Depression is a common psychiatric disorder, mainly manifested by low mood, reduced interest, pessimism, slow thinking, lack of initiative, self-blame, poor diet and sleep, fear of suffering from various diseases, feeling unwell in many parts of the body, and in severe cases, suicidal thoughts and behaviors. Depression is the disease with the highest suicide rate in psychiatry, and now it has become the second most important disease among global diseases causing a serious burden to human beings, causing suffering to patients and their families, and causing losses to society that are unmatched by other diseases. The main reason for this situation is the lack of proper understanding of depression in society and the prejudice that makes patients reluctant to go to psychiatry. In China, a large number of depressed patients do not seek medical treatment, and patients do not receive timely diagnosis and treatment, and their condition deteriorates, even with serious consequences of suicide. On the other hand, due to the lack of knowledge about depression among the public, those who have depressive symptoms are mistakenly thought to be in a mood and cannot give due understanding and emotional support, which causes more psychological pressure on the patients and makes their condition further deteriorate.
Types.
1, endogenous depression, i.e., the “five signs” of laziness, dullness, change, worry and concern (relative or absolute deficiency of brain serotonin levels).
2. insidious depression, where symptoms of low mood and depression are not obvious, but often manifest as a variety of physical symptoms, such as palpitations, chest tightness, mid-upper abdominal discomfort, shortness of breath, sweating, weight loss, insomnia, etc.
3. adolescent depression, which can lead to learning difficulties, inattention, memory loss, overall decline or sudden decline in performance, anorexia, fear of learning, truancy or refusal to learn.
4, secondary depression, such as hypertensive patients, after taking antihypertensive drugs, resulting in persistent depression and depression.
5. postpartum depression, with strong guilt, low self-esteem, hatred, and perverse psychology of not loving or loathing children for their babies. Crying, insomnia, inability to eat and depression, are common symptoms of this type of depression.
Symptoms.
Main symptoms.
Depression is fundamentally different from general “unhappiness” and has three main symptoms: depressed mood, slowed thinking, and motor inhibition. Depressed mood is not happy, always sad and sad, and even pessimistic and desperate. A typical example is Lin Daiyu, who frowned and sighed all day and wept 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 above typical symptoms. 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 rhythmical change of depression called day heavy and night light.
Most dangerous symptom.
Patients with depression are prone to suicidal thoughts in severe cases due to low mood, pessimism and anxiety. 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 studies, 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 their suffering.
Somatic symptoms.
Depression is mainly characterized by depressed state of mind, slowed thinking and reduced volitional activity, and in most cases, various somatic symptoms are also present.
1, depressed state of mind: the basic characteristics are depressed mood, distress and sadness, interest is not. 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 heavy daytime and light nighttime. Often co-existing with anxiety.
2. Delayed thinking: the thought association process is inhibited, the reaction is slow, and the self-consciousness of the brain does not turn, which is manifested by reduced active speech, significantly slower speech speed, and effortful thinking problems. Slow reaction, need to wait a long time, under the influence of depressed 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-guilt, thinking that living becomes a burden, committing a major crime, the emergence of the concept of hypochondria on the basis of somatic discomfort, believing that 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 incoherence and immobility, which can reach the level of rigor mortis. The most dangerous is the recurrence of suicide attempts and behaviors.
4. Somatic symptoms: Most depressed patients have somatic and other biological symptoms, such as palpitations, chest tightness, gastrointestinal discomfort, constipation, loss of appetite and weight loss. Prominent sleep disturbances, difficulty falling asleep and early awakening.
5. Other: depressive episodes can also present with hallucinations, depersonalization, dissociation of reality, obsessive-compulsive and phobic symptoms. Due to significant delay in thought association and memory loss, it is easy to affect the cognitive function of elderly patients and develop 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, overuse of the brain, etc., and the emotions are mainly anxiety and vulnerability, and the main clinical phases are emotional symptoms such as mental fatigue, tension, worry and irritability associated with cerebral excitement, and symptoms of physiological dysfunction such as muscle tension pain and sleep disorders. The symptoms of physiological disorders such as muscle tension pain and sleep disorders. Self-awareness is good, symptoms are volatile, and treatment is eagerly sought. In contrast, depressive disorder is mainly depressed mood, accompanied by delayed thinking, low self-esteem, self-criminality, desire to die, and biological symptoms (such as morning heaviness and evening lightness, loss of appetite, decreased libido, etc.), often losing self-awareness and 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 extremities and nausea, vomiting and other symptoms, depression is often masked by somatic symptoms. 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 usually ineffective, and antidepressant treatment is effective.
Early 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 days like years, painful, can not help themselves. Some patients may also be 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 socializing. Patients often complain of “no feelings”, “emotional numbness”, “can’t be happy”.
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-guilt and suspicion.
5. patients present with a significant, persistent and generalized depressive state, with difficulty in concentration, memory loss, brain dullness, closed-mindedness and slowness of action, but some patients show restlessness, anxiety, nervousness and agitation.
6. negative pessimism: great inner pain, pessimism, despair, feeling that life is a burden, not worth staying, seeking relief by death, and may produce strong suicidal thoughts and behaviors.
7. somatic 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 do not occur in every case
8, loss of appetite, weight loss: most patients have loss of appetite, poor appetite symptoms, delicious food is no longer tempting, the patient does not think about tea and food or tasteless, often accompanied by weight loss.
9, hypogonadism: early in the disease can appear to reduce sexual desire, men may appear impotent, female patients have sexy loss.
10, sleep disorders: typical sleep disorders are early awakening, 2 to 3 hours earlier than usual, not falling back to sleep after waking up, and falling into a sad atmosphere.
11, diurnal variation: the patient’s state of mind has a day-heavy and night-light variation. Early in the morning or morning into a state of depression, afternoon or evening gradually see improvement, can carry on a short conversation and meal. The incidence of diurnal variation is about 50%.
Self-tests and methods of determination
Depression is not a generalized bad mood. A person who is depressed but gets better after two days is not depressed. There are nine main symptoms of depression. As long as at least four of these symptoms are present below, and they last for two weeks without relief, and they affect normal life in general, you need to consider whether you are suffering from depression, and seek consultation with a specialist in time.
★ Loss of interest and no sense of pleasure.
★ Loss of energy, often with unexplained fatigue.
★ slower reaction, or easily agitated, hyperactive, and also easily irritated.
★ low self-esteem, frequent self-blame or feelings of guilt, which is a major cause of suicide in patients
★ Difficulty in association or reduced ability to think consciously, and difficulty in deciding on even minor matters of daily life.
★ Recurrent thoughts of death or suicidal or self-injurious behavior.
★Sleep disorders, such as insomnia, early awakening or excessive sleep.
★Decreased appetite or significant weight loss.
★Loss of sexual desire.
In addition to the above symptoms, there are also some “peripheral symptoms” of depression. In Asia, especially in China and Japan, most people with depression do not have emotional symptoms, but rather physical symptoms such as headache, dizziness, bloating, palpitations, and body aches. Therefore, it is important to consider the possibility of depression for some physical symptoms that have no physical cause to avoid delaying treatment.
Self-help prescriptions for depressed patients.
Psychiatrists have prescribed a self-help prescription for depressed patients: 1.
1. Do not blame yourself. Depression is a disease, and you don’t have the ability to create or choose it. Therefore, instead of blaming yourself for “why do I have this damn disease”, understand that you need help urgently and actively embark on the road to recovery.
2. Follow your treatment plan carefully. Take your medication as prescribed and visit your doctor regularly. Allow your doctor to accurately monitor the effectiveness of your treatment and adjust your treatment plan and medications when appropriate.
Don’t get discouraged. Tell yourself that it will take some time to get back to normal and that you should not be in a hurry. Always tell yourself, “I will get better.
Avoid making major life decisions. When you are depressed, your ability to make big decisions is impaired. Therefore, it is best to wait until your depression has cleared up and you are confident in your decision-making abilities before making major decisions.
3. Simplify your life. When you suffer from depression, you have to make appropriate changes in your life. Don’t expect to be able to do what you did before the onset of the disease, and if you find something too difficult to do, simply ignore it. If you still ask yourself to do many things at once like a healthy person, or to complete a task quickly, you may feel overwhelmed and thus become more depressed.
4. Participate in activities. Participate in activities that you are good at and that give you a sense of accomplishment, even if you are just a spectator at first, don’t give up these opportunities. Such activities can gradually restore your confidence, the treatment of depression is very beneficial.
5. Recognize small improvements. Whenever there is a small improvement in depression symptoms, you should learn to feel satisfied. This will allow you to gradually rejuvenate and find a little bit of your once healthy self.
6. Prevent relapses. One way to prevent relapse is to prevent it from happening in the first place. First, follow your doctor’s treatment plan to the letter and maintain good habits. Second, stay alert to the signs of relapse. Although the signs of relapse vary from person to person, it is important to watch out if you wake up early, eat less than usual, feel particularly irritable, or don’t care about anything. And if it lasts for about two weeks, please seek medical attention immediately.