What is a depressive syndrome. Perspective potential possibilities of St. John's wort. How to overcome astheno-depressive syndrome: treatment methods

Depressive syndrome is a painful condition of a person, which is characterized by various mental and physical disorders. And although many people under depression mean, as a rule, boredom, melancholy and apathy, to understand this pathology only as a manifestation of these symptoms is incorrect. In fact, depression is a rather serious disease that affects the physical health of a person, and sometimes can lead to irreversible consequences. Therefore, depressive syndrome requires careful diagnosis and often long-term treatment.

Manic depressive syndrome

Depression different people may develop into certain types pathologies that have common features, as well as specific. The latter are inherent only in a particular variety of this disease state and help to identify it in determining the diagnosis. So, the manic-depressive syndrome is distinguished by the alternation of two main phases - manic and depressive, in the intervals of which periodic enlightenments can appear.

The first phase is characterized the following symptoms depressive syndrome:

elevated mood;
Energy;
Psychomotor agitation;
Active gestures;
Acceleration of thought processes.

The patient in this phase usually talks and laughs a lot, often he overestimates his abilities and takes on work that he cannot actually do. Often he has confidence in his own genius, so patients with manic-depressive syndrome can pretend to be artists, poets, actors, etc.

The second, depressive phase is the exact opposite of the first. In this phase, the patient has the following symptoms:

Oppression;
sad mood;
Stiffness of movements;
Inhibition of thought processes.

Depressive phases, as a rule, last longer than manias, and the frequency of these conditions varies from person to person: from several days to months. It should be noted that patients with manic-depressive syndrome are usually aware and even critical of their condition, but they are unable to fight it.

In mild cases, the treatment of this type of depressive syndrome can be carried out on an outpatient basis, while in severe cases, it can be done inpatiently, using strong antidepressants.

Astheno-depressive syndrome

Astheno-depressive syndrome in medicine is called a mental disorder, which is characterized by such signs as:

General weakness of the body;
Fast fatiguability;
Anxiety;
Frequent headaches;
Hypersensitivity;
Inhibition of movements, speech and thought process.

The causes of this type of depression can be divided into internal and external. The former include various stressful situations and pathological states of the emotional sphere. The external causes of astheno-depressive syndrome are all kinds of diseases, for example: oncological diseases, major operations, injuries, infections, diseases of the cardiovascular system, etc.

In adolescents and young people, the symptoms of this type of depressive syndrome can acquire a bright negative connotation. In this case, signs such as:

Regular tantrums;
Coarseness;
Anger and irritability;
Unfounded protests.

A protracted illness is often fraught with the emergence of a guilt complex, which is joined by a gloomy assessment of both the surrounding world and one's own condition. In addition, astheno-depressive syndrome affects the physical health of a person. Against the background of this pathology, disturbances occur in the digestive system, pressure rises, appetite and sleep are upset, the menstrual cycle in women is often disturbed, sexual desire disappears, etc.

It is important to note that a characteristic feature of this type of depression is the improvement in the psycho-emotional state of a sick person after elimination somatic symptoms sickness or good rest.

Treatment of depressive syndrome in this case directly depends on the severity of the disease. In some cases, a short session of psychotherapy can help the patient, while in more neglected cases, not only a long course conducted by a psychotherapist, but also the use of antidepressants and sedatives for a long time will be required.

Anxiety-depressive syndrome

The name of this type of pathology speaks for itself: the main symptoms of this type of depressive syndrome are anxiety and panic fears. It is important to note that these features are more characteristic of adolescence, in connection with which this type of depression in most cases is observed precisely in the transition period. This is due to increased emotionality, vulnerability and even an inferiority complex that arise at this stage.

Anxiety-depressive syndrome is manifested by painful fears of a different nature, which gradually turn into phobias. Very often, adolescents who develop the syndrome are terribly afraid of punishment - for committed and imperfect actions, for not being beautiful enough, smart, talented, etc. An important symptom depressive syndrome in this case is almost total loss ability to objectively evaluate the world, various situations in it and own personality. All this is presented to the patient in the most gloomy light, since it is perceived extremely hostilely.

Against this background, persecution mania can also develop. It often seems to patients that everyone is deceiving them, adjusting life situations in such a way as to lure them into a trap. People around can be perceived as enemy agents who are watching their every move. Suspiciousness, suspicion, excessive sensitivity become permanent signs anxiety-depressive syndrome, taking away from the patient all the energy and strength to fight against dangers that do not exist in reality.

Treatment of a depressive syndrome in this case involves the immediate help of a professional psychotherapist, possibly with the use of sedative drugs.

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Depressive syndromes (lat. depressio depression, oppression; synonym: depression, melancholy) - psychopathological conditions characterized by a combination of depressed mood, decreased mental and motor activity(the so-called depressive triad) with somatic, primarily vegetative, disorders. They are common psychopathological disorders, second only to asthenia in frequency. Approximately 10% of those suffering from depression commit suicide.

With mild depression or in the initial stage, which is further complicated by a depressive syndrome, somatic disorders often occur simultaneously with depressed mood. Appetite decreases, patients cease to feel the taste of food, constipation, dyspeptic disorders appear - heartburn, belching, nausea, flatulence.
The appearance of the patients haggard, aged. They fall asleep with difficulty, the night sleep is superficial, intermittent, accompanied by disturbing and painful dreams in content, early awakening is characteristic. In some cases, patients have a feeling of sleep loss: objectively they are asleep, but they claim that they did not close their eyes all night. In the morning they experience lethargy, depression, weakness. It takes an effort of will to get up, wash, cook food. The coming day excites patients, they experience vague or specific painful forebodings. What has to be done during the day seems difficult, difficult to do, exceeding personal capabilities. I don't want to leave the house. It's hard to think, focus on one issue. Distractedness and forgetfulness appear. Mental activity is slowed down and impoverished, the figurative component of thinking weakens or is completely lost.
The mind is dominated by involuntarily arising painful thoughts in which the past and present are presented only as failures and mistakes, and the future seems aimless. People of intellectual labor feel much dumber; predominantly engaged physical labor often noted physical weakness. There is a lack of confidence in their abilities. In all cases, performance decreases, sometimes dramatically. For minor reasons, patients experience painful doubts, decisions are made with some difficulty and after hesitation. They continue to perform their usual work somehow, but if something new needs to be done, they usually cannot imagine how to take it on. Patients are often painfully aware of their failure, usually regard it as a manifestation of laziness, lack of will, the inability to pull themselves together.
They are annoyed at their condition, but they are unable to overcome it. AT initial period depressive syndrome various external stimuli, for example, those associated with communication, the need to do something at work, etc., weaken the existing disorders for some time. Quite often, patients say that it is easier for them at work, because they are “forgotten”. As soon as external motives disappear, the temporary improvement in the state disappears. Spontaneous complaints about Bad mood in the initial period do not exist in all cases. Often, patients with an undoubted depressive state, when asked directly about what their mood is, define it as normal. A more detailed questioning allows, as a rule, to find out that they experience lethargy, apathy, loss of initiative, anxiety, it is often possible to identify such definitions of their mood as sad, boring, depressed, depressed. In a number of patients, first of all, complaints of feeling internal trembling in the chest or in the most various areas body.

Mild depressions are often referred to as subdepressions, or cyclothymic (cyclothyme-like) depressions. In such patients, movements are slowed down, mimic reactions are depleted. Depending on the predominance in the structure of mild depressions of certain psychopathological symptoms distinguish several forms. So depression, accompanied by irritation, discontent, touchiness, is called grumpy, or dysphoric, depression. In those cases where the weakness of motives, lack of initiative, passivity predominates, they speak of adynamic depression. The combination of depression with neurasthenic, hysterical and psychasthenic symptoms makes it possible to distinguish neurotic depression. If depression is combined with easily arising reactions of weak-heartedness, we speak of tearful depression. Depression, combined with pathological sensations of mental genesis, is called senestopathic, and in cases where the patient assumes that he has any disease internal organs talk about hypochondriacal depression. Depression, in which only low mood is noted, is called hypothymic. There are other depressive syndromes.

With the deepening of depression, patients begin to complain of melancholy. Many have painful sensations in the chest, upper abdomen, less often in the head. Patients define them as a feeling of constraint, compression, compression, heaviness; in some cases they complain that they cannot breathe full chest. With a further increase in depression, to describe the feeling of longing, patients resort to such expressions as “the soul hurts”, “the soul was squeezed”, “the longing presses the chest”, “the soul tears into pieces from longing”. Many patients begin to talk about feeling pain in their chest, but not physical pain, but some other pain that they usually cannot define in words; some patients call it moral pain. Such states are defined as depressions with precordial anguish.

Already with subdepression, patients have a decrease in affective resonance - a state in which their former interests, attachments, desires have become dull to some extent. In the future, against the background of a pronounced dreary mood, a painful, often painful feeling of indifference is noted, reaching in some cases a feeling of inner emptiness (loss of all feelings) - the so-called mournful mental insensitivity. When describing it, patients often resort to figurative comparisons: “stupefied, stiffened, became callous, ruthless,” etc. Mental insensitivity is so intense that patients complain only of this disorder, not to mention longing, and even more so depression. It is especially painful in relation to relatives. Depression with mental insensitivity is called anesthetic depression. In other cases, patients talk about a feeling of change in the environment: “the light has faded, the foliage has faded, the sun has become less bright, everything has moved away and froze, time has stopped” (the so-called depression with melancholic derealization). Often, depersonalization and derealization disorders are combined with depression (see Depersonalization-derealization syndrome). With further deepening of depression, different in content, primarily depressive, delusional ideas arise. Patients accuse themselves of various offenses (selfishness, cowardice, callousness, etc.) or of committing crimes (debauchery, betrayal, deceit). Many demand a "fair trial" and a "deserved punishment" (nonsense of self-accusation). Other patients say that they are unworthy of attention, they take up space in the hospital in vain, they look dirty, they cause disgust (nonsense of self-abasement). A kind of depressive delirium is the delirium of ruin and impoverishment; it is especially often observed in patients of advanced and senile age (“there is not enough money for living, food is spent uneconomically, the economy has fallen into decay”, etc.).

Hypochondriacal delusions are very common in depression. In some cases, this is a delusion of the disease (the patient believes that he has cancer, tuberculosis, AIDS, etc.) - hypochondriacal delusional depression, in others - an unshakable belief in the destruction of internal organs (the intestines have atrophied, the lungs have rotted) - depression with nihilistic delirium. Often, especially in the elderly and senile age, depression occurs, accompanied by delusions of persecution, poisoning, damage (paranoid depression).

In some cases, there is a stuporous depression - distinct motor disorders, reaching the intensity of substupor and occasionally stupor. The appearance of such patients is characteristic: they are inactive, silent, inactive, do not change their posture for a long time. The facial expression is mournful. Eyes dry and inflamed. If patients are asked a question (often repeated several times), they answer in monosyllables, after a pause, in a quiet, barely audible voice.

Symptoms of depression (in mild cases and less often in severe cases) are especially intense in the morning; in the afternoon or evening, the condition of patients, both objectively and subjectively, can improve significantly (recovery by five o'clock in the afternoon, according to French psychiatrists).

Exists big number depression, in which there is primarily no motor, less often speech inhibition. They are called mixed depressions - a depressed or melancholy mood is accompanied by speech and motor excitement (agitation). At the same time, the depressive affect is also modified; it is usually complicated by anxiety, less often by fear (anxious-agitated or agitated depression with fear). In this state, patients do not leave painful premonitions of impending misfortune or catastrophe. In some cases, anxiety is pointless, in others it is specific (arrest, trial, death of loved ones, etc.). Patients are extremely tense. They can’t sit, they can’t lie down, they are constantly “tempted” to move. Anxious agitation with motor excitation very often manifests itself in the incessant appeals of patients to staff with the same requests. Speech excitation, as a rule, is manifested by groans, groans, monotonous repetition of the same words or phrases: “it's scary, scary; I killed my husband; destroy me” and others (the so-called anxious verbigeration). Anxious agitation can be replaced by melancholic raptus - a short-term, often "silent" frenzied excitement with the desire to kill or mutilate oneself. Anxious-agitated depressions may be accompanied by depressive delusions of various content. With them, Kotard's syndrome most often occurs - a fantastic nonsense of enormity and denial. Denial can extend to universal human qualities - moral, intellectual, physical (for example, there is no conscience, knowledge, stomach, lungs, heart); on the phenomena of the outside world (everything has died, the planet has cooled down, there are no stars, the Universe, etc.). Possible nihilistic or hypochondriacal-nihilistic delirium. With delusions of self-accusation, patients identify themselves with negative historical or mythical characters (for example, Hitler, Cain, Judas). Incredible forms of retribution for what they have done are listed, up to immortality with eternal torment. Cotard's syndrome in its most pronounced form appears in adulthood and senile age. Its individual components, for example, the idea of universal death, may arise in young age.

Depression is also complicated by the addition of various psychopathological disorders: obsessions, overvalued ideas, delusions, hallucinations, mental automatisms, catatonic symptoms. Depressions can be combined with superficial manifestations of a psychoorganic syndrome (the so-called organic depressions).

Latent depressions are a special variant of the depressive syndrome (synonym: vegetative depression, depression without depression, masked depression, somatic depression, etc.). In these cases, subdepressions are combined with pronounced, and often dominant in the clinical picture, vegetative-somatic disorders. Latent depressions, which occur almost exclusively in outpatient practice, are 10-20 times more frequent than ordinary depressions (according to T.F. Papadopoulos and I.V. Pavlova). Initially, such patients are treated by doctors of various specialties, and if they get to a psychiatrist, then usually a year or several years after the onset of the disease. The symptoms of latent depression are varied. Most often, they have disorders of the cardiovascular system (short-term, long-term, often in the form of paroxysms pain in the region of the heart, radiating, as is the case with angina pectoris, various violations rhythm of cardiac activity up to attacks of atrial fibrillation, fluctuations in blood pressure) and digestive organs (loss of appetite up to anorexia, diarrhea, constipation, flatulence, pain along the way gastrointestinal tract, nausea and vomiting). Unpleasant pain sensations in various parts of the body are often noted: paresthesias, migratory or localized pains (for example, characteristic of lumbago, toothache, headache). There are disorders that resemble bronchial asthma and diencephalic paroxysms, very often - various sleep disorders. Vegetative-somatic disorders observed in hidden depressions are called depressive equivalents. Their number is increasing. Comparison of the symptoms of latent depressions with the onset of various depressive syndromes reveals a certain similarity between them. And ordinary depressive syndromes often begin with somatic disorders. With hidden depression long time(3-5 years or more) no deepening occurs affective disorders. For latent depressions, as well as for depressive syndromes, periodicity and even seasonality of occurrence is characteristic. About mental conditioning somatic pathology with latent depressions also testifies to their successful treatment antidepressants.

Depressive syndromes occur in all mental illness. In some cases, they are their only manifestation (for example, schizophrenia, manic-depressive psychosis), in others - one of its manifestations (epilepsy, traumatic and vascular lesions of the brain, brain tumors, etc.).

DIAGNOSIS established on the basis of the clinical picture. In the elderly, it is often differential diagnosis with psychoorganic syndrome.

Mild forms of depression are treated on an outpatient basis, severe and severe - in psychiatric hospital. Antidepressants and tranquilizers are prescribed. With the complication of a depressive syndrome with delusional, hallucinatory and other deeper psychopathological disorders, antipsychotics are added. With anxiety-agitated depressions, especially those accompanied by a deterioration in the somatic condition, as well as depressions with a long-term adynamic component, electroconvulsive therapy is indicated. Lithium salts are used to treat and prevent some depressive syndromes. Due to the possibility of treatment, severe depressive syndromes, such as Cotard's delusions, are extremely rare; they mostly occur in non-expanded forms. The “shift” of the depressive syndrome towards subdepressions is an indication for mandatory application, especially under conditions outpatient treatment, psychotherapy, the form of which is determined by the structure of the depressive syndrome and the personality of the patient.

FORECAST depends on the development of a depressive syndrome, which can be paroxysmal or phase, i.e. the disease proceeds with remissions and intermissions. The duration of attacks or phases ranges from a few days to 1 year or more. The attack or phase can be single throughout life and multiple, such as annual. With multiple attacks or phases of a depressive syndrome, they often occur at the same time of the year. Such seasonality, other things being equal, is a favorable factor, because allows you to start treatment before the onset of painful disorders and thereby smooth out the intensity of the manifestation of the depressive syndrome. In old age, depressive syndromes often have chronic course. Therefore, in these patients, the issue of prognosis should be addressed with caution. Depressive syndromes that can lead to death, such as malignant presenile melancholia, have practically disappeared. The main danger of a depressive syndrome is the possibility of a suicidal attempt by patients. More often they tend to commit suicide at the beginning of development and with a pronounced reduction in depressive disorders. Therefore, such patients are not recommended to be discharged prematurely, it is better to “overexposure” them in the hospital. In a hospital setting, suicidal attempts are characteristic of patients with agitation, anxiety, and fear.

— mental illness, manifested not only by mental, but also by physical symptoms. In everyday life, depression is called melancholy and lack of desire to be active. But it's not the same. Depression is a serious condition that requires special treatment. Its consequences may be irreparable.

Manic depressive syndrome

Depression in different individuals proceeds with its own specifics. The doctor, establishing the diagnosis of a depressive syndrome, necessarily determines its type. With manic-depressive syndrome, two phases alternate (as the name implies). The intervals between them are called periods of enlightenment. manic phase characterized by the following manifestations:

acceleration of thought
excessive use of gestures
excitation of the psychomotor sphere
energy that may not be inherent this person during periods of enlightenment
good mood, even revealingly good

This phase is characterized by frequent laughter of the patient, he is in high spirits for no apparent reason, enters into communication with others, talking a lot. In this phase, he can suddenly be convinced of his own exclusivity and genius. Patients present themselves in many cases as talented actors or poets.

After this phase comes manic with the opposite clinic:

longing and
depression for no reason
thought is slow
movements are constrained, insignificant

Mania lasts less time than the phases of the depressive syndrome. It can be either 2-3 days or 3-4 months. Often, with this type of depression, a person is aware of the state he is in, but cannot cope with the pathological symptoms himself.

Astheno-depressive syndrome

This is a mental disorder, the main manifestations of which are:

slow flow of thought
slow speech
slow movements, gestures
rising anxiety
fast onset fatigue
weakness in the body

The reasons can be of two groups:

domestic
external

The first of these groups includes pathologies in the emotional sphere and stresses of various nature. External causes diseases appear:

pathology of the heart and blood vessels
infection
received injuries
surgery that went badly
oncology (tumors)

In patients of puberty and at a young age, this depressive syndrome can be very negative. The following symptoms are added:

protests for no reason
increased irritability
manifestations of anger in speech and behavior
rudeness towards others, even to the closest people
constant tantrums

When the disease lasts for a long time, does not go away, then the person may have guilt for what is happening to him (and that he cannot be cured by his own efforts). Then he begins to evaluate his condition extremely gloomily, gets angry at the world and evaluates it negatively.

Astheno-depressive syndrome has a direct reflection on the physical well-being of a person:

decreased libido
violation of the cycle of critical days
sleep disorder
decreased or lack of appetite
diseases of the digestive tract, etc.

It is worth knowing that with this type of depressive syndrome, a person feels better when he is well rested, or when the somatic symptoms of the disease are eliminated. Treatment is selected depending on how severe the pathology is in a particular case. Sometimes just a session with a psychotherapist is enough. But at severe course This type of depression requires a course of psychotherapy in combination with sedatives and antidepressants.

Anxiety-depressive syndrome

As in previous cases, the features of this type of depression can be understood from the name itself. There is a combination of anxiety and panic fears. These manifestations are inherent mainly in adolescents, therefore it is not surprising that the anxiety-depressive syndrome is most often diagnosed precisely in persons in puberty. The reasons for the characteristic this stage development of the personality of an inferiority complex, vulnerability and excessive emotionality.

Manifestations of this type are painful various fears that develop into phobias. Often adolescents with this syndrome are very much afraid of punishment, both for what they have done and for imperfect actions. They are afraid of punishment for insufficient intelligence, talent, skills, and so on.

A person can no longer objectively evaluate the world, his personality with all its characteristics and roles, the situations that occur with him. He sees everything in the darkest colors, perceives with big share hostility. It is likely the formation of persecution mania. Patients in such cases think that someone (most people or all) conspired to frame, deceive, hurt, etc.

With persecution mania, a person may begin to think that there are enemy agents around, monitoring the actions of the patient. A person becomes suspicious (even in relation to the closest people), excessive suspiciousness is characteristic. The patient's energy is spent on confronting the world and those elements that he himself invented. He begins to hide and take other actions to "protect himself from agents." To recover from anxiety-depressive syndrome (and persecution mania), you need to contact an experienced psychotherapist or psychiatrist. He may also appoint sedatives if he sees a need for them for a particular patient.

Depressed Personalities

Depressive individuals are characterized by:

pessimism (very rarely skepticism)
suppressed actions
slow motion
restraint
quietness
small expectations from life in your favor
lack of desire to talk about yourself
hiding your life

Depressed individuals may hide their character traits with poise. Separately, they consider gloomy-depressive personalities, who, in addition to a depressed state and a negative outlook on the world, have the following features:

sarcasm
grouchiness about and without
obnoxiousness

A depressed personality is not the same as a person with depressive psychosis. Depressive reactions are also not synonymous this concept. From the point of view of symptoms, the same disorders are depressive character neuroses and depressive personality structure. The difference between depressive neurosis is the presence various disorders mood, it is impossible to describe it with a clear characteristic symptomatology.

Personality becomes depressed due to the predisposition and characteristics of the relationship between the child and parents. A strong attachment to the mother (with ambivalence) is obligatory, which leads to the fact that the child cannot act independently, solve his problems. The child is afraid of losing affection. He has problems with self-determination. The formation of a depressive personality is influenced by the deterioration of relations with herself and her father, conflicts with other close people, and terrible life situations.

Treatment includes:

crowding out
formation of independence
elaboration of the subject of negative transfer

Depressive-paranoid syndromes

Levels of depression (classic development):

cyclomatic
hypothymic
melancholic
depressive-paranoid

When depression stops in its development at any of the above stages, this type of depression is formed:

cyclothymic
subsyndromal
melancholic
delusional

In the cyclomatic stage the patient becomes unsure of himself, evaluates his appearance/professional qualities/personal qualities low, etc. He does not enjoy life. Interests are lost, the person becomes passive. At this stage, there are:

psychomotor retardation
anxiety
affect of anguish
ideas of self-blame
thoughts of committing suicide

What is typical for this stage:

asthenic phenomena
sleep problems
decreased sexual desire

next,hypothymic stage, is special in that a dreary affect appears, moderately pronounced. The patient complains that he is hopeless; the person becomes despondent and sad. He says that a stone lies on the soul, that it does not mean anything for this world, that life has no purpose, and he wasted many years of time in vain. He sees everything as difficulties. The patient begins to think how exactly he can commit suicide, and whether it is worth doing it. Close people and a psychotherapist at this stage can convince a person that in fact everything is not as it seems to him.

The patient's condition at this stage is better in the evenings. He is capable of labor activity and team interactions. But these actions require the patient to activate his willpower. Their thought process slows down. The patient may complain that his memory recent times got worse. For some time, the patient's movements may be slow, and then a period of fussiness sets in.

The hypothymic stage is characterized by a typical appearance of patients:

pained facial expression
lifeless person
drooping corners of the mouth
dull look
uneven back
shuffling gait
monotonous and raspy voice
intermittent sweating on the forehead
the man looks older than his age

Vegetative symptoms appear: loss of appetite (as in the previous stage), constipation, lack of sleep at night. The disorder at this stage acquires a depersonalizing, apathetic, anxious or dreary character.

Melancholic stage of depression characterized by the excruciating suffering of the patient, his mental pain borders on the physical. The stage is characterized by a clear psychomotor retardation. A person can no longer conduct a dialogue with someone, the answers to questions become meek, monosyllabic. A person does not want to go anywhere, does nothing, only lies most of the day. Depression becomes monotonous. Appearance features characteristic of this stage:

dryness of mucous membranes
frozen face
devoid of emotions and many intonations voice
hunched back
minimum number of movements, almost complete absence gestures

A person thinks about suicide and tries to realize his plans for such an outcome. The patient may develop melancholic raptus. The person begins to rush back and forth around the room, wringing his hands, trying to commit suicide. Overvalued ideas of low value change to delusional ideas of self-abasement.

A person negatively evaluates his actions, actions in the past. He believes that he did not fulfill his family and professional obligations. And it is no longer possible to inspire them with the opposite. The patient lacks the ability of critical thinking, he cannot look at things and his personality objectively.

Delusional stage of depression has 3 stages. The first is characterized by delusions of self-blame, the second by delusions of sinfulness, the third by delusions of denial and enormity (at the same time, catatonic symptoms develop. The ideas of self-blame are that a person blames himself for everything that happens in the world, with his relatives and children.

Gradually paranoid clinic develops based on the following fears:

get sick and die
commit a crime and be punished for it
impoverish

When a person begins to blame himself even more, he begins to have false recognitions, ideas special significance what is happening. A little later, some catatonic manifestations appear, verbal hallucinations illusory hallucinosis.

A person in the hospital, at this stage in the development of the disease, begins to believe in many cases that he has been placed in prison. He takes the orderlies for guards. It seems to him that everyone around him is surreptitiously watching and whispering. Whatever the people around him are talking about, he thinks they are discussing his future punishment/revenge. He may consider even small mistakes in the past as his crime, which in fact are not violations of the law or even any rules established in society.

The paraphrenic stage, which comes after the one described above, is characterized by blaming the patient himself for all the sins and crimes that only exist in the world. They think that very soon there will be war all over the world, and the end of the world is near. The sick believe that their torment will be eternal when they are left alone after the war. Probably the formation of a delirium of possession (a person believes that he has reincarnated as a devil, symbolizing world evil).

In some cases, at this stage of depression, the so-called nihilistic delirium of Kotard is formed. At the same time, it seems to a person that they stink of rotting flesh, that everything inside them began to decay, or that their body does not exist. Probably, catatonic symptoms will join.

The depressive-paranoid syndromes described above (which are part of the disease of depression) are formed according to a certain specified image. They are distinct from delusional psychoses, which may be a consequence/manifestation of depression.

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Differences from depression and asthenia

Astheno-depressive syndrome combines the symptoms of asthenia (pathological fatigue) and depression (depressed mental state).

This type of disorder is observed mainly in people with neurosis, somatic diseases or cyclothymia. Patients report that without any visible reasons life suddenly loses its meaning, and the soul becomes heavy. The symbiosis of asthenia and depression in the form often manifests itself at the end of winter, when there is not enough sunny weather.

Asthenia is expressed in fatigue, anxiety, depression (). Associated symptoms depression in this mental disorder are:

Digestive disorders;
insomnia or;
loss of appetite;
decreased libido.

The syndrome differs from classical depression by a temporary improvement in the condition after good rest. Instead of classic depressive reactions, young people experience tantrums, unreasonable rudeness and anger. anxiety, overexcitation.

Kinds

Speaking of depression itself, it should be noted characteristics in the form of a pessimistic outlook on life, bad mood, haunted melancholy, suicidal thoughts.

There are also subdepressive states, which are typical and atypical.

With a typical syndrome, the symptoms of depression are “smoothed out” (sadness is more like a depressed state). To atypical syndromes relate:

Anesthetic subdepression

Associated with the loss of desires, feelings and emotions (the ability to empathize, hate or sympathy). A person does not feel the impulse to activity, he is haunted by painful feelings of emptiness.

Adynamic subdepression

Differs in a passive state of a person, constant apathy and laziness, emptiness, depression, unwillingness to do anything. Other signs of such a disorder include unwillingness to move, a “jelly-like” state and an indifferent attitude to what is happening.

Astheno-subdepressive syndrome

characterized by hypothymia vitality), emotional lability, inexplicable fatigue (the person seems to have done nothing, but feels a strong breakdown). One of the leading signs of such a disorder is general somatic weakness.

Reasons for the appearance

Physiological

Decreased immunity;
beriberi (lack of minerals and trace elements);
diseases of the endocrine system;
traumatic brain injury;
brain diseases;
alcohol or drug poisoning;
somatic diseases;
predisposition to mental disorders.

Risk factors

They contribute to the development of the disease.

Constant physical or mental stress;
lack of sleep and rest (violations of the daily routine);
overwork at work (irregular working hours, extracurricular work);
personal qualities of a person (pedantry, hyperresponsibility).

Often such a psycho-emotional disorder is observed in people prone to a depressive perception of the world, pessimism, and excessive self-criticism.

At risk are people with a creative mindset: artists, designers, directors, teachers and representatives of similar professions.

Characteristic symptoms

To make a diagnosis, you need to make sure that the patient has at least five signs.

Psychological symptoms

Pessimism and loss of interest in life;
fatigue, due to which it is impossible to complete the work begun;
sleep disturbances (insomnia or many hours of sleep, after which you still feel "broken");
feeling of melancholy and hopelessness;
reacting aggressively to criticism or failure;
causeless change of mood;
reluctance to leave the house and contact with people;
difficulty in concentrating (impossible to concentrate, confusion of thoughts);
the occurrence of unexplained phobias.

Physiological signs

Headache;
dizziness;
bouts of nausea;
violation menstrual cycle;
decreased libido;
gastrointestinal disorders;
attacks of tachycardia;
causeless increase in heart rate;
excessive sweating;
dyspnea;
subfebrile temperature (37-37.5C).

A person may experience so-called "phantom pains" - painful sensations of a false nature in the joints or muscles, the location of which is constantly changing.

Often sub depressive disorder accompanied by severe seizures unreasonable anxiety accompanied by feelings of fear and autonomic symptoms(rapid pulse, shortness of breath, tremor, confusion, pre-syncope).

Features of the disorder in children

Children also suffer from astheno-depressive syndrome in our time. This mental disorder manifests itself in them in the form of the following symptoms:

A sharp decline in academic performance;
loss of interest in studies, games and fun;
depressed mood;
sleep disorders;
headache;
loss of appetite;
problems in interpersonal relationships (conflicts with teachers, peers);
tearfulness.

Parents' inattention to the child's lifestyle, lack of rational nutrition, excessive workload in the form extra classes with tutors negatively affect the psycho-emotional state of the baby.

There is a pronounced symptomatology of asthenia, which is dangerous for its complications, in particular, depression. The causes of astheno-depressive syndrome lie in mental stress, stress, sedentary manner life. Even chronic diseases can provoke the development of this pathological condition. If a child who loved to communicate with peers suddenly ceased to be interested in his favorite activities and hobbies with friends, does not want to leave the house, withdraws into himself and spends all the time alone, these are significant prerequisites for believing that he has health problems. In such cases, please contact pediatrician(therapist, psychologist).

What is the danger of the syndrome

Depletion of the nervous system running can lead to an extremely "gloomy" assessment of a person's condition. He feels guilty about what is happening to him and angry at the whole world. This can lead to severe depression dangerous consequence which is suicide.

Against the background of astheno-depressive syndrome, disturbances in the functioning of the digestive system occur. Often, the patient's appetite is upset, the pressure rises, they appear.

Women experience menstrual irregularities. If not treated, the syndrome negatively affects a person’s personal life (sexual desire disappears, impotence develops in men).

Diagnostics

If a depression observed for a long time, he should contact a therapist for examination, blood tests (for vitamin and mineral deficiencies) and further diagnosis. Often the root cause of such a mental disorder is chronic diseases:

Hepatitis;
thyroid dysfunction;
diabetes;
heart diseases;
pancreatitis;
gastritis;
nephritis;
hormonal imbalance.

In the absence of organic pathologies, the causes of the development of the syndrome are psycho-emotional disorders.

The patient should contact a psychologist or psychotherapist to analyze the astheno-depressive phenomenon. Based on the symptoms and life history, the severity of the syndrome can be diagnosed and effective treatment can be prescribed.

The clinical picture of the disease is as follows: it is difficult for a person to formulate his judgments, he is in a stop state, slowness of thinking and speech is observed. One of the main symptoms is the unwillingness of the patient to go somewhere. He withdraws into the "four walls" and in himself, ignoring phone calls and invitations to meet friends.

Treatment

The absence of physical health problems does not mean that a person with the syndrome nervous exhaustion cope without the help of a psychiatrist. The doctor will select the treatment taking into account the individual characteristics of the individual.

Correction of astheno-depressive syndrome is based on the use of:

Medical therapy.
maintenance therapy.
Psychotherapy.

Of the medications used in the treatment of this type of psycho-emotional disorder, it can be noted:

Antidepressants

Fluoxetine, Azafen, Mipramine, Befol, Mianserin, Inkazan - will effectively bring a person out of a state of depression and emotional depression.

Preparations plant origin

Novo-Passit, Deprim, Relaxil, Sedasen, Tripsidan - are used as sedatives.

Antipsychotics

Glycine, Sonapax, Gidazepam, Afobazol - help get rid of panic attacks.

Adaptogen preparations

Tinctures of ginseng, eleutherococcus, aloe extract, mummy - have a general tonic effect on the central nervous system.

Treatment of astheno-depressive syndrome includes diet food, compliance correct mode day, ensuring sufficient physical activity. Methods and duration of treatment are also selected on an individual basis.

Of great importance is psychotherapy, which is one of the most effective methods dealing with mental disorders.

Conclusion

Astheno-depressive syndrome - alarm bell that with your body (and especially with the nervous system and psyche) not everything is in order. Conscious serious attitude to the state of your health will help to cope with an insidious disease quickly and without negative consequences. The main thing is to find the strength to go to a doctor, talk about problems and ask for help.

Depressive syndrome is a complex of mental disorders, the main feature of which is melancholy, despondency, apathy, melancholy. All this happens along with violations of the somatic and autonomic functions. nervous systems, mental disorders. Although the diagnosis of "depression" around the world arose not so long ago, in no case should you brush aside the detected signs. With this disease, you should immediately make an appointment with a doctor and begin treatment.

According to statistics, every year 10-15% of the population with this disease make a suicide attempt due to untimely assistance. Probably, every person at least once felt incredible melancholy, indifference to everything, despair and anxiety.

Feeling some kind of ballast behind your back, unwillingness to change, negative thinking, a pessimistic attitude are the main manifestations of the depressive syndrome that appear when a “black streak” occurs in a person’s life. Scientists have found that in 70% of cases, depression occurs in people with increased sensitivity of perception. In the weaker sex, this syndrome manifests itself twice as often as in men, they also distinguish special kind female depression - depressive housewife syndrome.

Depressive syndrome is a complex of mental disorders, the main feature of which is melancholy, despondency, apathy, melancholy

In depression syndrome, patients experience suppression of instincts, defensive reaction, lowering sexual needs, inferiority complex, excessive concentration on their problems, inattention, suicidal tendencies. Without proper treatment, this can all turn into chronic syndrome depression. Mental disorders will continue and physical pathologies will be added.

Symptoms of a depressive disorder

The signs are:

Melancholy. It manifests itself from weak depression to the strongest apathy, with the realization of hopelessness and lack of meaning in life.
Sluggish brain activity. Obsessed with his experiences, the patient answers any questions with a long pause.
Inhibition of reaction and movements, sometimes reaching a shock stupor. At times, such slowness can be replaced by a lightning attack of sadness and despondency, in which the patient jumps up, beats his head against the wall, screams, howls, deliberately injures himself.

Depressive syndrome - causes

No clearly defined causes of this disorder have yet been found, but 4 main assumptions can be made:

genetic propensity;
nervous disorders and pathologies;
mental instability;
stress.

Stress can lead to this disease

Symptoms of depression usually occur in the morning or at night. It is at this time of the day that patients experience complete hopelessness, tragedy, hopelessness and commit suicide. Often you can meet the opposite feelings - "emotional apathy." The patient complains of his indifference, indifference and indifference to what is happening around him.

Varieties

Types of depressive disorder:

Manic-depressive - consists in a change in 2 phases: mania and depression. It is characterized by high dynamism, rapid gestures, agitated psychomotor, increased brain activity. During the period of enlightenment, the patient is very self-confident, feels like a genius, takes on what he does not know how and never did. At this stage, the patient pours out his emotions, laughs hysterically, actively chats. At the end of the phase, depression comes, which is longer. Here the signs are absolutely opposite - sadness, longing, despondency appear. reactions, speech and brain activity slow down. Most often, this type of disease is inherited. Stress only provokes the disorder, but is not its main cause. A severe degree of the disease is treated inpatiently with the use of strong antidepressants and tranquilizers, mild stage possible self therapy and visiting a psychologist.
Astheno-depressive - combines cumulative depressive symptoms:

irritation;
high sensitivity and emotionality;
slow speech, gestures and reactions;
anxiety;
headache.

The syndrome causes headaches

The reasons are external and internal. The former include a variety of ailments that reduce human activity: oncology, heart disease, trauma, infection, childbirth, etc. Internal factors include mental pathology and stress. In a chronic course, the patient imposes a feeling of guilt on himself, he develops hypertension, disorders of the gastrointestinal tract, imbalance hormonal background sexual desires decrease or disappear altogether. For a mild form of the disease, only a few sessions of a psychologist will be needed; in severe cases, antidepressants and sedatives are prescribed:

anxiety-depressive- based on causeless fears and worries. Most often occurs in adolescents due to an unformed, sensitive psyche and a large amount of hormones released. It is very important to detect and help the child in a timely manner, otherwise everything will turn into chronic stage with different fears or suicide attempts. Because of the constant feeling of anxiety, persecution mania arises and suspicion of everything increases. The patient is prescribed psychotherapy and sedative medications. There are 2 forms this disorder: neurotic and suicidal. The latter appears after experienced dramas, tragedies, when a person is unable to survive all this, makes an attempt or kills himself. At this stage, the patient is placed in a hospital in order to avoid disastrous consequences.
Depressive-neurotic- the main reason is a protracted neurosis. The symptomatology is slightly different from other stages of the disease in its calmness of the course, the presence of common sense, and the readiness for action aimed at eliminating the problem. Phobias also appear here, obsessions, hysteria, but the patient recognizes himself as a person and understands that he is sick.

Depressive syndrome - what to do?

Distinguishing depressive disorder from others mental pathologies- schizophrenia, depressive-manic psychosis, vascular atherosclerosis. This is very important, because in this case it is necessary not only to localize depression, but also to fight the disease itself.

Medical treatment of the disease

The cure of the syndrome consists of the following types of therapy:

medication;
psychological;
non-drug.

At mild form prescribe psychotherapy and vitamins; in severe cases, sedatives are recommended medicines. The duration of the course should be from 2 to 4 weeks of medication to assess the effectiveness of treatment.

In especially difficult cases (hallucinations, delusions, inadequacy), neuroleptics are prescribed. They can also help physiotherapy, yoga, soothing compositions. Support is required from relatives and friends of the patient, because a lot depends on his emotions. If relatives are indifferent to the patient's problem, the treatment will not bring the desired result.

Depressive syndrome - ICD-10 code

The International Classification of Diseases of the Tenth Revision is a generally established systematization of medical diagnoses. Depression is on the ICD-10 list of mental disorders. The difference of this section is that each ailment is prone to relapses, which are not predictable and uncontrollable, since in most cases they do not depend on the patient, but on the events taking place with him.

The average form of a depressive syndrome

Forms of manifestation of the disease:

Light. Usually 2-4 signs appear - depression, low activity, indifference to former interests.
Average. 4 or more symptoms are expressed - a decrease in activity, bad dream, pessimism, poor appetite, an inferiority complex.
Heavy. A person does not see the point in life, considers himself useless and useless to anyone, thoughts arise about committing suicide, the body's reactions are inhibited, in more complex cases, delirium, fever and hallucinations appear.

Modern medicine considers a depressive disorder in the psyche to be a serious illness that requires urgent treatment. Therapy methods include the use of drugs and other procedures:

taking psychotropic, sedative drugs, tranquilizers;
various types of psychotherapy, sessions of psychologists and psychiatrists;
comfortable conditions for the patient, which sometimes require a change of place of work or social circle;
getting rid of bad habits, the right way of life;
normalized sleep, rest;
balanced diet;
physiotherapy: light therapy, healing sleep, music therapy and other soothing measures.

What causes depression?

Absolutely anyone can get sick with the syndrome. Not every individual is aware that he has signs of a mental disorder. He attributes all his problems to bad sleep, food, lack of time, etc. Such a disease does not go away on its own, and you definitely need to get rid of it.

Without assistance, the patient will feel worse and worse both psychologically and physically. In addition to the patient himself, his relatives will also suffer, because it is on them that he will compensate for his aggression, anger, pain, irritation and other emotions.

Symptoms of depression can also be observed in children and adolescents. They are slightly different from adults:

poor sleep or insomnia;
lack of appetite;
anxiety;
suspicion;
aggressiveness;
isolation;
persecution mania;

The syndrome can lead a person to withdraw

various phobias;
poor school performance;
difficulty in understanding with parents;
conflicts with classmates and teachers.

All this must be detected and treated in time. A protracted state of apathy can be life-threatening, because a large number of victims think about death. Remember that everything is curable, the main thing is the desire of the sick person and the help of a professional. A person with depression will be helped by psychiatrists, therapists, endocrinologists and psychologists.