Types of depression - signs, features

Causes of depression

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Causes

The main reasons are an unstable personal life, mental disorders, and a reaction to hormonal medications. In addition, the influence is exerted by:

fatigue;
the opinions of others;
mistakes and failures in professional activities;
illness;
constant loneliness and a feeling of uselessness.

Symptoms

There are a huge number of them, but I have highlighted only the main ones:

sad and empty feeling;
helplessness;
lack of interest not only in life, but also in hobbies;
rapid loss of energy;
inhibition of actions and thinking;
insomnia;
overeating or, conversely, loss of appetite;
suicidal thoughts.

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There are several types of depression. Among them are major depression, depression after the birth of a child, reactive depression, seasonal affective disorder, bipolar disorder, etc. Depending on who suffers from a depressive disorder, they speak of senile depression, adult blues, or depression in children and youth.

Depression can occur as a result of genetic predisposition, fluctuations in neurotransmitter levels, or due to traumatic events such as the death of a loved one or divorce.

According to the ICD-10 classification (International Classification of Diseases), episodes of depression are divided depending on the intensity of individual symptoms:

benign (main symptoms of mild depression);
moderate (main symptoms of moderate depression: disappointment in life, marked decline in social and professional functioning);
severe without psychotic symptoms (predominant: depression, significant psychomotor slowing, sometimes irrational fear, frequent thoughts of death, suicidal tendencies, inability to function socially and professionally);
severe with psychotic symptoms (all of the above, plus delirium, feelings of sinfulness, guilt and the need for punishment, hypochondria, auditory hallucinations, slowing of movements to the point of stupor).

In simplified terms, we can say that depression has as many types as there are possible causes. To facilitate understanding of the mechanisms that cause depression, the following division can be made, depending on the cause of the disorder:

endogenous and reactive (psychogenic);
primary or secondary depression, that is, occurring as a result of other diseases or as a result of the effects of medications used;
depression illness.

Endogenous depression has its origins in brain transduction disorders. A special role is attributed to substances such as norepinephrine and serotonin, the deficiency of which leads to a decrease in mood. Reactive depression occurs in response to a feeling of severe mental trauma that changes the patient’s life or threatens the previous order of the inner world.

The source of depression can be chronic medications taken, as well as liver disease and hormonal problems. Coronary heart disease deserves special attention. Depression affects about 15-23% of people with heart failure. A similar situation is observed in patients with coronary heart disease, especially in those who have suffered a myocardial infarction.

The causes of depression are often confused. Somatic diseases often contribute to the appearance of blues and despondency, and depression worsens the prognosis of recovery. The mixed type includes seasonal depression and postpartum depression, in which both mental and hormonal disorders play a key role.

Depression can also act as an element of affective personality disorder, formerly called manic-depressive psychosis. In this case, depression and apathy alternate with periods of unnaturally intense activity and euphoria.

Stages of depression

In psychology and psychiatry, depression remains the subject of lively debate. It is also probably one of the most “recognizable” disorders in our public consciousness. The stages of depression are distinguished based on the severity of the patient’s manifestations of the disease. There are different classifications, but the question of how many stages of depression to distinguish is a matter of practical needs. Basically, they adhere to the following stages of depression. If depression stops getting worse at a certain stage, then it is also called not a stage, but a degree of depression.

Of course, like any other division into degrees (stages), this is, first of all, done for the convenience of study and diagnosis, because the boundaries between them are not as specific and clear as they seem at first glance. The current ICD 10 classification, which is used to diagnose mental disorders, distinguishes mild, moderate and severe depression.

Criteria for depression

To correctly diagnose a major depressive episode, it is common to use a number of criteria.

- depressed mood for most of the day, and in children and adolescents, instead of a depressed mood, increased irritability may be observed; - a significant decrease in feelings of satisfaction; - significant weight loss or weight gain; - insomnia or hypersomnia; - psychokinetic activity or slowness of movements;

- increased fatigue, loss of strength, decreased performance; - a feeling of guilt (and this feeling quickly progresses and reaches the point of absurdity when a person begins to consider himself guilty of such things for which it is obviously not his fault); - indecision, decreased mental activity, impossibility concentrate your attention; - thoughts of death, suicide attempt.

It should be especially noted that one of the five symptoms required for diagnosis must be a depressed mood or a decreased sense of satisfaction.

Secondly, a patient cannot be diagnosed with depression if he experiences a so-called “mixed episode,” which expresses a state between mania and depression.

Thirdly, the person must clearly exhibit dysphoria - low mood with irritability, anger, gloominess, increased sensitivity to the actions of others, with a tendency to outbursts of aggression, etc.

Fourthly, all these symptoms should not be the result of another disease or the use of various substances (medicinal, toxic or narcotic).

Finally, fifthly, these symptoms should not be a manifestation of mourning, i.e. states of grief for a deceased loved one. However, if this state is prolonged for any reason and the person does not find peace, then mourning can easily turn into depression.

Stages of depression

The peculiarities of the course of each type of disorder make it possible to distinguish 5 stages of the development of the disease only for psychogenic depression. A severe emotional shock in a person with a healthy psyche triggers the process of gradual acceptance of the grief that has occurred.

First stage

A period of sharp denial of what happened. The initial stage, the first in which a person convinces himself that what happened did not happen to him. The patient maintains his usual lifestyle, there are no classical signs of pathology, but irritation arises at people trying to point out the problem.

Second stage

Awareness of what happened requires a search for the culprit, which provokes the development of acute resentment, increased irritability, and rage. Often at this stage the patient begins to look for shortcomings in himself, finds them and becomes convinced of his own inadequacy, which reduces self-esteem. Signs of the disease include attacks of rage, embitterment, and uncontrollable mood swings.

Third stage

This depressive phase is characterized by complete emotional and psychological exhaustion. The patient feels in a hopeless situation and perceives every attempt to change something as obviously hopeless. The person has already understood what happened, accepted it, but understands that he cannot cope on his own. The third stage is characterized by the desire to make deals with oneself, loved ones, God, even a psychiatrist. Treatment becomes possible only at this stage.

Fourth stage

In the absence of the necessary help from a specialist, an awareness of the acute hopelessness of the situation begins to prevail, a feeling of hopelessness, which provokes changes in the patient’s psychology, pushing him to abuse alcohol, drugs, and gambling. The patient constantly feels sorry for himself, limits his social circle as much as possible, and has problems at work, even threatening to be fired. In severe cases, an acute reluctance to communicate with others can provoke the development of a speech disorder.

Fifth stage

The last stage is characterized by accepting what happened and defining a new life direction. Restoring the ability to enjoy the world around us and perceive its beauty is possible only after completing the process of psychological perception of reality.

Deep depression

The problem of depression is still being intensively studied, new discoveries are emerging, and the names of individual disorders are also changing, despite the fact that outdated concepts are still in effect in the literature. All this leads to the identification of many types of depression. At the head of depressive disorders is major depression.

From year to year…

Otherwise, it is defined as endogenous depression, organic or unipolar. Its basis is organic factors, for example, dysfunction of the nervous system. In the case of this type of depression, pharmacological treatment is usually necessary, which aims to restore the correct parameters of the distribution of neurotransmitters, for example, optimal serotonin levels. The most effective treatment also includes psychotherapy.

During illness, deep melancholy, loss of a sense of the meaning of life and lack of desire to make social contacts dominate. A person with major depression, as a rule, is not capable of professional activity, he develops psychomotor slowing, problems with memory and concentration, very often thoughts of death and suicidal tendencies.

Although the etiology has not been fully understood, it is clear that the tendency to this type of depression is hereditary. The risk of the disease is estimated to range from 15% (if one parent was ill) to 50% (if both parents had episodes of depression).

Depression in teenagers

Teenage depression is a very complex disease. Recognizing it can sometimes be quite difficult. In some cases, parents and others may perceive teenage depression simply as poor upbringing, attribute it to character traits, and so on. This happens due to the fact that the symptoms of the disease are quite specific.

Signs of depression in a teenager:

attacks of aggression and outbursts of anger that are directed at loved ones;
gloominess;
deterioration in attentiveness, increased fatigue, loss of interest in studies, absenteeism, decreased academic performance;
conflicts with parents and others, which results in frequent changes of friends and acquaintances;
regular complaints that no one loves or understands him;
non-acceptance of any criticism addressed to you;
pretermission of duty;
the appearance of pain (headaches, in the heart area, in the abdomen);
unreasonable fear of death.

Masked depression

Masked depression is a very difficult type of affective disorder to diagnose. Its appearance is not accompanied by typical symptoms of depression, such as sadness, depression or psychomotor slowing.

The symptoms that accompany it are, first of all, somatic diseases, such as chronic pain (especially of the head, abdomen, but also other organs), sleep disorders, sexual disorders, menstrual disorders, bronchial asthma, and eating disorders.

The disease may be accompanied by symptoms of anxiety such as panic attacks, asthma attacks, symptoms of irritable bowel syndrome, hypertension, etc. Depression can take on many masks, and therefore manifest itself in a variety of symptoms that can change from one to another.

As a rule, masked depression reveals itself when there are no obvious organic changes, and symptoms intensify under the influence of various life events. Typically for masked depression, the disappearance of symptoms of the disease under the influence of taking antidepressants.

Anxious depression

In the clinical picture of the disease, the dominant symptom is anxiety, fear and panic. A person suffering from this type of depression is “explosive” and aggressive, both towards himself and the environment.

This behavior is a result of the need to relieve tension. A fairly accurate description of this emotional state is the statement that the patient cannot sit still.” Unfortunately, this type of depression is associated with a high risk of suicide.

Sequence of recovery from despondency

The most common stages of recovery from depression are listed below:

The first action is to allow the person to speak out
. A situation is created that allows a person to leave the closed state and enter into a conversation. If you manage to get a person to talk, then at this time the most important thing is that during the hour of conversation your presence is 10%, his presence is 90%. You must understand his any reproducible absurdity. It is necessary to motivate him to action, he must realize what is happening at the moment.
Relax
: meditate, listen to calm relaxing music, treat yourself to hot tea, take baths with essential oils and sea salt.
Switching attention and thoughts
. Go out into nature more often, walk in the fresh air, listen to birdsong, merge with the sounds of nature, admire the flowers and treetops, the skies, admire the environment and see how colorful it is and hear its sounds. You can start growing fresh flowers at home. You can get out of depression through this process. You can also start knitting, this causes great concentration, and the process of creation itself gives peace.
Get creative
. This refers to the switching method. In this case, you can start writing poetry, drawing pictures, and generally doing all the activities that result in something new and unusual.
Structure time
. Make plans for the future and decide on goals. Also start drawing up a daily schedule, because unsystematic spending of time creates confusion, leads to bad thoughts, as a result of which a person does not know how and does not want to create. By scrupulously observing the daily routine, a person structures his life and leaves no room for gloomy thoughts.
Recreate resource states
. Re-experience successful situations that increase self-esteem.

Postpartum depression

Depression after birth, manifested by sadness, despondency, apathy, weakness, mood swings or tearfulness, which affects approximately 80% of new mothers. Postpartum depression may be indicated by an increase in symptoms over two weeks or longer, which may be accompanied by increased illness.

The main cause of postpartum depression is the hormonal changes that accompany childbirth. A source of depression is also the sense of responsibility associated with the birth of a child. A woman's low mood is manifested by many other diseases with somatic symptoms, such as loss of appetite, headaches and abdominal pain.

The patient shows no interest in the child, feels tired, sleeps poorly or cannot fall asleep at all. The disorder is accompanied by increased feelings of guilt and thoughts, and even attempts, of suicide. A woman may not have the strength to get out of bed or, conversely, exhibit excessive anxiety.

Illness in psychology

In psychology, depression is a mental disorder (a type of affective state) characterized by the presence of a triad of symptoms:

Anhedonia is the loss of the ability to receive pleasure, pleasure, joy and satisfaction.
Disruption of thinking towards pessimism, predominance of negative emotions.
Reduced reactions and general inhibition of movements.

Subjectively, a person in a state of depression experiences painful experiences and difficult emotions - disappointment, depression, despair. A person feels helpless in the face of life’s difficulties, cannot rationally understand the essence of the problem and is inclined to blame himself for all sorrows.

People suffering from depressive disorders are characterized by self-flagellation and humiliation of their own self, presenting their own personality as worthless and incapable of anything. Aspirations and desires disappear, because a person considers himself unable to achieve what he wants or is unable to receive joy and satisfaction. Productivity and efficiency drop sharply, which entails social problems - job loss, narrowing of social circles, alcoholism, drug addiction. Each person experiences depression in his own way, so its forms in psychology are diverse.

The main clinical options are usually grouped into three large groups:

Somatogenic - caused by pathophysiological disorders and a number of diseases (traumatic brain injury, Alzheimer's disease, etc.):
symptomatic.
Endogenous (without external factors and pathophysiological processes):
involutional;
periodic;
schizophrenic.

Psychogenic - resulting from acute psychological trauma:
neurotic;
reactive.

In the vast majority of cases, depression is diagnosed based on the patient's history and subjective reports. There is a monoamine theory, according to which a number of depressive disorders arise due to insufficient production of biogenic amines: serotonin, dopamine, norepinephrine.

A deficiency of these compounds can be caused by taking medications and psychoactive substances - sleeping pills, sedatives and sedatives, tranquilizers, alcohol, opiates, drugs (cocaine, amphetamine).

Depression can only be diagnosed if all three symptoms of the depressive triad are present for a long time—more than two weeks. Otherwise, all manifestations are considered normal defensive reactions of the psyche in response to external factors.

Seasonal depression

Seasonal depression is the body's reaction to a lack of light and the associated decline in neurotransmitters. Appears periodically, in the autumn-winter period, when the intensity of sunlight is clearly limited. Most often affects people aged 30 to 60 years. This type may disappear on its own with the onset of spring, however, it should not be underestimated.

Seasonal depressive disorder should be treated at least to alleviate symptoms. Typical symptoms of seasonal depression are: decreased mood and energy, melancholy, irritability, excessive sleepiness, sleep disturbances, increased appetite for carbohydrates, and sometimes weight gain.

Dysthymia

Dysthymia is also defined as neurotic depression. Its typical symptom is a persistent tearful mood with mild intensity. Although dysthymia is much milder than major depression, but longer lasting, to diagnose dysthymia, this situation must persist for at least 2 years.

Symptoms of dysthymia can be defined as mild symptoms of depression. These include: sadness, tearful mood, depression, decreased vital energy, difficulty concentrating, sleep disorders, irritability, tension, increased or decreased appetite.

Dysthymia can occur at any age and is often seen in people during puberty and adolescence. In some cases, especially in older people, it is a consequence of an organic disease. Due to its milder nature, dysthymia is often seen as a personality trait or perceived as whining.

In reality, however, this pathological state of mind makes it very difficult for the patient to function, significantly disorganizing his life, limiting professional fulfillment, friendly contacts and quality of life.

Bipolar disorder

A person is not able to predict the occurrence of a prolonged bad mood, since it appears not only due to stressful situations, but also due to psychological problems. This is one of the most common diseases in the world. Individuals who experience this illness look at reality distortedly, paying more attention to negative components and exaggerating them tenfold.

Women's course

Consultations

The disease can have various forms of manifestation. I classified and organized them.

Depending on the nature of the flow, there are:

clinical;
chronic;
bipolar;
camouflaged;
psychotic;
neurotic;
atypical.

Depending on the severity of the sensations:

dysthymia (manifests in mild form);
clinical (moderate symptoms);
a serious condition characterized by psychotic disruptions.

Depending on the age category:

children;
teenagers;
aged people.

Depending on other signs:

postpartum;
larved;
seasonal.

Next, I will tell you in more detail about some types of the disorder and give their full symptoms and causes of development.

Clinical

This is the classic form of the disease. All symptoms are immediately visible:

depressed mood;
constant fears;
guilt;
lack of interest;
inactivity.

These manifestations disappear within two weeks. The causes are stress, expressed in a chronic form, and strong feelings. The way of thinking also undergoes changes, as a person experiences constant anxiety and apathy, and thoughts associated with suicide may arise.

Chronic

This disorder can last for two years or more. However, the signs are not so pronounced, since the patient does not stop contacting loved ones, cleaning the house, and devoting time to professional duties. But the symptoms are as follows:

rapid loss of energy;
severe fatigue;
bad mood;
insomnia;
decreased appetite;
constant headaches;
isolation;
suicidal thoughts.

With this type of disease, women's menstrual cycle is disrupted.

Bipolar

A very serious and severe depressive disorder that is inherited by a person or develops against the background of other psychological disorders. The main feature of this disease is a sharp change in mood. At first, the person feels irritated and depressed, refuses any communication, ceases to be interested in his hobbies, speech is inhibited, and there is a lack of physical activity and mental processes.

As the disease develops, hallucinations, aggressiveness, and bouts of delirium sometimes occur.

In order not to trigger this disorder, it is necessary to consult a specialist, be under constant supervision and undergo inpatient and medicinal treatment.

Camouflage

This variety is very difficult to notice, since the symptoms are hidden. A depressed state and physical decrease in activity can be confused with signs of vegetative-vascular dystonia, osteochondrosis and other diseases.

A person suffering from camouflage depression does not admit the presence of the disease; he cares only about his health, forgetting about his family and profession. He also stops taking care of himself. The most important symptom of the disorder is hyperactivity.

This disease is difficult to cure, since the patient does not want to take action. To recover, you need to visit a psychotherapist and undergo treatment with medications, so you will definitely improve your condition.

Psychotic

It is formed in people who have a hereditary predisposition to mental illnesses and brain injury. In addition to the classical symptoms listed, the individual experiences hallucinations, phobias, and a state of delirium. The patient's behavior remains unchanged; he feels depressed, sad and unwilling to communicate.

Neurotic

Such an illness is the quintessence of a classic disorder and neurosis. It often manifests itself in people suffering from a weak nervous system or having a special mindset and character. The main qualities of a person susceptible to depression:

cowardice;
uncertainty;
low self-esteem;
straightforwardness;
tearfulness.

The reason for the development of such depression is a conflict or a difficult situation from which the patient cannot get out of, being in a dead end. Signs of neurosis bother the individual with frequent headaches and muscle pain, poor digestion. The person himself realizes that he needs help, that he cannot cope with this on his own.

Atypical

Typical symptoms appear:

depressed feeling;
despondency;
feeling depressed;
increased appetite;
excessive sleepiness;
physical activity;
constant panic.

The patient also suffers from pain that is felt throughout the body. With this type of personality illness, tranquilizers and mood stabilizers are prescribed to prevent panic from occurring.

Postpartum

It often develops in females who experience the loss of a child: miscarriage, stillbirth, frozen fetus. The main reason is hormonal changes. Women who have given birth to a baby for the first time also develop depression after 2-4 months. The signs are:

excessive emotionality;
emptiness;
anxious thoughts;
feeling of guilt;
aggression.

Children's

It appears in children aged three years. Occurs due to severe psychological trauma, for example, due to the death of a loved one, loss of parents, or the departure of a family member.

Experiencing such discomfort, the child completely refuses to interact with family members, he stops looking straight into the eyes, does not show interest in hobbies, and becomes whiny and silent. He forgets everything his parents taught him. The baby may forget how to use the potty, cutlery, and put on clothes. He begins to eat poorly, experiences fears at night, and shows aggression towards loved ones.

Treatment can only be carried out by a qualified specialist; he must get along with the child and learn to understand him. It is not recommended to prescribe medications to a baby, as they are toxic.

Teenage

A very young person can also suffer from depressive illness. It develops between 12 and 18 years of age. It occurs as a result of hormonal imbalance. The child begins to rebel against his parents, their care and their beliefs. He stops accepting the established family order and constantly tries to disrupt it.

If you notice that your child’s mood suddenly began to deteriorate frequently, he began to withdraw into himself, stopped communicating with you and friends, his grades worsened, as did his behavior, do not hesitate, but rather seek help from a specialist.

To ensure that such a period never overtakes you, pay more attention to your child, spend time together, go to the cinema, share his hobbies, take an interest in his life, rejoice in his successes, praise him for small and large achievements and be sure to talk to him. The main thing is not to overdo it, so as not to turn a normal and healthy relationship into overprotection.

Bipolar affective disorders (bipolar disorder, depression, manic depression, manic-depressive psychosis) are characterized by alternating episodes of depression (severe depression of mood) and mania (elevated mood), interspersed with periods of remission.

During the manic period, symptoms such as clearly elevated mood, agitation, increased self-esteem, mental activity, decreased need for sleep, and verbosity predominate.

Features of treatment of depression at various stages

Treatment of a depressive state at a certain stage has some differences in terms of the choice of antidepressants according to the spectrum of action (sedatives, stimulants), etc. their power. The severity of depression (stage) usually has a certain relationship with the duration and, accordingly, with the duration of active therapy.

But in any case, depression at various stages can be treated using antidepressant therapy, taking into account the “power” of antidepressants, adequate doses, and the duration of treatment.

Seek help from professionals and you will regain your joy in life!

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