Severe depression is a complex mental disorder that occurs due to various factors, which is characterized by a constant feeling of overwhelming melancholy, a sense of worthlessness, emotional imbalance, and pessimism about everything. Psychologists note that every fifth person is susceptible to depression, regardless of social and financial status, as well as age and gender.

Severe depression causes

The causes are conventionally divided into two groups: psychological, which affect the soul, and physiological, which arise due to a disorder in the production of neurotransmitters.

Psychological causes include stress, various mental traumas: the death of loved ones, the experience of physical violence, presence at disasters. Often this condition disappears after two months, but in the absence of proper help it can drag on and become serious.

Constant stressful situations include minor troubles that last a long time. Such provoking troubles include living in the same territory with an unwanted person who is annoying; doing unloved work; poverty; chronic diseases that reduce quality of life. Old trauma refers to injuries received in childhood that suddenly resurface.

Frustration is the next cause of severe depression. This state is characterized by a feeling of unfulfilled desire.

The next reason is an existential crisis, which manifests itself in the loss of meaning, goals, and a sense of harmony. It is often both a sign and a cause of severe depression.

Physiological causes include overwork, exhaustion, cerebral circulatory failure, poisoning with alcohol, drugs, and medications; menopause, strokes, traumatic brain injuries, irregular sex life, as well as its absence; hormonal diseases, insufficient physical activity, diseases of internal organs, unhealthy diet, defects of the neurotransmitter system, hypovitaminosis. It must be borne in mind that depression caused by a single cause rarely appears. Often there are several in a complex. It is important to consider all reasons. Success in treatment depends on this.

Severe depression symptoms

Symptoms of severe depression: low mood, loss of pleasure and interests, decreased energy, increased fatigue, decreased activity and concentration, low self-esteem and lack of confidence, ideas of self-deprecation and guilt, a pessimistic and gloomy vision of the future; suicidal tendencies, sleep disturbances, loss of appetite.

The main symptoms of severe depression include the patient's daily depressed mood, decreased interest in previous activities, deterioration in the ability to think and concentrate, hesitation and indecisiveness, lethargy, changes in psychomotor activity, and loss of libido.

The clinical characteristics of severe depression are differentiated by the leading affect. Melancholy depression has an affect of melancholy, the experience of a life impasse, hopelessness, lack of perspective, chest sensations of heaviness, deterioration in the morning, psychomotor retardation, and disturbances in night sleep in the second half of the night.

Anxious depression is marked by the expectation of misfortune in the future, feelings of lack of air and anxiety in the chest, mental pain, psychomotor agitation, worsening of the condition in the evening, difficulty falling asleep, as well as worsening of night sleep in the first half of the night.

Apathetic severe depression is manifested by an affect of apathy with a painful feeling of laziness, as well as passivity, inability to exert volition, inactivity, and drowsiness.

Severe depression signs

If a person for a long time does not have enough strength or desire for anything and cannot force himself to start doing at least something, while a bad, indifferent mood is constantly present, then these are signs of a depressive state. Laziness, under the guise of which hides apathy and lack of desire for any activity, is also a sign of illness.

In a person with severe depression, the biochemical processes in the brain change, and these changes provoke laziness. In the brain, the transmission of three neurotransmitters is disrupted: serotonin, dopamine, norepinephrine. If they are not sufficiently transmitted from one neuron to another, then the patient experiences a deficiency of energy, a decrease in mood, and apathy appears. It becomes impossible to “pump yourself up”. If you do not include drug treatment, then over time the person will be too lazy to get out of bed, he will lose all interest in life, in people. Severe depression can trigger various negative consequences. The person will become anxious and experience manic fear.

Severe depression in pregnant women can lead to miscarriage, so expectant mothers should be careful about their health, and if they notice the first signs of depression, consult a doctor.

Severe depression and suicide

During a period of severe depression, when a person is overcome by a painful state, the instinct of self-preservation is suppressed and unbearable mental pain takes over, provoking thoughts of suicide. Suicide occurs in 15% of cases of all unrecognized disorders and often occurs after 5 years of illness. If there is severe depression, the patient has an obsessive desire to punish himself and not burden his loved ones with caring for himself. The patient is haunted by a delusional conviction about the meaninglessness of his existence.

Severe depression can be so debilitating that patients become weak and unable to take their own life, but after they begin to recover from this state, suicide attempts occur.

The patient is able to develop a suicide plan in detail, and after experiencing temporary relief, he will create an imaginary impression of an improvement in his condition, while still thinking about suicide.

The risk of suicide in severe depression increases in lonely people who suffer from somatic diseases, as well as in patients who have relatives who committed suicide. The suicidal period in severe depression includes premenstrual syndrome, as well as the anniversary of a tragic event for the patient.

Severe depression - what to do? This disorder requires immediate treatment, since a severe form of the disease can become chronic. Therefore, if you notice the first manifestations of a depressive state, consult a doctor.

Severe depression treatment

Treatment for severe depression includes family and individual counseling. The psychologist's attention will not be ignored by such conditions as difficulties in communication, violation of mutual understanding with parents, spouse, children, loved ones; divorce, experiencing personal crises, death of a loved one, separation from a loved one, fears, loneliness, self-doubt, loss of meaning in life, raising teenagers and children, psychosomatic diseases.

In the case of a severe neurotic form with autonomic dysfunction, it is necessary to be examined by a neurologist, have an EEG, MRI, REG done to exclude all kinds of vascular disorders, as well as traumatic brain injuries, intoxications, and neuroinfections.

Women should exclude the possibility of an early onset of menopause, for which they need to contact a psychoendocrinologist (endocrinologist), as well as a gynecologist. If necessary, the autonomic and hormonal imbalance caused by menopause should be eliminated.

Severe depression is treated according to the classical scheme. First, you need to choose a psychotherapist whom you can trust and decide on medication and psychotherapeutic treatment.

When choosing a medication option, give preference to drugs from the SSRI group - Rexetine, Paxil, Fluoxetine, Fevarin, Prozac, Asentra, Cipramil, Zoloft, Pram, Cipralex, as well as other modern antidepressants - Coaxil, Venlaxor, Remeron, Mirzaten, Valdoxan.

Internal tension, anxiety, as well as lack of sleep are eliminated by tranquilizing drugs - Alprazolam, Relanium, Alzolam, Diazepam, Mezapam, Nozepam, Phenazepam, Reladorm, Nitrest, Nitrazepam.

When choosing non-drug treatment, you should consult a clinical psychologist or psychoanalyst. Next, regular and direct work with a specialist begins. Working with a psychotherapist and a psychoanalyst is effective with regularity and a real desire to change what causes difficulties and provokes suffering. A pronounced personality disorder requires more effort on both sides. It will be unrealistic to resolve the problem in a few sessions; you need to be patient.

Treatment of severe depression includes classical psychoanalysis, psychodrama, symboldrama, cognitive behavioral psychotherapy, existential, body-oriented, Gestalt psychotherapy in group and individual versions.

Clinical depression comes in different forms. The most common are bipolar (manic) depression and major depressive disorder (MDD). There are some other, less common, forms of this disease.

Depressive states can vary in severity:

• Mild depression: the patient experiences isolated symptoms of depressed mood, but is able to engage in normal activities.
• Moderate Depression: Several symptoms of depressive disorder are diagnosed and result in a person's inability to carry out their daily activities.
• Severe depression: a person has all or almost all the symptoms of the disease, against which he is unable to do anything that was previously available to him, or it is extremely difficult for him to cope even with ordinary tasks in everyday life.

It is the severe form of depression that will be discussed in this article.

In diagnostic manuals and international statistical classifications, this condition corresponds to a severe depressive episode, in which symptoms such as a disorder of self-awareness, impaired social functioning, complete inability to perform household self-care and inability to satisfy biological needs (refusal of food, sexual activity) are observed.

In this condition, four or more symptoms are observed, some of which reach a severe degree of severity. Severe depression is also characterized by a high risk of suicide.

Experts classify the causes of depression according to their origin.

Physiological reasons

• Poisoning with medications, alcohol, drugs: such intoxication leads to various disorders of the central nervous system, which may well provoke the appearance of a depressive disorder.
• Traumatic brain injuries: contusions to the frontal and temporal parts of the brain contribute to the occurrence of melancholy, anxious and apathetic depression.
• Diseases of the cardiovascular system: the risk of developing depressive conditions in patients suffering from cardiovascular pathology increases significantly compared to people who do not have such pathology.
• Sedentary lifestyle, poor diet: these factors predisposing to obesity can also trigger the development of depressive disorder.
• Hormonal imbalances: depression can be caused by damage to the glands and endocrine organs.
• Stress is a state of psychological and physical tension that occurs in difficult and beyond human control situations.
• An existential crisis is a personality crisis, which is expressed in a state of anxiety, internal disharmony and a feeling of deep psychological discomfort arising from the loss of the meaning of life.
• Mental trauma is damage caused to the human psyche in situations of powerful influence of unfavorable environmental factors (natural and man-made disasters, terrorist attacks, wars), or harm from the effects of acute emotional stress (death of significant people, violence, loss of property).
• Frustration is a mental state that occurs in a person due to the inability to satisfy needs.

Psychological reasons

All existing forms of depression belong to a group of diseases under the general name - affective disorders. Moreover, each of them has its own clinical picture and symptoms. However, the main symptoms characteristic of a severe depressive episode can be identified:

• Decreased mental activity: significant difficulty concentrating, problems with remembering information and making decisions.
• Chronic fatigue, decreased vital energy.
• Feelings of self-blame, devastation, despondency, uselessness and hopelessness.
• Appetite and sleep disorders.
• Complete loss of interest in the surrounding reality, favorite activities, hobbies, work activities.
• Physical symptoms that are not amenable to traditional treatment: headaches and heart pain, indigestion, a feeling of heaviness in the intercostal space.
• Unfounded fears.
• Constantly recurring thoughts of suicide, attempts to commit suicide, self-harm.
• Severe psychomotor impairment.
• Social isolation by choice.
• Lack of need for sex (complete loss of libido).
• Significant decrease in self-esteem.
• A vision of the future in dark colors.

Among other things, with severe depression, the patient experiences a pronounced depressive mood most of the time every day, which intensifies in the morning. Sometimes depression is combined with psychotic symptoms: hallucinations, delusions and depressive stupor.

What should you do if you, a member of your family or another person significant to you has become a victim of this disease? A person with severe depressive symptoms, regardless of the presence or absence of psychotic symptoms, requires urgent inpatient treatment.

What to do for those who have become victims of severe depression

If symptoms of a severe depressive episode are detected, the patient must contact a psychoneurological clinic. Treatment of severe depression, which is accompanied by a long duration and severe limitation of activity, is carried out using combination therapy: taking antidepressants and tranquilizers.

Psychotherapy in this case is secondary, but no less mandatory. However, due to their indecisiveness and lethargy, people suffering from depression are often unable to decide on treatment. It is easier for them to do nothing, leaving themselves in the care of family members who, in their opinion, can make this decision for them.

It is important for relatives of a person suffering from depression to remember that due to the high likelihood of suicide, patients need help from specialists such as a psychiatrist, psychotherapist and clinical psychologist.

Drug therapy takes place in three stages:

• Selection of antidepressants and their adequate dose.
• Carrying out a course of therapy designed to minimize the symptoms of the disease.
• Implementation of a set of preventive measures, as well as supportive treatment for several months after the patient’s condition has normalized.

Non-drug therapy:

Non-pharmacological therapy can improve the effectiveness of drug use. However, its use is justified only when drug treatment brings significant relief to the patient. If this is the case, then the psychotherapist selects an appropriate form of psychotherapy for the patient that will help him cope with the disease. The most commonly used types of psychotherapy in practice, with the help of which depression disappears into oblivion, are:

• Cognitive-behavioral therapy: The therapist seeks to help patients identify distortions in their thinking and bring it into line with reality, as well as learn to modify actions and behaviors that increase the severity of depressive experiences.
• Psychodynamic therapy: internal conflicts that are unconscious to a person are considered as the psychological basis of depressive disorders. The psychotherapist focuses the patient's attention on awareness of the conflict and helps to effectively resolve it.
• Interpersonal therapy: depression here is interpreted as a result of difficulties in interpersonal relationships. The psychotherapist teaches the patient effective forms of interaction with others.
• Family therapy: the task of the psychotherapist is to familiarize the patient’s family members with the illness that is tormenting him. The specialist helps the patient's relatives understand what and how they need to do to achieve the best treatment results for their loved one.

In addition, at the discretion of the physician, treatment with light therapy, hypnotherapy, and electroconvulsive therapy (ECT) may be used in selected cases. The use of the latter is advisable for the following groups of patients:

• Patients who truly cannot take their medications on their own.
• Patients with severe depressive and manic states.
• Patients with psychosis who exhibit suicidal tendencies.
• People whose severe depression does not respond to other treatments.

The quality of electroconvulsive therapy has improved significantly in recent years. So, at the present stage, the patient is given a muscle relaxant before the procedure. Treatment with ECT is carried out under general anesthesia.

During the procedure, the patient does not realize that he is being stimulated. The doctor attaches electrodes to certain areas of his head: electrical impulses lead to a short convulsion of the brain. This treatment consists of several sessions and is very effective.

Prevention

It is important to know that the risk of recurrent depression, especially in severe cases, is about 70%. What should a person do if depression has returned, because successful treatment does not guarantee that a relapse will not occur.

Experts say that if the patient continues to take the same dose of antidepressants that was prescribed to him during a severe depressive episode, a recurrence of the disease can be avoided.

Interpersonal therapy is also effective during periods when a person is not taking medications.

You can prevent depression from driving you into a corner again with the help of general preventative tips for maintaining mental and physical health:

1. Follow a daily routine, sleep at least eight hours a day.
2. Lead a healthy lifestyle, try to avoid smoking and drinking alcohol.
3. Eat right, move more. You don't have to run in the morning; you can do exercises or go to the pool.
4. Avoid stressful situations whenever possible. You won’t be able to completely eliminate stress from your life, but minimizing it is quite possible.
5. Organize leisure time with your loved ones and friends.
6. Don't forget to devote time to your personal affairs and hobbies.
7. Make plans for the future.

Physiological

• overwork;
• sedentary lifestyle;
• poor nutrition.

Psychological

1. Stress– the body’s reaction to a factor that disrupts the stable state of the nervous system. Very often stress factors are troubles at work or school, or family difficulties.
2. Frustration- a state that arises as a result of a discrepancy between what is desired and what is actually realized, the effect of unfulfilled hopes.
3. Mental trauma– damage caused to a person as a result of a single or repeated exposure to adverse factors: physical or sexual violence, death of a loved one, presence during the commission of violence, disaster.
4. Existential crisis– a personality conflict that arises as a result of the loss of the meaning of life, goals and priorities, and internal harmony.

1. Bio-psycho-social model considers the causes of depression as a complex: disorders of health, physiology, psyche and social realization of the individual. A prime example is postpartum depression. Here we can talk about a change in the social role of a woman-mother, and about biological, hormonal changes, and about mental changes - the emergence of a sense of responsibility for the child, fears of making a mistake and harming him.
2. Biological model The main causes of severe depression are hormonal imbalances and other neurochemical processes.
3. Psychological model puts stress factors, communication problems in society and in the family in the first place.
4. Social model considers severe depression as a consequence of social isolation, high competition in society, difficult economic situation, instability - political and economic.

Symptoms and signs

Physiological

• appetite disorders;

Emotional

• sudden mood changes;

Behavioral

Thinking

• feeling of uselessness;
• thoughts of suicide;
• inhibition of reactions;

1. Postpartum depression caused by a complex of reasons, often becomes severe. After childbirth, physiological and hormonal changes occur, and a reassessment of values ​​and one’s social role occurs. There is no single factor; a complex of reasons operates.
2. Manic-depressive form characterized by relapse of symptoms, there are periods of agitation. The danger of this form is that it is often ignored, explaining mood swings by fatigue, stress or bad character.
3. Severe depression against the background of schizophrenia: it acts either as its main symptom or as a consequence of other symptoms.
4. Senile form associated with age-related changes. In men it occurs later than in women. Most often, a person suffering from senile depression has not previously had other forms of this disease. Characteristic: withdrawal from social contacts, withdrawal into oneself, decreased tone.

What can it lead to?

The consequences of severe depression can follow a person throughout his life:

1. Loss of social status.
2. Suicide attempts.

What to do? Treatment

1. Biological therapy: The patient is helped to get rid of depression with the help of antidepressants prescribed by the doctor. While taking medications, regular visits to your doctor are necessary.
2. Psychotherapy:

• Family therapy.
• Group therapy.

Video: How to cope

Symptoms and treatment of severe depression

Severe depression is a complex mental disorder in which a person feels worthless and is constantly in a state of overwhelming sadness and apathy.

• Symptoms and treatment of severe depression
• Causes of severe depression
• Symptoms of depression
• How to cure severe depression?
• Severe depression as a complex mental illness
• Symptoms of severe depression
• Severe depression and suicide attempts
• Treatment of severe depression
• Symptoms, causes and consequences of severe depression
• Severe depression: what is it?
• Causes
• Physiological
• Psychological
• Symptoms and signs
• Physiological
• Emotional
• Behavioral
• Thinking
• Forms
• What can it lead to?
• What to do? Treatment
• Video: How to cope
• How to recognize and treat severe depression?
• Causes of severe depression
• Genetic factors
• Social and psychological factors
• Organic factors
• Signs that can help diagnose severe depression
• Psychotic signs of depression
• Somatic signs
• Consequences of a major depressive episode
• Suicide: when is it possible?
• Treatment of severe depression
• Antidepressants
• Tranquilizers and neuroleptics
• Psychotherapy
• Prevention of depression and duration of therapy
• Severe depression
• Severe depression causes
• Severe depression symptoms
• Severe depression signs
• Severe depression and suicide
• Severe depression treatment
• Doctors specializing in Medical Psychology
• Medical psychology:
• Our doctors

The disease can occur against the background of various factors - mental trauma, imbalance in the body, stress.

All segments of the population are susceptible to depression, regardless of gender, age, financial and social status. It is almost impossible to get out of depression on your own. Therefore, at the first signs of this condition, you should immediately seek help from a psychotherapist.

Causes of severe depression

Depression can manifest itself for various reasons, which are classified according to their origin into physiological and psychological. Physiological reasons are:

• various types of poisoning - alcohol, drugs, medications;
• hormonal imbalance;
• unhealthy diet and sedentary lifestyle;
• head injuries;
• cardiovascular diseases.

Psychological factors include:

• mental trauma arising from disasters, wars, loss of loved ones, physical violence;
• stressful situations provoked by poverty, chronic illnesses, unbearable work, living with hateful people;
• personal or existential crisis, characterized by internal discomfort, anxiety and loss of meaning in life;
• a state of frustration as a consequence of the inability to satisfy one’s desires and needs.

Depression is always caused by a number of reasons. There are rare cases when a disease manifests itself under the influence of only one cause. If all of them are taken into account, success in treatment is guaranteed.

Symptoms of depression

The depressive state is divided into 3 stages according to severity. With a mild disorder, the patient does his usual activities, but is constantly in a depressed mood. At the moderate stage, disorders are observed in which a person is no longer able to carry out daily activities. With severe depression, the patient cannot cope with himself and the assigned tasks. All stages of depression belong to affective disorders and differ in their symptoms and clinical picture.

Symptoms of severe depression affect both a person's nervous system and physical condition. The patient's level of vitality decreases, chronic fatigue is observed, sleep and appetite are disturbed. It is very difficult for a person with such a disease to concentrate his thoughts and attention, remember information and make any decisions. There is a feeling of helplessness, uselessness, emptiness. The patient is constantly depressed, renounces the world around him, and isolates himself. A person’s self-esteem decreases, suicidal thoughts and self-flagellation appear. In addition to psychological disorders, physical symptoms are observed: heaviness between the ribs, headaches and pain in the heart, stomach problems, psychomotor disturbances, and the need for sex disappears.

There are several types of severe forms of depression: melancholy, anxious and apathetic. The melancholy form is characterized by hopelessness, lack of aspiration, deterioration in the morning state, heaviness in the chest, retardation of movements and insomnia during the second half of the night. The apathetic form is characterized by the manifestation of passivity and laziness, drowsiness and inactivity. With anxious depression, mental anguish, agitation, deterioration in the evening, and sleep disturbances in the first half of the night are observed. The patient is in anticipation of trouble.

Signs of the disease manifest themselves in apathy, indifference, reluctance to do anything, and lack of strength. Depression can change the biochemical processes in the brain, which provokes laziness. Lost interest in the world around us and in people. The patient experiences fear and anxiety, mood deteriorates and energy decreases significantly. With disorders over a long period, a person can no longer fight mental anguish and a painful state. Delusional thoughts arise about a meaningless existence, an obsession with punishment and ridding loved ones of self-care. All this provokes thoughts of suicide.

How to cure severe depression?

In a state of deep depression, the patient cannot independently find a way out. If you notice symptoms of the disease, your family and friends should consult a psychotherapist and be patient. People suffering from depression cannot decide on such a move themselves because of their inhibition and indecision.

Treatment of severe depression is a rather lengthy process, which includes combination therapy with antidepressants and tranquilizers, as well as psychotherapy.

Due to the high risk of suicide, the patient will need the help of a psychotherapist, clinical psychologist and psychiatrist.

The stage of deep depression is treated with antidepressants, which gradually and slowly improve the patient’s mood and increase the patient’s activity. Pharmacotherapy also includes the use of sleeping pills and tranquilizers, which can relieve internal tension, get rid of anxious feelings and eliminate insomnia.

Along with drug therapy, psychotherapy is no less important. Together, these methods allow you to get rid of the disease forever. The use of non-pharmacological methods increases the effectiveness of drug use. In psychotherapy, there are several methods that can be used to get out of a depressive state: cognitive-behavioral, family, interpersonal and psychodynamic therapy. The psychotherapist selects treatment for each patient individually, based on the symptoms of the disease.

People suffering from deep depression and severely inhibited reactions require treatment in special psychiatric clinics. The help of inpatient clinics lies in the fact that the patient has a beneficial effect on a change of environment, a reduction in the workload in hospital conditions, and the connection between interpersonal relationships is broken. It is very difficult to treat such patients. It is important to find an approach, even if the patient does not make contact and remains indifferent.

When a person begins to feel more independent and relaxed, thinking is restored, activity and mood improve, it is necessary to return him to the previous rhythm of life. There are various training programs for this. Activities where patients can do something with their own hands have a beneficial effect on depressed patients. In addition to the main treatment, restorative therapy is used - walks, massages, thermal treatments, listening to music.

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Source: depression as a complex mental illness

Severe depression as a complex mental illness is characterized by a person’s feelings of depression, melancholy, emotional discomfort, pessimism and indifference. Approximately 20% of people on the planet are susceptible to depressive disorders, but some do not even think about the presence of such a disease. That is why it is very important to know the causes, symptoms and methods of treating this disease.

There are two main groups of causes of severe depression: psychological and physiological. Reasons of a psychological nature include various stresses, mental trauma, for example, the death of loved ones, problems at work and in personal life, divorce, and so on. As a rule, after some time this state of mind disappears, but in some cases it remains for months and develops into a disease.

Today, every person, to a greater or lesser extent, is exposed to frequent stress. This could be a poor financial situation, conflicts at work, rudeness from a stranger, traffic jams, and so on. And childhood traumas, for example, poor upbringing or bullying from peers, significantly increase the likelihood of a serious illness.

Psychological causes include frustration and existential crisis. Frustration is a mental state characterized by the impossibility of fulfilling one’s desires and hopes. And an existential crisis arises due to a person’s loss of the meaning of life and a sense of harmony.

The main physiological causes include physical fatigue, exhaustion of the body, traumatic brain injury, alcohol or drug abuse, poor sleep and nutrition, hypovitaminosis, and a sedentary lifestyle. Severe depression occurs due to several factors from different groups, not just one. Considering all these reasons, one can hope for effective treatment.

Symptoms of severe depression

Symptoms of this mental disorder include:

A sick person cannot think at the same level, all his actions become inhibited, he is not interested in his previous hobbies, and he becomes very indecisive. The clinical picture of this disease is differentiated by the main affect. It is characterized by the affect of worries, melancholy, lethargy, hopelessness, sleep disturbances, and so on.

Severe depression is characterized by severe anxiety, which manifests itself in constant anticipation of future misfortune, mental pain, lack of oxygen, especially bad mood in the evenings and poor sleep in the first half of the night. Apathetic depression is also possible, when a person becomes passive and lazy, does nothing and sleeps in bed all day long.

The first symptoms of severe depression are considered to be a lack of strength in a person to perform any work, lack of desires, indifference, and laziness and apathy are frequent additions to the clinical picture. Depression is also accompanied by physiological changes in the body.

Thus, in the brain the ratio of the hormones serotonin, dopamine and norepinephrine changes significantly. Their insufficient quantity leads to a decrease in vital energy, mood and the appearance of apathy. It becomes increasingly difficult for a sick person to force himself to do something, so he spends boring days in bed.

If you do not start taking medications in the first stages of such a disorder, then depression will only intensify, becoming severe. In addition to thoughts of suicide, she is characterized by manic fear and constant anxiety, so it is very difficult for such a person to live and work in a team.

Expectant mothers especially need to take care of their psychological health, because severe symptoms of the disorder can lead to illness in the child or even to miscarriage. Therefore, it is necessary to immediately consult a doctor at the first symptoms.

Severe depression and suicide attempts

Severe depression as a complex mental disorder is characterized by a suppressed instinct of self-preservation. This is why, when signs of depression reach their peak, many people experience thoughts and even attempts at suicide. According to statistics, if a person does not treat the disorder and has been ill with it for more than 5 years, then suicide attempts are observed in 15%. They arise due to the patient’s feeling of defenselessness and doom, as well as due to the reluctance to burden family members with their problems. If a person loses the meaning of life, then the appearance of such thoughts is only a matter of time.

Severe depression and suicide attempts are characterized by even the development of a suicide plan. If a person’s mood improves, then he does not stop thinking about it. Lonely people who do not have someone who can listen to them and help them are most susceptible to such thoughts. Also, if a person has had loved ones or acquaintances who committed suicide, this further increases the risk of premature death.

To prevent the disease from becoming chronic, it is necessary to begin its immediate treatment. The first thing to do if you have signs of depression is to see a doctor.

Treatment of severe depression

In the treatment of human mental disorders, individual and family psychological sessions are used. The psychologist carefully studies all aspects of the patient’s behavior, for example, his manner of communication, relationships with his spouse, children, parents, emotions that arose after separation, accidents, improper upbringing, and so on. If the symptoms of the disease are quite severe, then it is necessary to undergo examination by a neurologist, do an MRG, an EEG to identify possible skull injuries and intoxication.

After choosing a psychotherapist, severe depression is treated with medication. The most common drugs are antidepressants Remeron, Valdoxan, Coaxil, tranquilizers Alzolam, Mezapam, Reladorm, Alprazolam and others. But the prescription of such drugs occurs only after a thorough examination of all the symptoms that accompany the disease.

The body is examined for the possibility of an allergic reaction to the drugs. Also, if a person has high blood pressure, then not all medications can be prescribed to him. This means that you should never take anti-depression medications on your own.

Source: Causes and Consequences of Severe Depression

Severe depression is the most complex form of depression. Signs of the disease manifest themselves in behavior, physiology, and the emotional sphere. How to diagnose and cure this disease, and not allow it to ruin a person’s life?

Severe depression: what is it?

Depression is a disease of the 21st century. This has been confirmed by research by scientists around the world. Depending on the severity, severe, moderate and mild forms are distinguished.

Severe depression is a complex, multifaceted mental disorder, a serious illness that affects communication, ability to work, and general physical tone.

This form is considered the most critical and has physiological, behavioral, mental, and emotional manifestations. According to statistics, severe depression is a common illness among residents of developed countries.

Causes

A person is susceptible to depression regardless of his social and financial status. Researchers classify the causes of depression depending on the nature of their origin.

Physiological

• poisoning or overdose of medications, alcohol, drugs;
• cerebral circulatory disorders.
• overwork;
• injuries (mainly traumatic brain injuries).
• cardiovascular diseases;
• hormonal abnormalities, irregular sex life;
• sedentary lifestyle;
• poor nutrition.

Psychological

1. Stress is the body’s reaction to a factor that disrupts the stable state of the nervous system. Very often stress factors are troubles at work or school, or family difficulties.
2. Frustration is a state that arises as a result of a discrepancy between what is desired and what is actually realized, the effect of unfulfilled hopes.
3. Mental trauma is damage caused to a person as a result of a single or repeated exposure to unfavorable factors: physical or sexual violence, death of a loved one, presence during the commission of violence, disaster.
4. An existential crisis is a personal conflict that arises as a result of the loss of the meaning of life, goals and priorities, and internal harmony.

Modern scientists have conducted a number of studies, as a result of which models of the main factors of severe depression have been identified:

1. The bio-psycho-social model considers the causes of depression as a complex: disorders of health, physiology, psyche and social realization of the individual. A prime example is postpartum depression. Here we can talk about a change in the social role of a woman-mother, and about biological, hormonal changes, and about mental changes - the emergence of a sense of responsibility for the child, fears of making a mistake and harming him.
2. The biological model names hormonal imbalances and other neurochemical processes as the main causes of severe depression.
3. The psychological model puts stress factors and problems in communication in society and in the family in the first place.
4. The social model considers severe depression as a consequence of social isolation, high competition in society, a difficult economic situation, and instability - political and economic.

Symptoms and signs

How does severe depression manifest? The symptoms of severe depression are multifaceted. The most typical manifestations are as follows.

How does autumn depression manifest in women? Read on.

Physiological

• disorders of the digestive system;
• pain in the muscles, heart, headaches;
• high fatigue, drowsiness or insomnia against a background of general weakness;
• appetite disorders;
• lack of sexual needs.

Emotional

• state of despair, melancholy, sadness;
• sudden mood changes;
• constant self-flagellation - blaming oneself for all failures, heightened feelings of guilt;
• insensitivity – a person is unable to rejoice or have pleasure;
• heightened sense of anxiety, danger;
• loss of interest in what is happening around.

Behavioral

• lack of work activity, lack of initiative;
• consumption of alcohol, psychotropic substances;
• unauthorized social isolation, solitude;
• refusal of active recreation, walks, entertainment.

The first 3 groups of reasons are noticeable from the outside, but the last one does not always manifest itself openly.

Thinking

• feeling of uselessness;
• pessimism, gloomy perception of the world;
• thoughts of suicide;
• inhibition of reactions;
• it is difficult for a person to concentrate and make a decision.

Borderline symptoms are hallucinations that develop against the background of other mental disorders.

Forms

Reactive is the most common and simplest form of depression. It mainly exists in mild or moderate forms. The factor is any event: moving, dismissal, death of a loved one, divorce, ruin.

What all these factors have in common is the loss of something. It becomes severe in cases of lack of qualified assistance.

1. Postpartum depression is caused by a complex of reasons and often becomes severe. After childbirth, physiological and hormonal changes occur, and a reassessment of values ​​and one’s social role occurs. There is no single factor; a complex of reasons operates.
2. The manic-depressive form is characterized by a relapse of symptoms and periods of agitation. The danger of this form is that it is often ignored, explaining mood swings by fatigue, stress or bad character.
3. Severe depression against the background of schizophrenia: acts either as its main symptom or as a consequence of other symptoms.
4. The senile form is associated with age-related changes. In men it occurs later than in women. Most often, a person suffering from senile depression has not previously had other forms of this disease. Characteristic: withdrawal from social contacts, withdrawal into oneself, decreased tone.

What can it lead to?

The consequences of severe depression can follow a person throughout his life:

1. Without treatment, depression can become more severe and last for years.
2. Loss of social status.
3. Suicide attempts.
4. Overflow into other mental illnesses.

Read the article on how to get rid of depression on your own.

What to do? Treatment

Remember: this disease must be treated! A patient with severe depression needs combined help. The main methods of treatment: medicinal biological and psychological.

1. Biological therapy: the patient is helped to get rid of depression with the help of antidepressants prescribed by the doctor. While taking medications, regular visits to your doctor are necessary.
2. Psychotherapy:

• Psychodynamic therapy is based on helping to overcome unconscious conflicts. The therapist helps to transfer the conflict into the conscious sphere and find a constructive solution.
• Cognitive therapy is complex in nature; the patient is helped to deal with everyday and social difficulties, unconscious problems, and behavioral manifestations of depression.
• Behavioral therapy focuses on current symptoms of depression: withdrawal from socializing, withdrawal from entertainment, and lack of interest in activities.
• Family therapy.
• Group therapy.

Treatment of severe depression requires the use of psychoanalysis, existential, behavioral, and body-oriented theories.

Video: How to cope

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Source: Recognize and Treat Severe Depression?

Severe depression is a mental disorder in which, along with a constant depressed mood, a marked decrease in interest in everything that was previously liked, and increased fatigue, there are suicidal thoughts, low self-esteem, excessive inadequate feelings of guilt, loss of appetite and a number of other signs.

It is necessary to understand that this condition is not laziness, not a whim of a person, but a dangerous disease that requires proper treatment!

To assess the severity of depression, they resort to additional research methods, special psychodiagnostic scales, the most accurate of which are the Hamilton Depression Severity Rating Scale, the Montgomery-Asberg scale, and the Beck scale.

Causes of severe depression

Why severe depression occurs in a particular person is one of the first questions a doctor will ask himself when communicating with a patient. Further treatment tactics will depend on this.

The role of genetic, organic and socio-psychological factors in the development of severe depression has been reliably confirmed.

Genetic factors

A significant part of severe depressive disorders are endogenous depressions. The latter arise due to a deficiency in the body of special substances called monoamines, which are involved in the regulation of emotions, cognitive processes, attention, and memory. These are the well-known norepinephrine, serotonin, and dopamine.

Depression may be one of the phases of bipolar disorder, a disease with a hereditary predisposition.

Social and psychological factors

Some people are predisposed to depression. They are distinguished by uncompromising, straightforwardness, and an “excessively serious” understanding of the sense of duty. The experiences of such people are affectively rich, but at the same time they tend to inhibit the external manifestation of emotions.

Social factors that can lead to the development of depression are bereavement (death of a loved one, divorce, separation), lack of social support, when a person has to overcome everything on his own, no one to expect help from, financial problems, loneliness, various serious illnesses and related with them are social problems and financial costs.

Organic factors

Depression can be not only an independent disease caused by genetic characteristics or social problems, but also a secondary pathology, a complication of another nosology.

Brain stroke, Huntington's chorea, Parkinson's disease, thyrotoxicosis, hepatitis, cancer and many other pathologies can be complicated by the development of a depressive episode.

Signs that can help diagnose severe depression

The current international classification of diseases, 10th revision, distinguishes 3 degrees of severity of depression (depressive episode):

1. mild depressive episode;
2. moderate depressive episode;
3. severe depressive episode with or without psychotic symptoms.

Main symptoms of depressive disorder:

• a depressed, clearly abnormal mood for a given person, which persists almost all the time, for at least two weeks;
• a distinct decrease in interest in activities that the person previously liked;
• severe fatigue, lack of energy.

These symptoms (or at least 2 of them) are almost always observed with depression of any severity.

• excessive unreasonable feelings of guilt or self-condemnation, it is these manifestations that can contribute to the emergence of thoughts of suicide;
• a gloomy, even pessimistic vision of the future;
• feeling of self-doubt, low self-esteem;
• recurring thoughts of suicide or even suicidal attempts (how to suspect the presence of suicidal thoughts in a person, during which periods the risk of attempting suicide is greatest, you can read about this in the article “Suicide with depression“);
• problems with concentration, the ability to think, the appearance of indecision;
• appetite disturbances (it can be either increased or decreased), combined with weight changes;
• sleep pathology;
• motor disorders manifested in the form of lethargy or severe emotional arousal.

Psychotic signs of depression

Psychotic manifestations that may be signs of severe depression:

• delusional ideas - unlike schizophrenia, which is characterized by delusions of a fantastic nature, with severe depression delusions of guilt, relationships, denial, nihilistic delusions (the patient claims that the world has stopped or internal organs have stopped working), hypochondriacal delusions (the patient is confident in the presence of a serious illness, although in fact there are no signs, he is completely healthy);
• hallucinations;
• depressive stupor - immobility, numbness.

Somatic signs

In severe depression, so-called somatic symptoms will almost always be present, which are not necessary in a mild or moderate depressive episode.

Somatic symptoms of severe depression:

• waking up in the morning 2 hours or even more before the usual time;
• mental state is more severe in the morning;
• significant decrease in appetite;
• lack of reaction to an activity, an event that in the past should have necessarily caused it;
• weight loss (5% or more of last month's weight);
• decreased sex drive.

Not every patient can have all of the listed symptoms of severe depression; sometimes, due to depressive stupor or strong emotional arousal (agitation), a person cannot talk about the manifestations of the disease that bother him; in this case, the information that close people can tell, how attentive they are, is very important were.

Consequences of a major depressive episode

A patient with severe depression is unable to lead a normal life, work, get around himself, take care of himself or someone else. As they say, it exists, but does not live.

This disease places an unbearable burden not only on the person himself, but also on his family and society as a whole. This is why this condition needs treatment. Waiting for a person to come out of severe depression on his own is extremely imprudent. So you can wait for the dangerous consequences of severe depression - a suicide attempt.

Suicide: when is it possible?

As a rule, patients with severe depression are lethargic and lethargic. Despite having suicidal thoughts, they do not have the strength to act on these thoughts.

There are 2 dangerous periods when the chances of committing suicide attempts are highest: the beginning of depression and the moment of recovery from it.

At the initial stages of a depressive episode, the mood is already painful, the patient may be visited by various bad thoughts, and motor retardation is not yet very pronounced. During such periods, it is necessary to carefully monitor the person so that he does not do something irreparable.

A similar situation occurs a couple of weeks after the start of treatment. The first symptoms that begin to improve with treatment for severe depression are movement disorders. Negative thoughts, unreasonable feelings of guilt, and a pessimistic vision of the future disappear a little later. During a slight improvement, patients can put into practice everything that they had time to think at the peak of depression. So during this period, maximum control is also necessary not only over the patient’s actions, but also over one’s words, so as not to say anything unnecessary or provoke the person to do something.

Support from loved ones and their care is necessary for depression of any severity, so I recommend reading the article “How to help someone with depression” to know how to support such a person, what you can say in his presence and what you shouldn’t.

Depression occurs a little differently in women than in men. That’s why I devoted a separate article to this topic.

Treatment of severe depression

How to get out of severe depression? Can I do this myself? These questions are most often asked by patients and their relatives.

The first thing to do is see a doctor. It is necessary to understand that severe depression is a serious mental disorder that not only negatively affects the patient’s life, but can also lead to dangerous consequences.

Such a disease does not go away without competent and comprehensive treatment.

In one of the articles, I already described the steps that need to be taken to get out of depression. These measures are very effective for mild or moderate depression, but for severe forms of the disease they are, unfortunately, powerless or ineffective. It is impossible to do without drug treatment.

Antidepressants

Antidepressants are medications that help normalize mental state. They eliminate motor, somatovegetative, and emotional manifestations of depression, thereby helping a person return to their previous pre-morbid state.

The choice of drug depends on a number of factors:

• existing symptoms;
• concomitant diseases;
• the effectiveness of treatment in previous episodes (if any);
• the patient’s level of income - if a person’s financial situation is not high, then it makes no sense to prescribe him effective but expensive drugs that he will not be able to take as long as he needs.

The main groups of antidepressants used to treat severe depression:

• serotonin and norepinephrine reuptake inhibitors (venlafaxine);
• selective serotonin reuptake inhibitors (paroxetine, fluvoxamine, sertraline);
• tricyclic antidepressants (amitriptyline, imipramine) and others.

Tranquilizers and neuroleptics

Another group of drugs actively used in the treatment of severe depression are tranquilizers (diazepam, clonazepam). These substances relieve anxiety, sleep disorders, and emotional tension.

If psychotic manifestations are present, then there is a need to prescribe antipsychotics. They help eliminate delusional ideas and hallucinations. In the treatment of depression, preference is given to atypical antipsychotics, such as risperidone, olanzapine, quetiapine.

Psychotherapy

To get out of severe depression, you need not only to take the medications prescribed by your doctor, you need to eliminate the external factors that caused this condition. Of course, it is not always possible to completely eliminate them, but you can change your attitude towards them, accept the current situation if there is nothing else left. It is best to work in this direction with a psychotherapist.

Psychotherapy is most effective in cases where socio-psychological factors are leading in the development of the disease. It is very difficult for a person to understand himself, his problems, complexes, relationships with other people, but a psychotherapist will help you look at the problem from the other side and find the right way out.

After watching this video, you will learn how depression and self-esteem are interconnected, a look at this problem from Jacques Fresco, designer and futurologist, organizer of the Venus Project.

In the complex treatment of depressive disorder, other non-drug methods of treating depression can be used.

Prevention of depression and duration of therapy

How to not only cope with severe depression, but also prevent its development in the future?

Treating severe depression is a long process. It is necessary to take medications not for a week or even a month. It turns out that the best prevention of severe depression and relapses of the disease in the future is compliance with the optimal treatment period.

Even if you feel practically healthy, this does not mean that you can stop taking your medications. You must carefully follow your doctor's recommendations.

There are 3 main phases in the treatment of depression, compliance with which is the best prevention of relapses of severe depression in the future:

1. The active treatment phase (acute) lasts about a month. During this time, many patients eliminate most of the symptoms of a mental disorder, their mood noticeably improves, and even their ability to work is restored. If treatment is interrupted at this stage, there is a high probability that after some time the disease will relapse and the symptoms will return again.
2. The stabilizing phase (ongoing) begins after remission is achieved. However, even a significant improvement in mental state does not mean that the disease has receded forever. It is necessary to continue treatment, take antidepressants, albeit in smaller doses. The duration of this phase is from 6 months to 1 year.
3. The maintenance phase consists of taking the minimum dose of the drug necessary to control the course of the disease. The duration of this phase is determined individually.

I experienced severe depression myself: I couldn’t do anything, I didn’t want to live, my mood was constantly terrible, I even had thoughts of suicide several times, that in this way I would save myself and my family from all the problems. It’s good that I didn’t give in to such thoughts.

If it weren’t for the treatment in the neurosis department, I don’t even know what would have happened to me. There they prescribed me antidepressants, gave me an eye drop, and after ten days my condition began to improve little by little.

Vika, I’m glad for you that you were able to overcome severe depression. Thank you for sharing your positive experience.

When I remember myself just six months ago, it seems that I was a completely different person. I didn’t feel anything, I didn’t want anything, I couldn’t do anything. It seemed to me that I had lost all feelings, that I was only disturbing my husband and children, that if I died, their life would only get better. True, I did not have the strength to commit suicide. Now I understand that I had very severe depression. It’s good that my husband insisted on treatment. In the hospital they put me on drops and gave me different pills to take, but thank God, 3 weeks after the start of treatment I felt like a completely different person, as if I had returned to life.

Vika, I am sincerely happy for you!

In my life I have experienced all the horrors of severe depression. When you have no strength to do anything at all, when it seems that life is a real hell, and everything will only be terrible, when you blame yourself for everything, when you have no strength for either your children or your husband. Thanks to my husband for noticing my condition, insisting on treatment, and supporting me all the time. And now I understand what edge I was on, and I feel much better.

Yes, I also felt this condition myself. Moreover, it manifested itself for me over the course of 3 years: in spring and autumn. Eternal brokenness inside, everything was falling out of my hands, I have no strength to do anything, I don’t want to see anyone and I’m always in no mood... It was very difficult for me then.

Hello! For quite some time now I have been wondering whether I am normal or not?

I’m 25 years old, I live with my parents, mostly with my grandmother. I have a normal job (what I wanted to do and worked towards it for a long time), and at the same time I’m getting a graduate degree in absentia. I love my family and they love me very much. Everything seems to be fine, I’m happy, I had a happy childhood. It seemed that I should rejoice in my happiness. But it doesn't work. From childhood, as far as I can remember, I was terribly withdrawn and uncommunicative, I was embarrassed by everyone, although sometimes there were very rare gaps. There were no friends. Or rather, there were no permanent friends. They still don't exist. In children in kindergarten and elementary school he was very aggressive and pugnacious. Now, on the contrary, he is quite peaceful and harmless. However, even from my school years, I began to notice that quite often (this feeling grew over the years) I was visited by some kind of melancholy, a feeling of hopelessness and a vile, destructive apathy. These negative experiences appear several times a year (although I did not follow any pattern in the manifestations). But when I “calm down” in time, there still remains an unpleasant feeling that “it” has not left me - “it” is always nearby, invisibly present and waiting for the right moment to take up residence in my head again. “It was and is, and joy and fun (although it seems to me that I have stopped experiencing these wonderful emotions, or I do, but somehow not consciously) even if they do not exist for long. Almost constantly haunted by a feeling of loneliness, misunderstanding, and abnormality. I don’t tell my family any of this (I don’t understand why, I’m probably embarrassed), and I don’t tell anyone what’s going on inside. During my school years I read books, and as a student I tried to play sports seriously. I even competed several times, I really enjoyed it, there were so many emotions and experiences! But in addition to these positive moments, there were frequent, very frequent injuries and I was told that this sport (Muay Thai) was not for me, it would cripple me. I felt it myself. As a result, I gave up training. I can't finish anything. I abandoned everything that I could call my hobby sooner or later. The loneliness and alienation that haunted me came back to haunt me. And to get rid of them, at the age of 21 I started smoking hashish and marijuana. No, they didn’t save me from this; on the contrary, I plunged even deeper into my experiences while in a “trip” state. It seemed to me that this was exactly what I needed all my conscious life, anyway, after all, I would soon die and no matter how. And in the absence of grass, I drank alcohol and got to the point that to this day I can’t completely part with it. As a teenager, I had abnormal thoughts - for example, I wanted to become a maniac, and Jack the Ripper was almost an idol. Now this is not the case, but sometimes I think, maybe I’m not a person at all? Well, that is, a bodily shell, yes, but in reality? Who am I? How can I continue to live? Well, I will definitely work (especially since I dreamed of this job and found it with difficulty). And what else? Why is it that if I'm happy, I don't feel it? Why is there no joy in life? Why am I like this in the end? I am absolutely sure that I will never get married, start a family like all normal people and will not have time to grow old. Thoughts of suicide visited me, but I coped with them. Sometimes I fantasized about standing in a hemp field, dousing myself with solvent and burning myself. The skin burns - I’m alive, the eyes burst and flow - I’m alive...

Physically, I seem to feel fine, I eat with pleasure, I just get up poorly and periodically feel slightly unwell during the day.

My memory was crap before, but now I’m so completely absent-minded, I’m terribly inattentive, I forget everything, I lose everything. They said that in childhood I had something like encephalopathy and a disturbance in the emotional-volitional sphere. Now it seems not.

Andrey, first of all, you need to stop using drugs. Nothing good will come from this for sure! The source of positive emotions must be sought elsewhere - in travel, in hobbies.

You can contact a psychotherapist or psychologist so that a specialist can help you understand yourself and your experiences.

Now I am in the deepest depression. During the next attack she almost threw herself out the window, but her husband stopped her. My parents hate me, I don't have a single person I can talk to. My husband doesn't want to support me. I think I’ll go to a psychiatrist tomorrow, otherwise I’ll commit suicide in a state of passion, and I have two children.

Nadezhda, you urgently need to see a psychiatrist.

I also suffer from terrible depression. And what is typical is that it repeats itself every six months. The most terrible condition is that I have lost interest in life. I am tired and have no strength. I go to doctors, but the city is small, there are few particularly good specialists. I take depressants but I suffer for 1.5 months. I have no education I work as a cleaner. But this doesn’t mean that depression needs to go away. In this state, I work, although it’s very hard. It always seems to me that there are no people like me. Sometimes it seems to me that I’m screwing myself up. But why don’t I always screw myself up and at times. It’s probably a disease. I don’t know, I’m lost, please help me. I have a family, a husband, two children. But I’m sick all the time, I’m pining away, I don’t live, I exist.

Svetlana, given that you experience symptoms of the disease regularly, you need to constantly take antidepressants.

Try to find a competent psychiatrist who will select treatment for you. And remember that only constant treatment in your case will alleviate the symptoms of the disease and allow you to lead a normal life.

For the last 2.5 years I have been under constant stress, I began to eat poorly, lose weight, and the last two months have been absolutely terrible, sometimes my child’s tests are bad, sometimes my cytology is bad, but thank God everything is fine, and then my husband left for another and this the day everything changed, I just stopped eating, no appetite, in the mornings and at lunch there is some kind of lump in my stomach, I feel bad, I can hardly force myself to get up, it’s heavy, nothing is interesting, life has lost all its charms. I visited a psychiatrist and prescribed Gidozepam 0.2 1/2 twice a day and Prodep, began to eat in the evening without disgust, but the ex came to work and it became even worse again. I eat with difficulty, there is no joy, I let it go a little in the evening. Am I thinking of going to the hospital?

Marina, first of all, you should pull yourself together. You are alive, healthy, you have a child.

Of course, it is very difficult if a loved one betrays you, but you can cope with it! You can't get limp! You can’t drive yourself into a swamp of self-pity.

Talk to a psychiatrist, it may be necessary to increase the dose of Prodep, or it has not yet begun to act (the effect of this drug appears only after 2-3 weeks). And if the condition fails to improve on an outpatient basis, then you can combine drug treatment with psychotherapy or go to a hospital.

Paranoia is a rare psychosis, the only manifestation of which is the gradual development of systematic

P.S. In continuation to my previous comment. I wrote it with t...

Do I have any feelings or emotions at all? What is in me...

Hello, please tell me, my brother thinks that he is being poisoned, will give birth...

Mental illnesses. Schizophrenia. Depression. Affective insanity. Oligophrenia. Psychosomatic diseases.

A severe form of depression is called major depressive disorder. Unlike other options, this is a real mental disorder, and not just a temporary deterioration in mood. MDD, or clinical depression, requires hospitalization in the vast majority of cases. The insidiousness of this state is that depression or melancholy may not be observed. However, most of the symptoms will be noticeable. The course of MDD is very difficult to predict. For example, depression without depression is only assessed by the patient in such a way that he does not notice the melancholy and depressed state. It is possible that due to the fact that a person experiences constant inexplicable anxiety and it does not allow him to realize the presence of an extremely bad mood. So, severe depression: symptoms and treatment of this disorder.

The danger of the situation is that the patients themselves, their loved ones, colleagues and friends often cannot understand that a person has severe depression. They popularly believe that a person has let something happen on himself, that he has come up with problems out of nowhere. Only people with appropriate professional training and those who were once treated themselves can understand the essence of what is happening. For the rest, including the patients themselves, for the time being everything seems not so serious. What is happening, how is it expressed?

• The patient experiences a gloomy mood most of the day.
• Nothing arouses interest, and what pleasure there is has long been forgotten.
• Constant feeling of loss of strength. Fatigue occurs after 5-10 minutes of any work - mental or physical.
• Decreased ability to concentrate on something.
• Loss of determination and difficulty making decisions. For example, patients may look at a store shelf for several minutes and think about what to buy. And then leave the department in confusion.
• Loss of self-esteem and self-confidence. If this is connected with the body, then panic attacks may occur as a reaction to the fact that the body seems to be somehow different.
• The desire to blame yourself for something and think that there is no forgiveness.
• The future is seen only in gloomy colors.
• The emergence of suicidal tendencies. There may also be a desire to damage one’s body.
• Sleep disorder.
• Loss of appetite. As a syndrome, it can take the form of anorexia nervosa.
• Weight reduction. Patients can lose weight even if their appetite is not lost and they eat relatively normally.
• Sexual dysfunction.
• Memory impairment.

Sometimes MDD takes on a resistant form. Then the effect of antidepressants decreases or disappears completely. Depression becomes chronic and is treated with great difficulty, and sometimes is not treated at all and continues until the end of the patient’s life.

Treatment of severe depression

The drug regimen is selected taking into account the symptoms and individual characteristics of the patients. The core consists of antidepressants. Their selection is quite a complex and responsible task. If the patient primarily needs stimulating antidepressants, and he uses a sedative, then increased lethargy, drowsiness will appear, and the ability to concentrate may seriously decrease. In the opposite case, when a sedative effect is required, and stimulants are prescribed, crises of anxiety disorders may appear or a desire for suicide may arise.

Suicidal thoughts are quite common in severe depression

In cases where the use of antidepressants does not give the expected effect, they switch to another pharmacological group of drugs or use combinations. A method is also used when, together with antidepressants, substances are prescribed that in themselves do not have any effect, but enhance what the antidepressants have.

Many studies show that signs of severe depression are more common in people who can be classified as economically and socially disadvantaged. These are those who do not have a permanent job, their own home, or a stable income. In terms of employment, the likelihood of developing MDD increases significantly if people are forced to do jobs that they do not like.

Patient lifestyle and MDD

Let's imagine such a way of life. In the morning, a person jumps up and rushes to get dressed, eating breakfast on the run. He is afraid of being late for a job he doesn't like. He runs where his legs cannot go. There he performs actions that are uninteresting to him and also receives scolding from his superiors. On the way home, to relieve stress using “improvised” methods, he goes to a bar and drinks a few glasses of beer. But it could also be something stronger. At this time, on TV they tell him what new terrorist acts have happened in the world, that the ceasefire has been violated in Donbass, and that the country is facing a new round of price increases. Arriving home, he receives a scolding from his wife, who was not delighted with his methods of relaxation. In response, he scolds her for the poorly prepared dinner, and she scolds him for the state of the wiring, which he never fixed. And all this time, somewhere in the depths there was also the question of how he would close the last loan. Our hero’s salary is below the regional average, and the management refers to the crisis and clarifies that they are not keeping anyone. Then another portion of TV shows and then he goes to bed with his wife. And nothing worked because of dysfunction. This was the last stress for today.

The paragraph above can be re-read several times, because all our hero’s days are the same. It is not at all necessary that he be a laborer. This is also how engineers, accountants and representatives of hundreds of intelligent professions live.

He considers advice about finding a new job and even a wife only as harmful. Another job is just a different place, but the essence is the same. And women are similar to each other. What difference does it make who you argue with in the evenings? With this one it’s at least familiar and logical.

People suffering from severe depression feel that there is no way out of this situation.

At a certain moment, there comes an understanding that this whole wheel of samsara, which is also a wheel for a two-legged squirrel, is life. It’s as if the psyche is deliberately spoiling itself, as if telling its owner that everything is very bad. And she's right, what's good about all this?

The task of psychotherapy

Let's try to imagine what this person could wish for. He doesn’t want it this way, but how does he want it? And there will be a deep stupor. A person does not know what he wants at all. In recent years, so-called wish fulfillment technologies have gained some popularity.

We will not make any judgments towards them. This is a separate topic. However, let us pay attention to this interesting phenomenon. Students of psychological thematic courses are told that they must form some kind of desire. And then supposedly abstract examples are given. A house, a car, some things, trips to exotic countries. Sometimes it means getting a good job. This is already the maximum - for the most gifted. With the development of individual ones, obvious tension can be traced.

Those who suffer from depression need to be told that every situation has a solution.

This person from the example with the squirrel in the wheel - he has no idea what he wants. Let's say he works as an engineer. He studied at a technical university. He doesn’t know how to write books, he doesn’t know how to compose music, and he doesn’t know how to draw either. What other dream job could he move to? And only a true adventurer can open his own company during the years of permanent crisis. If a person has worked as a technical clerk for five years, then his thinking has become appropriate. Only performers think this way...

Therefore, he does not know what his life could be like. Meanwhile, the problem has a solution. And it is simple, smart and correct. The task of psychotherapy is to teach a person how he could get such ideas into his head so that they inspire him. Of course, first you need to get him out of a state of major depression. But such therapy in itself does not make sense. As it goes out, so it goes in. It is necessary for the patient to have something that gives him wings... And this is always something surprisingly real, and not the wonders of idle speculation.

Example. For 10 years the person worked in the market supporting 1C software systems. And it seems that money knew how to run away from him. The more you work, the poorer you become. Sooner or later it turned out to be BDR. A psychotherapist worked with him. Already at the third session he comes with a mysterious smile on his lips. The doctor noticed, but did not clarify anything.

After about a month, the patient suddenly says:

• How could I not have thought of this before?

It turned out that he switched from supporting 1C to creating websites on 1C:Bitrix. Already the first two orders brought in a tidy sum. Firstly, he freed himself from his ever-sinking and annoying inferior business. Secondly, I began to engage in creative and favorite work. Thirdly, he made good money.

A qualified psychotherapist can help you cope with severe depression.

The psychotherapist understood that somehow websites were being made, but he had never even heard anything about Bitrix. The patient had already thought of this himself. During therapy, he learned to be attentive to subtle emotions and feel when his heart prompts the necessary steps. He took a step and suddenly realized that this was his, this was for him. Imagine, he had severe depression. What was needed to be done? Rebuild your thinking a little and the way out appeared on its own. The depression never returned.

Clinical depression can manifest itself in different forms, the characteristics of which depend on the severity and ethological factors. The most common are manic depression and major depressive disorder. There are some other, less common forms.

Depending on the severity of depression, there are:

• mild depression: symptoms of depressed mood, fatigue, but the person is able to engage in usual activities;
• moderate depression: a combination of several symptoms of a depressive disorder that lead to an inability to carry out daily activities;
• severe depression: all the symptoms of depressive conditions are present, which have a destructive and functional effect on a person, making him unable to perform even basic everyday tasks.

Major depression is the most complex form of depression. It corresponds to a severe depressive episode, in which the following are observed: a disorder of self-awareness, impairment of everyday self-care and social self-functioning. A person becomes unable to satisfy his biological needs: food, sleep, sexual relations.

A severe depressive state is dangerous due to its suicidal tendencies, as a result of deep introspection, self-flagellation, and low self-esteem.

Physiological causes of depression

Severe depression can be caused by a number of physiological factors, among which the most common are:

• Poisoning with medications, drugs, alcohol, leading to disturbances in the central nervous system, provoking the appearance of a depressive state.
• Traumatic brain injuries: bruises to the temporal and frontal lobes of the brain can lead to melancholy, apathy, and depression.
• Cardiovascular disease can cause symptoms of depression. According to statistics, depression is more common in people with diseases of the cardiovascular system.
• Factors predisposing to obesity (sedentary behavior, poor diet) contribute to the appearance of depressive states.
• Hormonal imbalance in the body caused by damage or pathologies of the endocrine glands.
• Stress, states of psychological tension that arise in various situations beyond a person’s control.
• Personal crisis periods, which are accompanied by states of anxiety, disharmony, deep psychological discomfort, the search for the meaning of life, and disappointments.
• Psychotraumas that occur under the influence of a number of environmental factors (natural factors, violence, loss of property, death of significant people).
• Frustration is a mental state in which it is impossible to satisfy needs.

Depression belongs to a group of diseases collectively called “affective disorders.” Each disease in this group has its own characteristics.

However, it is possible to identify general symptoms characteristic of most affective disorders:

In severe depression, the patient experiences a severe depressive state most of the time. It usually gets worse in the morning. Sometimes depression is combined with symptoms of psychopathy: hallucinations, delusions, stupor.

A severe depressive state is characterized by the fact that it is impossible to get out of it on your own. In addition to medical intervention, it is necessary to follow a number of everyday recommendations, the implementation of which is complicated by the patient’s condition. In this case, relatives and friends of a patient with severe depression can provide invaluable help.

If you discover symptoms of severe depression in yourself or a loved one, you should immediately contact a psychoneurological clinic. Treatment of severe depression is long-term and is carried out with the help of complex drug treatment: simultaneous use of and. Naturally, this should take place under the strict supervision of a doctor.

In the case of major depressive disorder, psychotherapy is secondary. However, it is no less mandatory. The reason for this is that the physiological signs of depression need to be relieved first. In addition, depressed patients find it difficult to decide on treatment. Moreover, they are not able to be active in this direction. Therefore, it is better to do drug therapy as the first stage, gradually “pulling up” psychotherapeutic therapy.

Relatives and loved ones of depressed patients need to remember the high risk of suicidal actions in severe forms of depressive conditions. Patients with severe depression need additional supervision from specialists such as a psychotherapist, clinical psychologist, and psychiatrist.

Drug therapy takes place in three stages:

• Stage 1: selection of the type and optimal dose of medications.
• Stage 2: conducting a course of medication to minimize depressive symptoms.
• Stage 3: implementation of a set of preventive measures and supportive therapy for the patient’s normal condition.

Non-drug treatment allows you to enhance the impact of drugs and make the first practical result of the treatment effect stable. However, the use of non-drug methods makes sense only after the use of medications that alleviate the symptoms of the disease. The doctor selects the most suitable and effective form of psychotherapy for the patient, with the help of which the patient’s mental state will be influenced.

The most common forms of psychotherapy:

• Cognitive-behavioral therapy to help patients identify distortions in their way of thinking and look for opportunities to modify actions and behaviors that have an increasing impact on depression;
• psychodynamic therapy with the aim of eliminating a person’s internal conflicts, which most often are not realized by a person;
• interpersonal therapy in order to identify difficulties in interpersonal relationships and master the forms and methods of interaction with others;
• family therapy with the goal of familiarizing the patient’s family members with the characteristics of severe depression and determining ways of psychological support for the patient by family and friends.

Electroconvulsive therapy is often used to treat severe forms of depression in hospital settings.

Severe depression is a complex mental disorder in which a person feels worthless and is constantly in a state of overwhelming sadness and apathy. The disease can occur against the background of various factors - mental trauma, imbalance in the body, stress.

All segments of the population are susceptible to depression, regardless of gender, age, financial and social status. It is almost impossible to get out of depression on your own. Therefore, at the first signs of this condition, you should immediately seek help from a psychotherapist.

Causes of severe depression

Depression can manifest itself for various reasons, which are classified according to their origin into physiological and psychological. Physiological reasons are:

• various types of poisoning - alcohol, drugs, medications;
• hormonal imbalance;
• unhealthy diet and sedentary lifestyle;
• head injuries;
• cardiovascular diseases.

Psychological factors include:

• mental trauma arising from disasters, wars, loss of loved ones, physical violence;
• stressful situations provoked by poverty, chronic illnesses, unbearable work, living with hateful people;
• personal or existential crisis, characterized by internal discomfort, anxiety and loss of meaning in life;
• a state of frustration as a consequence of the inability to satisfy one’s desires and needs.

Depression is always caused by a number of reasons. There are rare cases when a disease manifests itself under the influence of only one cause. If all of them are taken into account, success in treatment is guaranteed.

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Symptoms of depression

The depressive state is divided into 3 stages according to severity. With a mild disorder, the patient does his usual activities, but is constantly in a depressed mood. At the moderate stage, disorders are observed in which a person is no longer able to carry out daily activities. With severe depression, the patient cannot cope with himself and the assigned tasks. All belong to affective disorders and differ in their symptoms and clinical picture.

Symptoms of severe depression affect both a person's nervous system and physical condition. The patient's level of vitality decreases, chronic fatigue is observed, sleep and appetite are disturbed. It is very difficult for a person with such a disease to concentrate his thoughts and attention, remember information and make any decisions. There is a feeling of helplessness, uselessness, emptiness. The patient is constantly depressed, renounces the world around him, and isolates himself. A person’s self-esteem decreases, suicidal thoughts and self-flagellation appear. In addition to psychological disorders, physical symptoms are observed: heaviness between the ribs, headaches and pain in the heart, stomach problems, psychomotor disturbances, and the need for sex disappears.

There are several types of severe forms of depression: melancholy, anxious and apathetic. The melancholy form is characterized by hopelessness, lack of aspiration, deterioration in the morning state, heaviness in the chest, retardation of movements and insomnia during the second half of the night. The apathetic form is characterized by the manifestation of passivity and laziness, drowsiness and inactivity. When there is mental anguish, agitation, deterioration in the evening, sleep disturbance in the first half of the night. The patient is in anticipation of trouble.

Signs of the disease manifest themselves in apathy, indifference, reluctance to do anything, and lack of strength. Depression can change the biochemical processes in the brain, which provokes laziness. Lost interest in the world around us and in people. The patient experiences fear and anxiety, mood deteriorates and energy decreases significantly. With disorders over a long period, a person can no longer fight mental anguish and a painful state. Delusional thoughts arise about a meaningless existence, an obsession with punishment and ridding loved ones of self-care. All this provokes thoughts of suicide.

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How to cure severe depression?

The patient cannot find a way out on his own. If you notice symptoms of the disease, your family and friends should consult a psychotherapist and be patient. People suffering from depression cannot decide on such a move themselves because of their inhibition and indecision.

Treatment of severe depression is a rather lengthy process, which includes combination therapy with antidepressants and tranquilizers, as well as psychotherapy.

Due to the high risk of suicide, the patient will need the help of a psychotherapist, clinical psychologist and psychiatrist.

The stage of deep depression is treated with antidepressants, which gradually and slowly improve the patient’s mood and increase the patient’s activity. Pharmacotherapy also includes the use of sleeping pills and tranquilizers, which can relieve internal tension, get rid of anxious feelings and eliminate insomnia.

Along with drug therapy, psychotherapy is no less important. Together, these methods allow you to get rid of the disease forever. The use of non-pharmacological methods increases the effectiveness of drug use. In psychotherapy, there are several methods that can be used to get out of a depressive state: cognitive-behavioral, family, interpersonal and psychodynamic therapy. The psychotherapist selects treatment for each patient individually, based on the symptoms of the disease.

People suffering from deep depression and severely inhibited reactions require treatment in special psychiatric clinics. The help of inpatient clinics lies in the fact that the patient has a beneficial effect on a change of environment, a reduction in the workload in hospital conditions, and the connection between interpersonal relationships is broken. It is very difficult to treat such patients. It is important to find an approach, even if the patient does not make contact and remains indifferent.

The disease can occur against the background of various factors - mental trauma, imbalance in the body, stress.

All segments of the population are susceptible to depression, regardless of gender, age, financial and social status. It is almost impossible to get out of depression on your own. Therefore, at the first signs of this condition, you should immediately seek help from a psychotherapist.

Causes of severe depression

Depression can manifest itself for various reasons, which are classified according to their origin into physiological and psychological. Physiological reasons are:

• various types of poisoning - alcohol, drugs, medications;
• hormonal imbalance;
• unhealthy diet and sedentary lifestyle;
• head injuries;
• cardiovascular diseases.

Psychological factors include:

• mental trauma arising from disasters, wars, loss of loved ones, physical violence;
• stressful situations provoked by poverty, chronic illnesses, unbearable work, living with hateful people;
• personal or existential crisis, characterized by internal discomfort, anxiety and loss of meaning in life;
• a state of frustration as a consequence of the inability to satisfy one’s desires and needs.

Depression is always caused by a number of reasons. There are rare cases when a disease manifests itself under the influence of only one cause. If all of them are taken into account, success in treatment is guaranteed.

Symptoms of depression

The depressive state is divided into 3 stages according to severity. With a mild disorder, the patient does his usual activities, but is constantly in a depressed mood. At the moderate stage, disorders are observed in which a person is no longer able to carry out daily activities. With severe depression, the patient cannot cope with himself and the assigned tasks. All stages of depression belong to affective disorders and differ in their symptoms and clinical picture.

Symptoms of severe depression affect both a person's nervous system and physical condition. The patient's level of vitality decreases, chronic fatigue is observed, sleep and appetite are disturbed. It is very difficult for a person with such a disease to concentrate his thoughts and attention, remember information and make any decisions. There is a feeling of helplessness, uselessness, emptiness. The patient is constantly depressed, renounces the world around him, and isolates himself. A person’s self-esteem decreases, suicidal thoughts and self-flagellation appear. In addition to psychological disorders, physical symptoms are observed: heaviness between the ribs, headaches and pain in the heart, stomach problems, psychomotor disturbances, and the need for sex disappears.

There are several types of severe forms of depression: melancholy, anxious and apathetic. The melancholy form is characterized by hopelessness, lack of aspiration, deterioration in the morning state, heaviness in the chest, retardation of movements and insomnia during the second half of the night. The apathetic form is characterized by the manifestation of passivity and laziness, drowsiness and inactivity. With anxious depression, mental anguish, agitation, deterioration in the evening, and sleep disturbances in the first half of the night are observed. The patient is in anticipation of trouble.

Signs of the disease manifest themselves in apathy, indifference, reluctance to do anything, and lack of strength. Depression can change the biochemical processes in the brain, which provokes laziness. Lost interest in the world around us and in people. The patient experiences fear and anxiety, mood deteriorates and energy decreases significantly. With disorders over a long period, a person can no longer fight mental anguish and a painful state. Delusional thoughts arise about a meaningless existence, an obsession with punishment and ridding loved ones of self-care. All this provokes thoughts of suicide.

How to cure severe depression?

In a state of deep depression, the patient cannot independently find a way out. If you notice symptoms of the disease, your family and friends should consult a psychotherapist and be patient. People suffering from depression cannot decide on such a move themselves because of their inhibition and indecision.

Treatment of severe depression is a rather lengthy process, which includes combination therapy with antidepressants and tranquilizers, as well as psychotherapy.

Due to the high risk of suicide, the patient will need the help of a psychotherapist, clinical psychologist and psychiatrist.

The stage of deep depression is treated with antidepressants, which gradually and slowly improve the patient’s mood and increase the patient’s activity. Pharmacotherapy also includes the use of sleeping pills and tranquilizers, which can relieve internal tension, get rid of anxious feelings and eliminate insomnia.

Along with drug therapy, psychotherapy is no less important. Together, these methods allow you to get rid of the disease forever. The use of non-pharmacological methods increases the effectiveness of drug use. In psychotherapy, there are several methods that can be used to get out of a depressive state: cognitive-behavioral, family, interpersonal and psychodynamic therapy. The psychotherapist selects treatment for each patient individually, based on the symptoms of the disease.

People suffering from deep depression and severely inhibited reactions require treatment in special psychiatric clinics. The help of inpatient clinics lies in the fact that the patient has a beneficial effect on a change of environment, a reduction in the workload in hospital conditions, and the connection between interpersonal relationships is broken. It is very difficult to treat such patients. It is important to find an approach, even if the patient does not make contact and remains indifferent.

When a person begins to feel more independent and relaxed, thinking is restored, activity and mood improve, it is necessary to return him to the previous rhythm of life. There are various training programs for this. Activities where patients can do something with their own hands have a beneficial effect on depressed patients. In addition to the main treatment, restorative therapy is used - walks, massages, thermal treatments, listening to music.

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Severe depression as a complex mental illness

Severe depression as a complex mental illness is characterized by a person’s feelings of depression, melancholy, emotional discomfort, pessimism and indifference. Approximately 20% of people on the planet are susceptible to depressive disorders, but some do not even think about the presence of such a disease. That is why it is very important to know the causes, symptoms and methods of treating this disease.

There are two main groups of causes of severe depression: psychological and physiological. Reasons of a psychological nature include various stresses, mental trauma, for example, the death of loved ones, problems at work and in personal life, divorce, and so on. As a rule, after some time this state of mind disappears, but in some cases it remains for months and develops into a disease.

Today, every person, to a greater or lesser extent, is exposed to frequent stress. This could be a poor financial situation, conflicts at work, rudeness from a stranger, traffic jams, and so on. And childhood traumas, for example, poor upbringing or bullying from peers, significantly increase the likelihood of a serious illness.

Psychological causes include frustration and existential crisis. Frustration is a mental state characterized by the impossibility of fulfilling one’s desires and hopes. And an existential crisis arises due to a person’s loss of the meaning of life and a sense of harmony.

The main physiological causes include physical fatigue, exhaustion of the body, traumatic brain injury, alcohol or drug abuse, poor sleep and nutrition, hypovitaminosis, and a sedentary lifestyle. Severe depression occurs due to several factors from different groups, not just one. Considering all these reasons, one can hope for effective treatment.

Symptoms of severe depression

Symptoms of this mental disorder include:

A sick person cannot think at the same level, all his actions become inhibited, he is not interested in his previous hobbies, and he becomes very indecisive. The clinical picture of this disease is differentiated by the main affect. It is characterized by the affect of worries, melancholy, lethargy, hopelessness, sleep disturbances, and so on.

Severe depression is characterized by severe anxiety, which manifests itself in constant anticipation of future misfortune, mental pain, lack of oxygen, especially bad mood in the evenings and poor sleep in the first half of the night. Apathetic depression is also possible, when a person becomes passive and lazy, does nothing and sleeps in bed all day long.

The first symptoms of severe depression are considered to be a lack of strength in a person to perform any work, lack of desires, indifference, and laziness and apathy are frequent additions to the clinical picture. Depression is also accompanied by physiological changes in the body.

Thus, in the brain the ratio of the hormones serotonin, dopamine and norepinephrine changes significantly. Their insufficient quantity leads to a decrease in vital energy, mood and the appearance of apathy. It becomes increasingly difficult for a sick person to force himself to do something, so he spends boring days in bed.

If you do not start taking medications in the first stages of such a disorder, then depression will only intensify, becoming severe. In addition to thoughts of suicide, she is characterized by manic fear and constant anxiety, so it is very difficult for such a person to live and work in a team.

Expectant mothers especially need to take care of their psychological health, because severe symptoms of the disorder can lead to illness in the child or even to miscarriage. Therefore, it is necessary to immediately consult a doctor at the first symptoms.

Severe depression and suicide attempts

Severe depression as a complex mental disorder is characterized by a suppressed instinct of self-preservation. This is why, when signs of depression reach their peak, many people experience thoughts and even attempts at suicide. According to statistics, if a person does not treat the disorder and has been ill with it for more than 5 years, then suicide attempts are observed in 15%. They arise due to the patient’s feeling of defenselessness and doom, as well as due to the reluctance to burden family members with their problems. If a person loses the meaning of life, then the appearance of such thoughts is only a matter of time.

Severe depression and suicide attempts are characterized by even the development of a suicide plan. If a person’s mood improves, then he does not stop thinking about it. Lonely people who do not have someone who can listen to them and help them are most susceptible to such thoughts. Also, if a person has had loved ones or acquaintances who committed suicide, this further increases the risk of premature death.

To prevent the disease from becoming chronic, it is necessary to begin its immediate treatment. The first thing to do if you have signs of depression is to see a doctor.

Treatment of severe depression

In the treatment of human mental disorders, individual and family psychological sessions are used. The psychologist carefully studies all aspects of the patient’s behavior, for example, his manner of communication, relationships with his spouse, children, parents, emotions that arose after separation, accidents, improper upbringing, and so on. If the symptoms of the disease are quite severe, then it is necessary to undergo examination by a neurologist, do an MRG, an EEG to identify possible skull injuries and intoxication.

After choosing a psychotherapist, severe depression is treated with medication. The most common drugs are antidepressants Remeron, Valdoxan, Coaxil, tranquilizers Alzolam, Mezapam, Reladorm, Alprazolam and others. But the prescription of such drugs occurs only after a thorough examination of all the symptoms that accompany the disease.

The body is examined for the possibility of an allergic reaction to the drugs. Also, if a person has high blood pressure, then not all medications can be prescribed to him. This means that you should never take anti-depression medications on your own.

Symptoms, causes and consequences of severe depression

Severe depression is the most complex form of depression. Signs of the disease manifest themselves in behavior, physiology, and the emotional sphere. How to diagnose and cure this disease, and not allow it to ruin a person’s life?

Severe depression: what is it?

Depression is a disease of the 21st century. This has been confirmed by research by scientists around the world. Depending on the severity, severe, moderate and mild forms are distinguished.

Severe depression is a complex, multifaceted mental disorder, a serious illness that affects communication, ability to work, and general physical tone.

This form is considered the most critical and has physiological, behavioral, mental, and emotional manifestations. According to statistics, severe depression is a common illness among residents of developed countries.

Causes

A person is susceptible to depression regardless of his social and financial status. Researchers classify the causes of depression depending on the nature of their origin.

Physiological

• poisoning or overdose of medications, alcohol, drugs;
• cerebral circulatory disorders.
• overwork;
• injuries (mainly traumatic brain injuries).
• cardiovascular diseases;
• hormonal abnormalities, irregular sex life;
• sedentary lifestyle;
• poor nutrition.

Psychological

1. Stress is the body’s reaction to a factor that disrupts the stable state of the nervous system. Very often stress factors are troubles at work or school, or family difficulties.
2. Frustration is a state that arises as a result of a discrepancy between what is desired and what is actually realized, the effect of unfulfilled hopes.
3. Mental trauma is damage caused to a person as a result of a single or repeated exposure to unfavorable factors: physical or sexual violence, death of a loved one, presence during the commission of violence, disaster.
4. An existential crisis is a personal conflict that arises as a result of the loss of the meaning of life, goals and priorities, and internal harmony.

Modern scientists have conducted a number of studies, as a result of which models of the main factors of severe depression have been identified:

1. The bio-psycho-social model considers the causes of depression as a complex: disorders of health, physiology, psyche and social realization of the individual. A prime example is postpartum depression. Here we can talk about a change in the social role of a woman-mother, and about biological, hormonal changes, and about mental changes - the emergence of a sense of responsibility for the child, fears of making a mistake and harming him.
2. The biological model names hormonal imbalances and other neurochemical processes as the main causes of severe depression.
3. The psychological model puts stress factors and problems in communication in society and in the family in the first place.
4. The social model considers severe depression as a consequence of social isolation, high competition in society, a difficult economic situation, and instability - political and economic.

Symptoms and signs

How does severe depression manifest? The symptoms of severe depression are multifaceted. The most typical manifestations are as follows.

How does autumn depression manifest in women? Read on.

Physiological

• disorders of the digestive system;
• pain in the muscles, heart, headaches;
• high fatigue, drowsiness or insomnia against a background of general weakness;
• appetite disorders;
• lack of sexual needs.

Emotional

• state of despair, melancholy, sadness;
• sudden mood changes;
• constant self-flagellation - blaming oneself for all failures, heightened feelings of guilt;
• insensitivity – a person is unable to rejoice or have pleasure;
• heightened sense of anxiety, danger;
• loss of interest in what is happening around.

Behavioral

• lack of work activity, lack of initiative;
• consumption of alcohol, psychotropic substances;
• unauthorized social isolation, solitude;
• refusal of active recreation, walks, entertainment.

The first 3 groups of reasons are noticeable from the outside, but the last one does not always manifest itself openly.

Thinking

• feeling of uselessness;
• pessimism, gloomy perception of the world;
• thoughts of suicide;
• inhibition of reactions;
• it is difficult for a person to concentrate and make a decision.

Borderline symptoms are hallucinations that develop against the background of other mental disorders.

Forms

Reactive is the most common and simplest form of depression. It mainly exists in mild or moderate forms. The factor is any event: moving, dismissal, death of a loved one, divorce, ruin.

What all these factors have in common is the loss of something. It becomes severe in cases of lack of qualified assistance.

1. Postpartum depression is caused by a complex of reasons and often becomes severe. After childbirth, physiological and hormonal changes occur, and a reassessment of values ​​and one’s social role occurs. There is no single factor; a complex of reasons operates.
2. The manic-depressive form is characterized by a relapse of symptoms and periods of agitation. The danger of this form is that it is often ignored, explaining mood swings by fatigue, stress or bad character.
3. Severe depression against the background of schizophrenia: acts either as its main symptom or as a consequence of other symptoms.
4. The senile form is associated with age-related changes. In men it occurs later than in women. Most often, a person suffering from senile depression has not previously had other forms of this disease. Characteristic: withdrawal from social contacts, withdrawal into oneself, decreased tone.

What can it lead to?

The consequences of severe depression can follow a person throughout his life:

1. Without treatment, depression can become more severe and last for years.
2. Loss of social status.
3. Suicide attempts.
4. Overflow into other mental illnesses.

Read the article on how to get rid of depression on your own.

What to do? Treatment

Remember: this disease must be treated! A patient with severe depression needs combined help. The main methods of treatment: medicinal biological and psychological.

1. Biological therapy: the patient is helped to get rid of depression with the help of antidepressants prescribed by the doctor. While taking medications, regular visits to your doctor are necessary.
2. Psychotherapy:

• Psychodynamic therapy is based on helping to overcome unconscious conflicts. The therapist helps to transfer the conflict into the conscious sphere and find a constructive solution.
• Cognitive therapy is complex in nature; the patient is helped to deal with everyday and social difficulties, unconscious problems, and behavioral manifestations of depression.
• Behavioral therapy focuses on current symptoms of depression: withdrawal from socializing, withdrawal from entertainment, and lack of interest in activities.
• Family therapy.
• Group therapy.

Treatment of severe depression requires the use of psychoanalysis, existential, behavioral, and body-oriented theories.

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How to recognize and treat severe depression?

Severe depression is a mental disorder in which, along with a constant depressed mood, a marked decrease in interest in everything that was previously liked, and increased fatigue, there are suicidal thoughts, low self-esteem, excessive inadequate feelings of guilt, loss of appetite and a number of other signs.

It is necessary to understand that this condition is not laziness, not a whim of a person, but a dangerous disease that requires proper treatment!

To assess the severity of depression, they resort to additional research methods, special psychodiagnostic scales, the most accurate of which are the Hamilton Depression Severity Rating Scale, the Montgomery-Asberg scale, and the Beck scale.

Causes of severe depression

Why severe depression occurs in a particular person is one of the first questions a doctor will ask himself when communicating with a patient. Further treatment tactics will depend on this.

The role of genetic, organic and socio-psychological factors in the development of severe depression has been reliably confirmed.

Genetic factors

A significant part of severe depressive disorders are endogenous depressions. The latter arise due to a deficiency in the body of special substances called monoamines, which are involved in the regulation of emotions, cognitive processes, attention, and memory. These are the well-known norepinephrine, serotonin, and dopamine.

Depression may be one of the phases of bipolar disorder, a disease with a hereditary predisposition.

Social and psychological factors

Some people are predisposed to depression. They are distinguished by uncompromising, straightforwardness, and an “excessively serious” understanding of the sense of duty. The experiences of such people are affectively rich, but at the same time they tend to inhibit the external manifestation of emotions.

Social factors that can lead to the development of depression are bereavement (death of a loved one, divorce, separation), lack of social support, when a person has to overcome everything on his own, no one to expect help from, financial problems, loneliness, various serious illnesses and related with them are social problems and financial costs.

Organic factors

Depression can be not only an independent disease caused by genetic characteristics or social problems, but also a secondary pathology, a complication of another nosology.

Brain stroke, Huntington's chorea, Parkinson's disease, thyrotoxicosis, hepatitis, cancer and many other pathologies can be complicated by the development of a depressive episode.

Signs that can help diagnose severe depression

The current international classification of diseases, 10th revision, distinguishes 3 degrees of severity of depression (depressive episode):

1. mild depressive episode;
2. moderate depressive episode;
3. severe depressive episode with or without psychotic symptoms.

Main symptoms of depressive disorder:

• a depressed, clearly abnormal mood for a given person, which persists almost all the time, for at least two weeks;
• a distinct decrease in interest in activities that the person previously liked;
• severe fatigue, lack of energy.

These symptoms (or at least 2 of them) are almost always observed with depression of any severity.

• excessive unreasonable feelings of guilt or self-condemnation, it is these manifestations that can contribute to the emergence of thoughts of suicide;
• a gloomy, even pessimistic vision of the future;
• feeling of self-doubt, low self-esteem;
• recurring thoughts of suicide or even suicidal attempts (how to suspect the presence of suicidal thoughts in a person, during which periods the risk of attempting suicide is greatest, you can read about this in the article “Suicide with depression“);
• problems with concentration, the ability to think, the appearance of indecision;
• appetite disturbances (it can be either increased or decreased), combined with weight changes;
• sleep pathology;
• motor disorders manifested in the form of lethargy or severe emotional arousal.

Psychotic signs of depression

Psychotic manifestations that may be signs of severe depression:

• delusional ideas - unlike schizophrenia, which is characterized by delusions of a fantastic nature, with severe depression delusions of guilt, relationships, denial, nihilistic delusions (the patient claims that the world has stopped or internal organs have stopped working), hypochondriacal delusions (the patient is confident in the presence of a serious illness, although in fact there are no signs, he is completely healthy);
• hallucinations;
• depressive stupor - immobility, numbness.

Somatic signs

In severe depression, so-called somatic symptoms will almost always be present, which are not necessary in a mild or moderate depressive episode.

Somatic symptoms of severe depression:

• waking up in the morning 2 hours or even more before the usual time;
• mental state is more severe in the morning;
• significant decrease in appetite;
• lack of reaction to an activity, an event that in the past should have necessarily caused it;
• weight loss (5% or more of last month's weight);
• decreased sex drive.

Not every patient can have all of the listed symptoms of severe depression; sometimes, due to depressive stupor or strong emotional arousal (agitation), a person cannot talk about the manifestations of the disease that bother him; in this case, the information that close people can tell, how attentive they are, is very important were.

Consequences of a major depressive episode

A patient with severe depression is unable to lead a normal life, work, get around himself, take care of himself or someone else. As they say, it exists, but does not live.

This disease places an unbearable burden not only on the person himself, but also on his family and society as a whole. This is why this condition needs treatment. Waiting for a person to come out of severe depression on his own is extremely imprudent. So you can wait for the dangerous consequences of severe depression - a suicide attempt.

Suicide: when is it possible?

As a rule, patients with severe depression are lethargic and lethargic. Despite having suicidal thoughts, they do not have the strength to act on these thoughts.

There are 2 dangerous periods when the chances of committing suicide attempts are highest: the beginning of depression and the moment of recovery from it.

At the initial stages of a depressive episode, the mood is already painful, the patient may be visited by various bad thoughts, and motor retardation is not yet very pronounced. During such periods, it is necessary to carefully monitor the person so that he does not do something irreparable.

A similar situation occurs a couple of weeks after the start of treatment. The first symptoms that begin to improve with treatment for severe depression are movement disorders. Negative thoughts, unreasonable feelings of guilt, and a pessimistic vision of the future disappear a little later. During a slight improvement, patients can put into practice everything that they had time to think at the peak of depression. So during this period, maximum control is also necessary not only over the patient’s actions, but also over one’s words, so as not to say anything unnecessary or provoke the person to do something.

Support from loved ones and their care is necessary for depression of any severity, so I recommend reading the article “How to help someone with depression” to know how to support such a person, what you can say in his presence and what you shouldn’t.

Depression occurs a little differently in women than in men. That’s why I devoted a separate article to this topic.

Treatment of severe depression

How to get out of severe depression? Can I do this myself? These questions are most often asked by patients and their relatives.

The first thing to do is see a doctor. It is necessary to understand that severe depression is a serious mental disorder that not only negatively affects the patient’s life, but can also lead to dangerous consequences.

Such a disease does not go away without competent and comprehensive treatment.

In one of the articles, I already described the steps that need to be taken to get out of depression. These measures are very effective for mild or moderate depression, but for severe forms of the disease they are, unfortunately, powerless or ineffective. It is impossible to do without drug treatment.

Antidepressants

Antidepressants are medications that help normalize mental state. They eliminate motor, somatovegetative, and emotional manifestations of depression, thereby helping a person return to their previous pre-morbid state.

The choice of drug depends on a number of factors:

• existing symptoms;
• concomitant diseases;
• the effectiveness of treatment in previous episodes (if any);
• the patient’s level of income - if a person’s financial situation is not high, then it makes no sense to prescribe him effective but expensive drugs that he will not be able to take as long as he needs.

The main groups of antidepressants used to treat severe depression:

• serotonin and norepinephrine reuptake inhibitors (venlafaxine);
• selective serotonin reuptake inhibitors (paroxetine, fluvoxamine, sertraline);
• tricyclic antidepressants (amitriptyline, imipramine) and others.

Tranquilizers and neuroleptics

Another group of drugs actively used in the treatment of severe depression are tranquilizers (diazepam, clonazepam). These substances relieve anxiety, sleep disorders, and emotional tension.

If psychotic manifestations are present, then there is a need to prescribe antipsychotics. They help eliminate delusional ideas and hallucinations. In the treatment of depression, preference is given to atypical antipsychotics, such as risperidone, olanzapine, quetiapine.

Psychotherapy

To get out of severe depression, you need not only to take the medications prescribed by your doctor, you need to eliminate the external factors that caused this condition. Of course, it is not always possible to completely eliminate them, but you can change your attitude towards them, accept the current situation if there is nothing else left. It is best to work in this direction with a psychotherapist.

Psychotherapy is most effective in cases where socio-psychological factors are leading in the development of the disease. It is very difficult for a person to understand himself, his problems, complexes, relationships with other people, but a psychotherapist will help you look at the problem from the other side and find the right way out.

After watching this video, you will learn how depression and self-esteem are interconnected, a look at this problem from Jacques Fresco, designer and futurologist, organizer of the Venus Project.

In the complex treatment of depressive disorder, other non-drug methods of treating depression can be used.

Prevention of depression and duration of therapy

How to not only cope with severe depression, but also prevent its development in the future?

Treating severe depression is a long process. It is necessary to take medications not for a week or even a month. It turns out that the best prevention of severe depression and relapses of the disease in the future is compliance with the optimal treatment period.

Even if you feel practically healthy, this does not mean that you can stop taking your medications. You must carefully follow your doctor's recommendations.

There are 3 main phases in the treatment of depression, compliance with which is the best prevention of relapses of severe depression in the future:

1. The active treatment phase (acute) lasts about a month. During this time, many patients eliminate most of the symptoms of a mental disorder, their mood noticeably improves, and even their ability to work is restored. If treatment is interrupted at this stage, there is a high probability that after some time the disease will relapse and the symptoms will return again.
2. The stabilizing phase (ongoing) begins after remission is achieved. However, even a significant improvement in mental state does not mean that the disease has receded forever. It is necessary to continue treatment, take antidepressants, albeit in smaller doses. The duration of this phase is from 6 months to 1 year.
3. The maintenance phase consists of taking the minimum dose of the drug necessary to control the course of the disease. The duration of this phase is determined individually.

I experienced severe depression myself: I couldn’t do anything, I didn’t want to live, my mood was constantly terrible, I even had thoughts of suicide several times, that in this way I would save myself and my family from all the problems. It’s good that I didn’t give in to such thoughts.

If it weren’t for the treatment in the neurosis department, I don’t even know what would have happened to me. There they prescribed me antidepressants, gave me an eye drop, and after ten days my condition began to improve little by little.

Vika, I’m glad for you that you were able to overcome severe depression. Thank you for sharing your positive experience.

When I remember myself just six months ago, it seems that I was a completely different person. I didn’t feel anything, I didn’t want anything, I couldn’t do anything. It seemed to me that I had lost all feelings, that I was only disturbing my husband and children, that if I died, their life would only get better. True, I did not have the strength to commit suicide. Now I understand that I had very severe depression. It’s good that my husband insisted on treatment. In the hospital they put me on drops and gave me different pills to take, but thank God, 3 weeks after the start of treatment I felt like a completely different person, as if I had returned to life.

Vika, I am sincerely happy for you!

In my life I have experienced all the horrors of severe depression. When you have no strength to do anything at all, when it seems that life is a real hell, and everything will only be terrible, when you blame yourself for everything, when you have no strength for either your children or your husband. Thanks to my husband for noticing my condition, insisting on treatment, and supporting me all the time. And now I understand what edge I was on, and I feel much better.

Yes, I also felt this condition myself. Moreover, it manifested itself for me over the course of 3 years: in spring and autumn. Eternal brokenness inside, everything was falling out of my hands, I have no strength to do anything, I don’t want to see anyone and I’m always in no mood... It was very difficult for me then.

Hello! For quite some time now I have been wondering whether I am normal or not?

I’m 25 years old, I live with my parents, mostly with my grandmother. I have a normal job (what I wanted to do and worked towards it for a long time), and at the same time I’m getting a graduate degree in absentia. I love my family and they love me very much. Everything seems to be fine, I’m happy, I had a happy childhood. It seemed that I should rejoice in my happiness. But it doesn't work. From childhood, as far as I can remember, I was terribly withdrawn and uncommunicative, I was embarrassed by everyone, although sometimes there were very rare gaps. There were no friends. Or rather, there were no permanent friends. They still don't exist. In children in kindergarten and elementary school he was very aggressive and pugnacious. Now, on the contrary, he is quite peaceful and harmless. However, even from my school years, I began to notice that quite often (this feeling grew over the years) I was visited by some kind of melancholy, a feeling of hopelessness and a vile, destructive apathy. These negative experiences appear several times a year (although I did not follow any pattern in the manifestations). But when I “calm down” in time, there still remains an unpleasant feeling that “it” has not left me - “it” is always nearby, invisibly present and waiting for the right moment to take up residence in my head again. “It was and is, and joy and fun (although it seems to me that I have stopped experiencing these wonderful emotions, or I do, but somehow not consciously) even if they do not exist for long. Almost constantly haunted by a feeling of loneliness, misunderstanding, and abnormality. I don’t tell my family any of this (I don’t understand why, I’m probably embarrassed), and I don’t tell anyone what’s going on inside. During my school years I read books, and as a student I tried to play sports seriously. I even competed several times, I really enjoyed it, there were so many emotions and experiences! But in addition to these positive moments, there were frequent, very frequent injuries and I was told that this sport (Muay Thai) was not for me, it would cripple me. I felt it myself. As a result, I gave up training. I can't finish anything. I abandoned everything that I could call my hobby sooner or later. The loneliness and alienation that haunted me came back to haunt me. And to get rid of them, at the age of 21 I started smoking hashish and marijuana. No, they didn’t save me from this; on the contrary, I plunged even deeper into my experiences while in a “trip” state. It seemed to me that this was exactly what I needed all my conscious life, anyway, after all, I would soon die and no matter how. And in the absence of grass, I drank alcohol and got to the point that to this day I can’t completely part with it. As a teenager, I had abnormal thoughts - for example, I wanted to become a maniac, and Jack the Ripper was almost an idol. Now this is not the case, but sometimes I think, maybe I’m not a person at all? Well, that is, a bodily shell, yes, but in reality? Who am I? How can I continue to live? Well, I will definitely work (especially since I dreamed of this job and found it with difficulty). And what else? Why is it that if I'm happy, I don't feel it? Why is there no joy in life? Why am I like this in the end? I am absolutely sure that I will never get married, start a family like all normal people and will not have time to grow old. Thoughts of suicide visited me, but I coped with them. Sometimes I fantasized about standing in a hemp field, dousing myself with solvent and burning myself. The skin burns - I’m alive, the eyes burst and flow - I’m alive...

Physically, I seem to feel fine, I eat with pleasure, I just get up poorly and periodically feel slightly unwell during the day.

My memory was crap before, but now I’m so completely absent-minded, I’m terribly inattentive, I forget everything, I lose everything. They said that in childhood I had something like encephalopathy and a disturbance in the emotional-volitional sphere. Now it seems not.

Andrey, first of all, you need to stop using drugs. Nothing good will come from this for sure! The source of positive emotions must be sought elsewhere - in travel, in hobbies.

You can contact a psychotherapist or psychologist so that a specialist can help you understand yourself and your experiences.

Now I am in the deepest depression. During the next attack she almost threw herself out the window, but her husband stopped her. My parents hate me, I don't have a single person I can talk to. My husband doesn't want to support me. I think I’ll go to a psychiatrist tomorrow, otherwise I’ll commit suicide in a state of passion, and I have two children.

Nadezhda, you urgently need to see a psychiatrist.

I also suffer from terrible depression. And what is typical is that it repeats itself every six months. The most terrible condition is that I have lost interest in life. I am tired and have no strength. I go to doctors, but the city is small, there are few particularly good specialists. I take depressants but I suffer for 1.5 months. I have no education I work as a cleaner. But this doesn’t mean that depression needs to go away. In this state, I work, although it’s very hard. It always seems to me that there are no people like me. Sometimes it seems to me that I’m screwing myself up. But why don’t I always screw myself up and at times. It’s probably a disease. I don’t know, I’m lost, please help me. I have a family, a husband, two children. But I’m sick all the time, I’m pining away, I don’t live, I exist.

Svetlana, given that you experience symptoms of the disease regularly, you need to constantly take antidepressants.

Try to find a competent psychiatrist who will select treatment for you. And remember that only constant treatment in your case will alleviate the symptoms of the disease and allow you to lead a normal life.

For the last 2.5 years I have been under constant stress, I began to eat poorly, lose weight, and the last two months have been absolutely terrible, sometimes my child’s tests are bad, sometimes my cytology is bad, but thank God everything is fine, and then my husband left for another and this the day everything changed, I just stopped eating, no appetite, in the mornings and at lunch there is some kind of lump in my stomach, I feel bad, I can hardly force myself to get up, it’s heavy, nothing is interesting, life has lost all its charms. I visited a psychiatrist and prescribed Gidozepam 0.2 1/2 twice a day and Prodep, began to eat in the evening without disgust, but the ex came to work and it became even worse again. I eat with difficulty, there is no joy, I let it go a little in the evening. Am I thinking of going to the hospital?

Marina, first of all, you should pull yourself together. You are alive, healthy, you have a child.

Of course, it is very difficult if a loved one betrays you, but you can cope with it! You can't get limp! You can’t drive yourself into a swamp of self-pity.

Talk to a psychiatrist, it may be necessary to increase the dose of Prodep, or it has not yet begun to act (the effect of this drug appears only after 2-3 weeks). And if the condition fails to improve on an outpatient basis, then you can combine drug treatment with psychotherapy or go to a hospital.

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