Depression is both a mental illness and a psychological disorder. Depression is a type of mental disorder with persistent onset and obvious symptoms caused by a variety of reasons. Generally speaking, depression is reflected in both psychiatric and psychological disorders. In the early stage of depressive mood, patients’ symptoms are mostly based on abnormal psychological feelings, and once it develops into depression, some psychotic symptoms will appear. Therefore, there is no clear boundary in clinical medicine whether depression is a mental illness or a psychological disease. Therefore, once you notice signs of depression in yourself or someone around you, such as regular depressed mood or loss of interest in things around you, you should be treated as early as possible. You should also visit a psychiatric psychiatry department for examination and treatment first.
In addition, because the causes of depression are complex and the symptoms are variable, patients with serious conditions are likely to harm themselves and society, so depression should be taken seriously by the general population.
I. Etiology.
1, genetic: genetic factors are one of the important pathogenic factors of depression, and the risk of depression among first-degree relatives of depressed patients is found to be about 2-10 times higher than that of the general population.
2. social environment: life contingencies, such as loss of a loved one, poor marital relationship, unemployment, serious physical illness, etc., are risk factors for the development of depression.
3, abnormal neurological function: when the patient’s neurotransmitter function and endostasis function imbalance, abnormalities in the function of the nervous system such as hypothalamic-pituitary-adrenal axis, may also be one of the important factors in the development of depression.
II. Symptoms.
1. 3 core symptoms: depressed mood, loss of interest and pleasantness, and decreased energy leading to increased exertion and decreased activity.
2, 7 additional symptoms: reduced attention, reduced self-esteem and self-confidence, self-guilt and feelings of worthlessness, perception of a bleak and pessimistic future, self-injurious or suicidal ideas or behaviors, sleep disturbances, and decreased appetite.
Third, the diagnosis of.
1.Mild depression: with at least 2 core symptoms and at least 2 additional symptoms, and the patient has some difficulties in daily work and social activities, with mild impact on the patient’s social function.
2, moderate depression: with at least 2 core symptoms and at least 3 additional symptoms, and the patient has considerable difficulty in working socially or living
3, major depressive disorder: the presence of all 3 core symptoms and the presence of at least 4 additional symptoms, and the patient’s social, work and life functions are severely impaired.
4. with psychotic symptoms: meeting the dispute criteria for moderate and severe depressive episodes and the presence of symptoms such as hallucinations, delusions and depressive malaise. Delusions generally involve notions of self-sin, poverty, or imminent disaster, and the patient believes himself to be responsible for the disaster that befalls him; hallucinations are mostly auditory and olfactory hallucinations, with auditory hallucinations commonly being denigrating or accusatory sounds and olfactory hallucinations mostly being the smell of filthy rotting flesh.
The diagnosis of depressive episode generally requires a duration of at least 2 weeks and the presence of clinically significant distress or impairment of social functioning.
IV. Treatment.
1. Psychological: Through listening, comforting, explaining, guiding and encouraging, we help patients to understand and treat their illness correctly so that they can actively and positively cooperate with treatment. Usually implemented by doctors or other professionals, this therapy can be applied to almost all patients and can be used in combination with other treatment modalities.
2. Drugs: There are many drugs available for antidepressant treatment in the clinic, such as fluoxetine, duloxetine, mirtazapine, and other traditional antidepressants such as amitriptyline, clomipramine and promethazine. Such drugs can only be prescribed after diagnosis by a doctor, and the measurement is strictly controlled, so that patients cannot personally buy and use them.
3, physical: such as electric convulsion therapy, repetitive transcranial magnetic stimulation therapy, etc., which can be used alone or combined with drugs and psychological interventions.
After antidepressant treatment, most patients’ depressive symptoms can be effectively relieved or significantly reduced, but there are still about 15% of patients who cannot achieve clinical cure. After remission of the first depressive episode, about half of patients do not relapse, but the risk of relapse is as high as 90% for patients with three or more episodes, or those who do not receive maintenance treatment.
Therefore, in-hospital rehabilitation of such disorders is very important and should be carried out as soon as possible after the patient’s hospitalization to help the patient regain as much social function as possible, improve the cure rate, and lay a good foundation for recovery.