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- Sad for a long time: doctors talked about the peculiarities of dealing with prolonged depression
Sad for a long time: doctors talked about the peculiarities of dealing with prolonged depression
It's rare for a Russian to not think about depression in the fall. This condition is mistakenly attributed to a slight melancholy and longing for the past summer. However, this syndrome is much more complicated and dangerous than just sadness. Is it possible to adapt to depression, what will happen if you ignore the advice of doctors, and what threatens a quiet nervous breakdown — in the material of Izvestia.
No sleep, no rest
In clinical practice, depression is regarded not just as a "bad mood", but as a specific syndrome, explained to Izvestia in the psychiatric and drug treatment clinic of Dr. Isaev.
— In Russian psychiatry, it is customary to talk about the "depressive triad": low mood, slow thinking, motor inhibition, — says the head of the Clinic, psychiatrist, narcologist Ruslan Isaev. — To this are added sleep disorders, appetite, decreased energy, loss of interest in habitual activities, feelings of guilt or worthlessness, suicidal thoughts.
Unlike short-term sadness, depression is stable, the expert warns. It lasts at least two weeks, does not depend directly on external circumstances and leads to a significant decrease in working capacity and social activity.
"The causes of depression are always multifactorial: hereditary predisposition, changes in neurotransmitter metabolism and hormonal levels, chronic somatic diseases, stressful or traumatic events," Ruslan Isaev lists. — Depression most often occurs at the intersection of biological vulnerability and external stressors.
Autumn depression is not a myth, but it is not an axiom either
Seasonal affective disorder exists, but it is less common than commonly thought, says Ruslan Isaev. In some people, depressive episodes do recur mainly in autumn and winter.
— They are accompanied by characteristic drowsiness, lethargy, and cravings for carbohydrates. In spring and summer, variants with insomnia, irritability, and decreased appetite are described. However, most depressive episodes are not strictly tied to the season. What is commonly called the "autumn blues" is not a clinical depression," explains Ruslan Isaev.
The risk group includes people with a family history of depression or other affective disorders, who have suffered severe stress and loss, have chronic diseases, especially neurological and endocrine, as well as people with addictions, Isaev emphasizes.
— The reason for going to the doctor is a persistent depressed mood for more than two weeks, loss of interest in life, decreased working capacity and social activity. You should immediately seek help if you have suicidal thoughts or actions," Ruslan Isaev warns.
What not to do:
— waiting for it to "pass by itself";
— try to treat depression with alcohol or psychoactive substances;
— shut yourself in, stay isolated;
— prescribe any medications for yourself (or cancel previously prescribed ones).
How to reduce the risk of depression
According to Ruslan Isaev, depression can take a chronic course. Living with depression without treatment means constantly being in a state of reduced quality of life, increased risk of somatic complications and suicide.
— Modern psychiatry has effective treatment methods – antidepressants of different groups, psychotherapy, combined approaches. Treatment is selected individually, based on the severity and related factors. Therefore, you should not live with depression and try to adapt to it," sums up Isaev.
There is no guaranteed protection against a painful condition, but it is possible to reduce the risk. The greatest benefits, according to Isaev, are:
— regular physical activity;
— stable sleep and nutrition regime;
— restriction of alcohol and other psychoactive substances;
— maintaining social ties, having trusting communication;
— stress management, including psychotherapy;
— clear life goals and activities that bring a sense of meaning.
These measures are not a substitute for treatment, but they can significantly reduce the likelihood of relapse in those who have already experienced depression.
— Alcohol and illegal substances do not treat depression, but, on the contrary, worsen the course, — says the narcologist. Alcohol is a depressant: after a short—term mood boost, depression, anxiety, and insomnia increase. Regular alcohol consumption forms an addiction, which in itself significantly increases the risk of suicide.
Any psychoactive substances create the illusion of short-term relief, but then a sharp decline occurs, which significantly increases depressive symptoms, Isaev notes.
"Therefore, trying to 'drown out' depression with psychoactive substances is one of the worst and most dangerous strategies, leading to a double pathology: a combination of depression and addiction, which complicates both the course of both diseases and their treatment," the narcologist comments.
What is a silent breakdown?
Recently, in addition to classical depression, Russians have been hearing the so-called silent breakdown. From the outside, a person looks very successful, but at some point surprises others by the fact that even against the background of external well-being, he suddenly closes in on himself and, in a psychological sense, gives up.
According to psychiatrist and psychotherapist Alexei Vilkov, the condition called a silent breakdown is well known to specialists. There are two variants of this problem. In the first case, such a breakdown is a sign of the most common type of depression — apathetic. A person's motivation and activity in all areas decreases, there is no desire to do anything, and indifference appears.
— Another option is neurasthenia, that is, emotional exhaustion, burnout, when due to heavy loads, prolonged stress and lack of proper rest, complete apathy occurs, there is no strength and motivation to do the usual thing, — explains Alexey Vilkov.
You can understand yourself and differentiate an unpleasant condition at the appointment of a psychotherapist or psychiatrist. You should not ignore the warning signs.
When it is necessary to treat nerves
Sometimes, as a complication of severe depression, a person may have suicidal thoughts, warns Alexey Vilkov. Especially if there are some external factors and psychological problems. And if there are signs of endogenous depression, even external stress is not needed to worsen the situation — a violation of neurotransmitter metabolism plays a fatal role.
The suicide of Alexander Tyunin, CEO of the scientific and production company Khimprominzhining, was widely discussed online. Judging by the contents of the suicide note, he committed suicide due to a prolonged depression that lasted for the fifth year. The man passed away, unable to find the strength to fight.
— This situation is quite rare if a person is seen by a specialist and receives medical help, — comments Alexey Vilkov. — Usually, the specialist notices changes in the patient's condition. When depression worsens and outpatient care is ineffective, according to indications, a person is referred to a hospital for treatment.
The psychiatrist emphasizes that a tragic ending in the case of depression is possible precisely if a person does not consult a doctor or is observed by a doctor irregularly, refuses treatment, does not take medication. Those who are trying to cope with depressive experiences on their own are also at risk. You should not ignore the first signs of depression, and you should not hesitate to ask for help. Sometimes even the closest people try to cheer up a relative with common words: "get it together, you can do it," "you're just manipulating, everything is fine with you," "there is no depression, it was invented by charlatans." Alexey Vilkov notes with regret that a situation where family members do not believe that their loved one is really depressed, or consider his condition to be a manifestation of laziness, moods and temporary weakness, is quite common. The person is trying to match the optimistic calls, but the situation is only getting worse.
— Here you need to take into account objective data — what the specialist says, to focus on your feelings, — says Alexey Vilkov. — An adult, an adult, must make a decision on his own and seek help, especially if he does not feel support from his loved ones.
The psychiatrist believes that each case should be considered individually, but emphasizes that a person should first take care of his own health, notice the first signs of deterioration.
— If the depression is prolonged, then in this state a person already psychologically does not have the strength and resources to engage in psychotherapy, understand himself, and look for the causes of depression. He just doesn't have any emotions. And it is only by taking medications that you can improve your condition in a short time and achieve either remission or cure," says Alexey Vilkov.
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