Depression

I feel like this sometimes, but it’s not like you want to commit suicide.

CCMD-3 definition of depression

Mainly characterized by a low mood, which is not commensurate with the situation. It can range from unhappy to grief-stricken, and even stupor. In severe cases, psychotic symptoms such as hallucinations and delusions may occur. Anxiety and motor agitation are prominent in some cases.

Depression: An affective mental disorder characterized by sadness, low self-esteem, difficulty concentrating, and other related symptoms.

Types of depression

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1. Endogenous depression includes the "five types" of laziness, dullness, change, worry and worry. "Signs" (the brain's biogenic amines are correct or absolutely insufficient).

2. Reactive depression is depression caused by various mental stimulations and setbacks. In life, people with poor psychological tolerance are prone to reactive depression due to sudden natural and man-made disasters, love break-ups, marriage changes, serious illness, career setbacks, etc.

3. The symptoms of low mood and depression in latent depression are not obvious and often manifest as various physical discomfort symptoms, such as palpitations, chest tightness, middle and upper abdominal discomfort, shortness of breath, sweating, weight loss, insomnia, etc. .

4. Depression characterized by learning difficulties. This type of depression can cause students to have learning difficulties, loss of concentration, memory loss, overall or sudden decline in grades, weariness, fear of learning, and truancy. Or refuse to go to school.

5. Secondary depression caused by drugs. For example, some hypertensive patients may continue to feel depressed and depressed after taking antihypertensive drugs.

6. Secondary depression caused by physical diseases, such as heart disease, lung disease, endocrine and metabolic diseases, and even severe colds and high fevers, can all cause this type of depression.

7. Postpartum depression, especially strong guilt, low self-esteem (especially when rural women are discriminated against by their mother-in-law or husband after giving birth to a baby girl), hatred, unloving or disgust towards their baby Abnormal psychology of children. Crying, insomnia, inability to eat, and depression are common symptoms of patients with this type of depression.

I The three main symptoms of depression

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Many people are familiar with depression, but depression is different from the general " There is an essential difference between "happy" and "happy". It has obvious characteristics. Taken together, it has three main symptoms, which are depression, slow thinking and motor inhibition.

Being in a low mood means not being happy, always feeling sad, or even pessimistic and despairing. Lin Daiyu in "A Dream of Red Mansions" who frowns and sighs all day long and sheds tears at every turn is a typical example.

Slow thinking means that you feel that your brain is not working well, you cannot remember things, and you have difficulty thinking about problems. The patient feels that his mind is empty and he has become dull.

Motor inhibition means not being active and feeling lazy. Walking slowly, speaking less, etc. In severe cases, you may not be able to eat or take care of yourself.

II Other symptoms of depression

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Patients with the above typical symptoms are rare. Many patients have only one or two of these conditions, and the severity varies from person to person. Depressed mood, anxiety, loss of interest, lack of energy, pessimism and disappointment, low self-evaluation, etc. are all common symptoms of depression, and sometimes it is difficult to distinguish them from a general short-term bad mood. Here is a simple method: If the above discomfort is severe in the morning and partially relieved in the afternoon or evening, then you are more likely to suffer from depression. This is the so-called rhythmic change of day and night in depression.

III The most dangerous symptoms of depression

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Patients with depression are depressed, pessimistic and world-weary. In severe cases, it is easy to have suicidal thoughts. Moreover, because the patient's thinking logic is basically normal, the success rate of committing suicide is also high. Suicide is one of the most dangerous symptoms of depression. According to research, the suicide rate of patients with depression is 20 times higher than that of the general population. More than half of the people who commit suicide in society may be patients with depression.

Some people who commit suicide for unknown reasons may have suffered from severe depression before their death, but it was just not discovered in time. Because suicide occurs when the disease has developed to a certain degree of severity. Therefore, early detection of the disease and early treatment are very important for patients with depression. Don't wait until the patient has committed suicide to think that he may be suffering from depression.

Many patients with depression think of dying to relieve their pain. Patients often have thoughts and actions about death in order to end their pain, suffering, and confusion.

IV Physical symptoms of depression

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Depression is mainly characterized by depressed mood, slow thinking and decreased volitional activity. In most cases There are also various physical symptoms.

(1) Depressive mood: The basic characteristics are low mood, distress and sadness, and lack of interest. I feel pessimistic and hopeless, in unbearable pain, and feel that my days are like years and life is worse than death. They often describe their inner experience by saying that life is meaningless and that they cannot be happy. Typical people have the characteristics of depression, heavy day and light night. Often associated with anxiety.

(2) Slow thinking: The process of thinking and association is inhibited, the reaction is slow, and the mind is conscious that the brain is not turning. It is manifested as a reduction in active speech, a significant slowdown in speech speed, and laborious thinking. Slow response, long wait, low self-esteem, low self-esteem, sense of uselessness and worthlessness, pessimism and suicidal intention, self-blame and guilt, feeling that life has become a burden. He committed a serious crime and developed hypochondriacal ideas on the basis of physical discomfort, believing that he was suffering from an incurable disease.

(3) Decreased volitional activity: Active activities are significantly reduced, life is passive, unwilling to participate in outside activities that are usually interesting, and often stay alone. Living a lazy life can progress to silence and can reach the level of stupor. The most dangerous are repeated suicide attempts and behaviors.

(4) Somatic symptoms: Most depressed patients have physical and other biological symptoms, such as palpitations, chest tightness, gastrointestinal discomfort, constipation, decreased appetite and weight loss. Sleep disorders are prominent, mostly difficulty falling asleep.

(5) Others: Hallucinations, depersonalization, derealization, obsessive-compulsive and phobic symptoms can also occur during depressive episodes. Due to significant slowness in thinking and association and decline in memory, it is easy to affect the cognitive function of elderly patients and lead to depressive pseudo-Alzheimer's disease.

Mild depression often has main complaints such as dizziness, headache, weakness and insomnia, and is easily misdiagnosed as neurasthenia. There are certain psychosocial factors before the onset of the latter, such as long-term stress, excessive use of the brain, etc., emotional Mainly anxiety and fragility, the main clinical symptoms are mental fatigue, nervousness, worry and irritability and other emotional symptoms related to mental excitability, as well as symptoms of physiological dysfunction such as muscle tension pain and sleep disorders. He has good insight, his symptoms are passive, and he is eager to seek treatment. Depressive disorder is mainly characterized by low mood, accompanied by slow thinking, low self-esteem, self-crime, wanting to die, and biological symptoms (such as mood day and night, decreased appetite and sexual desire, etc.), often losing insight, and not actively seeking treatment. identification.

Latent depression is an atypical form of depression, mainly characterized by repeated or persistent physical discomfort and autonomic symptoms, such as headache, dizziness, palpitations, chest tightness, shortness of breath, numbness of limbs and Symptoms such as nausea and vomiting, and depressive mood are often masked by physical symptoms, so it is also called depressive isotopia. Most patients do not see a psychiatrist, but go to other departments for treatment. Physical examination and auxiliary examinations often have no positive findings and can easily be misdiagnosed as neurosis or other physical diseases. Symptomatic treatment is generally ineffective, but antidepressant treatment is more effective.

V Early symptoms of depression

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1. Depressive moods vary in degree, ranging from mild bad mood to sadness, pessimism, despair. The patient feels heavy-hearted, life is boring, he cannot be happy, he is depressed, his days are like years, and he is in unbearable pain and cannot extricate himself. Some patients may also experience anxiety, irritability, and nervousness.

2. Loss of interest is one of the common symptoms of depressed patients. Loss of enthusiasm and fun in previous life and work, and no interest in anything. Unable to experience family happiness, disdain for past hobbies, often living alone behind closed doors, alienating relatives and friends, and avoiding social interactions.

Patients often complain of “no feelings anymore”, “emotional numbness”, and “cannot be happy anymore”.

3. Loss of energy, fatigue and weakness, difficulty in washing, dressing and other small things in life, and feeling powerless. Patients often use "mental breakdown" and "deflated ball" to describe their condition.

4. Low self-evaluation: Patients often underestimate their own abilities and view their present, past and future with a critical, negative and negative attitude. This is not good, and that is not right either. If you are useless, your future will be dark. Strong self-blame, guilt, sense of uselessness, worthlessness, and helplessness. In severe cases, self-guilt and hypochondriacal ideas may appear.

5. Patients are in a significant, persistent, and widespread state of depression, with difficulty concentrating, memory loss, brain dullness, blocked thinking, and slow movement. However, some patients show restlessness, anxiety, tension, and agitation.

6. Negative and pessimistic: Feeling very painful, pessimistic, and desperate in the heart, feeling that life is a burden and not worth lingering on, seeking relief through death, which can lead to strong suicidal thoughts and behaviors.

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. They are very common, but not in every case. ?

8. Loss of appetite and weight loss: Most patients have symptoms of loss of appetite and poor appetite. Delicious food is no longer tempting. Patients do not want to eat or drink, or their food is tasteless, which is often accompanied by weight loss. .

9. Sexual dysfunction: Reduced sexual desire can occur in the early stage of the disease, men may suffer from impotence, and female patients may have a lack of sex appeal.

10. Sleep disorders: A typical sleep disorder is waking up early, 2 to 3 hours earlier than usual, not falling back to sleep after waking up, and falling into a sad atmosphere.

11. Day and night changes: The patient's mood changes from heavy to heavy during the day and light at night. She falls into a low mood in the early morning or morning, gradually improves in the afternoon or evening, and is able to have brief conversations and meals. The incidence of diurnal changes is about 50%.

Self-test and diagnosis methods for depression

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Depression is a common mental illness, mainly characterized by low mood. Decreased interest, pessimism, slow thinking, lack of initiative, self-blame, poor diet and sleep, worry about suffering from various diseases, feeling multiple discomforts throughout the body, and in severe cases, suicidal thoughts and behaviors.

Depression has the highest psychiatric suicide rate. Depression has now become the second most important disease in the world that imposes a serious burden on mankind. The pain it causes to patients and their families and the losses it causes to society are unmatched by other diseases. The main reason for this situation is society's lack of correct understanding of depression, and prejudice makes patients reluctant to seek psychiatric treatment. In China, only 5% of patients with depression have received treatment. A large number of patients do not receive timely diagnosis and treatment, their condition worsens, and they even have serious consequences of suicide. On the other hand, due to the public's lack of knowledge about depression, they mistakenly believe that those who experience depressive symptoms are in a mood, and cannot provide due understanding and emotional support, which causes greater psychological pressure on the patients and further worsens the condition. Here's a simple way to tell if you have depression.

Please read the following questions carefully, circle the score that best suits your situation, and then add up the scores. If the score is above 15, it means you should go to the hospital for treatment. A score between 5 and 15 indicates that you have a certain degree of depression and should seek medical help. If you have thoughts of suicide or harming others, tell your doctor right away. The score for each item is: 0 points for “not”, 1 point for “sometimes”, 2 points for “sometimes”, and 3 points for “often”.

1. Do you feel depressed and melancholy?

2. Do you find it difficult to do the things you used to do now?

3. Do you feel panic or fear for no reason?

4. Do you cry easily or feel like crying?

5. Are you less interested in doing things you used to do?

6. Do you feel restless or uneasy?

7. Is it difficult for you to fall asleep easily at night without taking medicine?

8. Do you feel anxious as soon as you leave your room?

9. Have you lost interest in things around you?

10. Do you feel tired for no reason?

11. Do you lose your temper more than usual?

12. Do you wake up earlier than usual and never sleep well after waking up?

Diagnosis of depressive neurosis

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There are certain psychological and social factors as inducements, chronic onset, definitely but not too serious The main basis for diagnosing depressive neurosis is that depression is accompanied by neurotic symptoms, work, communication, and living abilities are slightly affected, there is a desire to seek treatment, the personality is complete, and the course of the disease lasts for more than 2 years. The following 10 items can be used as a reference for diagnosing depressive neurosis:

(1) There was a depressive personality before the disease;

(2) It was induced by mental factors;

(3) Psychomotor inhibition is not obvious;

(4) No biological symptoms such as weight loss and anorexia;

(5) Depression is the main symptom;

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(6) Accompanied by anxiety symptoms;

(7) No serious self-blame;

(8) No psychotic symptoms such as delusions and hallucinations;

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(9) There is a requirement for active treatment;

(10) There has been no break between attacks in the past.

The incidence of depression

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Depression is called the "blue worry" in the West. According to relevant surveys, in The incidence rate of depression in our country is about 3-5, and currently more than 26 million people suffer from depression. With the development of society, white-collar workers living in big cities such as Beijing, Shanghai and Guangzhou have quickly become a high-risk group for this disease in a high-pressure and highly competitive environment. Regrettably, in sharp contrast to the high incidence rate, the current recognition rate of depression in hospitals at or above the prefecture level across the country is less than 20%. Among current patients with depression, less than 10% receive relevant medication. According to the latest survey statistics of the World Health Organization, the global incidence of depression is about 3.1%, while in developed countries it is close to 6%. In 2002, there were more than 89 million patients with severe depression worldwide, and the number of depression patients worldwide has reached 340 million. Among adults aged 20 and over, depression is increasing at an annual rate of 11.3%. It is expected that the incidence of depression will rise to 8-10% in developed countries by 2005; by 2020, the functional residues responsible for severe depression will rise to second place in the general category of diseases, second only to ischemic heart disease . The situation of depression in our country is not optimistic either. The current incidence rate of depression in our country is about 4%. According to epidemiological survey data in some areas using the new disease classification and diagnosis system, the prevalence of depression in my country is about 10‰ to 15‰, which is similar to the statistical results of developed countries. Neuropsychiatric diseases rank first in the total disease burden in my country, accounting for approximately 20% of the total disease burden. According to estimates by the World Health Organization, the burden of neuropsychiatric diseases in China will rise to 1/4 of the total disease burden by 2020. Data show that 70% of people in our country are in a sub-health state, and patients with psychological stress-related diseases account for about 5% to 10% of the population. Physical and mental diseases and psychological disorders have become frequently-occurring and common diseases.

In 2002, the amount of neurological drugs used in typical hospitals in key cities in my country reached about 1.42 billion yuan, with the proportion in Beijing, Shanghai and Guangzhou accounting for 63.28%, and antidepressants accounting for about 1/5.

Self-regulation of depression

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Depression is a common mental illness, mainly characterized by pessimism, despair, irritability, diet Changes in habits, insomnia, decreased interest or distraction, suicidal thoughts, resistance to fulfilling social responsibilities, extreme fatigue, slow response or sensitivity, etc. If the above symptoms persist for a long time, you should seek medical advice from an expert as soon as possible in order to receive timely treatment. In addition, self-care is also crucial for early recovery.

Do what interests you most. If you are not successful in your career, find ways to improve your skills and start with the things you are most interested in; or look for other opportunities for success. Plan to do activities that can gain happiness and confidence, especially on weekends, such as cleaning the house, riding a racing car, writing letters, listening to music, going shopping, etc. In addition, it is also important to maintain a normal routine in life. Try to eat on time, have a regular daily life, and arrange a period of time every day for physical exercise. Participating in physical exercise can improve people's mental state, improve the function of the autonomic nervous system, and is beneficial to people's mental health.

Make good friends. People who keep in touch with friends often have a much better mental state than those who live alone, especially when the situation is bad. "Friends are good doctors." To make friends, you must first make friends with someone you can confide in, and you must also make friends who are interesting, funny, and enjoyable. Develop the habit of staying in regular contact with friends, which can avoid and heal feelings of loneliness and divorce, and reduce symptoms of depression.

Avoid taking certain medications. Oral contraceptives, barbiturates, cortisone, sulfa drugs, and reserpine can cause depression and should be avoided as much as possible.

In addition, eating more foods rich in vitamin B and amino acids, such as cereals, fish, green vegetables, eggs, etc., is also beneficial to getting rid of depression.

Treatment methods for depression

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Understand in advance:

Many types of antidepressant drugs and psychotherapy Can treat depression. For some patients, antidepressants are more effective; for others, psychotherapy is more effective; and for most patients, both may be most effective together. Especially for patients with severe depression, medications can be used to reduce depressive symptoms relatively quickly, while psychotherapy teaches patients how to reduce their depressive symptoms and deal with the problems in their lives that often trigger depressive symptoms.

Depending on the severity of your symptoms, your doctor may ask you to take medication or undergo psychological treatment. Most people with depression do not require hospitalization. Electroconvulsive therapy is often an effective treatment for patients with severe depression and those who cannot take antidepressant medications, especially when antidepressant medications are not effective enough in reducing depressive symptoms.

After depression, you must first use antidepressant drugs. After taking them for a period of time, you can cooperate with a psychiatrist for psychological treatment. It is still necessary to insist on taking medication during psychotherapy. Generally speaking, depression can be cured if you persist in taking medication for more than 5 years after the first episode of depression is diagnosed.

In recent years, another type of traditional Chinese medicine meridian therapy has emerged. This is a product that uses harmless nano-biotechnology to treat insomnia and depression. It uses silicon chips made of special materials to act on special acupuncture points of the human body. , producing acupoints and meridians effects. Promote the restoration of balance in the (own) nervous system, comprehensively adjust the functions of the human nervous system, correct the obstacles in the network interconnection of the human nervous system, promote the normal secretion of the neurotransmitter serotonin, and fundamentally solve the basic problems of insomnia and depression. , so as to achieve the purpose of curing insomnia and depression...

In addition:

The risk of another depression after the first episode is almost 50%; the risk of the third episode reaches 70%; If the disease recurs for the third time, the risk of recurrence in the future is as high as 90% or more.

Countermeasures: Adequate maintenance treatment can significantly reduce the risk of recurrence. Regular outpatient visits plus continuous drug treatment can keep about 80% of patients in a stable state

Differential diagnosis of depression:

(1) Endogenous depression:

If you have one of the following symptoms, you should consider the possibility of endogenous depression:

1. Have a history of mania or depression in the past.

2. There is a history of mania or depression in the family.

3. Mania manifested during the course of the disease.

4. There is psychomotor retardation.

5. Waking up early or symptoms changing from mild to severe in the morning and evening.

6. Low visceral function, loss of appetite or weight loss, but no physical disease.

7. Ideas of self-guilt, any fantasies or delusions

8. Serious suicide attempts or multiple suicide attempts.

9. Unable to take care of oneself, with a serious lack of insight.

(2) Reactive depression:

If one of the following conditions exists, the possibility of reactive depression should be considered:

1. Acute onset, The course of the disease was less than half a year.

2. It is obviously induced by environmental factors, and the symptoms are related to environmental factors.

3. Mental trauma often lingers in the mind and is difficult to get rid of.

(3) Depressive state caused by drugs:

Patients may have a history of drug use.

(4) Organic disease or depressive state associated with the body:

Organic disease can be found.

(5) Depressive state associated with other neurosis and psychosis:

Except for depressive symptoms, the patient has no other symptoms of neurosis or psychosis.

Diagnosis of depression:

(1) Meet the diagnostic criteria for neurosis.

(2) Long-lasting mild to moderate depression is the main clinical phase, accompanied by at least three of the following symptoms.

1. Interest decreased but not lost.

2. Be pessimistic and disappointed about the future, but not despair.

3. Feeling tired or low in energy.

4. Self-evaluation has declined, but is willing to accept encouragement and help.

5. Not willing to take the initiative to interact with others, but good at passive contact and willing to accept sympathy and support.

6. I have thoughts of death but have many worries.

7. Feeling that the condition is serious and difficult to treat, but taking the initiative to seek treatment in the hope of being cured.

(3) None of the following symptoms

1. Obvious psychomotor inhibition.

2. Early awakening and symptoms that are severe in the morning and light in the evening.

3. Serious guilt and self-guilt.

4. Persistent loss of appetite and significant weight loss (not caused by physical disease).

5. More than one suicide attempt.

6. Unable to take care of oneself.

7. Hallucinations and delusions.

8. Lack of insight.

The incidence of depression:

According to foreign statistics: the prevalence of this disease is 4.5 per 1,000, accounting for about 5-10% of psychiatric outpatients. A 1982 domestic epidemiological survey of 12 regions showed that the prevalence of the disease was 3.11 per 1,000, accounting for 14.0% of neurotic patients. The prevalence in rural areas (4.12 per 1,000) was higher than that in cities (2.09 per 1,000). The disease mostly begins in adolescence, and adult patients are more common in women than men.

The causes of depression:

The occurrence of this disease is related to the patient's psychological quality and social psychological factors.

(1) Psychosocial factors

The onset of most patients is triggered by psychosocial stress; however, this type of stress is mostly caused by contradictions and conflicts in daily life, and almost all People have experienced it in their lives, so it is difficult to be used as the cause of the disease, and at best it can only be used as an inducement.

(2) Psychological quality

1. Genetic factors

According to the survey, patients’ families suffer from emotional diseases, neurosis, personality disorders, alcoholism and The rate of suicide and other diseases is higher than that of the general population, reflecting the genetic heterogeneity of the disease. At the same time, heredity determines the susceptibility to the disease, that is, the personality quality of suffering from the disease.

2. Personality characteristics

Some patients have obvious personality abnormalities before the disease, such as dependent type and histrionic type. Or borderline personality traits, etc. The outstanding characteristics of his personality are low self-esteem, lack of self-confidence, and severe inferiority complex. It is easy to be pessimistic and disappointed when encountering setbacks. It can also manifest as timidity and fear of getting into trouble, obvious dependence and passivity, weakness and sensitivity, etc. Some patients' depression and personality defects are intertwined and difficult to separate, which is called personality depression.

Various manifestations of male depression

Psychiatrists at the New York Medical Center in the United States pointed out that depressed men need to help themselves

Data show that nearly 70% of male patients with depression Diseases are taboo and medical treatment is taboo. As everyone knows, male depression is easier to cure. Therefore, once male friends suffer from depression, they should seek treatment in time. In addition, if male patients want to get out of the haze of depression as soon as possible, self-help is also very important. Psychiatrists at the New York Medical Center have prescribed a self-help prescription, which is also recommended by the American Psychological Association (APA).

Don’t blame yourself. Depression is a disease and you have no power to create or choose it. Therefore, instead of blaming yourself "Why did I get this damn disease?" understand that you are in urgent need of help and actively embark on the road to recovery.

Follow the treatment plan carefully. Take your medicines as prescribed and see your doctor regularly. This allows doctors to accurately monitor the efficacy and adjust treatment plans and medications in a timely manner.

Don’t be discouraged. Tell yourself that it will take some time to get back to normal, so don't rush. Always tell yourself "I'm going to get better."

Avoid making major life decisions. When you suffer from depression, your ability to make important decisions is affected. Therefore, it is best to wait until your depression is gone and you are confident in your decision-making ability before making major decisions.

Simplify your life. After suffering from depression, you need to make appropriate changes in your life. Don't expect to be the same as you were before the onset of the disease. If you find something too difficult to do, just ignore it. If you also ask yourself to be able to do many things at the same time or complete a task quickly like a healthy person, you may feel inadequate and become more frustrated.

Participate in activities. Participate in some activities that you are good at and that give you a sense of accomplishment. Even if you are just a bystander at first, don't give up these opportunities. Such activities can gradually restore your self-confidence and are very helpful in treating depression.

Recognize small improvements. As long as your depressive symptoms improve a little, you should learn to be content. This will allow you to gradually regain your vitality and find your once healthy self little by little.

Prevent recurrence. One way to prevent relapse is to nip it before it happens. First of all, strictly follow the treatment plan formulated by the doctor and maintain good living habits. Second, stay alert to signs of recurrence. Although the signs of recurrence are different for everyone, you should pay attention if you get up early, eat less than usual, feel particularly irritable, or are indifferent to everything. If it lasts for about two weeks, please seek medical attention immediately.

Self-regulation of depression

Depression is a common mental illness, mainly characterized by pessimism, despair, irritability, changes in eating habits, insomnia, reduced interest or distraction, There are suicidal thoughts, resistance to fulfilling social responsibilities, extreme fatigue, slow reaction or sensitivity, etc. If the above symptoms persist for a long time, you should seek medical advice from an expert as soon as possible in order to receive timely treatment. In addition, self-care is also crucial for early recovery.

Do what interests you most. If you are not successful in your career, find ways to improve your skills and start with the things you are most interested in; or look for other opportunities for success.

Make good friends. People who keep in touch with friends often have a much better mental state than those who live alone.

In addition, eat more foods rich in vitamin B and amino acids

1. Set a practical goal.

2. Accurately define your goals.

3. Divide your action plan into small enough steps to ensure that your plan can be completed.

4. Use your own behavior to define success.

5. There should be no emotional component in the goal.