According to the World Health Organization, three percent of the world’s population suffers from depression. The incidence of depression in some developed cities in China, such as Beijing and Shanghai, is already close to the world average. According to survey data, 62.9 percent of the more than 26 million depressed people in China’s urban population have never sought medical treatment to date, and only 10 percent have received regular medication.
Depression is a feeling that is irresistible or unknown to oneself. Depression does not distinguish between nationality gender age, it is a civilization disease that exists everywhere and is one of the most common mental illnesses. There are three periods in a person’s life when he or she is more likely to get depression, namely the latter part of adolescence, middle age and after retirement, and depression is also more frequent in the elderly.
Everyone has times when they are unhappy and in a bad mood, but if it lasts too long, it’s depression. Depression is a common experience for most people, but when it persists and gets worse to the point where it is impossible to lead a normal life, it is called depression.
If five or more of the following symptoms are present for more than two weeks, the person needs to visit a psychiatrist to get specialist help.
1. persistent sadness, anxiety, or blankness of mind.
2. too much or too little sleep.
3. weight loss and loss of appetite.
4. loss of pleasure and interest in activities.
5. restlessness or impatience.
6. persistence of somatic symptoms unresponsive to treatment.
7. difficulty concentrating, memory loss, and difficulty making decisions.
8.Fatigue or mental exhaustion.
9, feeling guilty, hopeless or worthless in themselves, or even thoughts of suicide or death.
Depression is a curable disease. It is estimated that 80 to 90 percent of people with depression can be cured with professional treatment.
Professional treatment includes.
1. chemotherapy (antidepressant medication, other medications)
2. physiotherapy (electroconvulsive therapy, sleep deprivation therapy, light therapy, rapid transcranial magnetic stimulation)
3, psychotherapy (cognitive/behavioral/interpersonal therapy, etc.)
4, sociological treatment (socialized environmental treatment).
The following four classes of antidepressants are recommended as first-line medications, such as selective 5-HT reuptake inhibitors, NE and 5-HT reuptake inhibitors, NE and specific 5-HTergic antidepressants, and tricyclic antidepressants. SSRIs are the first new generation of antidepressants marketed in the last decade or so of the last century, including fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine, etc. 5 kinds.
Their advantages are.
Effective in various depressive episodes; mild adverse effects; no effect on α-adrenergic receptors, avoiding postural hypotension; no toxic effects on the heart and safe in case of drug overdose; patients who are ineffective to one SSRI can remain effective to another SSRI. These five selective 5-HT reuptake inhibitors have different characteristics for specific clinical applications because of the differences in their respective chemical structures.
In addition to first-line medications, other medications included in the second line, such as amoxapine, moclobemide and bupropion, may be preferred for psychotic depression, atypical depression, and bipolar disorder depressive episodes, including tianeptine, adenosine methionine, and lutetide, etc. New atypical antipsychotics such as risperidone and olanzapine may also be used as appropriate.
Although there is no name for depression in Chinese medicine, based on the clinical symptoms and onset of the disease, this disease belongs to the category of depression in Chinese medicine. All people have the seven emotions and six desires. Under normal circumstances, emotional activities play a coordinating role in the physiological functions of the body and do not cause disease.
Chinese medicine refers to the seven emotions of happiness, anger, sadness, thought, grief, fright and fear as “emotion and will”, and lists abnormal emotion and will activities as the internal causes of disease in Chinese medicine. As early as the era of Nei Jing, there was a more systematic study on the disease caused by internal depression of emotions. The Ling Shu records that “those who are happy and angry, good at forgetting, and good at fearing, get worried and hungry” and “when mania begins, it is first from sadness”, which indicates that doctors have noticed that manic patients can have depression within a period of time. The manifestation of depression. In modern times, some TCM scholars have applied Zhuangyao San and Chaihu Shuhebei San with additional flavor to treat depression with good results. If treatment with western medicine is used, its efficacy is significantly better than that of the control group with western medicine alone. In Japan, some scholars treated depression meeting the diagnostic criteria of DSM-IV with the addition of Guiqi Spleen Tang, and concluded that some qi tonifying and spleen strengthening drugs could improve depression and anxiety. Modern research suggests that the development of depression is related to neurotransmitters, receptors, neuroendocrine system, immune system, circulatory system and regulation of gene expression, and Chinese medicine treatment for depression is to regulate each system as a whole to achieve a cure.
Although new antidepressants are constantly appearing, today’s society pays more and more attention to the relationship between people and the environment, and people are worried that long-term use of Western medicine will produce side effects such as dependence, especially some elderly patients are more sensitive to drugs and less tolerable due to old age and weakness, and drug side effects are more and heavier than those of young and strong patients. Chinese medicine has the advantages of good efficacy and little side effects, so patients are more willing to accept Chinese medicine treatment. The clinical treatment of depression with herbal medicine is worthy of great promotion, but its pharmacokinetics and pharmacodynamics need to be further explored and verified.
Psychotherapy can help patients learn more effective ways to deal with life problems and modify their personality. Unfortunately, however, many depressed patients do not have regular checkups or drop out of treatment due to various factors. An important step toward better treatment of depression is to let people know that depression is not a sign of weakness, but a complex medical condition with real causes. Increasing knowledge about depression can help patients and those who show signs of depression to become aware of it. At the same time, removing the negative perceptions of depression will make it easier for people with depression to get help from a specialist.