Alcohol and antidepressant withdrawal syndrome

Causes of depression

The causes of prolonged melancholy and blues differ in men and women.
But in all cases of the development of depression in adults, they have external (endogenous depression) and innate factors. In women, depression can occur for the following reasons.

1. Genetic factors. The likelihood of developing pathology increases in those patients whose family members already suffer from this pathology.
2. Taking certain medications.
3. Environmental influence. These include conflicts, financial problems, lack of personal life, and lack of relationship with a spouse.
4. Psychological or social reasons: inadequate self-esteem, negative thinking, etc.
5. Age. Episodes of depression can occur even during adolescence.
6. Problems with the monthly cycle, infertility and other factors.
7. Postpartum disorders.
8. Loneliness.
9. No children.
10. Loss of a spouse or children.

• stress;
• problems at work, in the family, at home;
• problems in interpersonal relationships;
• failure to achieve goals;
• change or loss of job;
• money problems;
• need to care for children or the elderly;
• loss of a loved one;
• injuries;
• long-term chronic diseases;
• retirement;
• loss of independence;
• problems with potency (erectile dysfunction);
• loneliness;
• alcohol abuse;
• psychological trauma;
• aging in conditions of loneliness.

Antidepressants and tranquilizers: difference between groups

For depression accompanied by anxiety, tearfulness, fear and insomnia, the treatment regimen may include tranquilizers. Therapy with these drugs is carried out only under the supervision of a doctor, as they can cause addiction and drug dependence.

When prescribing tranquilizers, the dose is increased gradually - from minimum to optimal to achieve a therapeutic effect. The course of treatment should be short and not exceed 2-3 weeks. The most powerful and effective tranquilizers include:

• Chlordiazepoxide.
• Elenium.
• Diazepam.
• Seduxen.
• Lorazepam.
• Bromazepam.
• Phenazepam.

Taking tranquilizers affects the speed of psychomotor reactions and concentration. Side effects may include drowsiness, muscle weakness, tremors, constipation, urinary incontinence and decreased libido. It is prohibited to drink alcohol during treatment with these medications.

In addition to antidepressants, tranquilizers are also used in the treatment of depression:

• This group of drugs eliminates feelings of fear, emotional stress and anxiety.
• At the same time, the medications do not impair memory and thinking.
• Additionally, tranquilizers can prevent and relieve seizures, relax muscles, and normalize the functioning of the autonomic nervous system.
• In medium doses, tranquilizers lower blood pressure, normalize heart rate and blood circulation in the brain.

Thus, tranquilizers mainly differ from antidepressants by their opposite effect on the autonomic nervous system. Also, tranquilizers have the greatest effect on fear and anxiety, which can be eliminated even with a single dose, while antidepressants require a course of treatment. Tranquilizers are more likely to cause addiction and their withdrawal symptoms are more pronounced and severe.

If tranquilizers are abruptly discontinued after taking them for a long time, a withdrawal syndrome may develop, manifested by sweating, tremors of the limbs, dizziness, sleep disturbances, intestinal dysfunction, headache, drowsiness, increased sensitivity to sounds and smells, tinnitus, disturbances in the perception of reality, and depression.

Duration of antidepressant withdrawal

In the best case, your body will respond to the withdrawal of the usual medication for 10-14 days. These terms are very arbitrary; they depend on the duration of the appointment, the state of health, and the psycho-emotional state of the patient in a given life situation.

While a person is experiencing withdrawal symptoms, it is extremely difficult for him to go to work and carry out any of his usual duties, even around the house

Discontinuation of the medication should be carried out under the supervision of a physician. The medical staff will advise on what scheme to implement this, what symptomatic remedies to use. In the worst case, if you act on your own, you will begin to experience all the symptoms at the same time and even return to a state of depression and melancholy.

Your doctor will tell you how long antidepressant withdrawal symptoms last. After all, it’s difficult to answer unequivocally. Each body is individual, and a lot also depends on the drug you took. For example, Phenazepam withdrawal syndrome lasts from 14 days to a month.

Let's look separately at Amitriptyline. This is one of the most famous and long-standing drugs. It belongs to the group of tricyclic substances. The main advantage of an antidepressant is that it calms you almost instantly. When taking it, you don’t have to wait 2-4 days to see the effect. It perfectly eliminates panic attacks, and sleep problems are restored within 24 hours. Such effective therapeutic properties of the drug lead to the drug being abused. Amitripline withdrawal symptoms are usually the same as for other drugs in this group. The only thing is that it adds a feeling of dry mouth and spasmodic pain in the head. It is recommended to treat Amitripline withdrawal syndrome, only then you will not feel the negative effects.

Classification of depression

It should be borne in mind that depression is not only causeless anxiety and melancholy, a depressed depressive state. This is a very serious mental illness that requires adequate treatment.

• reactive depression (occurs as a reaction to a recently experienced traumatic situation); hidden (masked) - appears in people who know how to hide emotions and conceal them within themselves;
• resistant (resistant to treatment);
• moderate;
• heavy;
• protracted;
• recurrent (transient);
• alcoholic (arising from the consumption of alcoholic beverages);
• seasonal (autumn or winter);
• subclinical;
• expressed;
• suicidal;
• vital, or somatogenic (combined with physical manifestations);
• hormonal;
• atypical;
• monopolar (the so-called “large”);
• unipolar (manifested by severe mental disorders);
• vegetative.

What are antidepressants?

Let's first understand the concept of antidepressants.

Antidepressants are substances that are used in the treatment of depression. The doctor can prescribe them for other mental disorders, in combination with drugs from different groups. Antidepressants can have more than just antidepressant effects on the body.

Properties and effects of antidepressants.

All antidepressants, depending on their effect, can be divided into three groups:

1. Sedative antidepressants. In addition to the direct effect on depressive syndrome, they can help with anxiety, restlessness, and poor sleep. The most famous representative: Amitriptyline. The drug is a hundred years old, but it is not going to lose its position in terms of the strength of its antidepressant effect. Among the more modern ones I can name Mianserin and Buspirone. Doxepin has proven itself very well in my practice.
2. Antidepressants with stimulant action. Used in cases of predominance of lethargy, passivity, depression and indifference. Everything is clear here, I think. I would like to note one fact. The stimulating effect occurs significantly earlier than the antidepressant effect. This is not always good. I usually prescribe drugs from this group together with sedatives (sedatives) in small doses. The most prominent representative is Escitalopram.
3. Antidepressants with a balanced effect. They absorbed the properties of the first and second groups. Representatives Pyrazidol and Sertraline.

Symptoms of depression

• sadness, melancholy and isolation;
• feeling of pressure in the chest area;
• speech slows down, the voice becomes sluggish;
• decreased concentration and memory loss;
• change in appetite.

• greater need for food;
• constant self-flagellation;
• thoughts about a dangerous illness (for example, having cancer or AIDS);
• delusions and hallucinations (in this case, a person hears the voices of deceased relatives);
• thoughts of death (patients may exhibit suicidal tendencies).

Depression can be hidden. In such cases, a person is worried about asthenia, chronic pain, and sleep disturbances.

An exacerbation of the pathology with obvious signs of melancholy is possible (in this case they speak of clinical depression).

• a constant and ongoing feeling of melancholy, depression and oppression;
• loss of interest in life;
• exacerbation of phobias;
• the appearance of anxious thoughts;
• irritability;
• decreased self-esteem;
• constant feeling of guilt;
• increased anxiety;
• sleep disorders;
• appetite disorders;
• decreased or complete loss of sexual desire;
• pain throughout the body;
• tearfulness, avoidance of contacts;
• increased craving for bad habits - smoking and drinking alcoholic beverages;
• lower requirements for personal hygiene;
• the appearance of thoughts about uselessness, helplessness and even one’s own uselessness.

The course of this disease differs significantly among representatives of the stronger sex. Some men experience sadness, loss of interest in previous activities, and some withdrawal. Others experience irritability and withdrawal. They may “hide” from depression by working or, even worse, by drinking alcohol.

Increased aggressiveness can be dangerous, because men are capable of losing control of themselves and insulting (both psychologically and physically) relatives, friends, and acquaintances. Sometimes a person may exhibit behavior that is unusual for him or may go into an illusory world. Often men may become interested in dangerous sports, use alcohol or use strong drugs.

• blaming the problems of other people, especially loved ones;
• constant feeling of anger, irritability;
• constant conflict, suspicion;
• anxiety;
• anxiety;
• excessive excitement;
• despair;
• diffidence;
• fear of admitting your mistakes;
• pain in the back and head;
• sleep and digestive disorders;
• loss of sense of humor;
• temper and violence.

Astheno-depressive syndrome

Astheno-depressive syndrome is an anxiety-depressive disorder that manifests itself in loss of interest in life.

• loss of former hobbies;
• irritability;
• apathy, which gives way to a fussy and often foolish mood;
• problems with concentration;
• the appearance of phobias;
• attacks of anxiety and panic.

The causes of asthenic-depressive syndrome are the same as depression. It is very important to recognize the development of this syndrome in time and begin treatment. Modern medicine prescribes antidepressants and psychotherapy to such patients to overcome fears.

How to relieve withdrawal symptoms?

Cancellation of Amitripline or any other antidepressant will be easier if, in addition to the doctor, you listen to our advice.

Eat more fresh vegetables and fruits, it is very important to drink enough clean water so that the remaining drug is eliminated from the kidneys faster

According to reviews from patients who have successfully dealt with this condition, it is recommended:

• partially and gradually reduce the dose of the drug;
• increase the volume of liquid consumed (mineral water, juices, tea, compotes, fruit drinks). This is how the remaining chemicals leave the body;
• review your diet in favor of plant foods. The fiber they contain helps the functioning of the gastrointestinal tract;
• Don’t create stressful situations for yourself on purpose. If you have an important test or exams, it is better not to change your usual rhythm of life;
• do not neglect the help of a psychotherapist if you cannot stop the medication yourself.

By following these recommendations, there will be no problem with how to stop taking Amitripline or another drug for depression and nervous tension.

https://youtu.be/4VRQEXKKCFE

Treatment at home

During pregnancy, taking pills for depression is especially important. If the expectant mother is depressed, she endangers not only herself, but also the child. A nervous system disorder can trigger postpartum depression; this condition requires treatment under the supervision of a qualified specialist.

You need to be especially careful when choosing medications in the first trimester to avoid congenital anomalies of the fetus. Doctors often prescribe selective serotonin reuptake inhibitors to expectant mothers, which are the safest for the patient’s body. These include:

• Fluxen.
• Sertraline.
• Paroxetine.

A few weeks before giving birth, it is necessary to stop using antidepressants so that the child does not inherit the addiction. During the entire course of treatment, the patient’s condition should be monitored by a doctor. For early-stage depression, doctors recommend avoiding taking serious prescription drugs. They can be replaced with herbal medicines, which include St. John's wort, motherwort, valerian, and thyme.

When breastfeeding (BF), antidepressants and other psychotropic drugs can also have a negative effect on the child. The list of pills that are allowed during pregnancy includes:

• Valerian preparations.
• Motherwort.
• Notta.
• Glycine.
• Novo-Passit.
• Persen.

If herbal preparations during lactation do not have the desired effect and the nursing mother experiences a severe form of depression, the doctor prescribes antidepressants, and the newborn is transferred to artificial nutrition. During breastfeeding, therapy most often includes the following drugs:

• Zoloft. The safest antidepressant for mothers during lactation. It has a pronounced therapeutic effect and in a short time helps to cope with feelings of anxiety and apathy.
• Amitriptyline. The concentration of the drug in milk is low, but the antidepressant itself has a large number of side effects and can cause individual intolerance. It belongs to the very first drugs in the group and is sold only with a doctor’s prescription.
• Fluvoxamine. An effective remedy, but while taking it it is necessary to stop lactation. This medication has not been sufficiently researched.

During pregnancy and pregnancy, taking tranquilizers and antipsychotics is prohibited; the course of treatment with antidepressants should be at least 6 months. The choice of dosage and drug is made by the doctor.

Helping a person get out of depression can be very difficult. This may require the help of a psychologist. Combating depression with the help of alcohol to “improve your mood” is strictly contraindicated, because this substance is precisely a depressant, which only aggravates the symptoms of the disease.

There are varieties of antidepressants without a prescription. But this does not mean that drugs from this list of antidepressants can be purchased as soon as the first signs of depression appear. Before taking any medication, you should consult your doctor. Antidepressants do not become safe because they are not over-the-counter. The individual choice of dosage and dosage regimen for adults should be determined only by a specialist.

All the most effective medications for treating depression are divided into several groups, depending on how they affect inhibition processes. Here is the most common classification of antidepressants.

1. Preparations of a number of tricyclic antidepressants. They are first generation medicines. Prevents the reuptake of norepinephrine and serotonin. These include Amitriptyline, Doxepin, Desipramine, Trimipramine, Nortriptyline. Such medications have a large number of side effects (for example, hand tremors, heart rhythm disturbances, visual disturbances, problems with bladder emptying). Therefore, they are rarely used in medical practice.
2. Drugs from the group of selective serotonin reuptake inhibitors (SSRIs). These are Sertraline, Paroxetine, Fluoxetine, Flevoxamine, Cipralex, Prozac. Most often they are prescribed for the treatment of depressive disorders associated with feelings of fear, aggression and panic attacks. The main side effect of the drug is nervous agitation. Increased dosages lead to the accumulation of serotonin in the body.
3. Selective norepinephrine and serotonin reuptake inhibitors are indicated for the treatment of obsessive-compulsive disorder and phobias. Side effects - anxiety, sleep disturbance. These include Milnacipran and Venlafaxine.
4. Heterocyclic antidepressants are prescribed to elderly patients when symptoms of depression are combined with sleep disorders. They may cause drowsiness and weight gain. These include Mianserin, Nefazodone, Mirtazapine.
5. Monoamine oxidase inhibitors are the drugs of choice in the treatment of agoraphobia and psychosomatic disorders. There are reversible (Tranylcypromine, Phenelzine) and irreversible monoamine oxidase inhibitors (Befol, Pyrazidol, Moclobemide).
6. Reuptake activators are a new generation of antidepressants. They can quickly overcome the symptoms of depression. Effective for depressive states of alcohol origin, psychoses accompanied by irritability, anger, etc. Strong antidepressants (for example, Tianeptine or Coaxil) have recently not been sold with a prescription, since in many cases they are used by people with drug addiction.
7. Antidepressants of various groups - Buspirone, Heptral, Wellbutrin.

It is most preferable to treat depression with the help of new generation drugs to calm the nervous system. The most effective are such tablets that calm the nervous system.

1. Sertraline (or Zoloft) is the best treatment for depression.
2. Velaxin is prescribed for depression due to schizophrenia and other severe mental disorders.
3. Paroketin (Paxil) is effective in treating sadness, low mood, and lethargy. Effectively combats anxiety and suicidal tendencies. It is also used to treat personality disorders.
4. Opipramol is the optimal solution for the treatment of alcoholic depression. It prevents vomiting, convulsions, and stabilizes the functioning of the autonomic nervous system.
5. Fluoxetine has a milder effect. It is used for all the disorders described above.

• nausea;
• increased dryness in the mouth;
• vomit;
• diarrhea;
• constipation;
• pain in the head;
• increased anxiety;
• internal tension;
• dyskinesia.

The most dangerous antidepressants are Trianylcypramine, Imipramine, Phenelzine.

Neuroleptics

• Aminazine;
• Tizercin;
• Melleril;
• Truxal;
• Neuleptil;
• Seroquel;
• Haloperidol;
• ziprasidone;
• Risperpet.

These are stress relievers that do not cause drowsiness, mostly without a hypnotic effect, and when used correctly, without side effects and without addiction.

Sedatives

• Alora;
• Anantavati;
• Buspirone;
• Dormiplant;
• Ignacy homacord;
• Mebicar;
• Menovalen;
• Novo-passit;
• Noobut;
• Notta;
• Persen.

These herbal pills have virtually no side effects. Immunosuppressants and immunosuppressants are not prescribed for the treatment of depression.

• eliminate the feeling of fear;
• struggle with emotional stress;
• do not interfere with memory and thinking processes;
• relieve cramps;
• struggle with emotional lability;
• relax the muscular system;
• capable of lowering blood pressure.

As you can see, the main difference between tranquilizers and antidepressants is that they act oppositely. The anxiolytic effect can eliminate anxiety even after a single use.

Among the common tranquilizers (anxiolytics), drugs from such groups are used.

1. Benzodiazepine derivatives. They relieve anxiety, fear, panic attack, and obsessive states well. These include Bromazepam, Pexotan, Diazepam, Atarax, Afobazol, Chlordiazepoxide, Mezapam and others.
2. Heterocyclic drugs neutralize anxiety and calm well, without impairing memory and attention. Compatibility with alcoholic beverages is found. Such drugs include Ivadal, Zoligdem, Buspirone.
3. Triazolebenzodiazepines are used for depression, which is combined with anxiety. These drugs include Midazolam.

In severe cases, sedative injections are used to treat a nervous breakdown.

• St. John's wort;
• chamomile;
• hop cones;
• lemon balm root;
• peppermint;
• ginseng;
• Ivan tea;
• motherwort;
• valerian.

All recipes for preparing medicines are simple and accessible to everyone. Patients can view photos of plants to facilitate their collection or purchase.

Treatment with folk remedies using herbal preparations should last at least two weeks. All folk remedies should be taken only after consulting a doctor. It is necessary to use methods of psychological assistance with a specialist.

Diet implies nutrition enriched with vitamins and microelements. The patient can learn about different ways to get out of depression and take more fresh vegetables and fruits, juices, and chocolate to do this. But coffee, beer, marinades, pickles and smoked foods should be limited on the menu.

Hormone withdrawal syndrome

Hormone withdrawal syndrome is a condition that is dangerous not only to health, but also to human life.

Glucocorticoid withdrawal syndrome

Glucocorticoid therapy is especially dangerous and should be carried out exclusively under medical supervision. Worsening of the symptoms of the disease for which hormonal therapy was aimed is a common occurrence when treatment periods are not observed, as well as when the maximum permissible doses are exceeded.

As a rule, glucocorticoid withdrawal syndrome occurs only if the patient has self-medicated. Doctors have clear recommendations regarding the use of these hormonal drugs for the treatment of a particular disease. The severity of glucocorticoid withdrawal syndrome depends on how well the patient’s adrenal cortex remains functional:

• A mild course of corticosteroid hormone withdrawal syndrome manifests itself in a feeling of weakness, malaise, and increased fatigue. A person refuses to eat because he has no appetite. Muscle pain, exacerbation of symptoms of the underlying disease and an increase in body temperature may occur.
• Severe corticosteroid hormone withdrawal syndrome manifests itself in the development of Addisonian crisis. Vomiting, convulsions, and collapse may occur. If the patient is not given the next dose of hormones, there is a risk of death.

In this regard, therapy with glucocorticosteroid hormones is recognized by doctors as complex and dangerous, despite all the achievements of modern medicine. Doctors say that such treatment is easier to start than to complete. However, proper preparation of a regimen for taking drugs from this group increases its safety for the patient’s health. Before starting therapy, all possible contraindications and side effects of taking hormonal drugs must be taken into account. It is equally important to plan a “cover” scheme for people at risk, for example, switching from glucocorticoids to insulin for diabetes, the possibility of using antibiotics in the treatment of chronic foci of infection with hormones, etc.

Hormonal contraceptive withdrawal syndrome

When hormonal drugs intended for contraception are discontinued, the body increases the production of luteinizing and follicle-stimulating hormones. In gynecology, such a hormonal surge is called the “rebound effect,” which is often used to treat infertility.

After only three months of taking oral contraceptives, their cancellation will necessarily begin to stimulate ovulation and the release of the female body’s own hormones. It is possible that the cycle length may change or menstruation may be delayed by several cycles, which does not happen often.

In any case, a gynecologist should help you choose oral contraceptives after conducting a full examination. If, while discontinuing these drugs, a woman notices any undesirable symptoms, contacting a specialist is mandatory.

Features of manic-depressive psychosis

Manic-depressive psychosis (or circular psychosis) has two phases: the patient's excited state and depressed mood. There is a gap between them when the patient exhibits completely adequate behavior. This disease is genetically determined.

Most often in MDP the depressive phase predominates. The patient speaks quietly and indistinctly; he is constantly “within himself.” The melancholy state gradually develops into chest pain. A person constantly feels guilty about something. At the peak of the depressive phase, he has thoughts of committing suicide.

• pathological elevated mood;
• speech and motor stimulation;
• mental excitement.

At the peak of the manic phase, the patient has ideas about his own greatness.

Mild form of MDP is called cyclothymia. All phases proceed more smoothly, while the patient maintains normal performance. Some hidden forms of the disease are not noticed by the patient, but as they develop, he gradually begins to have thoughts of suicide.

Alcohol withdrawal syndrome

Alcohol withdrawal syndrome is a complex pathological reaction of the body that occurs in people suffering from alcohol dependence after quitting drinking alcohol.

Withdrawal syndrome can resemble a hangover, but it lasts longer and has a number of additional symptoms. Alcohol withdrawal syndrome will never develop in a person who is not dependent on alcohol. It is not enough to drink alcohol for a week for withdrawal symptoms to develop later. The period of time required for the formation of alcohol dependence varies between 2 and 15 years. At a young age, this period is reduced to 1-3 years.

Most often, there are three degrees of severity of alcohol withdrawal syndrome, which are characteristic of stage 2 alcoholism:

1. The first degree of alcohol withdrawal syndrome can be observed after short binges of 2-3 days. In this case, the person experiences increased heart rate, suffers from increased sweating, and dry mouth appears. There are signs of asthenic syndrome with increased fatigue, weakness, sleep disturbances and autonomic disorders (tachycardia, local hyperhidrosis, deterioration of potency).
2. The second degree of alcohol withdrawal syndrome occurs after prolonged binges for a period of 3-10 days. Autonomic disorders are accompanied by neurological symptoms, as well as problems in the functioning of internal organs. The following clinical manifestations are possible: hyperemia of the skin, redness of the eyes, increased heartbeat, surges in blood pressure, nausea accompanied by vomiting, heaviness in the head, clouding of consciousness, tremor of the limbs, tongue, eyelids, gait disturbances.
3. The third degree of withdrawal syndrome occurs after binges that last more than a week. In addition to somatic and autonomic disorders, psychological disorders are observed, which in this case come to the fore. The patient suffers from sleep disorders and suffers from nightmares, which are often very real. The person’s condition is disturbed, he suffers from feelings of guilt, is in a melancholy and depressed mood. He behaves aggressively towards people around him.

It is also possible to add symptoms that are associated with the functioning of internal organs, since long-term alcohol consumption affects their condition in a negative way.

Resumption of alcohol intake alleviates or completely eliminates withdrawal symptoms. Subsequent refusal leads to an intensification of the clinical syndrome, and also makes the craving for alcohol even more irresistible

Treatment of alcohol withdrawal syndrome is the responsibility of a narcologist. Patients with mild forms of disorders can receive care at home or in an outpatient setting. Hospitalization is necessary for exhaustion, dehydration, increased body temperature, severe tremors of the limbs, the development of hallucinations, etc. Mental disorders in the form of schizophrenia, alcoholic depression and manic-depressive psychosis are also dangerous.

In mild cases, alcohol withdrawal syndrome goes away on its own, on average, after 10 days. The course of severe withdrawal depends on the severity of somatic pathology, mental and autonomic disorders.

Read more: Alcoholism - causes, harm, signs and stages of alcoholism

Postpartum depression

This form of depression affects women after childbirth. It negatively affects the health of mother and baby. Postpartum depression requires effective and often emergency treatment.

• hormonal changes during pregnancy and after it;
• stress;
• release of adrenal hormones;
• unfavorable disposition to depressive disorders;
• unsatisfactory level of well-being of women;
• psychological problems;
• some character traits;
• external changes;
• bad habits;
• negative experience of a previous pregnancy.

• feeling depressed;
• complaints about the appearance of a guilt complex;
• irritability, absent-mindedness, increased aggressiveness;
• excessive emotional sensitivity;
• concern about the child's health;
• hypochondria;
• digestive tract disorders
• dizziness.

After giving birth, a woman is prohibited from using antidepressants. It is important to ensure a positive emotional mood. Much of the creation of a cozy, favorable atmosphere depends on the husband.

Childhood depression

This disease is increasingly being diagnosed in children. Sometimes you can find episodes of depression even in a 10-year-old child. Teenagers have nervous breakdowns in an average of 2% of cases.

• presence of the same disease in parents;
• genetic factors;
• influence of the external environment;
• poor living conditions.

• change in appetite;
• drowsiness or vice versa, insomnia;
• change of mood;
• feeling of not being needed by anyone;
• suicidal thoughts;
• lack of communication with peers.

The role of drug treatment for childhood depression is not fully understood. Therapy is provided to combat stress. Sometimes children may be prescribed tricyclic antidepressants.

Diagnosis of depression

Taking an anamnesis plays an important role in diagnosis. A conversation with the patient helps to identify certain signs of the disease and find out what factors contribute to its appearance.

• preoccupied appearance;
• the person avoids making eye contact;
• aching hands;
• hair loss;
• lethargy;
• self-judgmental or defiant behavior;
• sad expression.

To diagnose the disease, the doctor may prescribe additional laboratory tests (blood biochemistry). This is necessary to exclude pathological conditions of the thyroid gland.

It is imperative to treat depression, because its worsening leads to the development of a number of dangerous mental pathologies.