Approaches to the treatment of depression in general medical practice

If you are reading this article, it means that either you are a person who is depressed yourself, or you want to help a loved one who suffers from it. Are you ready to seek help from a psychologist for depression? However, you want to figure out who helps better: psychologists or a psychiatrist for depression. You need a reasoned explanation of who is better - a psychologist or a psychotherapist for depression. In this article, we will explain to you the difference between them, accurately define the symptoms of depression, and most importantly, answer the question of why and who experiences depression, why psychologists are powerless to help, and how to be guaranteed to cope with depression and start living happily. Knowledge of System-Vector Psychology by Yuri Burlan will help you accurately determine your psychological state and get rid of suffering.

Types of antidepressants prescribed to treat depression

Despite the similar expected treatment results, there are several groups of antidepressants that differ in their mechanism of action and chemical structure.

• Serotonin reuptake inhibitors interfere with its absorption from synapses (nerve cell junctions). Serotonin accumulates, as a result of which the symptoms of depression decrease.
• Dopaminergic antidepressants increase the concentration of dopamine at synapses. Dopamine is similar in action to serotonin and is also a substance that increases the overall level of mood.
• Tricyclic antidepressants. They were among the first to be used in clinical practice. Increases the concentration of serotonin and norepinephrine in synapses. They have a number of side effects associated with the blockade of acetylcholine receptors - dilation of the pupils, retention of stool and urination, increased heart rate, dilation of the bronchi.
• Serotonergic and noradrenergic antidepressants act similarly to tricyclics, and do not have the side effects of the latter.
• Heterocyclic antidepressants, in addition to the accumulation of serotonin and norepinephrine in synapses, cause activation of adrenaline receptors, increasing the overall tone of the body.
• NASA antidepressants mimic the effects of serotonin and norepinephrine, producing a similar activating effect.
• Dopaminergic antidepressants lead to the accumulation of dopamine in synapses, which has an activating effect.
• Noradrenergic drugs increase the concentration of norepinephrine with the same effect.
• Melatonergic antidepressants affect the deep structures of the brain, resulting in the restoration of the daily rhythm of activity, increasing the overall tone of the body, normalizing sleep, and improving mood.
• Monoamine oxidase inhibitors have stimulating and antidepressant effects. Based on the duration of the effect, there are reversible (the effect lasts several hours) and irreversible (the effect lasts two weeks) MAO inhibitors.

NLP

If you have doubts about whether a psychologist helps in cases of depression, you should take a closer look at specialists working using NLP technology. This is considered to be one of the most reliable approaches to combating suppressed sucking. Such techniques are aimed at studying one’s own hidden resources, reserves of energy and strength. The doctor helps a person determine values, formulate needs, starting from the need to formulate new positive attitudes. The doctor does not address previously negative experiences, but teaches the person to behave differently. NLP is neurolinguistic programming, within which life goals are formulated and the client is helped to achieve them. Working with a person in need, the doctor influences him through all channels of information transmission.

Studying how and why, and whether psychologists help people in general, we have to admit that there are many methods of influencing a person, and all of them can be used for the benefit of the person. The individual perceives information through taste buds, visual organs, smell and through touch, through the organs of hearing. A psychologist who knows how to work in all these areas gives the client the opportunity to understand depression, the strength to cope with it, as well as new patterns of action in life that allow them to achieve greater success without harming their own psyche.

Treatment regimens for chronic depression

According to modern approaches, treatment of long-term depression should be carried out in three stages:

1. Active treatment of a depressive episode.
2. Maintenance treatment.
3. Preventive treatment.

The duration of therapy and the combination of medications depend on how long chronic depression has been present. Treatment begins with modern drugs that have minimal side effects.

The presence of suicide attempts, anxiety and restlessness are indications for inclusion of benzodiazepine anxiolytics in the treatment regimen.

The most effective for long-term severe depression are noradrenergic and serotonergic antidepressants. They are prescribed for a course of 6 weeks. At the end of the course, the result of treatment is analyzed and the issue of continuing it, replacing medications, or supplementing with other medications is decided.

The criterion for the success of treatment is considered to be a noticeable improvement in the patient’s condition after 3-4 weeks from the start of therapy.

If the condition improves on the initially chosen treatment regimen, anxiolytics are discontinued after 3 weeks of use, and antidepressant treatment is continued for up to 6 weeks.

In case of severe depression, treatment is recommended to be carried out in an inpatient setting with daily monitoring of the patient’s condition and timely adjustment of treatment if necessary.

If the desired effect cannot be achieved, they move on to prescribing antidepressants of earlier generations, in particular tricyclics. For the fastest possible effect and reduction of side effects, it is recommended to begin treatment with intravenous drips of the drug. The treatment regimen is chosen as for more severe depression.

If an episode of depression lasts more than 6-9 months, the initial treatment regimen must include mood stabilizers or lithium salts. The result is assessed after a month of taking the drugs; if it is satisfactory, treatment is continued for up to six months, sometimes up to 8 months. After a course of antidepressants, long-term prophylactic use of mood stabilizers is prescribed.

If the result of such a treatment regimen is unsatisfactory, more complex, individually selected regimens are prescribed.

Help from a psychologist for depression: techniques and methods

Let's look at how a psychologist helps with depression. Before starting to give advice and recommendations, the psychologist will ask about the causes of depression, when it started, how long it lasts, what events preceded the appearance and development of this condition. A good psychologist will try to analyze all the signs of depression in order to exclude somatic causes - endocrine, tumor and other diseases that may be accompanied by depressive symptoms.

Help from a psychologist for depression can be provided in different ways. There are many different areas in psychology: consultation with a psychologist for depression can be based on the principles of Gestalt therapy, cognitive or psychoanalytic approaches, art therapy or some other areas. Therefore, no one will give you a single answer to the question of how psychologists get out of depression.

Treatment of co-occurring disorders

In the presence of psychopathological symptoms, atypical antipsychotics are prescribed. They help cope with hallucinations, delusions, manic-depressive episodes, psychomotor agitation, slow down the progression or eliminate negative symptoms - unemotionality, apathy, passivity.

Atypical antipsychotics help cope with anxiety, paranoid ideas, and the perception of the world around us as unreal.

“Minor” antipsychotics are used to treat psychopathic conditions and neuroses accompanying depression.

Psychologist for depression: an important warning

System-vector psychology explains that real black, sucking depression occurs only in a person with a sound vector. It is to him that psychologists’ advice on how to get out of depression seems empty and meaningless. And it is for him that the help of a psychologist for depression turns out to be ineffective.

The sound vector does not allow a person to enjoy the simple joys of life. Family, love, comfort, money, fame and power - what most people strive for, do not seduce him. The main thought that sounds in the head of a depressed sound artist is that life has no meaning. He cannot understand why he needs to sleep and eat, study and go to work, in the end, why he needs to live. He strives for loneliness, those around him irritate him. Neither his family nor his friends understand him. Therefore, advice from a psychologist on how to get out of depression does not work for a sound engineer.

If a person does not have a sound vector, then his condition cannot strictly be called depression. This can be apathy, when you don’t want anything, melancholy or a feeling of guilt before the deceased, when it seems that nothing can be fixed, resentment towards parents and the world around you, which slows you down and prevents you from developing, and much, much more, but not depression. Understanding the differences between these conditions is very important for a psychologist, because the path of treatment and specific help from a psychologist for depression depend on it.

What a psychologist usually recommends has no effect on real depression.

And can a psychologist who does not know the peculiarities of the sound vector understand the causes of depression? He looks for the causes of depression in external circumstances - in relationships with parents and loved ones, in problems at work, but the main question that torments the sound specialist remains unnoticed: questions about the meaninglessness of life that torment a person with a sound vector are not entirely clear to the psychologist.

Non-drug treatments

They are used to speed up healing, eliminate life-threatening manifestations, and bring about remission.

In case of active suicidal tendencies, refusal of food, or stuporous states, electroconvulsive therapy can be used.

Isulin-comatose therapy is used when pharmacological treatment is impossible, severe, life-threatening manifestations, especially if schizophrenia and chronic depression are combined. Treatment with these methods helps to significantly accelerate the onset of relative remission and move on to conservative therapy.

After a course of antidepressants, acupuncture (acupuncture and electroacupuncture), transcranial magnetic stimulation, light therapy, and physiotherapy can be used to consolidate remission.

Types of depression

In psychiatry, several types of human depressive conditions have been identified. They all differ only in the degree of their power to damage the psyche.

1. Major depression. The phenomenon is classic, characterized by a severe form of the condition and frequent impulses to commit suicide. It has a fairly long period of flow.
2. Dysthymia. The mildest depressive disorder. It is not as debilitating as other types. Characterized by a low level of depression.
3. Affective insanity. The disease manifests itself cyclically, with periods of sometimes long-term remission. During the depression phase, the patient experiences the same symptoms as with normal depression. And during the manic phase, severe overexcitation of the psyche and somatic disorders occur, which manifests itself in the appearance of nervous tics, too active jumps in thoughts, actions and reactions to the environment. Typically, such people in the manic phase may suddenly laugh hysterically or burst into tears. This indicates mental mobility and the inability to control one’s psychosomatic reactions.
4. Postpartum depression. A fairly common syndrome in the modern world. After childbirth, a sharply changing hormonal balance can bring a woman’s psyche to some extreme states, even suicide. This is usually due to inattention to the pregnant woman and a lack of nutrients, which the body especially urgently needs during this period.
5. Seasonal affective disorder. This type of illness affects the largest number of people. Lack of sunlight, cold weather conditions, magnetic storms, and shortened daylight hours can cause this type of disease.
6. Psychotic depression. A dangerous type of depression. Accompanied by severe psychosis, hallucinations, and delusional states. Sometimes such patients suffer from personality disorders due to these conditions, which makes them dangerous to society.

Maintenance treatment

After achieving clear remission, it is recommended to continue treatment with an antidepressant with proven effectiveness for the patient for 4-9 months. If the duration and severity of depression before treatment was very significant, maintenance treatment can be extended up to 12 months.

When taking tricyclic antidepressants, side effects associated with the action of acetylcholine may occur during the stage of preventive treatment. Then they are recommended to be replaced with a new generation antidepressant, in particular, serotonin reuptake inhibitors, NASA antidepressants or heterocyclic and atypical antidepressants.

Types of depression

• Depressive adaptation reaction
• Dysthymia
• Depressive episode with cyclothymia
• Masked depression
• Single depressive episode
• Recurrent (chronic) depression
• Depressive phase of bipolar disorder
• Postpartum depression
• Organic depression.

Depression is also characterized by a constant expectation of trouble and misfortune, increased causeless anxiety, internal tension, but there is also melancholy depression with despair and a feeling of melancholy, hopelessness, when a deterioration in the condition is observed in the morning after waking up. Often a patient with depression feels pain in the stomach, chest, back, etc. This is due to the fact that due to a decrease in serotonin, the threshold for pain sensitivity decreases and depressed patients experience subthreshold pain. Possible use of narcotic, psychotropic substances, as well as alcoholic beverages.

Characteristic signs of a depressive state are sleep disturbance with early awakening, a pessimistic assessment of what is happening, increased anxiety, indifference to performing one’s duties, decreased mood and performance. If you notice that your symptoms are getting worse over the course of two weeks, you should seek help from a specialist.

Preventative treatment

The usual duration of preventive treatment after an episode of depression is at least a year. In case of repeated episodes or suicide attempts, the duration of preventive medication can be increased to 5 years.

Melatonergic antidepressants have proven themselves well as preventative medications. Normotimics must be prescribed. It is possible to prescribe herbal medicine, including complex preparations.

To prevent seasonal relapses, light therapy and reflexology are prescribed.

There are more and more psychologists - there are also depressions

If you look at developed Western countries, you cannot say that they suffer from a shortage of psychologists. Nevertheless, Finland and the Netherlands are in first place in terms of the number of suicides, and in America every tenth person suffers from depression, if you count them together with babies. Are antidepressants and professional advice from psychologists on how to get out of depression really not helping them?

Indeed, we have to admit a sad fact: psychologists do not treat real depression. Recommendations from a psychologist for depression posted on the Internet are especially useless. This is nothing more than popular advice “about everything”. For example, a psychologist’s advice on how to get out of depression says “avoid loneliness.” But the problem of a person with depression is that those around him are a burden. And how, pray tell, can he implement such advice?

When a person wants to get out of depression, such advice from a psychologist does not help him. It is impossible to suddenly love people when they only cause irritation. It is impossible to feel the joy of life if you do not see the meaning in it. It is impossible to love yourself if even your own body seems like a burden from which you want to get rid of as quickly as possible. If you have real depression, and not a banal lack of money and love, then no psychologist will understand or help you. A different approach is needed here.

Psychotherapy

It is a mandatory component of all stages of treatment. Its role increases as severe symptoms are eliminated under the influence of pharmacotherapy. The following types of psychotherapy can be used:

• Family
• Behavioral
• Cognitive
• Problem-solving
• Interpersonal
• Short-term dynamic

Psychotherapy is an important factor in the prevention of relapse of depression during the after-treatment stage.

Psychotherapy sessions for depression

Not every patient requires hospitalization and drug treatment. Psychotherapy has proven itself to be very effective in the fight against depressive conditions. In the civilized world, psychiatrists, as well as psychologists at the government level, create psychological consultation centers that provide timely assistance to overcome various mental illnesses, and conduct psychotherapy sessions for depression.

Since depressive states are one of the most common personality disorders today, psychologists are developing all kinds of special techniques and projective tests adapted to various social groups, taking into account gender characteristics.

Group types of psychotherapy are very effective for patients suffering from the same type of mental disorders. Some people in the group open up, stop feeling alone with their illness, and are not afraid to discuss their condition in detail, which helps the psychiatrist determine the reasons that provoked the illness.

However, there are also patients who require a single individual approach and consultation “behind closed doors”. They are embarrassed to admit their conditions, avoiding answering or inventing inappropriate signs. In such cases, the doctor should help figure it out and show the way to his patient. Although, in these cases, the best outcome will be achieved only when the patient himself shows a desire to overcome his illness by any means in order to get rid of it.

Psychotherapy for depression sets its first goal to help the patient cope with emerging conditions independently, preventing their relapses in the future.

How to recognize?

Depression is a disease of the entire body. Depression has typical symptoms. These signs are very diverse and they can vary depending on what form the disease takes. Let's list the possible manifestations of depression.

Emotional manifestations:

• melancholy, depressed mood,
• anxiety, expectation that trouble is bound to happen, feeling of internal tension,
• high irritability,
• increased feeling of guilt, it is possible that a person often blames himself for what is happening,
• dissatisfaction with oneself, decreased self-esteem and self-confidence,
• anhedonia, that is, a person no longer experiences pleasure from what previously gave this pleasure,
• interest in what is happening around a person decreases,
• in case of deep depression, the ability to experience any feelings is lost in principle,
• Depressive disorder is often combined with symptoms such as anxiety about the health and fate of loved ones, as well as the fear of appearing incompetent in public.

Physiological manifestations:

• a sick person has disturbed sleep, this can be either insomnia or increased drowsiness,
• appetite is impaired, a sick person may stop eating altogether or begin to overeat,
• Intestinal function is also impaired, which manifests itself in the form of constipation,
• the need for sex decreases,
• fatigue increases, the person experiences weakness,
• a person experiences pain in the body.

Behavioral manifestations:

• the person becomes passive, it is difficult for him to be involved in purposeful activity,
• the person tries to avoid contacts, becomes prone to solitude, loses interest in other people,
• a person refuses entertainment,
• Problems with alcohol begin; the person, among other things, abuses psychoactive substances.

Mental manifestations:

• it becomes difficult for a person to concentrate, concentration decreases,
• difficulties arise when making decisions,
• gloomy thoughts about yourself and your life, as well as about the world in general, begin to prevail,
• the future seems gloomy, there is no prospect in it, thoughts appear that life has no meaning,
• in severe cases, thoughts of suicide may occur,
• a sick person is visited by thoughts that he is not significant for the world, is not needed by anyone and is helpless,
• A sick person's thinking slows down.

In order for a diagnosis of depression to be made, it is necessary that the listed symptoms be observed in the patient for at least two weeks in a row.

How to survive winter depression? Find out the answer right now.

About the mechanisms of depression, symptoms, treatment with medication and psychotherapeutic methods:

What does psychological help consist of?

Psychological help for depression may consist of general advice that a psychologist is competent to give .

Some of these tips include the following:

1. You cannot isolate yourself and the current problem; it is important to talk about your condition to your loved ones.
2. It is necessary to monitor your diet; in addition, it is important to monitor your daily routine, sleep hygiene, and hygiene in general.
3. You should not drink alcohol or drugs, and take medications only after consulting your doctor.
4. It is necessary to play sports.
5. It is important to find yourself a hobby.