Recently, Robin Williams, an Oscar winner, and Sun Zhongxu, a young translator, committed suicide due to depression one after another. The issue of depression prevention and treatment is again in the public eye. There have also been some recent discoveries in the field of research on antidepressants. Coinciding with the World Suicide Prevention Day, when the reporter interviewed Professor Xu wise, psychiatry department of Guangdong Provincial People’s Hospital, he said that depression is a high risk disease for suicide and has a heavy disease burden. According to WHO information, depression will become the second largest disease burden of human beings after ischemic heart disease in 2020, and by 2030, depression is likely to become the first largest disease burden of human beings. The prevention and treatment of depression should be taken seriously by the public. In particular, we should pay attention to the “smiling depression” which is apparently normal but depressed inside and has a high risk of suicide. Depression is not an incurable disease, but requires systematic and standardized treatment in both medication and psychological aspects. According to a new study in the United States, the antidepressant citalopram stopped the growth of brain plaques in a rat model of Alzheimer’s disease, according to foreign media and Science China. Although the finding is exciting, researchers warn that taking antidepressants to simply slow the progression of Alzheimer’s disease in humans seems premature. The researchers administered a series of antidepressant treatments to a number of transgenic rats that would develop Alzheimer’s disease in old age. The team fed citalopram to the older rats with brain plaques. Neurology professor Jin-Moo
Dr. Lee tracked plaque formation in rats with Alzheimer’s-like plaques over 28 days using a technique called two-photon imaging. Those given antidepressant treatment stopped the growth of existing plaques, and 78 percent of the rats reduced the formation of new plaques. In the second experiment, the scientists administered a single dose of citalopram to 23 individuals who had not experienced cognitive impairment and depression. Twenty-four hours after administration, samples of cremaster fluid taken from the participants showed a 37 percent decrease in beta amyloid levels. In response to this finding, it is generally believed that people with depression are at a correspondingly higher risk of developing Alzheimer’s disease, and both are closely linked to fluctuating levels of pentraxin in the brain. The study suggests that by maintaining the normal role of pentraxin in the brain, it may be possible to treat depression while correspondingly slowing the symptoms of Alzheimer’s disease. However, neither depression nor Alzheimer’s disease can be cured by one drug alone. The research and treatment of both diseases is much more complex than we think. Antidepressants cause weight gain? Many previous studies have suggested that taking antidepressants can cause weight gain, and Roy H. Perley, a psychiatrist at Massachusetts General Hospital in the U.S., has reported that antidepressants can cause weight gain. Roy H
The results of a study by Dr. Perli et al. showed that the effect of different antidepressants on weight gain in patients varied, and that short-term studies may have under-described and under-distinguished this risk. Of the dozen or so drugs currently available to treat depression, those that cause obesity problems are only individual drugs, and there are individual differences in sensitivity to whether they cause obesity. “The development of depression medications has advanced a lot and the so-called side effects of medications have been greatly reduced. Most side effects are gastrointestinal discomfort such as nausea and vomiting during the first two weeks of the drug-taking phase, and some can be drowsiness or sexual dysfunction, with minimal effects on liver and kidney function. Currently, although there is no direct clinical evidence, doctors still do not recommend pregnant women to take antidepressants, at least for the first and last trimester of pregnancy, to avoid taking them to avoid possible risks. In the treatment of depression, doctors usually do not rely on a single medication to treat depression, but rather find the best treatment plan for the individual patient through a combination of different medications.” For some depressed patients with somatic diseases such as diabetes and coronary heart disease, clinicians will promptly adjust the medication regimen according to the patient’s actual condition to avoid causing aggravation of somatic diseases, such as unstable control of blood sugar and blood pressure due to weight gain. On the other hand, the improvement of depression patients’ mood will also relieve their physical symptoms and improve their quality of life. Depression cure rate can reach 67% Depression is certainly not an incurable disease! “The cure rate for monotherapy is not high, for example, if only citalopram is used, the cure rate may only go up to 33%. If multiple medications are taken, along with psychotherapy, the overall cure rate can go up to 67%. This cure rate is higher than OCD.” ”Many patients and patients’ families think depression is a ‘neurological disease’, which makes many patients have a sense of stigma and fear social discrimination, and refuse to go to a psychiatric-psychological specialist for standardized treatment. Patients mostly go to internal medicine only, emphasizing purely on somatic symptoms to internal medicine doctors, hiding their emotional problems, stubbornly believing that their emotions will also be relieved when their somatic symptoms get better, and neglecting to treat from the ‘heart’, resulting in some degree of missed diagnosis, non-standardized treatment and delaying their condition.” Treatment of depression requires long-term medication. “Many patients do not adhere to the medication and stop it arbitrarily when their symptoms are relieved in the middle, causing recurrence of symptoms and eventually losing confidence in the treatment and giving up on it.” “Many patients end up committing suicide because they can’t stick to it. Drug treatment is about the whole treatment, in the acute phase to adhere to 6 to 12 weeks of medication; consolidation period takes 4 to 9 months. The third phase of maintenance treatment also requires more than 1 year of medication treatment. Many patients stop medication because of improvement, resulting in recurrence of the disease.” The treatment of depression requires a combination of medication and psychotherapy, and adherence to systematic and standardized treatment in both areas is necessary to effectively fight depression. “It’s not chatting, talking, or opening up in the sense we usually do, nor is it simple psychological counseling, but a professional means of psychotherapy. It requires standardized treatment and the support and cooperation of patients and their families and friends.” ”The negative perceptions and actions of anhedonia and suicide caused by depression are not only psychological, but also closely related to physiological changes in neurological functions. The lack of neurotransmitters in the brain causes insomnia, mood swings, memory loss, frequent negative perceptions and, in more severe cases, negative behaviors such as self-harm and suicide. “For example, low work efficiency and avoidance of interpersonal interactions, etc. Family members need to pay attention to these manifestations and should take the patient to consult a specialist and receive systematic treatment if necessary.” Many patients feel as if they are wearing a pair of gray glasses when describing their emotional feelings, seeing everything as gray, and some feel as if their heads are covered with dark clouds that linger. “Ten to 15 percent of people with depression die by suicide.” But all this does not mean that there is no way to combat depression. Systematic and standardized medication and psychotherapy can help people with depression get out of the clouds. In terms of prevention and treatment, first of all, it is important to pay attention to the structure of the state of life. In addition to work, it is important to enrich your spare time, have more fun in life, and have ways to open yourself up to change your mood so that there are good ways to vent negative emotions. Secondly, it is important to have the right sense of treatment when facing depression. Depression requires long-term systematic and standardized treatment, and patients and their families need to take the initiative to seek medical treatment early and actively cooperate with professional doctors. For some people with “smiling depression” (i.e., they look cheerful and normal on the surface, but they have fallen into a deep grayness inside), they need to be paid attention to by themselves and their friends and relatives in particular. When these patients are depressed to a certain degree, they will give vent to their repressed emotions in a radical way, such as: irritability, verbal or behavioral attacks on others, self-harm, suicide, etc. The most severely depressed patients even lose the ability to commit suicide. It is often the case that patients who have improved in treatment but have recurred, suddenly choose to commit suicide when they see a smile again, which requires particular attention. The main manifestations of depression The main manifestations of depressive episodes include: depressed mood, significant and persistent depressed emotions, depression and pessimism. In mild cases, sullenness, unpleasant feelings, loss of interest, and in severe cases, pain, pessimism and despair, life is like a year, life is worse than death. In severe cases, delusions of guilt and paranoia may occur, and some patients may experience hallucinations. Delayed thinking, slow reaction, and closed-mindedness. Clinical manifestations include slow behavior, passive and lazy life, unwillingness to do things, unwillingness to interact with people around them, living alone behind closed doors, alienating friends and relatives, and avoiding social interactions. In severe cases, even the physiological needs such as eating, drinking and personal hygiene are disregarded, and even develop into not speaking, not moving and not eating. Severe cases are often accompanied by negative suicidal ideas or behaviors. The main physical symptoms are sleep disorder, fatigue, loss of appetite, weight loss, constipation, pain in any part of the body, loss of libido, impotence, and amenorrhea. Sleep disorders are mainly manifested as early awakening, usually 2 to 3 hours earlier than usual, and inability to fall back to sleep after waking up. Some of them show difficulty in falling asleep and not sleeping deeply; a few patients show excessive sleep. There are also a few patients who show increased appetite and weight gain. Seventy-five to 80 percent of patients have multiple relapses, so patients with depression need preventive treatment. Long-term treatment or even lifelong medication should be given for more than 3 episodes. Most scholars believe that the dose of maintenance medication should be the same as the treatment dose, and regular outpatient follow-up observations should also be made. Psychotherapy and social support systems also play a very important role in preventing relapse of the disease.