Psychological laboratory Litvinova. Rules of behavior with a depressive personality. Schizoaffective disorder, manic type F25.0
Depressive personality type
The foundation
All decisions and actions are subject to proving their “goodness”, external evaluations. Dependence on someone else's opinion. Lack of faith in yourself. Pessimistic attitude. Love to overcome difficulties. The belief that happiness must be earned and it cannot be long. All life, all forces "for others", because loving yourself and doing things for yourself is "selfish" and "not good."
Disharmonious, conflicting traits
1. Position "everything for others, nothing for yourself."
2. Feelings of guilt (with or without reason).
3. Suffering, martyr mood.
4. Painful altruism.
5. "Holiness" (I suffer, overcome myself, deny myself everything, and around cruelty and violence - I'm a saint).
6. Folly, buffoonery - "I'm bad", "I'm a rebel."
7. The division of everything into "good" and "evil", "white" and "black", "good" and "bad". Waging "holy wars" with "evil".
8. Sacrifice of oneself, one's interests, desires, "shirts" for the sake of the need to receive a "good grade", "praise" and a feeling of overcoming ("I put my whole life on you").
9. Provocation of violence - "victims" of villains.
10. Overprotective.
11. Workaholism.
Harmonious features
1. Caring, always ready to help.
2. Helpful, executive.
3. Generous, easily share everything they have.
4. They put their whole soul, all their strength into the profession, business, especially if it involves helping others, salvation.
5. Kind, easily empathize.
6. Solve the problem, even if it takes a lot to overcome.
Fears, Displeasure from…
1. Happiness (unsuffering and lasting)
2. Absence of problems, suffering, overcoming
3. Undeserved, unsuffered achievements, successes
4. "Bad grades" (critics, "bad things")
6. Wish for yourself, confess your love for yourself
The pleasure of…
1. Mental experiences, torment, suffering, overcoming difficulties noticed (appreciated) by others.
2. Recognition by others of their "holiness".
3. Memories, dreams of rare minutes distant and unattainable happiness, a bright future (“if not me, then the children will live normally, happily, securely”).
4. Children and care for them, giving everything to them.
5. Dependencies (from relatives and from estimates).
6. Punishments for "bad behavior."
Professions (comfortable, realizing)
1. Rescuers, doctors, virtues, patrons.
2. Ministers of the Orthodox Church, monks, sisters of mercy.
3. Teachers, caregivers who suffer for their children.
4. Caring, passionately loving mothers. caring wives their husbands, professional housewives.
5. Charity, "free work."
6. Actors - sufferers, rescuers.
Games-Role-Manipulation
1. How evil and cruel you are, but I am kind.
2. Suffering poets, admirers.
3. "Christians", "saints", "Mother Teresa".
4. "Holy martyrs"
5. "Victims" of maniacs, monsters, husbands of alcoholics.
6. Heroes sacrificing themselves, life, shirt.
7. “Nothing depends on me, everything depends on my husband.”
8. "I'm bad" (rebelliousness, jokes, malice)
9. "I'll save you, even if you don't want to"
10. Domestic tyrant for the benefit of society
Appearance
Tortured, disheveled, tired, guilty
Physical activity
Tired, slightly saggy and swollen, suffering
Personal development (directions)
1. Positive vitality. Life and suffering are different things.
2. Acceptance of the possibility of lasting happiness without overcoming and suffering.
3. Independent choice of who will evaluate me, and whose opinion I am not interested in.
4. Removing the mask of "holiness", "martyrdom".
5. Do something for yourself, for yourself, love yourself and not be ashamed of it (healthy egoism). I don't live to serve others.
6. Understanding that there are many other shades between white and black, light and dark, good and evil - the world is multifaceted and it is not necessary to “save” it, “change it for the better” all the time.
7. Don't take the blame for other people's suffering
Depression, anxious depression, postpartum depression, seasonal depression, masked depression are just some of the types of depressive mood disorders.
In general, the classification of depression is complex and ambiguous. This difficulty is primarily due to the variety of criteria that characterize this disease. They may relate to the etiology, the period of onset of the disease, the clinical picture, the severity of symptoms, etc. This article aims to present the most popular types of depression.
Causes of depression
There are several types of depression. Among them are major depression, depression after childbirth, reactive depression, seasonal affective disorders, bipolar disorder, etc. Depending on who suffers from a depressive disorder, one speaks of senile depression, adult blues, or depression in children and young people.
Depression can result from genetic predisposition, fluctuations in neurotransmitter levels, or due to traumatic events such as death loved one or divorce.
What you need to know about depression
According to the ICD-10 classification (International Classification of Diseases), episodes of depression divided according to the intensity of individual symptoms:
- benign(major symptoms of mild depression);
- moderate(main symptoms of depression medium degree severity: disappointment in life, a pronounced decrease in social and professional functioning);
- heavy without psychotic symptoms (predominant: depression, significant psychomotor slowdown, sometimes irrational fear, frequent thoughts of death, suicidal tendencies, impossibility of social and professional functioning);
- heavy with psychotic symptoms (all of the above, plus delirium, feelings of sinfulness, guilt and the need for punishment, hypochondria, auditory hallucinations, slowing down movements up to stupor).
In a simplistic way, we can say that depression has as many types as it exists. 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, arising in the course of other diseases or as a result of the action of the drugs used;
- disease depression.
Endogenous depression originates in brain transduction disorders. A special role is attributed to such substances as norepinephrine and serotonin, the deficiency of which leads to a decrease in mood. Reactive depression occurs in response to a feeling of severe psychological trauma that changes the patient's life or threatens the former order of the inner world.
The source of depression can be chronic medications, 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 ischemic disease heart, especially in those who have suffered a myocardial infarction.
Causes of depression often mixed. Somatic diseases often contribute to the appearance of blues and despondency, and depression worsens the prognosis of recovery. To mixed type include seasonal depression and postpartum depression, in which both mental and hormonal disorders play a key role.
Depression can also act as an element of an affective personality disorder, formerly called manic-depressive psychosis. In this case, depression and apathy alternate with periods of unnaturally intense activity and euphoria.
deep depression
The issue 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 valid in the literature. All this leads to the fact that there are 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. It is based on organic factors, for example, malfunctions nervous system. In the case of this kind of depression, as a rule, pharmacological treatment is necessary, which aims to restore the correct distribution parameters of neurotransmitters, for example, optimal level serotonin. Most effective treatment also includes psychotherapy.
During illness, a deep longing dominates, a loss of a sense of the meaning of life and a lack of desire to make social contacts. Man with major depression usually incapable of professional activity, he develops psychomotor retardation, 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 kind of depression is hereditary. It is assumed that the risk of the disease ranges from 15% (if one of the parents was sick) to 50% (if both parents had episodes of depression).
masked depression
Masked depression is a very difficult kind of affective disorder to diagnose. Its appearance is not accompanied by typical symptoms of depression, such as sadness, depression, or psychomotor retardation.
The symptoms that accompany it are, first of all, somatic diseases, such as chronic pain(especially the head, abdomen, but also other organs), sleep disorders, sexual disorders, menstrual irregularities, bronchial asthma, and eating disorders.
The disease may be accompanied anxiety symptoms such as panic attacks, choking attacks, symptoms of irritable bowel syndrome, hypertension, etc. Depression can take on many disguises and therefore manifest itself various symptoms that can move from one to the other.
Usually, masked depression reveals itself when there are no clearly expressed organic changes, and the symptoms are aggravated under the influence of various life events. Typically for masked depression, the disappearance of symptoms of the disease under the influence of taking antidepressants.
anxiety 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 in relation to himself and the environment.
This behavior is the result of the need to discharge the voltage. Enough accurate characterization This emotional state is the assertion that the patient cannot sit still. Unfortunately, this type of depression is associated with a high risk of suicide.
postpartum depression
Depression after birth, manifested by sadness, despondency, apathy, weakness, mood swings or tearfulness, which affects approximately 80% of new mothers. O postpartum depression may indicate an increase in symptoms for two weeks or longer, which may be accompanied by an increase in disease.
Main cause of postpartum depression- this is hormonal changes accompanying childbirth. The source of depression is also the sense of responsibility associated with the birth of a child. A woman's mood drop is manifested by many other diseases with somatic symptoms, such as decreased appetite, headaches and abdominal pain.
The patient does not show 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, suicide. A woman may not have the strength to get out of bed or, conversely, shows excessive anxiety.
Reactive depression
Reactive depression is a reaction to a difficult, stressful, and often traumatic experience. These are, for example, rape, the death of a loved one, the shock caused by watching someone suffer, divorce, etc.
This type is relatively easy to diagnose, especially if the cause is known, and the best form of help in this case is psychotherapy, sometimes pharmacological treatment helps.
seasonal depression
Seasonal depression is the body's response to a lack of light and the resulting drop in neurotransmitter levels. Appears intermittently, autumn-winter period when the intensity sunlight clearly limited. Most often affects people aged 30 to 60 years. This type may disappear by itself with the onset of spring, however, it should not be underestimated.
Seasonal depressive disorders 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 on 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 significantly milder than major depression, but more prolonged, in order to diagnose dysthymia, this situation must be maintained, according to at least, 2 years.
Symptoms of dysthymia can be defined as mild symptoms depression. These include: sadness, tearful mood, depression, decreased vital energy, difficulty concentrating, sleep disturbances, 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 the elderly, it is the result of an organic disease. Due to its softer stroke, dysthymia is often seen as a personality trait or perceived as whining.
In reality, however, this pathological condition of the mind, which makes the functioning of the patient very difficult, significantly disorganizing his life, limiting professional realization, friendly contacts and quality of life.
Bipolar disorder
Bipolar affective disorders (bipolar disorder, depression, manic depression , manic-depressive psychosis) is characterized by alternating episodes of depression ( strong decline mood) and mania (high spirits), interspersed with periods of remission.
In the manic period, symptoms such as clearly elated mood, arousal, increased self-esteem, mental activity, reduced need for sleep, and verbosity predominate.
The onset of the disease can occur at any age, usually occurring between 20 and 30 years of age. It is also assumed that large group patients, the disease manifests itself already in childhood and adolescence.
The disease begins, as a rule, with an episode of mania, which develops over several days, and sometimes even several hours. The disease lasts a lifetime. The risk of recurrence is estimated at approximately four pronounced episodes of the disease during the first 10 years from the date of diagnosis.
In this group of patients, there is a very high rate of suicide, of which up to 20% ends in death. Although the etiology has not been fully understood, there is a significant genetic factors in the development of the disease.
Child whose parents are ill bipolar disorder, will get sick with a probability of 75%. The treatment of bipolar depression is mainly pharmacotherapy, which uses antidepressants, mood stabilizers, and antipsychotics.
Depressive stupor and depression of schizophrenia
depressive stupor is a state of psychomotor inhibition, which is one of the most severe forms depression. A person in this state does not show any activity, does not eat, does not contact with environment, remains fixed in one position.
This condition requires intense inpatient treatment. And the depression of schizophrenia appears as a reaction to a past episode of schizophrenia. The clinical picture is dominated by symptoms of depression, schizophrenic are still present, but have a milder character.
The characterological patterns of manic-depressive personalities are created by the depressive dynamics. People who can be called manic are characterized by a denial of depression and are guided by life strategies opposite to those unconsciously used by depressed people. Yet the basic organizing themes, fears, conflicts, and unconscious explanatory constructs of depressed and manic people are similar.
It has been observed that people in a depressed state direct most of their negative affect not on another, but on themselves, hating themselves beyond any correlation with their actual shortcomings. This phenomenon has been described as "inward anger". Depressed individuals are painfully aware of every sin they have committed - despite the fact that they ignore their own good deeds, experiencing for a long time each of their selfish manifestations. Sadness is another of the main affects of people who have depressive psychology.
The most powerful and organizing defense that these types usually use is introjection. Another frequently observed defense mechanism is turning against oneself. By turning against oneself, anxiety is reduced, especially separation anxiety (if someone believes that it is anger and criticism that cause abandonment, he feels safer directing them at himself), and a feeling of power is maintained (if the "badness" is in me, I can change this disturbed situation). Another defense is idealization. Since the self-esteem of depressed individuals decreases in response to experiences, the admiration with which they perceive others increases it.
People with depressive psychology believe that they are inherently bad. They lament their greed, selfishness, vanity, pride, anger, envy, and passion. They view all these normal aspects of experience as perverted and dangerous, and worry about their inherent destructiveness. They try very hard to be "good" and are afraid of being exposed for their sins and rejected as unworthy.
Since people with a depressive personality type are constantly in a state of readiness to believe the worst about themselves, they are very vulnerable. Criticism devastates them. In any message that contains a message about their shortcomings, they tend to distinguish only that part of the communication.
Depressed individuals are deeply sensitive to being left behind and are unhappy when alone. They experience the loss as proof of their negative individual properties.
Mania - back side depression. People endowed with a hypomanic personality have a depressive organization that is neutralized through the defense mechanism of denial.
Manic people are characterized by high energy, excitement, mobility, switchability and sociability. When negative affect occurs in people with manic and hypomanic personalities, it manifests itself not as sadness or frustration, but as anger—sometimes in the form of a sudden and uncontrollable display of hatred.
The main defenses of manic and hypomanic people are denial and reaction. Denial manifests itself in their tendency to ignore (or transform into humor) events that upset and disturb most other people. Manic individuals are usually prone to devaluation, a process isomorphic to the depressive tendency to idealize. For a manic personality, everything that distracts from emotional suffering is preferred.
Home hallmark of this type is a lack of will and an inability to withstand pressure from the outside world. Such individuals easily go astray from the true path both under the pressure of circumstances and under the influence of others. It is natural that with their malleable behavior they are also sensitive to good influences.
Probably the most famous of the syndromes corresponding to this type was defined by Ernst Kretschmer as cyclothymia. Manic-depressive personalities can be described as dependent personalities in the context of the following characteristics:
1) unable to make decisions without much advice or support from others;
2) allows others to make important decisions for him, such as where to live, what job to choose;
3) because of the fear of being rejected, agrees with people, even when he believes that they are wrong;
4) it is difficult for him or her to take the initiative in any undertakings or simply act alone;
5) volunteers to do harmful or humiliating work in order to earn the sympathy of others;
6) feels discomfort or helplessness when alone, goes to great lengths to avoid loneliness;
7) feels empty or helpless if a close relationship with someone ends;
8) he is often overcome by the fear of being abandoned by everyone;
9) He is easily offended by criticism or disapproval.
A feature of this syndrome is that the centers of attraction of dependent individuals are in others, and not in themselves. They tailor their own behavior to please those on whom they depend, and the search for love leads to the rejection of thoughts and feelings that others may not like.
Personalities of this type are markedly endomorphic - Sheldon's "whales in the atlas" are rarely compared with people of any other character, and about the totality of such personalities, we can say that this is the most endomorphic group.
depressive type personality.
To relate to a depressive personality type, it is not necessary to be clinically depressed, it is enough to use the protective mechanisms characteristic of this type, that is, to respond in a certain way to difficulties.
Depressed people are sure that deep down they are bad. They consider ordinary human weaknesses and peculiarities to be their sins and exaggerate their greed, selfishness, pride, and envy. As a rule, at an early age they had to go through the experience of losses (father or mother), and deep down they are sure that something inside them led to the departure of a loved one. In the future, they remain afraid that as soon as the partner gets to know them better, he will see their inferiority and leave them. Therefore, they try very hard to be good for others and attribute the reasons for all the difficulties and failures in relationships only to themselves.
It is not known whether the predisposition to depression is genetically transmitted, as it may be due to the fact that the child adopts the behavior patterns of the father or mother. The most common reason for the formation of this predisposition is the loss of a father or mother at an early age. This loss is not always obvious and obvious, for example, it can also be felt by the child if the parent forces him to become independent too early, before the child is ready for it.
People with a depressive personality type use introjection, retroflection, and idealization as defense mechanisms.
When a child feels the loss of a loved one, he imagines that he has left him, feeling resentment and anger, that is, he projects his own feelings onto the departing person. Then he appropriates all the negative qualities of the departed person to himself: he himself was bad, that's why they left him. This is partly due to the egocentrism that is natural for the child, partly it is an attempt to mitigate unpleasant experiences by assigning responsibility for what happened to ourselves, because when something depends on us, we can change it. Hence the feeling of their own badness, inferiority, characteristic of depressed people.
It is useless to convince the child that he is not the reason for parting with the departed person: at the age of, for example, 2 years, the child is not yet able to accept these explanations, so early separation from a loved one practically guarantees depressive dynamics.
Another factor that forms a depressive personality type is a negative attitude in the family towards grief and crying. If the mother believes that the child should consider leaving the father’s family as a blessing, just as she does, and if tears and experiences are considered weakness, self-indulgence, self-pity and are condemned, grief goes deep and there is a feeling that something is wrong inside. Sometimes children feel that their experiences are painful for the remaining parent, and try to keep him from them.
And finally, another factor in the formation of depressive dynamics is depression in one of the family members in early years child development. Such an adult can only carry out mechanical care, he is constantly tired and asthenic, and the child gets used to the fact that his needs are a burden to another person, that they weaken and exhaust other people. All these factors contribute to the development of depressive dynamics.
Another defense mechanism used by the depressive personality type is retroflection. When a child stays with one of the parents, the anxiety of abandonment becomes stronger, so the anger that he expresses at the remaining parent becomes dangerous for him, and then this anger turns to himself. When such a child is angry, he may begin to stumble, fall, hit corners and other objects. Related to this is the habit of depressed people to pinch themselves in situations of excitement, hit themselves on the knee with their fist, pull on the wounds on their hands, etc.
The idealization characteristic of depressed personalities differs from the idealization of narcissistic personalities: in the latter it is associated with power and status, while in the depressive personality type idealizes moral character other people. They tend not to notice and forgive the shortcomings of other people, tolerantly treat them.
