders. Some episodes come out of nowhere, some are caused by medical conditions: cancer, endocrine system disruption, hormonal imbalance after childbirth or menopause, and heart disease.

Stages of pathological syndrome formation

Severe depression does not occur suddenly, but develops gradually. Stages of pathological syndrome formation:

1. Negation. Outwardly, a person’s lifestyle does not change, but he experiences a severe internal conflict. The patient turns on psychological defense mechanisms based on denial of reality. It manifests itself as changes in eating behavior, psycho-emotional instability, and sudden mood swings.
2. Resentment and anger. At this stage, a person begins to look for those to blame for his serious condition. Signs such as attacks of uncontrolled aggression, tearfulness, increased anxiety, and irritability appear.
3. Stage 3. The patient experiences hormonal disruptions, and the production of serotonin, the pleasure hormone, decreases. A person begins to lose or rapidly gain weight, suffer from insomnia, headaches, and suffer from exacerbation of chronic pathologies.
4. Last stage. It is characterized by pathological processes that destroy the physical health and psyche of a person. The patient loses control over his own behavior, the ability for adequate, rational thinking, and becomes potentially dangerous both for himself and the people around him.

Psychotic signs of major depression

Major depression can be expressed psychotically:

• hallucinations;
• obsessive states;
• denial of life's realities;
• intolerance to other people's opinions;
• hypertrophied feeling of guilt;
• panic fear;
• expectation of something terrible (fatal illness, disaster, death of loved ones).

Somatic signs of prolonged depression

Prolonged depression has somatic signs:

• heart pain;
• disturbances of heart rhythm and palpitations;
• pain in the lower abdomen;
• pain in the hypochondrium;
• prostration;
• problems with the functioning of the digestive system.

Patients complain of various painful sensations and often convince themselves of the presence of severe pathologies, but medical studies and analyzes do not reveal any physiological abnormalities in a person.

What to do about depression? 8 steps to self-healing

The ways to get out of depression are inherent in us - we just need to be able to activate them, says neuroscientist David Servan-Schreiber. Sometimes this requires the help of a psychotherapist, but we can change physical activity, nutrition and our environment ourselves.

Standing on the Pont Neuf, I watch the Seine flow between the white stones. On the shore, in the very center of Paris, a man is fishing with his son. The boy has just caught a fish, and his eyes are shining with happiness.

I often remember long walks along this same river with my father when I was that boy's age. My father told me that when he was little, his father, my future grandfather, still swam in the Seine, even in winter. And he added that now the river is so polluted that not only is it impossible to swim in it, but there is even no fish.

Thirty years later the fish returned. Perhaps we can go swimming again. It was enough to stop polluting the Seine for it to cleanse itself. Rivers are living things. They, like us, strive for balance and homeostasis. In essence - to self-healing. When they are left alone, when they stop throwing waste into them, they become cleansed.

Like all living things, rivers live in constant interaction with their surroundings: rain, air, earth, trees, algae, fish and people. And this living exchange creates order, organization, and ultimately cleanliness.

Only standing waters are not involved in the exchange and therefore rot. Death is the opposite of life: there is no longer interaction with the outside world, and the constant restoration of balance and order that characterizes life gives way to chaos and destruction. But as long as natural forces act, they strive for balance.

Aristotle believed that every form of life conceals within itself a force that he called “entelechy,” or self-completion. A seed or egg contains within it the power that will cause it to become a much more complex organism, be it a flower, a tree, a chicken, or a human being. This process of self-completion is not only physical - in humans it continues with the acquisition of wisdom. Carl Jung and Abraham Maslow made the same observation. They saw the mechanisms of self-healing and self-completion as the foundation of life itself.

The treatments that I have discussed in previous pages are aimed at supporting the self-completion mechanisms inherent in all living things, from the cell to the entire ecosystem, including humans. It is precisely because they use the natural forces of the body and promote harmony that they are very effective and have almost no side effects. Because each of these methods has its own way of supporting the brain and body's efforts to find harmony, they have a strong joint effect (synergy), and it would be a mistake to choose one of them to the exclusion of all others. Taken together, these methods mutually enhance each other's effects, having the ability to stimulate the activity of the parasympathetic system, which calms and heals the body and soul at a deep level.

In the 1940s, with the advent of antibiotics, medicine changed radically. For the first time, with the help of drug treatment, it was possible to defeat diseases that until then were considered fatal. Pneumonia, syphilis, and gangrene receded to simple medications. Their effectiveness was so high that it led to a revision of the postulates of medicine, which were considered immutable. The doctor-patient relationship, nutrition, patient behavior - everything turned out to be unimportant. The patient took his pills, and they helped: even if the doctor did not talk to him, even if the diet was wrong, and even if the patient himself remained absolutely indifferent to his treatment. It was from this fantastic success of antibiotics in the West that a new approach to practical medicine was born: one that does not take into account either the circumstances of the disease, or the internal vitality of the patient, or his ability to self-heal. This mechanical approach has become common in medicine, extending beyond infectious diseases.

Today, almost all medical education consists of learning how to diagnose disease and prescribe appropriate treatment. This approach works great in acute cases: when you need to operate on appendicitis, prescribe penicillin for pneumonia or cortisone for allergies... However, when it comes to chronic diseases, this approach only helps to cope with symptoms and exacerbations. No matter how well we are able to treat heart attacks and save the patient’s life with oxygen, trinitrine and morphine, our treatment cannot cope with the disease in which the coronary arteries of the heart are blocked. Not so long ago it was established that only radical changes in the patient’s lifestyle can make this disease recede. We are talking about stress management, nutrition control, physical activity and so on.

The same is true with depression, which is a chronic disease in the full sense of the word. It would be a fallacy to believe that a single intervention, no matter how good, can long-term balance the complex set of causes that have maintained the disease for many years and even decades. All medical practitioners and theorists agree on this. Even the most die-hard supporters of psychoanalysis, on the one hand, and the most advanced neuropsychologists, on the other, are forced to admit: the best treatment for chronic depression that classical medicine can offer combines psychotherapy and medication. This is confirmed by an impressive study conducted simultaneously at several universities and published in the New England Journal of Medicine.

I started with the image of a river that cleans itself when people stop polluting it. Similarly, when treating chronic diseases, it is necessary to develop a program that will solve the problem while simultaneously engaging various self-healing mechanisms. It is necessary to create a powerful synergy of different intervention methods that will forestall the development of the disease. It was in order to create such a synergy that I described various methods of self-healing in this book. Their combination, tailored to each specific case, is more likely to transform emotional pain and restore vitality.

We have looked at many ways to help you get to the core of your emotional being and restore coherence. But where to start? The experience gained at the Pittsburgh Center for Complementary Medicine has allowed us to develop fairly simple rules for selection that are suitable for every person. Here they are.

1. First of all, you should learn to control your internal state. Each of us throughout our lives finds ways to console ourselves that help us overcome difficult moments. Unfortunately, more often we are talking about cigarettes, chocolate, ice cream, beer or whiskey, and even anesthesia from television programs. These are the most common ways to distract yourself from life's troubles. If we resort to the help of classical medicine, these daily toxins are easily replaced by tranquilizers or antidepressants. And if, instead of a doctor, we are given advice by friends and classmates, tranquilizers, as a rule, are replaced by more radical methods of self-consolation: cocaine or heroin. It is obvious that such ineffective and most often toxic influences should be replaced with techniques that use the self-healing capabilities of the emotional brain and restore harmony between reason, emotions and a sense of self-confidence. In Pittsburgh, we encouraged each patient to discover the capacity for cardiac coherence and to learn to enter this state at the slightest stress (or when tempted to relax with a less healthy and less effective way to relieve the stress).
2. If possible, painful events from the past that continue to cause distress in the present should be identified. Most often, patients underestimate the significance of the emotional boils that they carry within themselves and which affect their attitude towards life, impoverishing it. Most practicing doctors, as a rule, do not attach importance to this or do not know how to help patients free themselves from difficult memories. But usually a few sessions of EMDR (eye movement desensitization and reprocessing, a modern method of psychotherapy. - Ed.) are enough to get rid of the burden of the past and give birth to a new, more harmonious outlook on life.
3. It is equally important to always analyze chronic conflicts in emotional relationships: both in your personal life - with parents, spouses, children, brothers and sisters - and at work. These relationships directly impact our emotional ecosystem. By becoming healthier, they will be able to regain inner balance. And by continuing to regularly pollute the “stream” of our emotional brain, they ultimately block self-healing mechanisms. Sometimes simply revisiting the consequences of past traumas allows emotional relationships to be reborn with renewed vigor. By freeing yourself from ghosts, which, I note, have nothing to do in the present, you can open up a whole new way of connecting with other people. When we learn to control our heart coherence, it will be easier for us to manage our emotional relationships. Nonviolent communication also allows you to directly and effectively harmonize emotional contacts and find inner balance. We must constantly strive for better emotional communication. If training in these methods from an experienced psychotherapist is not enough, you should engage in a more complex process of family therapy (when the most important conflicts lie in the sphere of personal life).
4. Almost everyone will benefit from dietary modifications that allow them to obtain the required amount of omega-3 fatty acids, thus providing the body and brain with the ideal building blocks for recovery. Today it is known that the so-called “Cretan” (Mediterranean) diet can not only cope with stress and depression, but also increase heart rate variability. Therefore, everyone should reconsider their diet, giving preference to fish (or taking omega-3 in the form of dietary supplements) and reducing the intake of omega-6.
5. Introduction to physical activity is accessible to everyone and requires almost no financial investment. As for the time investment, twenty minutes of training three times a week is enough.
6. It is also within our power to change the way we wake up in the morning. To reconfigure the biological clock, it is enough to replace the alarm clock with a lamp that simulates the dawn - the effort is minimal, and the result can be impressive.
7. Acupuncture, on the other hand, requires time and investment. I recommend it mainly to those who, in addition to emotional suffering, also have physical problems - mainly pain. In this situation, needles usually help to cope with both problems at the same time (it is very difficult to relieve depression for someone who is constantly tormented by body pain).
8. Finally, to achieve true inner peace, it is important to gain a deeper understanding of the role we play in society, beyond our family. Those who managed to find meaning in this, as a rule, are not limited to just achieving mental comfort. There is a feeling that these people are discovering a source of energy that gives life a new impetus.

Like all French schoolchildren, at the age of sixteen I read Camus’s story “The Stranger.” I remember very well the excitement that gripped me then. Yes, Camus is right, nothing makes sense. We float blindly down the river of life, stumble upon strangers who are just as confused as we are, arbitrarily choose paths that determine our entire destiny, and ultimately die without ever knowing what we should have done. another... And if we are lucky, we will be able to maintain the illusion of integrity, at least partially aware of the general absurdity of existence. This awareness of the absurdity of existence is our only advantage over animals. Camus is right. There is no more waiting.

Today, at forty-one, after many years spent at the bedsides of men and women of all nationalities, confused and suffering, I remember The Stranger again, but in a very different way. Now it is absolutely clear to me that Camus’s hero has lost touch with his emotional brain. He had no inner peace, or he never addressed it: he felt neither sadness nor pain at his mother's funeral, did not feel tenderness in the presence of his wife; he hardly felt anger as he prepared to commit murder. And apparently he had no connection to society that he could value (hence the title of the book).

But our emotional brain, the fruit of millions of years of evolution, craves precisely these three aspects of life that the Outsider did not have access to: emotions, which are the movements of the soul of our body, harmonious relationships with those who are dear to us, and a sense of what we occupy your place in society. Deprived of them, we search in vain for the meaning of life outside of ourselves, in a world where we have become... strangers.

It is the waves of sensations emanating from these sources of life to activate our body and our emotional neurons that give direction and meaning to our existence. And we can become healthy only by developing each of them.

Peculiarities of thinking of depressed individuals

The depressive personality type occurs in people who are especially prone to developing depression. In most cases, they are pessimists and see the world in “black terms”.

Personalities of this type are not satisfied with themselves and those around them, no matter how much success they achieve in the social sphere. Most often, such people are introverts, reserved, difficult to make contact, and prefer solitude.

They are characterized by excessive feelings of guilt, self-doubt, fear of failure, panic states that arise during any changes, changes, or life difficulties.

Insomnia, drowsiness

According to research, about 75 percent of patients with MDD suffer from insomnia or, on the contrary, sleep a lot and feel drowsy during the day. It is important to consider that lack of sleep may not always be caused by a mental illness. In the current conditions of increased fatigue in the workplace, a sedentary lifestyle and poor daily routine, insomnia appears rather as a functional disorder.

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But if symptoms persist for several weeks, that should bring you to the doctor's office. With clinical depression, people often begin to have a negative attitude towards sleep. For example, if the illness is accompanied by panic disorders, patients are afraid to go to bed. For chronic insomnia, doctors prescribe antidepressants and sleeping pills to avoid the transformation of depression into psychosis.

Diagnostics

Diagnosis of depressive syndrome begins with a consultation with a psychotherapist. While talking with the patient, the doctor evaluates his speech, speed of reactions, and cognitive functions. Conducts an analysis of concomitant symptoms and the results of the collected anamnesis.

To make an accurate diagnosis and determine the stage of depression, a pathopsychological examination, differential diagnosis, and psychological tests are performed.

Patients are prescribed laboratory tests, an ECG, a consultation with a narcologist and a therapist in order to exclude Parkinson's disease, hypothyroidism, drug or alcohol addiction, and oncology.

How to help a friend

Women's depression rarely goes away in a hidden form and immediately manifests itself in the form of apathy. Usually the moment when a girl completely stops caring about the life around her is preceded by a long period of blues. The woman complains that they no longer understand her, that her life is unbearable, that she is tired and “can’t do this anymore.” The situation is aggravated by the fact that close people, as a rule, do not provide the patient with any real help for a long time, and even, on the contrary, respond to the girl’s condition with irritation.

The best friend can be one of the first to notice changes in a woman’s behavior and correctly evaluate them. First of all, she should ask the sick person’s relatives about symptoms that are hidden from prying eyes, but cannot go unnoticed by relatives: the quality of sleep, appetite and general well-being of the person suffering from depression.

The second step will be to convey to the patient’s relatives information about the nature of her behavior, so that they do not provoke the dynamics of the development of pathology with random comments or reproaches. If a woman works hard or has a lot of responsibilities around the house, a friend, having previously agreed with her relatives about support, should gently persuade the patient to take a break and temporarily get away from all worries. It is advisable to find an opportunity to take a depressed person away from home, pulling him out of his usual everyday environment, and it is not necessary to plan long trips. A great option would be a short tour of the sights of your region.

The patient needs to get enough sleep and spend as little time alone as possible. Going to the movies and exhibitions in a small company of understanding and optimistic people will significantly ease her situation, and events such as bachelorette parties or get-togethers with friends will give the woman the opportunity to speak out.

Treatment of severe depression

The treatment of severe depressive syndrome should be approached comprehensively and very seriously. The following methods of therapy are most effective:

• use of antidepressants;
• diet therapy;
• psychotherapy;
• insulin;
• electroconvulsive.

Medications allow you to relieve the physiological and somatic manifestations of depression, and sessions with a psychologist help you find a purpose in life and find a way out of the current difficult situation.

To achieve a positive result, it is important to provide the patient with a balanced and fortified diet, good rest, walks in the fresh air, physical activity, and protect him as much as possible from stress factors.

The task of a person in this state is to make his life as harmonious and easy as possible: positive emotions, joyful meetings with pleasant people, improving skills in his favorite hobby.

Which specialist should I contact?

Diagnosis and treatment of severe depressive conditions are carried out by specialists such as neurologists, psychologists, and psychotherapists. In especially advanced cases, you will need the help of a psychiatrist who will help you choose the right medications and methods of psychotherapeutic correction.

Drug treatment

The following medications are used to relieve the syndrome:

• atypical antidepressants;
• drugs that promote serotonin reuptake;
• monoamine oxidase inhibitors;
• tricyclic antidepressants.

Drug therapy also involves the use of tranquilizers, which eliminate the feeling of anxiety and have pronounced sedative properties.

Nootropic drugs help improve blood circulation and normalize brain functions.

Immunomodulating agents, vitamin-mineral complexes, and sleeping pills are also prescribed.

Psychologist's advice

The patient needs individual psychological consultations using methods of occupational, Gestalt and art therapy. Classes in self-help groups give good results.

To eliminate a depressive state, you should pay attention to the advice of a psychologist:

• do not engage in self-flagellation;
• reduce the load and give the body proper rest;
• spend more time in nature, take walks in the fresh air;
• get a good night's sleep;
• lead a regular intimate life.

It is important not to be ashamed of your emotions and not to hide them, to find the meaning of life and a sense of significance by caring for children, animals, and performing social tasks. A person needs to reconsider his life, evaluate his own successes and make plans for the future, without setting unattainable goals.

You should not withdraw into yourself, you need to go out to people, communicate even in the absence of such a desire.

How to get out of deep depression on your own?

Getting out of deep depression on your own is an extremely difficult task. First of all, a person needs to realize that there is a problem and get support from family and friends.

The following recommendations will help you overcome depressive syndrome:

1. Positive thinking. It is difficult to think optimistically while in such a state, but you should control your thoughts and promptly replace negative language with positive one.
2. Keeping a diary and doing creative work are methods that allow you to throw out your negative experiences and analyze your own thinking.
3. Physical activity. In case of depression, you should play sports and give your body regular, feasible physical activity.
4. Improving quality of life. A person needs to try to bring as many positive emotions into his life as possible. To do this, you should try to make your old dream come true, to do those things that previously brought pleasure and joy.

Fatigue and loss of energy

Fatigue is another common symptom of clinical depression. One scientific study found that 90 percent of people with MDD experience severe fatigue, despite 8 in 10 regularly taking antidepressants. Apathy and lethargy sap your motivation, prevent you from focusing properly on the tasks at hand, impair your productivity, and interfere with your personal relationships.

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Disease prevention

The following preventive measures will help prevent the development of this disease:

• adherence to daily routine;
• adequate sleep (at least 8 hours throughout the day);
• spending time together with family members and friends;
• healthy lifestyle, giving up cigarettes and alcohol abuse;
• regular physical activity;
• proper, balanced nutrition;
• reducing stress levels in life to a minimum.

Even with a busy schedule, it is important to find time for self-development, entertainment, doing what you love, and communicating with interesting, pleasant people. Making plans for the future and defining clear life goals will also reduce the risk of developing depression.

How depression is experienced

Depression is experienced as a loss of hope to achieve another. How to lose the spark to move towards someone else.

“No one can help me, no one will stretch out their hand to pull me out of this hole. And I have no hope that such a person will appear. It simply doesn't exist. Or he was, but died."

When we refuse to wait for such a person because he will not come, we feel a moment of intense pain. And to survive this pain, we turn inward.

Depression is a way to turn to myself so as not to die: I anesthetize myself, I begin to save energy.

Depression is like lethargy; it's like bear hibernation, during which your metabolism slows down. These are the defense mechanisms of bears who wait for spring to survive.

In his lecture, Francesetti shared an interesting experiment called the Still Face Experiment.

Edward Tronick of Harvard University conducted an experiment called "Lifeless Face" (or "Stone Face"). In the experiment, he asked parents to behave as usual with their small child, and after a while - to freeze. Parents were instructed to continue looking at the baby, but to give a blank expression to their faces.

At first the child is surprised, does not understand what is happening, then tries to attract the mother’s attention in every possible way, but does not receive a reaction. Then the baby begins to protest against the loss of contact, get scared, cry or get angry. Defense reactions are activated. And if this doesn’t help, the withdrawal phase begins. The child loses hope of achieving a connection with his mother, he gives up.

According to Francesetti, if after 20 minutes the child does not receive a response from the parent, he loses the sense of his own existence, there is no longer any meaning to existence: there is no connection.

Many have heard stories of babies being left alone in Soviet maternity hospitals and even being told “if they cry, they’ll stop.” And now everyone is wondering why there are so many traumatized people in society.

When I'm depressed, I can't get close to someone else because he's too far away.