Psychotic depression is an affective disorder, one of the manifestations of endogenous depression that can be inherited. Development occurs due to disruption of biochemical processes in the body. Researchers note that psychotic depression is often experienced by people whose relatives may have suffered from schizophrenia or similar disorders. In the case of a depressive disorder, such people experience precisely the psychotic form.
Roots of Depression
Andrew Solomon
, an American writer who himself experienced severe depression more than once, gave a brief and very symbolic definition of depression:
«Sadness
, this is depression commensurate with the circumstances,
depression
is sadness disproportionate to them. This is suffering, similar to the tumbleweed grass, which feeds, as it were, on air alone and grows, although it is torn off from the nutritious soil.” (“The Noonday Demon: The Anatomy of Depression”)
Can depression feed on air and grow?
?
Where are the roots of depression? What feeds depression? Developing the concept of the unconscious
, Sigmund Freud came to the conclusion that time does not exist in the unconscious -
the unconscious is timeless
.
All our experiences, including childhood experiences, starting from the moment of birth, accumulate in our unconscious and influence our lives as if the past exists in the present
.
American psychoanalyst Rene Spitz
dedicated his life to the study of childhood experiences. He is one of the first psychoanalysts to draw public attention to the often overlooked suffering of children:
“A small child cannot explain what he is experiencing, but this does not mean that he does not suffer. Our indifference, lack of empathy and imagination lead to incredible cruelty towards children." (“First year of life”)
Depression feeds on the horror of our childhood experiences, starting from the moment we are born. What is terrible for a child may seem unreasonable
children's tears that should not be ignored.
“unreasonable” sadness
is formed , which is called
depression
.
New way to diagnose depression
Having found a solution to both problems, scientists conducted an experiment. It involved 16 people with depression who had not been helped by traditional treatments. The control group consisted of 16 people without any mental disorders. Their heartbeats were measured for four days and three nights. The study found that before taking ketamine, the heart rate of depressed people was on average 15 beats per minute higher than that of healthy people. During sleep, the heartbeat of healthy people became calmer, but in volunteers with depression, the rhythm remained just as fast . After taking ketamine, the heart rate of people with depression became the same as that of healthy people.
Depression affects a person's heart rate
With these results, the researchers created an app that diagnoses depression based on their heart rate during the day and night. If there is no significant difference, the system gives an affirmative verdict, and if there is a difference, it means the person is healthy. During testing, the application gave correct results in 14 out of 16 cases. But can we assume that a new way of diagnosing depression has already been created and should we wait for a new mobile application? Scientists say no.
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As part of the study, they proved the effectiveness of ketamine and identified a difference in the heart rate of healthy people and patients with symptoms of depression. But in order to officially recognize the new method as trustworthy, it is necessary to conduct additional studies involving more people. In addition, in the course of further work, they may identify other signs of depression, which will increase the accuracy of the results.
Trauma of birth
From a comfortable and familiar intrauterine environment, constant satiety, darkness and stable temperature, the baby is pushed into life. In the first cry of a child, we can hear all the horror that he faces at birth. This is the first disappointment in life. Being born into the world can be called an existential deception
.
Hungarian psychoanalyst Sándor Ferenczi
very accurately and succinctly described the parents’ task related to this:
“It takes extraordinary love, tenderness and care for a child to forgive his parents for being born without his knowledge.” (“The Unexpected Child and His Desire for Death”)
The baby’s psyche is formed in the form of “islands”, thanks to the feeling of happiness that the mother gives him by satisfying his needs (Veikko Tehke). During the first months of development, the baby requires a quick response from the mother to his needs for milk from her breast, the warmth of her body, her soothing voice, her loving eyes. As a result of the frequent or prolonged absence of the mother or her unsympathetic attitude towards the baby, the continuous formation of the child’s psyche does not occur (M. V. Romashkevich). psychosis in adulthood
(schizophrenia, MDP).
More often, things are better, the psyche manages to consolidate, but a “hole” remains in it - then anaclitic depression
(Rene Spitz).
Anaclitic depression concept
opens a new perspective on the study of the nature of depression - thanks to the observations of the American psychoanalyst
Rene Spitz
in orphanages, it became clear that the cause of childhood depression is
a lack of
attention, care and love in early childhood (emotional deprivation).
Anaclitic depression
is the basis for any depression in later periods of life.
Psychotic depression - symptoms and manifestations
This disease is characterized by manifestations of psychosis: visual and auditory hallucinations, delusions, depersonalization, disorientation, etc. A person loses the ability to fully perceive the world around him. He may be haunted by “voices”; visual hallucinations may take on images of living people, animals or objects.
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Due to the loss of contact with reality, it is difficult to maintain a dialogue with the patient - his thoughts become inconsistent and illogical. Delusional ideas lead to delusions of staging, when a person begins to feel that everything that happens to him turns out to be a carefully planned action of certain forces.
Symptoms of psychotic depression include:
- increased irritability;
- suicidal thoughts;
- depression;
- depressed mood;
- hypochondria;
- poor concentration, sudden loss of attention;
- various sleep and bowel disorders;
- anxiety.
The development of psychotic depression may be due to a lack of production of certain substances in the brain. Steroid use can also lead to the development of this disease.
The main risk of psychotic depression is the risk of the disease progressing to bipolar disorder.
A powerful emotional outburst can serve as a kind of “trigger” after which the disease begins to develop. Physical abuse, loss of loved ones, chronic pain or cancer can accelerate the disease. Lack of treatment for apathy and long-term depression are also some of the causes of psychotic depression.
Psychoasthenic individuals are most vulnerable to psychotic depression. This is caused by a certain type of character.
As a rule, such people have the following traits:
- irritable weakness;
- embarrassment;
- indecision;
- tendency to doubt;
- timidity;
- shyness;
- low activity;
- tendency to fruitless mental work;
- desire for introspection;
- abstract intellectual constructs divorced from reality;
- vulnerability;
- feeling of inferiority.
Also, such individuals have increased suggestibility, lack of will and passive obedience. Usually, not all pathologies appear, but only certain ones. For example, it could be only hallucinations or only delusions.
During the year, the patient's condition may change. As a rule, depression intensifies in the autumn and spring periods. The peak intensity of depression occurs in the first half of the day, and subsequently the patient’s condition begins to improve.
Basal anxiety
The baby is born helpless
, therefore, all those born into the world are characterized by
a feeling of helplessness
, this gives rise to anxiety in front of the world around them, which seems hostile.
If the mother cannot always be there to soothe her baby - then the mother cannot provide her child with a sense of predictability and therefore security - and then he experiences a chronic feeling of helplessness
.
This disrupts the normal formation ’s ego
: the world around him is perceived as unreliable, incomprehensible, unfair, hostile, merciless and scary - this is how
a basic distrust of the world
.
This, in turn, causes a violation of the child’s attitude towards himself; he seems weak
and
worthless
in this unfriendly world - this is how
low self-esteem
.
The immediate consequence of all this is what psychoanalyst Karen Horney
called
basal anxiety
(from the Greek
basal
- basic).
This is how anxiety becomes part of the personality, and it colors the perception of the world in the darkest colors, being the core around which depression
.
If the child’s mother herself is prone to anxiety, this only intensifies the child’s anxiety, reinforcing its basal character.
.
An anxious mother tends to overprotect the child, to protect him from a world that seems dangerous to her - accordingly, her child develops a fear of life
.
In the happy eyes of the mother, the child sees how beautiful the world is. A child cannot be happy if his mother is unhappy. Without sufficient experience of a happy relationship with his mother, the child will not gain basic trust in the world
(Erik Erikson). Such a child will constantly see only the dark sides of life.
“When you’re depressed, you don’t feel like you’ve been given a gray veil, and you see the world through a veil of sadness. You think that the veil has been lifted from you - the veil of happiness - and now you see everything in its true light.” (Andrew Solomon. “The Noon Demon: The Anatomy of Depression”)
A small child perceives the world through the prism of his mother's perception. A child cannot see the joy of life if the mother herself does not see this joy - and he will not be able to be fascinated by life, and will only expect disappointment from life, which is a characteristic feature of depression
.
Depression
is the inability to experience happiness.
Research by psychoanalyst Heinz Kohut
showed that children attribute
omnipotence
: parents for a child are gods.
Only the perception of parents as omnipotent
can provide a child
with confidence in the future
.
But for this, parents must be able to maintain in a small child the illusion of his absolute security
, and for this, his parents themselves must feel confident enough in their lives.
Premature and, especially, sharp disappointment in parents leads to a catastrophic collapse of ideals, disappointment in life, a feeling of vulnerability
and
powerlessness
, which causes
narcissistic personality disorder
and is the cause of
depression
.
What symptoms are characteristic of the disease?
Like any other disease, depression has certain criteria, upon identification of which, in fact, a diagnosis is made, and based on this, other methods of treatment are made. The following main symptoms are considered:
- depressed, joyless state, persistent sad mood,
- loss of interest in life and past hobbies,
- predominance of negative thoughts, pessimism about the future,
- feelings of loss, helplessness, despair, hopelessness, guilt, melancholy,
- impaired memory and concentration,
- fear of making decisions, anxiety, high anxiety,
- lack of initiative, passivity,
- periodically encounter this problem,
- lack of energy, fatigue,
- loss of appetite, noticeable weight loss,
- lack of sexual desire,
- pain in the body (for example, pressure in the chest or muscle pain),
- increased sweating, dry mouth, nausea, constipation and other vegetative manifestations.
We recommend that you read: What is chronic depression and how to get rid of it
With certain types of depression, not all of these signs may be present, but some of them, a certain combination of symptoms. The type of disease, severity and choice of treatment method depend on a specific set of criteria.
Suppressed aggression
Child education
inevitably associated with the suppression of his desires and, as a consequence, the child’s grievances against his parents.
Resentment
is helpless anger.
The main task of education is personality development
child, and for this it is inevitably necessary
to suppress the developing personality
of the child, because it is necessary that development proceed in a certain direction and within certain limits.
And, unfortunately, there is no other way - you can only choose softer parenting tactics, in which there is less stick
and more
carrots
.
The history of a child’s development is a history of rebellions against their parents, which in psychology are called developmental crises.
.
The main ones are: the rapproshman conflict
at 1.5–2 years,
the crisis of three years
and
the teenage crisis
. But the presence of crises does not mean that in other periods the child’s development goes smoothly.
The mother’s anxiety and the father’s excessive severity form a whole conglomerate of prohibitions for the child, thereby suppressing most of his desires and deforming his personality. Psychoanalyst Rene Spitz
called this parental behavior
psychotoxic
.
Despite the fact that the child grows physically and develops mentally, he still feels helpless before the power of his parents. Basal anxiety
intensifies largely as a result of the conflict between existing dependence on parents and rebellion against them.
If the parents always win, suppressing all the child’s aggression, this aggression is repressed and transformed into his Super-Ego
.
Classification of depressive episodes
Unipolar depression belongs to affective disorders, to the category of “depressive episode”. A depressive episode includes unipolar depressive disorder, unipolar, major, autonomic depression, and can last from several weeks to several years. The following conditions are noted within the framework of unipolar disorder:
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- Recurrent disorder or single episode of depression.
- Dysthymia and other chronic disorders (chronic major depressive disorder, incomplete remission in MDD).
- Subthreshold depression, unspecified depressive episode, brief recurrent depression.
The disease can occur as a mild, moderate or severe mental disorder:
- Light form. Symptoms are mild, the clinical picture may be dominated by one symptom, and there are no pronounced affective manifestations.
- Moderate form. Moderately severe symptoms, there are signs of impairment in professional and social functioning.
- Severe form. Severe impairments in professional functioning, symptoms of impaired social functioning, inability to perform their duties. Stupor (motor retardation), ideas of illness and guilt, psychomotor retardation, apathy, agitation, high anxiety, suicidal tendencies.
Unipolar depression can progress, the course of depressive episodes changes, and the severity of symptoms increases. Depression of this type is divided into stages of development:
- The stage preceding the onset of the episode is manifested by subclinical symptoms and subthreshold mood changes.
- At this stage, progression to recurrence of the depressive episode occurs with developing resistance to antidepressant medications.
Hard Super-Ego
Super Ego
- an important and necessary component of the human mental apparatus, a container of morality and a source
of guilt
, thanks to which
conscience
.
With an underdeveloped Super-Ego,
a person becomes a criminal, an antisocial personality, a psychopath.
Parents for a child are objects of love and affection ( libidinal objects
, as they say in psychoanalysis) – their attitude is very significant for the child.
The child very early begins to understand prohibitive gestures and intonations on the part of the parents, even before speech recognition. When something is forbidden to a child, he becomes frustrated
- he experiences a strong emotional experience associated with the prohibition of satisfying the desire he was striving for.
Strong emotional experiences contribute to imprinting in memory - fixation
on the interrupted action, which is called
the Zeigarnik effect
.
As psychoanalyst Harry Sullivan
, prohibitive gestures and intonations are “peeled off,”
incorporated
(absorbed) and become part of the child’s worldview, forming
the early superego
. Now the child will be afraid to do what his parents forbade him to do, because this prohibition already exists within him.
“The superego is a representation of our attitude towards our parents. We knew these higher beings when we were small children, we admired them and feared them, and later we took them into ourselves.” (Sigmund Freud. “I and It”)
Freud believed that the superego
is formed as a result of
the collapse of the Oedipus complex
only by the age of five.
Observations of children show that the child acquires the concept of what not to do
much earlier.
And by the age of five, a child begins to develop morality
, because he is already able to understand
what is good and what is bad
.
The early Super-Ego is pre-moral
, there is only a prohibition in it;
it is impossible
without understanding
why
- a small child is not yet capable of understanding the logic of cause-and-effect relationships, therefore
the early Super-Ego
is formed through mechanistic
identification with the aggressors
, who are the prohibiting parents of the child.
If a child from an early age is not allowed to express his aggression in response to parental prohibitions, all this aggression is introjected into the superego
, which becomes stronger and tougher - this is how the child’s own aggression is directed against himself.
In adulthood, this is expressed in self-doubt, in constant dissatisfaction with oneself, blaming oneself for all problems, in a word, in self-aggression
, which is the main characteristic of depression.
Auto-aggression can also be expressed in serious illnesses, primarily cancer, increased trauma, in deliberate self-harm and suicide. The Hindu goddess Kali, the creator and destroyer of life - the image of the archaic mother.
The earlier the Super-Ego
in a child, the more primitive and uncompromising it is in character, turning into an internal tyrant.
The more prohibitions, the more frustrations
, the more helpless the child feels in the face of the gods, which for him are his parents - the more terrible these gods seem, the same as people imagined them at the dawn of humanity, describing them as cruel in ancient myths, heartless and indifferent to people.
Therefore, in psychoanalysis, the early superego
is called
archaic
.
Archaic Super-Ego
becomes the core of
a mature Super-Ego
, and the larger this core, the more tyrannical
the Super-Ego
, the more obedient the child turns out to be, the more unhappy he feels.
The archaic Super-Ego
, which psychoanalysts also call
sadistic
, is a constant source of anxiety and shame, causing
depression
.
Complete suppression of aggression against parents and peers makes the child an obedient and compliant introvert.
, completely defenseless, unable to defend their rights.
Depression
- This is suppressed anger due to a feeling of complete helplessness.
Economic Model of Depression
Under the economy
in psychoanalysis we mean a description of the movements
of vital energy
within the human psyche.
Freud called this energy libido
, attributing to it a sexual character.
In modern psychoanalysis, libido
is often understood as psychic energy in a broad sense, as Jung defined
libido
.
Eid
produces impulses (
drives
) from which desires are formed.
The id
is the source of vital energy.
The task of the Super-Ego
is to control
the Ego
so as not to allow it to follow impulses
of the Id
that contradict its inhibitions.
Archaic Super-Ego
, primitive in essence because it was formed in the first years of mental development, gives these prohibitions an absolute character.
As a result of this, the Ego
turns out to be almost completely devoid of energy emanating from
the Id
, and
the Id
is overflowing.
The ego
turns out to be “bledless”, the person feels powerless, apathy, indifference to life, because all desires are suppressed -
depression
.
Eid overcrowding
, (
congestion
, as Freud put it) leads to a constant vague feeling of anticipation of an imminent catastrophe, an explosion.
And the Ego
, deprived of energy, turns out to be paralyzed.
Due to the suppression of desires, feelings
.
Without the desire to realize desires, the will
.
With the paralysis of the will, the intellect
.
Suppression (paralysis) of feelings, will and intellect constitutes depression syndrome
.
Analysis of patients suffering from depression shows that behind the apparent absence of feelings, emptiness
As those suffering from depression often say, there always lies a “stormy ocean” of repressed desires, hatred and the need for love.
The analysis of these feelings is the task of psychoanalysis in the treatment of depression
.
Ontogenesis of depression
During childhood, depression does not manifest itself in a specific way that can be diagnosed.
In infancy, the clinical picture of childhood depression, which is called anaclitic
, basically consists in the fact that the child has poor appetite and sleep, and his asthenia and apathy may look like the consequences of poor physical condition caused by an illness that always accompanies the development of
childhood depression
.
At a young age, a depressed child is less active than other children, is not so demanding of his parents and is more obedient, which, as a rule, quite suits his parents, and they do not even realize that behind their child’s “comfort” is the lack of his cheerfulness
- a specific feature
of depression
.
Due to mental depression, lack of self-confidence and, as a rule, retardation in physical development, such a child loses in competition to his peers, he has to constantly give in, for example, give his favorite toy to a stronger and braver play partner. He is already depressed, and the lost battles in kindergarten only contribute to the formation of his idea of the world as dangerous
and
uninhabitable
place.
This outlook on life makes you grow up faster, leaving childish carelessness ahead of schedule. Children who mature prematurely are depressed children
.
They are able to notice the tragedy and fatalism of life, because they do not have the “rose-colored glasses” of a carefree childhood
.
Here is an example of such a philosophical saying from a five-year-old child: Everything in the world comes to an end
.
A child’s preoccupation with existential problems, which is characteristic of old people, is a consequence of a depressive perception of the world
(however, like mature existentialism, because a fairly happy person simply does not think about the frailty of existence until old age).
During adolescence, such a child inevitably finds himself in situations that seem hopeless to him. Usually this is associated with unbearable mental pain as a result of another humiliation, another lost conflict with peers or parents. Often the cause is unhappy love
, and often -
bullying
by classmates, but there may be other reasons that may seem insignificant from the point of view of an outside observer, because the main reason is
unhappy love
towards parents and
bullying
oneself.
As an adult, such a person, who does not have sufficient experience of victories and is inclined to react to defeats with shame, will capitulate in advance, doomedly realizing that he is unworthy of successful competition. All this will only strengthen the gloomy outlook on life and form a detailed clinical picture of depression
, which can appear only by the age of 20-30, or even only by the age of 40.
The reason for this may be a minor traumatic experience, so to speak, the last straw
that has overflowed
the cup of patience
, although to a superficial glance such a person may even look successful. The later depression debuts, the more favorable the prognosis for its treatment. The earlier depression manifests itself in an expanded form, the shorter the history of a relatively favorable period of development, the less positive experience has been accumulated on which you can “rely” in the process of recovery from depression (after all, you cannot pull yourself out of the swamp by your hair, like Baron Munchausen).
Many patients who come to a psychoanalyst for treatment of depression consider their childhood, if not happy, then at least normal
,
average
: in their childhood there was no obvious cruelty on the part of their parents, and they received appropriate care and concern.
Only in the process of analysis is it gradually discovered that, although childhood was outwardly normal, there was a lot missing, and there were so many concessions and capitulations in conflicts, so much resentment, hatred and pain had accumulated. Depression does not necessarily result from overt trauma in a child. On the contrary, cruel treatment of a child can give rise to justified and, therefore, conscious anger in him, and to some extent protect him from auto-aggression. But the cowardly complacency of parents can deprive the child of the ability to express anger towards them. This is probably what Freud had in mind when he wrote that excessively soft parents can give rise to an overly hard superego, because the child cannot be angry with them. And even if there were mental traumas, the main cause of depression is still a deficiency
: lack of attention and love on the part of parents - their myopia and lack of empathy.
Narcissistic depression
There are stories of the development of depression when a child in childhood did not have the visible signs of developing depression described above; on the contrary, such a child was active and motivated to succeed, willingly entered into competition and often won.
Parents are gods for a child
. Some parents give their child the idea that he can earn love only if he demonstrates his achievements, only if he is worthy of admiration. Such children often achieve fantastic success in order to earn the love of their parents. The tragedy of such a child is that despite all his achievements, he does not receive love, because the parent who promised love does not know how to love.
A breakdown, which can only occur in the middle of life, is evidence that such a person lived his entire life at the limit of his capabilities, that he was a colossus with feet of clay
.
Narcissistic depression that follows a breakdown
characterized by a feeling of complete defeat, the collapse of one’s entire life and a sense of one’s own worthlessness.
Most often, such a person can no longer recover from the shock on his own and further attempts to continue striving for achievements are unsuccessful. This is often accompanied by a feeling that something has broken
, or that you
are dead tired
. Such depression can lead to suicide, conscious or, more often, involuntary, or, as a compromise, to a serious illness that turns out to be an indulgence.
Only as a result of his analysis does a patient with such a story begin to understand how difficult, in fact, everything was given to him in childhood, and how he lacked the love of his parents, their acceptance and empathy. Analysis does not “make” such patients into “ordinary” people who are content with what they have - because the desire for achievement has already become the core of their personality. Having understood their feelings, and receiving support from a psychoanalyst, they will continue their ascent to success, now based on more realistic assessments of their capabilities.
If parents (or their substitutes) significantly and wisely invest in the creative development of the child, teach him hard work and perseverance personally or give him a good education, hire talented tutors (or relatives perform this function), developing in the child the ability to enjoy creativity and joy from achievements - then in adulthood, such people, thanks to the base received in childhood, manage to overcome all the breakdowns, and they continue to move towards success, becoming outstanding people, and the whole world applauds them - and the attention of the public seems vital for them. But often, paradoxically, it is success that makes their life meaningless. Although the whole world applauds them, this cannot replace the love of a mother and the admiration of a father, not received in childhood, because it is precisely this deficiency
stimulated them to achieve. And they feel that everything they have achieved is meaningless.
“And I looked back at all my works that my hands had done, and at the labor that I labored in doing them: and behold, all was vanity and vexation of spirit, and there was no profit from them under the sun!” Bible. Book of Ecclesiastes [2:11]
Narcissistic depression
is not always expressed in a detailed clinical picture, like that of King Solomon (Ecclesiastes), but more often manifests itself in
a tragic death
.
Whoever ended his life tragically is a true poet! And if it’s on time, then to the fullest! At number 26, one stepped under the gun, while the other climbed into a noose in Angleterre.
Vladimir Vysotsky in this verse of his song talks about Lermontov, who was so obsessed with duels that his desire to commit suicide was obvious, especially considering the image of the hero of his time
suffering from
narcissistic depression
; and about Yesenin, lonely and disappointed in life, who hanged himself in a room at the Angleterre Hotel, writing before his death:
In this life, dying is not new, but living, of course, is not new.
Vysotsky in this song continues the martyrology of great poets who ended their lives tragically
. Vysotsky himself, abusing alcohol and morphine, experienced clinical death at the age of 41, but this did not stop him in the unconscious desire to commit suicide, and he died a year later from a heart attack at the zenith of his fame.
::
A narcissistic attitude towards achievement is not always a consequence of parents stimulating their child to achieve. Often, as a result of emotional emptiness and anxiety on the part of parents, a passionate desire for grandiose achievements is born “by itself,” behind which lies the unconscious idea of earning admiration from parents, making them happy and loving (“revive” their “dead” parents). This desire is born from emptiness
just as a lonely God created the world
out of nothing
.
Such a child finds himself forced to feel like a god in order to survive in this emptiness. Most often, this option for a child’s development turns out to be the most tragic, because his parents are not able to invest in their child not only emotionally, but also intellectually and financially. And such a child does not become a god, emptiness remains emptiness, and his life turns into a soap bubble. But, growing up, he, as a rule, desperately continues to “cling” to the illusion of his own grandiosity in his fantasies. This is what prevents him from moving forward, because, without the appropriate education and experience of persistent work, he avoids acting in order to avoid failure. And for him appearing
turns out to be better than
being
- such a constellation forms the most severe
syndrome of narcissism
.
In general, any depression always carries with it a narcissistic radical
self-abasement and fatalism, the futility of all aspirations: everything, sooner or later, begins to seem like
vanity of vanities - everything is vanity!
Causes of depression
Depression
does not necessarily have its roots in infancy, but its origin is always associated with the first 10 years of life, when a personal core and an optimistic outlook on life are formed.
This requires adequate support from parents in the difficult process of child development, tolerance and respect for the child’s personality that has just begun to form, for his desires and needs - in a word, everything that we call love
.
Depression occurs as a result of a lack of
such support against the background of natural
anxiety
and
feelings of helplessness
.
Separately, it should be highlighted among the causes of depression
depression or even just the depressive personality of the mother, which deprives the child of the necessary positive experience of experiencing happiness with the mother.
Such an emotional deficit
does not lay the necessary foundation for the formation of optimism, does not provide the opportunity to experience stress without a feeling of helplessness and doom - i.e.
depression
.
In the process of development, identifies
with his mother, and, accordingly, with her
depressive perception of the world
.
And, in the end, the obstacle to being happy for the child of a depressed mother is his feeling of guilt
towards the mother, who constantly suffers.
Depression
always arises at the site
of a deficit
, as a result of which a “hole” remains in the psyche: when parents did not pay enough attention, did not show tolerance, did not support, could not, because it was hard for themselves, they did not have enough strength to love, and they did not know how to love, because their parents did not know how to love.
If a young child is allowed to develop deep roots that are nourished by the life force and love of the parents, he can experience significant psychic trauma in later life without being seriously damaged: You cannot kill deep roots by cutting off a few branches
(Thomas Wolfe).
The cause of depression is a lack of roots
.
Cordylidae bites its tail when in danger
Depression grows and develops as a result of auto-aggression
: This does not necessarily have to be expressed in a tendency to blame only oneself for everything or feel hatred towards oneself.
In the case of depression, auto-aggression is expressed primarily in the inability to be in contact with one’s anger
, often not even the ability to feel one’s anger.
The symbol of depression is the ouroboros
- a dragon biting its own tail.
Treatment of unipolar depressive disorder
In the treatment of unipolar depression, antidepressants are used as monotherapy. In about a third of patients with severe depression, treatment with antidepressants causes some improvement in their condition. The condition of the same number of patients does not change. If treatment is ineffective, the doctor replaces the drug with another from this or another group of antidepressants. A program has been developed to treat patients who demonstrate resistance to certain depression medications. As an adjunct to antidepressants, lithium is prescribed, which is ineffective for unipolar depression, but can enhance the effect of other drugs.
The treatment program for depression also depends on the severity of the disease. In mild cases, antidepressant therapy is not recommended unless the disease is chronic. In mild cases of depression, treatment depends on the mental characteristics of the patient; in most cases, the doctor limits himself to psychotherapy. Moderate and severe depression require combined treatment, including antidepressants, antipsychotics, lithium drugs, antipsychotics as indicated, and psychotherapy. Also, the treatment program depends on the type of depressive episode; treatment of melancholic disorder is more effective with the use of electroconvulsive therapy, psychotherapy and TCA drugs. Combination treatment (antipsychotics + antidepressants + psychotherapy) is effective for psychotic disorder.
The course of an episode in unipolar disorder can change significantly - the disease progresses, episodes are repeated more often, become more severe, and last longer. Therapy for unipolar disorder includes several stages:
- Cupping phase. The period starts from the start of therapy and ends with the onset of remission.
- Long-term therapy. It begins with the onset of remission and is carried out to prevent relapse of the disease.
- Prevention or maintenance therapy. Helps ensure lasting restoration of the patient's mental health, reduces the risk of relapse of depression and suicide.
The patient receives psychiatric support throughout the entire treatment period; the doctor recommends that the patient participate in self-support and rehabilitation groups.
