Anxiety-depressive syndrome is included in the category of common diseases typical of modern society. Its development begins imperceptibly. People do not pay attention to the first symptoms and attribute them to influencing factors. As a result, the disease begins to develop and progress, which causes a deterioration in the quality of life of the patient and others. A person with this disorder is unpredictable. Therefore, immediate attention should be paid not only to physical, but also to psychological health.
It is immediately worth noting that treatment of anxiety syndrome is carried out only under the supervision of specialists. Unsystematic use of medications that affect the psycho-emotional background can significantly aggravate the situation. Therefore, at the first signs of illness, you should immediately consult a doctor.
Many people are in no hurry to do this because they are afraid of publicity. There is no need to worry about this topic. Any information relating to a person’s physical or mental health is strictly confidential. Therefore, it is inaccessible to unauthorized persons, and the specialist strictly observes medical confidentiality.
Factors in the manifestation of the disease
The following can cause anxiety-depressive disorder:
● taking antidepressants, neuroleptics, tranquilizers and anticonvulsants uncontrolled;
● drug addiction and alcoholism, depleting the nervous system;
● loss of a job and futile attempts to find one, debts, temporary inability to ensure a comfortable existence - all this leads to anxiety for the future, instead of attempts to normalize an already disastrous situation;
● fighting a serious illness;
● predisposition to psychosomatic disorders;
● chronic or short-term, but severe stress;
● mental and physical fatigue, characterized by a feeling of “burnout” inside;
● age factor. The risk zone includes pensioners, women over 40 years of age, teenagers, men during the onset of the “midlife crisis”;
● low level of intelligence and lack of education.
Causes and factors of occurrence
The term "depression" is often misunderstood. Sometimes it mistakenly refers to a bad mood, short-term apathy, physical and mental fatigue. Only doctors (psychotherapist or psychiatrist) can diagnose depression. The patient experiences depression and bad mood for 2 weeks or more. However, psychotherapy does not help.
The causes of depression and subsequent depressive disorder are:
- genetic predisposition;
- disorders of the neuroendocrine system;
- tendency to anxiety;
- stress;
- emotional turmoil;
- neurological diseases;
- prolonged loneliness;
- lack of hobbies;
- lack of fulfillment;
- non-acceptance of oneself;
- grievances;
- obsessive fears.
There are age differences. Most often, mental disorders are diagnosed in adulthood and old age. This is due to hormonal changes in the body, retirement or loss of ability to work. This mental illness can also occur at a young age, but there must be good reasons for this.
Risk factors are:
- alcohol abuse;
- drug addiction;
- presence of oncological pathologies;
- previous depression;
- long-term suppression of emotions;
- presence of mental disorders in close relatives.
A dangerous mental disorder occurs if depression is not treated in time.
Sometimes people live with this diagnosis for several years and don’t even know it. The disease progresses, so it becomes more difficult to get rid of it.
Anxiety and depression competition
Both of these states dominate a person’s mood and constantly alternate. It is the sharp change from depressive inhibition to anxious arousal that often causes difficulties during diagnosis. Both conditions enhance each other's effect. For example, adequately insignificant threats in the outside world in the patient’s brain take on a cosmic scale; the person does not see ways to solve the “problem,” as a result of which severe nervous strain occurs.
Even a mentally healthy person experiencing fear is not always able to soberly assess the state of affairs, and in the case of anxiety-depressive syndrome, the patient’s will is completely paralyzed by a feeling of hopelessness. The next stage is characterized by uncontrollable aggression. The brain, unable to successfully overcome internal and external physical stress, releases stress hormones into the blood, namely cortisol and adrenaline. These substances push living beings to take protective actions.
If the patient tries his best not to resort to methods of defense, the level of anxiety begins to inexorably increase due to the same hormones, which this time poison the human nervous system purposefully. At this moment, the patient’s condition can be safely equated to sitting on a powder keg - the fear of “flying up into the air” drives the patient crazy. The situation is worsened by emerging depression, which partially obscures what caused the anxiety and does not allow any measures to be taken to resolve the situation.
Symptoms of neurosis
The manifestation of a specific violation is individual. Each person has their own characteristics of the functioning of the brain, so the symptoms do not always manifest themselves clearly.
Clinical signs
Recurrent depressive disorder - what is it?
On the physiological side, profuse sweating, rapid heartbeat, tremor, tachycardia, gastrointestinal disorders (diarrhea or constipation), photophobia and sensitivity to sounds appear.
Important! When the disease occurs, a combination of motor retardation and increased activity occurs.
For example, a person may think slowly and sleep poorly, but speak and move very quickly. Another will think quickly, but due to lack of mood do nothing.
As the condition worsens, dry mouth, dizziness, muscle fatigue, etc. are noted.
Psychological signs
Anxiety and depression are often accompanied by panic attacks. At this moment, the feeling of anxiety increases greatly, which is accompanied by fear of death, dizziness, and disorientation.
Important! A panic attack is limited in time and does not exceed 5 minutes in duration.
The person experiences sudden mood swings and sleep disturbances. Fears intensify, new phobias appear, and this interferes with leading a normal lifestyle.
The patient may feel lethargic, restless, or irritable. He is unable to control his condition. All this leads to the fact that a person is gradually deprived of social contacts, loses his job and worsens his financial situation.
You cannot get rid of anxiety-depressive disorder by taking independent actions. In the absence of timely treatment, there may be a serious decline in quality of life.
Often, complications arise against the background of the disease in the form of cardiovascular disorders and diseases of the central nervous system. People with these problems have an increased risk of strokes and heart attacks.
In severe cases, suicidal thoughts occur. With complications, anxiety-depressive disorder is more difficult to treat.
Who to contact for help
The best option for a person struggling with symptoms of anxiety-depressive syndrome is to make an appointment with a psychotherapist. This doctor treats mild to moderate mental illness. If he decides that he is unable to help the patient, he refers the patient to a psychiatrist.
A psychotherapist works with cause-and-effect relationships that are fixed in the mind. His professional assistance consists of three stages:
● rational belief;
● use of meditation and other relaxation techniques;
● conversation sessions.
Diagnosis methods
There are three standard ways to determine whether a patient has an anxiety-depressive disorder. The results of the Luscher color test accurately show the state of the individual and the degree of neurotic deviations. The first method is the Zung scale and the Beck questionnaire. These tests determine the presence of depression and its severity. The Montgomery-Asberg scale and the Hamilton scale assess the level of depressive disorder. Based on the test results, the treatment method is determined - psychotherapeutic or medicinal.
The assessment of the clinical picture depends on:
● the presence of symptoms of depression and anxiety, and the duration of their manifestation;
● presence or absence of factors for their occurrence;
● the primacy of the signs of a given disease (it is necessary to have full confidence that the symptoms are not a manifestation of somatic diseases).
Diagnostics
Diagnosis is carried out exclusively by a doctor of the appropriate profile. Disorders of this type are divided into classes according to the ICD. Each class is assigned an individual code.
- F-40. Anxiety disorders of the phobic type. Characterized by fear of certain situations. As a result, the patient makes every effort to avoid them. If this fails, a physiological reaction occurs. For example - trembling, fainting, numbness, loss of voice, etc.
- F-41. Other anxiety disorders. Characterized by spontaneous anxiety, regardless of any situation.
- F-42. Obsessive-compulsive disorder. Characterized by obsessive thoughts, which leads to a set of forced actions.
- F-43. Adaptive dysfunction and reaction to a stressful situation. Includes disorders caused by reactions to unfavorable situations in life, which leads to impaired social functioning.
- F-44. Dissociative type disorders. They have a psychogenic etiology. Characterized by a loss of integration between memories associated with past events, personal awareness and the ability to control one's own body.
- F-45. Somatoform type disorders. They are characterized by the manifestation of somatic symptoms in the absence of diseases of a similar nature, so senestopathic syndrome has no basis.
- F-48. Other disorders related to neurotic. Characterized by various symptoms. They are divided into specified and unspecified.
Drug therapy
Antidepressants such as Imipramine, Prozac and Amitriptyline have a beneficial effect on the levels of dopamine, norepinephrine and serotonin in nerve cells. The above drugs help improve the patient’s condition (increase mood, reduce feelings of anxiety, apathy, emotional instability, sleep and appetite return to normal). A long course of treatment with antidepressants is explained by the fact that their substances must accumulate in the body. Therefore, tranquilizers often need to be taken along with them. Their effect appears after 15 minutes. The doctor selects antidepressants for each patient individually and prescribes a course of treatment that must be strictly adhered to. These drugs are not addictive.
"Seduxen", "Elzepam" and "Phenazepam" are tranquilizers that successfully fight panic attacks, anxiety and emotional stress. The effect of the drugs is noticeable almost immediately and lasts for several hours. Injections give even faster results, but the effect disappears just as quickly. Tranquilizers are addictive, so the course of treatment is quite short.
If this emotional disorder is complicated by autonomic dysfunction, the patient is prescribed beta-blockers. They restrain vegetative-vascular symptoms, namely sweating, fever, tremors, weakness, increased heart rate and blood pressure. Beta-blockers include drugs such as Atenolone, Anaprilin, Betaxolol and Metoprolol.
Other treatments
Physiotherapy cannot be discounted, since it is an integral part of the treatment and prevention of all psychosomatic diseases. Let's consider the basic physical procedures:
● massage - has a strong tonic and calming effect, effectively relieves muscle tension;
● electroconvulsive treatment - increases the intensity of brain activity;
● electrosleep therapy - promotes calm, relaxation and restoration of healthy sleep.
In addition to physical therapy and medications, treating anxiety and depressive disorder with folk remedies as a supplement is also encouraged. Valerian, motherwort and hawthorn soothe, tincture or tablets based on ginseng relieve fatigue and help improve performance. Lemon is indicated for depression as a powerful stimulant for awakening active life.
One of the following homeopathic medicines can be included in the complex treatment of anxiety-depressive disorder:
● “Hypnosed” (eliminates excessive excitability and insomnia);
● “Arnica Montana” (relieves depressive and anxiety symptoms);
● elm bark and leaves help relieve increased fatigue, thereby increasing endurance.
Symptoms of major depressive disorder
The clinical picture of major depressive disorder corresponds to the signs of a severe episode of depression described in the ICD. A diagnosis of major depression is made when at least five of the following criteria are met:
- Depressive mood;
- Insomnia or increased sleepiness;
- Significant weight loss without dieting or weight gain;
- Decreased or increased appetite;
- Significant decrease in interest or loss of pleasure in all or almost all activities;
- Decreased ability to concentrate, think;
- Indecisiveness;
- Excited psychomotor state or slowing of motor and mental activity;
- Feelings of worthlessness or excessive guilt;
- Fatigue or loss of energy;
- Recurrent thoughts of death, repeated suicidal thoughts without a specific plan, suicide attempts, or the presence of a specific plan to commit suicide.
Symptoms of clinical depression should be present almost every day or most of the day. Signs of depression are noted both by the patients themselves and by people around them. In major depressive disorder, one of the clinical manifestations is necessarily decreased mood, loss of pleasure or interest. Symptoms of major depression cause clinically significant impairment in occupational or social functioning.
Impaired cognitive function in major depressive disorder is represented by social, “hot” and “cold” cognitions (a set of mental processes that serve to process and process information). “Hot” cognitions have the following manifestations:
- Shift in the processing of emotional information towards negative stimuli (priority of negative information);
- Focus on internal sensations;
- Overreacting to negative feedback;
- Enhanced perception and memory of negative stimuli.
Cold cognitions in major depression represent an impairment in the processing of non-emotional information. Patients' attention, operational and episodic memory, and executive functions deteriorate.
Patients who have impaired social cognition in major depressive disorder have difficulty understanding the mental states of others. Low-level social cognitions (recognition of voice intonation, facial expressions, postures) and the following high-level social cognitions are affected:
- Feeling of compassion;
- Determining the mental state of other people;
- Regulation of one's behavior depending on the context of the social situation.
The severity of cognitive impairment depends on the clinical type of the depressive episode. The melancholic subtype has a negative impact on cognitive functioning during the period of weakening of the symptoms of the disease. With early onset of major depressive disorder at the age of 18-50 years, there is a deficit of episodic memory and greater severity of cognitive impairment. If the clinical picture of major depression develops at a later age, there is a greater severity of impairment in executive function and speed of information processing. An increase in the number of depressive episodes negatively affects the severity of cognitive deficits.
To identify the risk of developing major depressive disorder, psychotherapists use the following screening tools:
- Zang Self-Rating Depression Scale;
- Beck Depression Inventory;
- Questionnaire;
- Major Depression Questionnaire;
- Test for major depressive disorder.
Doctors at the Yusupov Hospital establish a clinical diagnosis of depression after a comprehensive examination, taking into account the results of long-term observation of the patient.
Disease prevention
A person who is mentally resistant to the outside world:
● tries not to get hung up on emotions that cause unpleasant sensations and learns to switch to positive ones;
● refuses alcohol, nicotine, eats healthy food and engages in sports that interest him;
● does not overwork mentally and physically;
● gets enough sleep;
● expands the “comfort zone” (travels, learns new things, meets people);
● attends various hobby groups (a favorite hobby helps to repress anxious thoughts and minimizes the chances of depression).
