Three main symptoms
Depression is fundamentally different from general “unhappiness” and should not be confused with it. It has three main symptoms: depressed mood, slowed thinking, and motor inhibition (mainly restricted motor mechanisms).
Depressed mood is not happy, always sad, even pessimistic despair. A typical example is Lin Daiyu, who frowns and sighs all the time and weeps at every turn in Dream of the Red Chamber.
Delayed thinking means that you feel that your brain is not working well, that you cannot remember things, and that you have difficulty thinking. The patient feels that her brain is empty and dumb.
Motor inhibition is inactivity and laziness. Walking is slow, and speech is low. In severe cases, the patient may not eat or move and may not be able to take care of himself/herself.
Other symptoms
It is not common for patients to have the typical symptoms listed above. Many patients have only one or two of these symptoms, and the severity varies from person to person. Depression, anxiety, loss of interest, lack of energy, pessimism, and low self-esteem are all common symptoms of depression, and sometimes it is difficult to distinguish them from a general short period of bad mood. Here is an easy way to introduce to you: if the above discomfort is severe in the morning and partially relieved in the afternoon or evening, then it is more likely that you are suffering from depression. This is the rhythmic variation of depression called day heavy and night light.
The most dangerous symptom
People with depression are depressed and pessimistic due to their low mood. In severe cases, it is easy to have suicidal thoughts. And, because the patient’s thinking and logic are basically normal, the success rate of committing suicide is also higher. Suicide is one of the most dangerous symptoms of depression. According to research, the suicide rate of depressed patients is 20 times higher than that of the general population. More than half of the socially suicidal population may be depressed. Some unexplained suicides may have suffered from severe depression during their lifetime, but were just not detected in time. Since suicide occurs only when the disease has progressed to a certain level of severity, early detection of the disease and early treatment are important. Therefore, early detection of the disease and early treatment are very important for patients with depression. Do not wait until the patient has already committed suicide to think that he may have depression.
Many depressed patients think of dying to relieve their pain. Patients often have thoughts and behaviors of death in order to end the pain, suffering and confusion.
Somatic symptoms
Depression is mainly characterized by a depressed state of mind, slowed thinking and reduced volitional activity, and in most cases, various somatic symptoms are also present.
1. Depressed mood: The basic characteristics are depressed mood, distress and sadness, and lack of interest. Feeling pessimistic and desperate, painful and unbearable, with the feeling that life is like a year and life is worse than death. The inner experience is often described as meaningless and unhappy. The typical person has a depressed mood, with the characteristics of heavy daytime and light nighttime. It often coexists with anxiety.
2. Delayed thinking: the thinking association process is inhibited, the reaction is slow, and the brain is not spinning consciously, which is manifested by the reduction of active speech, the speed of speech is significantly slowed down, and the thinking problem is laborious. Slow reaction, need to wait a long time, under the influence of low mood, low self-esteem, low self-esteem, a sense of uselessness and worthlessness, feeling that living is meaningless, pessimistic and suicidal intentions, self-blame and self-sin, think that living becomes a burden, committing a big crime, on the basis of physical discomfort, the emergence of the concept of hypochondriac, think they are suffering from an incurable disease.
3. Decreased volitional activity: active activities are significantly reduced, life is passive, reluctant to participate in the outside world and activities that are usually of interest, and often solitary. Life is lazy and develops into silence and immobility, which can reach the level of rigor mortis. The most dangerous thing is the recurrence of suicide attempts and behaviors.
4.Somatic symptoms: Most depressed patients have physical and other biological symptoms, such as palpitations, chest tightness, gastrointestinal discomfort, constipation, loss of appetite and weight loss. Sleep disorders are prominent, mostly difficulty in falling asleep.
5, Other: Depressive episodes can also be characterized by hallucinations, depersonalization, dissociation of reality, obsessive-compulsive and phobic symptoms. Because of the significant delay in thinking association and memory loss, it is easy to affect the cognitive function of elderly patients and appear depressive pseudo-alzheimer’s disease.
Mild depression often has complaints of dizziness, headache, weakness and insomnia, and is easily misdiagnosed as neurasthenia. The latter has certain psychosocial factors before the onset of the disease, such as long-term tension and overuse of the brain, and the emotions are mainly anxiety and vulnerability, and the main clinical phases are emotional symptoms such as mental fatigue, mood tension, worry and irritability associated with mental excitement, and symptoms of physiological dysfunction such as muscle tension pain and sleep disorders. Self-awareness is good, passivity of symptoms is high, and treatment is eagerly sought. In contrast, depressive disorder is mainly depressed mood, accompanied by delayed thinking, low self-esteem, self-crime, desire to die, and biological symptoms (such as light mood around the clock, decreased appetite, libido, etc.), and often loss of self-awareness, not actively seeking treatment, which can be distinguished.
Occult depression is an atypical depression, mainly manifested by recurrent or persistent various somatic discomfort and vegetative symptoms, such as headache, dizziness, palpitations, chest tightness, shortness of breath, numbness of the limbs and nausea, vomiting and other symptoms, depressed mood is often masked by physical symptoms, so it is also called depressive isotonic disorder. Patients often do not seek psychiatrists but go to other departments. Somatic examination and ancillary tests are often not positive, and are easily misdiagnosed as neurosis or other somatic diseases. Symptomatic treatment is generally ineffective, and antidepressant treatment is effective.
Main symptoms
1. The degree of depressive state of mind varies, and can range from mildly poor mood to sadness, pessimism and despair. Patients feel heavy, life is meaningless, happy, depressed, spending time like years, painful, can not help themselves. Some patients may also appear anxious, easily agitated, nervous and restless.
2.Loss of interest is one of the common symptoms of depressed patients. Loss of enthusiasm and pleasure in life and work, and loss of interest in everything. The patient does not experience the joy of family, does not care about the past hobbies, often lives alone behind closed doors, alienates friends and relatives, and avoids social life. Patients often complain of “no more feelings”, “emotional numbness”, “no more happiness”.
3. Loss of energy, fatigue and weakness, difficulty in washing, dressing and other small daily tasks, and inability to cope with them. Patients often use the words “mental breakdown” and “deflated ball” to describe their condition.
4. Low self-evaluation: Patients tend to excessively devalue their own abilities, and view their present, past and future in a critical, negative and negative manner, describing themselves as useless and having a dark future. Strong feelings of self-blame, guilt, uselessness, worthlessness, helplessness, and in severe cases, self-criminality and suspicion may appear.
5.Patients show significant, persistent and general depression, difficulty in concentration, memory loss, slow brain, closed mind, slow action, but some patients show restlessness, anxiety, tension and agitation.
6, negative pessimism: very painful, pessimistic, despair, feel that life is a burden, not worth staying, to die for relief, may produce strong suicidal thoughts and behavior.
7, physical or biological symptoms: depressed patients often have biological symptoms such as loss of appetite, weight loss, sleep disorders, low sexual function and diurnal fluctuations in mood, which are very common, but not in every case.
8, loss of appetite, weight loss: most patients have poor appetite, poor appetite symptoms, delicious food is no longer tempting, patients do not think about tea and food or tasteless, often accompanied by weight loss.
9, sexual hypogonadism: early in the disease can appear to reduce sexual desire, men may appear impotent, female patients have sexy loss.
10.Sleep disorder: The typical sleep disorder is early awakening, 2 to 3 hours earlier than usual, not going back to sleep after waking up, and falling into a sad atmosphere.
11.Diurnal variation: The patient’s mood has the variation of heavy day and light night. Early in the morning or in the morning, they fall into a low mood, and in the afternoon or evening, they gradually get better and can have a short conversation and a meal. The incidence of diurnal variation is about 50%.
Somatic symptoms of depression
In addition to mood symptoms, depression can also cause somatic symptoms, including sleep disturbances (difficulty falling asleep, light sleep, early awakening, and in one case, the person thinks he or she is sleeping well but does not feel asleep at all), weakness or loss of energy, loss of appetite (70% of depressed people have this condition, ranging from no appetite in mild cases to loss of appetite in severe cases), and non-specific physical symptoms such as hypogonadism (women may experience amenorrhea during the onset of depression), weight loss, constipation, and generalized pain and discomfort.
Diagnostic criteria
In the International Classification of Diseases-20, depressive episodes do not include depressive states that occur in bipolar disorder. Therefore, depressive episodes include only first-episode depression or recurrent depression.
The general criteria for depressive episodes in ICD-20 are 3.
1. The depressive episode must last for at least 2 weeks.
2. There are no episodes of hypomania or mania in the patient’s previous life sufficient to meet the criteria for hypomania or mania (f30.-).
3. The most common condition to be excluded: such episodes are not due to psychoactive substance use (f10-f19) or any organic psychiatric disorder (f00-f09). The symptoms of depressive episodes are divided into two main categories, which can be roughly referred to as core symptoms and additional symptoms, respectively.