Depression is a common psychiatric disorder that is characterized 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. The prevalence of depression is so high that almost 1 in 5 adults is depressed, which is why it has been called the flu of psychiatry. Depression has now become the second most important global disease causing a serious burden on human beings, causing suffering to patients and their families, and causing damage to society that is unmatched by any other disease. 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, only 5% of depressed patients have been treated, and a large number of 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 considered to be in a mood and cannot give due understanding and emotional support, which causes more psychological pressure on the patients and further deteriorates their condition.
Types
1.Endogenous depression, i.e., laziness, dullness, change, worry, and worry “five signs” (brain biogenic amine cited or absolutely insufficient).
2.Incognito depression The symptoms of depressed mood and melancholy are not obvious, but often manifest as various physical symptoms, such as palpitations, chest tightness, upper and middle abdominal discomfort, shortness of breath, sweating, weight loss, insomnia, etc.
3, adolescent depression, 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 some hypertensive patients, after taking antihypertensive drugs, resulting in continued depression, depression.
5, postpartum depression Its especially strong guilt, low self-esteem, hatred, do not love or loath the child’s perverse psychology for their babies. Crying, insomnia, inability to eat and depression, are common symptoms of such depressed patients.
6, white-collar depression, young women with depression have disorders of the neuroendocrine system, the normal physiological cycle is also disrupted, with a variety of symptoms, in addition to mental depression, depression, inactivity, sulking, overthinking, insomnia, dreaminess, dizziness, forgetfulness and other major mental symptoms, anorexia, nausea, vomiting, abdominal distension and other symptoms of digestive and absorption dysfunction, menstrual irregularities, menstrual abdominal pain and other gynecological Gynecological symptoms such as irregular menstruation and abdominal pain during menstruation are also not uncommon.
Symptoms
1.Main symptoms
Depression is fundamentally different from general “unhappiness”. It has distinctive features, and has three main symptoms, namely depressed mood, slowed thinking and motor inhibition.
(1) Depressed mood means not being happy, always sad, even pessimistic and despairing. Dream of the Red Chamber” in all day frowning and sighing, moving on the tears of Lin Daiyu is a typical example.
(2) Retarded thinking means that you feel that your brain is not working well, you can’t remember things, and you have difficulty thinking about problems. The patient feels that the brain is empty and dumb.
(3) Motor inhibition is inactivity and laziness. Walking is slow and speech is low. Severe cases may not eat or move, and cannot take care of themselves.
2.Other symptoms
It is not common for patients to have the above typical symptoms. Many patients have only one or two of them, and the severity varies from person to person. Depression, anxiety, loss of interest, lack of energy, pessimism, low self-esteem, etc. are all common symptoms of depression, and sometimes it is difficult to distinguish them from the 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 change of depression so-called day heavy and night light.
3.The most dangerous symptom
Patients with depression are depressed and pessimistic due to their depressed mood. In severe cases, it is easy to have suicidal thoughts. And, because the patient’s thinking logic is basically normal, the success rate of implementing 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, only to be undetected 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.
4.Somatic symptoms
Depression is mainly characterized by depressed mood, slowed thinking and reduced volitional activity, and in most cases, various physical symptoms are also present.
(1) Depressed state of mind: the basic features 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 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 self-consciousness of the brain does not turn, 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 for 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, thinking that living becomes a burden, committing a major crime, the emergence of suspicion on the basis of physical discomfort, thinking 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, often solitary. The laziness of life develops into silence and immobility, and 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. Sleep disorders are prominent, mostly difficulty in falling asleep.
(5) Other: depressive episodes can also present with hallucinations, depersonalization, dissociation of reality, obsessive-compulsive and phobic symptoms. Depressive pseudo-dementia can occur due to significant slowing of thought associations and memory loss, which can easily affect the cognitive function of elderly patients.
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-criminality, desire to die, and biological symptoms (such as lightness of mood around the clock, decreased appetite, libido, etc.), self-awareness is often lost, not actively seeking treatment, 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 physical symptoms, so it is also called depressive equilibrium. 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 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 impotence, 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 a change 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%.
”Self-help prescriptions” for people with depression.
Psychiatrists at the New York Medical Center in the United States have prescribed a self-help “prescription” specifically for people with depression:.
1. Don’t 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 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 return to normal and that you should not rush. 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. Do not 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.