Depressed pain (pour bitter water, don't enter if you don't like it)

Depression is an emotional disease, also known as neurotic depression, which is caused by biological, psychological and social factors, with persistent depression as the main symptom. Patients are often accompanied by anxiety, physical discomfort and sleep disorders.

The clinical manifestations of depression are as follows:

1. Feeling depressed. This is the most important feature of patients with depression. The light person is in a bad mood, distressed and sad, and sighs all day long. Serious people are depressed, pessimistic, desperate and suicidal.

2. lack of pleasure. Loss of interest in daily life, lack of fun in all kinds of entertainment or pleasant things. Lighter people try to avoid social activities; In severe cases, people live alone behind closed doors, alienate relatives and friends and stop socializing.

3. Persistent fatigue without obvious reasons. Lighter people feel tired, unable to do their job, and lose enthusiasm and initiative in life and work; The worst thing is that you can't even take care of eating, drinking and personal hygiene.

4. Sleep disorders. About 70% ~ 80% of patients with depression are accompanied by sleep disorders. Patients usually have no difficulty in falling asleep, but they wake up after a few hours, so they are called early morning insomnia, midway awakening and terminal insomnia, and they are depressed after waking up. Anxiety patients have difficulty falling asleep and have many nightmares. A few patients with depression sleep too much, which is called "narcolepsy depression".

5. Changes in appetite. It is characterized by eating less and losing weight. Serious people don't think about tea and rice all day, but there are also a few patients with increased appetite.

6. Physical discomfort, depression patients generally have physical discomfort. Patients often check and treat unexplained pain, fatigue, sleep disorder, throat and chest urgency, constipation, indigestion, flatulence, palpitation, shortness of breath and other diseases, but most symptomatic treatments are ineffective.

7. Low self-evaluation. Lighter people have a sense of inferiority, uselessness and worthlessness; In the worst case, they say they are useless, have a strong sense of guilt and self-blame, and even choose suicide as a way of self-punishment.

8. Suicidal thoughts and behaviors are the most dangerous behaviors of depression. Patients with severe depression often choose to commit suicide to get rid of their own pain.

9. others. Elderly patients with depression may also have symptoms such as agitation, anxiety, low libido and memory loss.

If you have depression with the above three symptoms for more than two weeks, you can conclude that it is depression after excluding other diseases.

We might as well use the above performance comparison to check our lifestyle and behavior norms, and then make a judgment on whether we have mental illness. If you have signs of depression, you'd better consult a psychologist.

Treatment measures for depression

Psychological counseling, behavioral therapy, family therapy, diet therapy, music therapy, drug therapy.

Depression mainly changes people's mood and does not affect people's intellectual and physical development. Therefore, patients who have suffered from depression can live and work with peace of mind as long as they are actively treated.

"Sunday Depression" threatens men and women who live alone.

People who have been separated for a long time may often experience that inexplicable depression often comes into your life with holidays such as Sunday, and you will feel lonely, uneasy and uneasy. Psychologists call this phenomenon "Sunday Depression".

"Sunday depression" is not only a psychological disease, but also a social disease. Most importantly, we can't solve the psychological conflict of "what we want to do and what we should do" on Sunday. Living together for a long time is the direct cause of depression. For example, people who go abroad, migrant workers and businessmen who do business in different places will be particularly anxious and often hostile when they see family reunion and enjoy family happiness on Sundays and holidays. Similar phenomena occur from time to time in some special occupations, such as seafarers, geological exploration, drilling workers, police and so on. Because of the different nature of work, husband and wife often can't be together on Sundays and holidays. Coupled with the unsatisfactory working environment, there is nowhere to vent their dissatisfaction, and finally psychological pressure is formed.

Urban female depression

A survey of about 38,000 people in 10 countries and regions initiated by the American Medical Association shows that on average, 5% people suffer from depression, and the age group with the highest incidence of depression is between 25 and 30 years old, in which the proportion of women is significantly higher than that of men. Accordingly, the moderator of this survey, Dr. mosman of the Psychiatric Research Association of new york, USA, believes that depression is more likely to plague young women. A survey of seven major provinces and cities in China in the 1990s showed that about 27‰ of women suffered from mental disorders (depression ranked first), and half of female patients developed mental disorders at the age of 20-29.

The reason why young women are prone to depression is closely related to their own psychological and physiological characteristics and social environmental factors. Young women are not as strong as men of the same age, but they have to bear the same great psychological pressure, which may be the direct reason why young women are more likely to suffer from depression.

Depression and sense of belonging

Recently, a recent study by researchers at the University of Michigan shows that a lack of sense of belonging may increase a person's risk of depression.

The researchers sent questionnaires to 365,438+0 patients with major depression and students from 379 community colleges. The content of the questionnaire mainly focuses on psychological belonging, personal social network and social activities, conflict and loneliness. The survey found that belonging is the best predictor of a person's possible experience of depression. Low sense of belonging is an important indicator of a person falling into depression.

A weak sense of belonging can be summed up as having nothing in mind, losing confidence in life and not caring about relatives and friends. Mainly manifested as: lack of passion for the work, weak sense of responsibility; Narrow social circle and few friends; Amateur life is monotonous and lacks hobbies; Do not like reading books and newspapers, and do not pay attention to absorbing all kinds of knowledge and nutrition; Lack of necessary physical exercise.

Beware of adolescent depression

In recent years, the incidence of adolescent depression has been rising, but people still don't know the true face of Lushan Mountain. The author investigated 62 patients, aged 65,438+05-23, who were "finally diagnosed" in the Department of Cardiology. The results show that the self-identification rate of patients is almost zero, the average identification rate of schools, families and society is less than 1%, and the identification rate of some general hospitals is only about 15%. In the eyes of non-experts, the manifestations of adolescent depression are confused with ideological and moral problems and personality problems, or misdiagnosed as cerebral blood supply deficiency, nervous headache, neurasthenia, schizophrenia, cardiovascular system and digestive system diseases. But for specialists, these symptoms are specific manifestations of adolescent depression and provide an important basis for diagnosis and differentiation.

There are six main manifestations of adolescent depression:

First, there is no smooth road. Faced with the goal achieved, the ideal realized and the smooth road, the patient felt sad and painful instead of joy. If you are admitted to a famous university, you are sad and preoccupied, and want to back down. Some people often run home for no reason during college and want to drop out of school.

Second, it seems that illness is not a disease. Patients are generally young, do not express emotional problems, and only say some physical discomfort. If some children often hold their heads with their hands, they say they have a headache and dizziness; Some people put their hands over their chests and said they had difficulty breathing. Some people say that there seems to be something in the throat that affects swallowing. Their "illness" seems to be serious, chronic or recurrent, but after many physical examinations, no problems were found and many drugs were taken, and the "illness" still showed no signs of improvement.

Third, bad hints. Mainly manifested in two aspects: first, the subconscious level will lead to physical obstacles. If patients arrive at the school gate, classroom or work unit, they will feel dizzy, nausea, abdominal pain, fatigue and so on. When he left this particular environment and returned home, everything returned to normal. The other is the level of consciousness, only making negative guesses. If the patient thinks that the examination result is not ideal; I will not associate with others; I think some practices are a mistake or even a sin, which has caused trouble to others; Your illness may be "mental illness". What if it is really "mental illness"?

Fourth, we must change the environment. There may be some contradictions at school or at work, or there is no reason at all. Patients feel the heavy pressure of their environment, often upset and unhappy, unable to study and work with peace of mind, and urgently ask their parents to find ways to change classes, schools or work units for them. When I really went to a new place, the patient's condition did not improve, but there were other reasons and excuses, still thinking that the environment was unsatisfactory and repeatedly demanding changes.

5. Rebel against parents. In childhood, patients follow their parents' instructions. When they reach puberty or step into society, they not only don't communicate with their parents, but they are at odds with their parents everywhere. Generally, I don't tidy my room, throw clothes around, wash my face slowly, comb my hair slowly, eat slowly and finish my homework. The more serious manifestations are truancy, staying out at night, running away from home, and settling old scores with parents (rough childhood education, the influence of parents' divorce and remarriage on themselves, etc. ), and parents make a clean break.

Sixth, suicidal behavior. There are many ways to commit suicide in critically ill patients. For those who fail to commit suicide, if they only save their lives and do not receive antidepressant treatment (including psychotherapy), patients will still commit suicide repeatedly. Because this kind of suicide has psychological and pathological factors and biochemical factors, the patient does not want to die willingly, but is influenced by disease factors, and there is no way.

The treatment of adolescent depression should be based on the principle of paying equal attention to antidepressants and psychotherapy, and it is not correct to rely solely on drugs or psychological counseling. When drug therapy relieves and improves the condition, combined with psychotherapy, patients will understand the condition, change their cognition, improve their personality, and enhance their ability and confidence in coping with difficulties and setbacks. Only in this way can we achieve the goal of radical cure.

References:

/mental health/xlzs/cs/200602/mental health _ 49 1 . htm

Depression is a kind of brain disease, which has its own occurrence and development law. For many years, the study of depression and antidepressants has been an important research field of contemporary psychiatry. Although the etiology and pathophysiology of depression are still unclear, it does not hinder the effective treatment of this disease.

There are many treatments for depression, such as psychotherapy, sleep deprivation therapy, phototherapy, electroconvulsive therapy, etc., but at present, medication is the main treatment, supplemented by psychotherapy. It should be pointed out that people with depression often have negative and pessimistic thoughts, and in severe cases, they have suicidal tendencies and world-weariness Doctors should be on high alert and warn their families to take strict precautions. If conditions permit, it is best to be hospitalized. Electrospasm therapy has direct resuscitation effect and should be used decisively and quickly.

Antidepressants are a large category of many psychotropic drugs, which are mainly used to treat depression and various depressive states. Here are only two drugs with definite curative effect and generally recognized:

1, the first generation of classic antidepressants: including monoamine oxidase inhibitors (maoi) and tricyclic antidepressants (tca).

2. The second generation of new antidepressants: Due to the rapid development of new drugs, new drugs emerge one after another, such as venlafaxine and nafazodone, but at present, selective serotonin (5- HT) reuptake inhibitors are still the main ones, and these drugs are also the most widely used in clinic. However, the antidepressant effects of some antipsychotic drugs, such as sulpiride, alprazolam, roller, buspirone and methylphenidate, are still controversial, so they are omitted.

There are two kinds of classic antidepressants in the first generation, namely monoamine oxidase inhibitors and tricyclic antidepressants.

1, single oxidase inhibitor

Isopropylhydrazine is the first antidepressant that came out in 1950s. Isopropylhydrazine is an anti-tuberculosis drug. 65438-0957 has been successfully tried in patients with depression because of its central excitatory effects such as talkativeness, hyperactivity, insomnia and euphoria. Animal experiments show that it can reverse the apathy and inactivity caused by reserpine, and at the same time increase the monoamine content in the brain. It is speculated that its central excitatory and antidepressant effects are due to the decrease of monoamine degradation caused by inhibition of brain singleton oxidase, which leads to the increase of singleton content in the burst release gap. Therefore, the relationship between animal behavior and brain receptors is put forward, which has important theoretical and practical significance and lays a foundation for the study of psychopharmacology and etiology of mental diseases.

Also included in this category are isocarbohydrazide, phenelzine and amphetamine. These drugs used to be widely used, but they were soon eliminated because they interacted with certain foods and substances to produce serious adverse reactions such as hypertensive crisis and acute yellow liver atrophy.

In the late 1980s, a new generation of half-day oxidase inhibitors appeared, which is a subtype of reversible monoamine oxidase (mao-a). Its characteristics are: 1 has high selectivity to mao-a, but low selectivity to another isoenzyme mao-b, so it can still degrade coolamine in food, thus reducing the risk of hypertensive crisis. The inhibitory effect of 2 on mao-a is reversible, and it takes only 8- 10 hour to restore the enzyme activity, while the inhibitory time of old amine oxidase inhibitor is as long as 2 weeks, which reduces the risk of interaction with food. The main product is moclobemide, the dosage is 150-450mg/d, and it is taken in batches. It is said that the efficacy is equivalent to tricyclic antidepressants.

Although it is safer than the old half-day amine oxidase inhibitor, we should still pay attention to postural hypotension and the potential interaction between food and drugs, which are generally not the first choice.

2. Tricyclic antidepressants

It is another kind of antidepressant after monoamine oxidase inhibitor, represented by imipramine.

Its chemical structure is similar to chlorpromazine. People think that it may be a new antipsychotic drug, but the clinical trial results are unexpected. This drug has no effect on schizophrenia, but it can improve depression. Later, it was confirmed by a large number of double-blind placebo-controlled studies that replacing monoamine oxidase inhibitors became the first choice for depression treatment, monopolizing the antidepressant market for 30 years.

There are 10 kinds of tricyclic antidepressants. In addition to imipramine, there are amitriptyline, doxepin and clomipramine in China. Although maprotiline has a tetracyclic structure, its pharmacological effects are consistent with tricyclic antidepressants. The indications of tricyclic antidepressants are various types of depression, the effective rate is about 70%-80%, the onset time is 1-2 weeks, the dosage range is 50-250mg/d, and the dosage is slowly increased and taken in batches. Because of its strong sedative effect, the dosage should be large at night. The plasma concentrations of imipramine and amitriptyline are 50-250ng/ml.

Tricyclic antidepressants have been used for the longest time in clinic, and their pharmacological effects have been studied most and fully. In short, their main pharmacological effects are: 1 blocking the reabsorption of monoamine transmitters (mainly adrenaline and 5-ht), increasing the content of synapses and producing antidepressant effects. Blocking a variety of transmitter receptors has nothing to do with the therapeutic effect, which is the main cause of many adverse reactions, such as acetylcholine M receptor stagnation, which can cause dry mouth, blurred vision, sinus tachycardia, constipation, urinary retention, glaucoma aggravation and memory dysfunction; Blocking adrenaline a 1 receptor can enhance the antihypertensive effect of prazosin, causing postural hypotension, dizziness and reflex tachycardia. Yin stagnation of histamine h 1 receptor can strengthen central inhibition, sedation, drowsiness, weight gain and blood pressure reduction; Yin stagnation of dopamine d2 receptor may lead to extrapyramidal symptoms and endocrine changes.

If the side effects of antidepressants are serious, they should be reduced, stopped or switched to other drugs. Generally speaking, the combination of two or more antidepressants is not recommended. Because of the high recurrence rate of this disease, treatment should be maintained for 4-6 months after the symptoms are relieved to consolidate the curative effect and prevent recurrence.

Let melancholy see the rainbow again

I have no energy or ability to do anything. What's more, I feel that living is meaningless and have suicidal thoughts. In this state, most people can realize that their state is abnormal, but they don't think they have the ability to change. They often take a negative coping style, lying in bed and saying to themselves: When my mood gets better, I can. However, when will the mood get better? It seems out of your control.

Faced with this situation, people are often quite distressed, eager to get rid of it but don't know where to start, so they can only wait blankly. In fact, people's emotions, thinking and behavior are interrelated, with one moving and all three moving. Among the three, behavior is the easiest to change by self-control. Therefore, when the mood is bad, individuals can indirectly improve their mood by actively changing their behavior. Here, I want to introduce you to a behavioral therapy. As long as you can fulfill the requirements, your life will be beautiful again. It is worth noting that if you or your friends have no hope of improvement at all, or even have suicidal thoughts, then you'd better see a psychologist. )

Find something you have always liked but haven't done for a long time, make a practical plan and finish it, and gradually increase meaningful activities in your life. With the increase of activities, you will find that there are many things you can do and your interest in life will gradually recover.

1, set a practical goal.

This goal should be feasible, that is to say, both external conditions and their own conditions should be met. The initial plan is easier to implement and requires less time and effort. If this process takes too much time and energy, if you are not interested in anything, you are more likely to give up halfway. If you are ready to act enthusiastically as soon as you think of a certain goal, you don't have to look down. You are not the object that this article hopes to help. If you live in an inland province, don't plan to enter DaHai You yet: If you have only swam in the swimming pool, don't plan to cross the Qiongzhou Strait. These goals are too ambitious for you at present.

Now, let's assume that your goal is to learn to swim this summer. Is this goal feasible? Yes, because several of my friends learned to swim in one summer, and they are not sports geniuses; I know there is a swimming pool not far from home, which provides swimming lessons; I have money to go to swimming lessons; I have time this summer.

2. Define your goal accurately.

Only when the goal is clear can we judge whether we have achieved it. Otherwise, you can always say to yourself, "I failed." To regain your confidence in life, you need a successful experience. Therefore, in the process of implementing this kind of behavioral therapy, you should make sure that you will succeed again and again and convince yourself that you can do what you want. So, please define your success criteria accurately.

Learn to swim this summer. When does this summer mean? June to September 2004. What kind of swimming? What is learning in breaststroke? You can swim 100 meters without any auxiliary tools. Well, on September 30th, you can check whether your goal has been achieved according to these standards.

3. Divide your action plan into small enough steps to ensure that your plan can be completed.

Make a detailed plan for your goals, and the goals to be achieved in each step of the plan are small enough to ensure that you can achieve them. For example, your first goal may be to determine the time of swimming class. You may scoff at this goal and think it is too easy. But for some people with depression, it is not easy to think of it and do it. Remember, when determining each sub-goal, make sure that you can accomplish it. Every time you accomplish a goal, you win, and every success will gradually increase your confidence. If you set too big a sub-goal, you are bound to fail. Failure again and again will hurt your confidence. Perhaps, after several failures, you will completely lose interest and confidence in this plan, give up halfway and return to the state of doing nothing before.

4. Define success by your own behavior.

In other words, don't involve other people's behavior in the goal. If your goal is to associate with people, be careful not to make such a goal: to have coffee with Xiao Li after work. The mistake of this goal is that whether this goal can be achieved depends on whether Xiao Li accepts your invitation. You can control your own behavior, but you can't control the behavior of others. So your goal violates the previous principle, and you are not sure whether this goal can be achieved. According to the principle of ensuring success, you can modify your goal like this: invite Xiao Li to have coffee with you after work. You will succeed as long as you make an invitation. As for Xiao Li's reaction, it doesn't matter. Invitation skills are another problem.

Don't add emotional factors to your goals.

In this plan, what matters is doing, not how you feel in the process of doing it. You can control your behavior, but you can't directly control your emotions. In a depressed state, it is difficult for you to get a happy feeling from any activity. Emotion will be affected by behavior, but this effect is not immediate and takes some time. Therefore, if you must be happy for success, then you are likely to fail. Don't set such a goal: "I want to swim happily twice", just "I want to swim twice" is enough.

Well, the main principles are over, and you can start making and implementing your plan. If you fail at some point, don't worry, failure at the first attempt is inevitable. Look back at these five principles, find out your mistakes and correct them. I believe you will overcome your depression and live a colorful life.

References:

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