Depressive neurosis (dysthymia, neurotic depression)

What is depressive neurosis

A condition that combines signs of depression and neurosis is called neurotic depression in medicine, but is better known as depressive neurosis.

A distinctive feature of the disease is that a person, despite a depressed state, retains a positive opinion about the future. There are also no personality disorders.

Treatment

To determine how to treat depressive neurosis, a consultation with an experienced psychotherapist or psychiatrist is necessary, who will help identify the individual life characteristics of a particular medical history. Treatment of depressive neurosis is carried out using psychotherapy in combination with medications. There are various psychotherapeutic approaches: suggestive methods (suggestion and hypnosis), psychoanalysis (based on the unconscious sphere), the existential method (understanding goals in life during consultations), etc. A psychotherapist or psychiatrist in personal consultations must ensure that the patient’s reactions to certain life events.

Causes

There are several causes of depressive neurosis. Most often these are acute stressful situations. These include a variety of psychotraumatic conditions.

In addition, among the provoking factors are:

1. Long-term influence of psychotraumatic factors. This could be an uncomfortable family situation, caring for a sick relative, frequent stress at work, financial difficulties, or long-term illness. The disease is often observed in adolescents who are in a state of constant psychological or physical violence from peers, parents or other relatives.
2. Human characteristics. The disease can occur in people who are accustomed to restraining their emotions and experiencing everything on their own, who have low self-esteem, and who have difficulty making decisions. People who have difficulty adapting to changes in their lives are susceptible to depressive neurosis.

Neurotic depression usually appears against a background of prolonged stress. It does not occur after a single case of neurosis or stress. The reason for its appearance is the long-term impact on the human psyche, which greatly aggravates the patient’s condition and complicates treatment.

Risk group

Based on the research conducted, it has been established that there is a special group of people who are most susceptible to the appearance of depressive neurosis.

First of all, these are purposeful individuals who are not used to flaunting their emotions. Their psycho-emotional state is unstable, and if there is irrefutable evidence that they are wrong, the nervous system cannot withstand the stress.

Helpful information

The risk group also includes people with low self-esteem. The disease can occur when there is a need to make a difficult decision. In addition, such people have difficulty adapting to changes in life and the environment.

Patients at risk should be more attentive to their psychological state and avoid stressful situations.

Reasons for development

Depressive neurosis occurs for various reasons. A psychotraumatic factor appears in a person’s life, affecting the general emotional state. If it does not disappear for a long time, it becomes increasingly difficult to fight, and a mental illness arises.

Many people do not understand the difference between neurosis and depression. The main sign of depression is complete apathy towards everything around, nothing makes a person happy, it’s hard for him to open his eyes in the morning, he doesn’t see anything good. If neurosis is not treated in time, it can develop into such a condition.

With depressive neurosis, the patient's condition is not so severe. There is a situation that traumatized the psyche, causing depression, temporary apathy, but at the same time a person retains the ability to rejoice - sometimes a little thing is enough to lift the mood. As soon as you remind the problem about yourself, apathy returns, the state becomes depressed again.

The most common causes of depressive neurosis are:

• separation from a loved one;
• protracted conflicts with relatives, especially close relatives living nearby;
• problems at work: hatred of the work one has to do, conflicts with colleagues, superiors;
• the need to hide the truth, most often found in children and adolescents;
• financial difficulties, inability to pay off debts, often occurs among men who are unable to support their family;
• complexes - for example, the presence of external defects due to which a person is unsure of himself.

These are just some of the reasons for the onset of depressive neurosis. The provoking factors are so diverse that each case is individual. The sooner you start fighting them, the faster you will be able to cope with the disease.

Symptoms of the disease develop gradually. After a traumatic event has occurred, a person becomes fixated on it constantly. For example, out of hopelessness, he gets a job he hates - a psychologically traumatic factor. He goes to see it every day, thinking about how he doesn’t want to do this - a cycle occurs.

After all thoughts revolve around what happened, the mood is always depressed. As soon as you get distracted by something pleasant, memories immediately come flooding back. Next comes sleep disturbance, most often insomnia, then the patient is out of sorts from the very morning. A person often cannot get up on time and is late, which brings even more worries.

Stress is complemented by low self-esteem resulting from self-flagellation - a person constantly digs into himself, thinks about the reasons that led to the tragedy, blames himself, becomes indecisive, and loses his ability to work. In this case, other symptoms of depressive neurosis arise, affecting not only the psychological state:

• loss of appetite, causing diseases of the digestive system;
• nausea, vomiting;
• body temperature rises, especially in moments of strong emotions;
• arterial hypotension;
• lethargy, inability to concentrate, new phobias;
• headaches, dizziness.

Unlike ordinary depression, a person suffering from neurosis sees his problem, but does not know how to solve it. Often he tries to console himself with illusions about a bright future, trying not to think about the tragedy that happened. But the diagnosis constantly reminds itself. Depressive neurosis belongs to the astheno-neurotic syndrome, when the nervous system is simply exhausted, the patient is deprived of strength.

Autumn blues

To understand the phenomenon, it is necessary to consider the disease fully: establish the concept, identify symptoms, causes, mechanisms of development.

Concept

Depressive neurosis is a type of functional psychogenic reversible disorder, which manifests itself in prolonged depressive symptoms.

Symptoms

The disease, depending on the nature of its course, can manifest itself in two areas: mental and physiological.

Mental symptoms of neurotic disorder of depressive type:

1. Manifestation of negative moods, lack of joy.
2. Negative thoughts.
3. General pessimism, while maintaining an optimistic attitude towards one's future.
4. Apathy.
5. Anxiety.

Physical symptoms:

1. Decreased motor activity, lethargy.
2. Dizziness.
3. Cardiopalmus.
4. Blood pressure surges.
5. Decreased appetite.
6. Disturbances in the digestive system.
7. Weakness.
8. Sleep disorders.

Causes

Factors in the occurrence of depressive disorders are external circumstances that have a traumatic effect on the human psyche.

Two main groups of causes of the disease:

• several consecutive failures in life;
• inability to have the necessary emotional sensations - communication with loved ones, intimacy with them, constant interaction with a loved one, doing what you love.

Development mechanism

The disease develops in the process of constant exposure to traumatic factors. Features of the development of the disease are a person’s attempts to hide and eliminate the emotional manifestations of the disease, and not the cause of the problem itself.

Before deciding on the treatment methodology and choosing the best option, the doctor must determine exactly what kind of illness the patient has - depression or neurosis.

Depressive neurosis is quite difficult to diagnose, since external manifestations and symptoms are similar to signs of depression. The task of identifying neurological disorders of the depressive type is the responsibility of a neuropsychiatrist.

The difficulty of diagnosis is manifested in the fact that when communicating with a doctor, the patient does not associate his condition with any traumatic event in life. When diagnosing, the doctor often concentrates on physical symptoms and determines the disease based on their manifestations (gastritis, colitis, etc.). To clarify the diagnosis, additional examinations may be required - ECG, ultrasound, etc. They will allow you to “filter” physical symptoms and “see” the true picture of the patient’s condition.

The disease in question is a reversible disorder, i.e., with proper treatment, the patient’s mental and physical condition can be completely restored. To achieve this goal, a combination of treatment techniques is required.

Treatment methods for neurotic disorders:

1. Medication.
2. Pharmacological.
3. Psychotherapeutic.

Psychotherapeutic methods include methods of persuasion and self-persuasion. Conviction allows you to work through a traumatic situation and reassess your life situation and attitude towards it. Self-persuasion makes it possible, using certain phrases or actions, to cope with the manifestations of the disease on your own.

The medication method is based on taking antidepressants. But taking medications without concomitant psychotherapy cannot give an absolute result. Medicines will only lead to a temporary retreat of the disease.

Not every person who faces such problems manages to maintain self-control, a sense of humor, and not succumb to despondency. On the contrary, when faced with stressful situations, most people experience: a tendency to self-flagellation, sudden mood swings and apathy. Neurotic depression can be triggered by a sedentary lifestyle and routine against the backdrop of a lack of joyful events, vivid impressions and a change of scenery. Accumulated anger, envy and other negative emotions similarly pose a danger to the psyche.

Neurotic depression is caused by the collapse of expectations and plans, as well as a protracted conflict between urgent needs and the rules dictated by society. Emotional distress can occur due to prolonged physical or mental stress and the inability to relax properly.

Symptoms

The clinical picture of depressive neurosis is varied. The disease combines signs of neurosis and depression. The most common symptoms are:

1. Depressed state, lack of good mood. But unlike simple depression, depression is moderate. There are mood swings throughout the day, but they are also not pronounced. In some cases they may be completely absent.
2. Fatigue, apathy and lethargy. It is difficult for a person to express and formulate his thoughts, his movements are slow. When performing work, breaks are required more often.
3. Loss or decreased interest in familiar things and hobbies. The sign is not clearly expressed. In some cases it does not appear.
4. Decreased performance. But its increase may also be noted. Thus, the patient strives to get away from problems and close himself off from the outside world. Often, a similar symptom is observed when there are problems in the family.

5. Sleep disturbance. Patients often complain of difficulty sleeping. It becomes superficial, the person often wakes up and cannot fall asleep again.

In addition, autonomic disorders are also observed. They are expressed in dizziness, sudden changes in blood pressure. Against the background of depression and loss of appetite, disturbances in the functioning of the stomach and other gastrointestinal organs are observed. There are attacks of rapid heartbeat.

Such signs do not indicate the presence of dangerous somatic pathologies, but also require the use of medications.

Depressive neurosis, symptoms and treatment, how to distinguish – Neurology

Neurotic depression is a type of neurosis characterized by the following symptoms: constant depression, impaired performance, apathy, sleep problems, autonomic disorders.

The disease develops against the background of an acute stressful situation.

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Description and characteristics

• Neurotic depression, or, in other words, depressive neurosis , is a disorder that combines symptoms inherent in both neurosis and depression.
• At the same time depressive symptoms manifest themselves moderately, since most patients retain a positive outlook on their own future, and there are no personality disorders that develop with long-term depression.
• In some countries, doctors do not consider neurotic depression to be an independent disorder and classify it as situational depression.

What is the difference between neurosis and depression?

How to distinguish depression from neurosis?

Both neurosis and depression have similar symptoms, such as loss of strength, problems with work ability, various sleep disorders, autonomic symptoms, irritability, depression and much more. But at the same time, it is impossible to say that neurosis and depression are the same thing.

, a feeling of hopelessness and depression prevail , often reaching extremes. The patient loses ability to work and loses interest in anything, including things that were dear and important to him before the onset of the disease.

He does not see the meaning in what surrounds him, often does not understand why he should continue to live, and may try to commit suicide out of despair.

Also, people with depression tend to hate themselves and believe that those around them also hate and despise them deep down.

1. And if for some reason this is not the case, they find other irrational explanations (“Actually, she just didn’t get to know me well enough, so she thinks I’m interesting and smart, but then she’ll understand everything”).
2. This kind of irrationality in thinking is one of the foundations of depression, according to cognitive psychology.
3. If a person suffers from depression, he partially or completely loses the ability to rejoice and have pleasure .

This does not happen with neurosis. Neurosis manifests itself more mildly, and irritability, tearfulness, sleep problems, and increased fatigue come to the fore.

But a person is still able to see his future in bright colors , his thinking does not generate irrational, negatively colored statements inherent in depression, he can enjoy what is dear to him.

The main driver of neurosis is stressful situations. If a person leaves the stress zone, the symptoms of neurosis soften or disappear completely, depending on the characteristics of the disease.

With depression, this works poorly or does not work at all, since its main engines are not only outside, but also inside a person.

Yes, depression, like neurosis, can be triggered by both chronic stress and an acute psychotraumatic situation , but the irrational attitudes inherent in depression do not allow a person to get out of it in the same way as from neurosis, and the strength to solve the external situation that aggravates the disease he is not there.

• And everything negative that happens around him only supports irrational attitudes and strengthens them.
• At the same time, it is important to understand that a person considers these attitudes, on the contrary, to be rational and is usually ready to support them with argumentation , which will seem extremely pessimistic and even strange to a person without depression.
• These two diseases often accompany each other, and against their background it is possible to develop other disorders, such as obsessive-compulsive disorder, anxiety disorder, and panic disorder.

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Classification and forms

The following forms of neurotic depression are distinguished, depending on the causes of occurrence:

1. Exogenous or reactive. The disease develops after experiencing a traumatic situation: the death of a loved one, a severe episode of violence, a painful breakup, dismissal and other reasons. For reactive neurotic depression, mood swings are not typical, and a person’s thoughts are concentrated on what happened.
2. Endogenous. Despite the fact that endogenous depression can develop after a traumatic episode or a moderately severe stressful situation, its occurrence is closely related to the personal and genetic characteristics of a person. Also, this form of depression can develop almost out of nowhere.

Forms of depression depending on the characteristics of mood swings:

1. Bipolar. This form is characterized by radical fluctuations in the patient’s condition, from manic (inappropriately elevated mood, increased performance, loss of sense of time) to depressive (extremely depressed mood, loss of performance).
2. Monopolar. There are no sudden changes in the state inherent in bipolar neurotic depression. The patient's mood is monotonously depressed, with possible slight daily fluctuations.

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Reasons for development

The main causes of depressive neurosis:

1. Acute stressful situation. This may include the following traumatic events: a break with a friend, close relative or partner, the death of an important person, an episode associated with any type of violence (physical, mental, sexual).
2. Chronic stress and long-term psychotraumatic influence. This group of reasons includes problems, stress at work, tense, conflictual situations in the family, caring for a bedridden relative, financial difficulties, illness of a loved one, the presence of prolonged violent influence from surrounding people (bullying in an educational institution or in the workplace, beatings and humiliation from parents, partners).
3. Personal characteristics. Two types of people are susceptible to neurotic depression: those who are used to restraining their emotions, and those who have low self-esteem, have difficulty making important decisions, worry a lot for various reasons, and have difficulty adapting to changes in life.

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Symptoms of depressive neurosis

Neurotic depression is accompanied by the following symptoms:

1. Depressed mood. Depressive neurosis is characterized by moderate depression, in contrast to ordinary depression. Daily mood fluctuations, also characteristic of classical depression, are weakly expressed or not observed.
2. Lethargy, apathy, increased fatigue. It becomes more difficult for the patient to think, his speech and movements are slowed down, and he needs to take rest breaks more often during work.
3. Decreased or loss of interest in usual activities. This symptom is not as severe as in classic depression and may be absent.
4. Deterioration in performance or, conversely, the desire to throw oneself into work in order to distance oneself from worries and feel better, especially if the cause of the development of depressive neurosis is related to problems in relationships with the family.
5. Sleep disorders. Patients find it difficult to fall asleep, their sleep is superficial, sensitive, they often wake up during sleep and have difficulty falling asleep again. During the day you may experience drowsiness and a feeling of exhaustion.
6. Autonomic disorders. Dizziness, changes in blood pressure, disruptions in the gastrointestinal tract (pain, flatulence, constipation, diarrhea), attacks of rapid heartbeat, loss of appetite, and a feeling of weakness may occur. Most people experiencing these symptoms go to the hospital, but no serious somatic diseases are detected, and symptomatic treatment does not help get rid of the disorders.

With neurotic depression, suicidal tendencies and the desire to isolate oneself from others are usually absent.

Methods of treatment and assistance

Like most mental disorders, neurotic depression is treated using pharmacological and psychotherapeutic methods.

1. Medicines are prescribed to the patient individually and taking into account his symptoms.
2. During the treatment process, medications may be replaced with others if it turns out that they are not suitable.
3. Drug therapy is an important aspect of the treatment of depressive neurosis, but not the central one, since after stopping the drugs, symptoms return if psychotherapeutic methods of treatment are not included.
4. The following groups of medications may be prescribed:

• antidepressants . Unlike other groups of drugs listed below, they are almost always present in the course of treatment. Examples: Citalopram, Imipramine;
• atypical antipsychotics (Quetiapine, Aripiprazole). Improve mood, reduce the severity of apathy and lethargy;
• sedatives . They have very few side effects, have a beneficial effect on sleep and mood, and reduce nervousness. Examples: valerian tincture, Novo-Passit;
• nootropics . They reduce lethargy and apathy, increase interest in life, and have a positive effect on concentration. Examples: Piracetam.

• Also, if necessary, complexes of vitamins and minerals and physiotherapy (massage, electrosleep, darsonvalization, hydrotherapy) are prescribed.
• In the treatment of neurotic depression, methods of cognitive-behavioral psychotherapy show high effectiveness.
• The psychotherapist teaches the patient to notice automatic thoughts associated with his irrational attitudes and refute them by recording them in a special table.

This technique has become widespread and allows you to achieve positive results in a fairly short time.

Psychological counseling may also be helpful.

During the conversation, the psychologist discusses the patient’s problems, changes his attitude towards them, shows other sides of the problems, and offers working solutions. In some cases, close people of the patient are invited to psychological consultation.

How to distinguish depression from neurosis

Despite their similarities, neurosis and depression are different diseases. Neurosis is established when the patient is in conflict for a long time. Symptoms from the nervous system are more pronounced than from the internal organs.

Neurosis manifests itself in the form of rapid and frequent changes in mood during the day, difficulty concentrating on certain activities, and sleep disturbances. Also among the signs are a decrease in sexual desire and the appearance of body pain.

A distinctive feature of neurosis is weakness and irritability to any external factor. In this case, a person can become upset to tears over even minor trifles.

Associated symptoms include low blood pressure, impaired attention and memory, inability to concentrate, tinnitus and abdominal pain.

Patients often complain of decreased sexual desire. This is precisely the reason for contacting a sexologist.

Depression manifests itself as a depressed state. The causes are internal psychological reasons. Patients exhibit symptoms such as lethargy, depressed mood, and difficulty thinking. The person avoids communication with others, he experiences sleep disturbances, loss of appetite, and lack of sexual desire.

As a result of a depressed mood, facial expressions become less pronounced, and constant melancholy or sadness is noted. Many characterize this condition as a “stone on the heart.” A hallmark of depression is the lack of reaction to good news or bad news.

In a depressed state, they also note long-term thinking about answers and difficulties in comprehending questions. Depression is characterized by taking a long time to fall asleep. The next morning you are left feeling tired and exhausted.

Patients describe their condition as uselessness and lack of talent. Appetite is significantly reduced, which leads to rapid weight loss. A person avoids communication and withdraws into himself so much that he is unable to take care of someone else or even himself.

Treatment methods

Therapy for depressive neurosis is carried out using drugs from various groups. The patient also requires the help of a psychologist.

Important information

In its advanced form, the pathology is difficult to treat. In each specific case, an individual treatment regimen is prescribed depending on the general condition of the person and the characteristics of the course of the pathology.

To restore the psycho-emotional state, various medications are used that complement and enhance each other’s effects. In addition, they improve brain function and have a positive effect on the nervous system.

The following groups of drugs are often prescribed:

1. Sedatives. They have a calming effect. Many of them are completely safe, as they are plant-based. The most effective are Nervoflux and Valoserdin. In severe cases, barbiturates are used. These are strong drugs that depress the central nervous system and have a hypnotic effect.

2. Antidepressants. Use only on the recommendation of a doctor, who determines the dosage and duration of use. They are considered potent drugs. When depressive neurosis is established, Toloxatone (Humoril) or Tsipramil are more often used.
3. Tranquilizers. They have a powerful effect and are used only in advanced stages. The dosage and duration of use are determined by the attending physician. Changing them is strictly prohibited. Afobazol and Medazepam are popular.

All medications should be taken only as prescribed by a specialist, as they affect the functioning of the nervous system.

What does depression have in common with neurosis?

The pathological condition is one of the most common forms of mental disorders, accompanied by despondency, loss of interest in what is happening around, and negative judgments. Depression is not just a bad mood, but a disease that requires adequate treatment.

The relationship between the two states is that they accompany each other. Depressive neurosis is a syndrome with symptoms of both disorders, which has common causes. The difference is that neurasthenia is an anxious condition that develops under the influence of negative factors. Depression is a feeling of depression, sadness associated with the inner psychological world.

Depression is not just a bad mood, but a disease

The root cause of depressive neurosis is associated with negative events:

1. Loss of a loved one.
2. Change of residence: a sudden change in the usual rhythm of life.
3. Long-term serious illness.
4. Mental trauma that occurred in childhood.

Depending on the type of psychological disorder, the symptoms of the disease also depend. The main difference between neurosis and protracted depression is the methods of treatment.

Self-help for depressive neurosis

When you are depressed, an integrated approach is important. In addition to medications, the patient can independently help his body return to normal life.

For depressive neurosis, it is recommended to play sports. Physical activity strengthens not only the body, but also the spirit. Helps you take your mind off things.

Experts also recommend visiting new places, going to the theatre, exhibition, performance, concert, or going on vacation or travel. New emotions will help you get out of a state of depression.

In addition, it is worth looking for yourself, for example, in cooking, poetry, drawing or music. It is important to find an activity that you enjoy. This could be knitting, sewing and more. It is useful to read good books and listen to music. It will also help to communicate with loved ones who are ready to listen and understand.

When the patient is a creative person, he transfers his state to paper, which does not allow negative emotions to accumulate.

Prognosis and prevention

A favorable prognosis for detecting depressive neurosis can only be achieved when a person seeks help from a specialist and starts taking medications. You should also not be afraid to reach out to relatives or friends. There will definitely be people among them who will listen and provide moral support.

For preventive purposes, it is recommended to follow the following rules:

1. Get rid of bad habits and lead a healthy lifestyle.
2. Exercise. Physical activity gives you energy and allows you to take your mind off unpleasant thoughts.
3. Listen to music. It is important that it does not reinforce the depressed state. She should be cheerful and positive.

4. Communicate with people who have predominantly positive emotions.
5. Contact a psychologist if problems arise. A specialist will help you cope with your mood.
6. Ensure yourself proper rest. The duration of sleep for an adult should be at least 8 hours.

Following simple rules will help to significantly reduce the likelihood of developing depressive neurosis. The reason why it arose will remain in memory. But you should learn to live with this and see positive emotions even in the most insignificant things, for example, spring rain, morning sun or the first snow.

Depressive neurosis is a dangerous condition in which, especially in advanced cases, you have to take medications for the rest of your life. An integrated approach is important in treatment. Along with medications, psychological assistance methods are also used. Only in this way can the psycho-emotional state be restored.

Diagnosis of pathological conditions

You can make a diagnosis yourself if you know how to distinguish depression from neurosis, but it is better to seek help from a qualified specialist. Without the intervention of a doctor, it is easy to confuse the signs of various diseases.

When a patient notices symptoms of neurosis or depression, but their causes cannot be determined, the following measures should be taken:

• consult a neurologist;
• donate blood for hormones;
• increase activity;
• switch to a nutritious diet.

Having noticed symptoms of mental disorders in loved ones or relatives, you should communicate with the person, find out about his condition, show him your participation in his fate, try to discuss the problem and push him to solve it. For depressive syndrome, support will speed up the treatment process and reduce the risk of negative consequences for the patient.

To diagnose a pathological condition, you should consult a neurologist