Depression is not just a bad mood, apathy and an unwillingness to work. This is a mental disorder that occurs cyclically, and therefore a significant majority of depressive episodes within 3-5 months pass without treatment. However, this does not mean that if you or your loved one get sick, you should have patience to suffer and wait until the illness passes. Passive waiting is all the more ridiculous, because depression is quite treatable today - a significant effect of treatment is observed in a significant majority (80% or more) of patients.
Depression treatment is a doctor's task, but it is very important that the patient is sufficiently informed in this area and performs his part of the medical work.
Treatment for depression has three main objectives:
- reduction or complete elimination of its manifestations;
- restoration of the patient's ability to perform professional, family, social and other duties;
- reducing the risk of relapse of depression in the future.
ANTI-DEPRESSANTS
In the treatment of this disorder, the main and most frequently used method is the use of antidepressant medications. The high efficacy of these drugs has been tested and proven by the vast experience of using them in dozens, if not hundreds of millions of patients around the world. The mechanisms of the therapeutic effect of antidepressants are well studied - they are able to interfere with the biochemical imbalance that arises in the brain in this disease, primarily in the disturbance of the transmission of nerve impulses by serotonin and norepinephrine neurons (neurons).
The number of antidepressants is increasing every year. The choice of them today is so wide that it allows choosing an effective and sufficiently safe treatment for the most diverse categories of people suffering from depression. The patient's task is to describe in detail and as frankly as possible to the doctor about his condition, his experiences, thoughts, doubts, etc., even those that seem to him ridiculous or unworthy of attention. If you have previously taken antidepressants, be sure to tell the doctor about it (what were the doses, the effect, how quickly it came, what were the side effects, etc.). If you think that this or that drug is not suitable for you or is dangerous, tell the doctor directly about it and explain why you think so. After the scheme of taking the drug is determined, it is best to fix it on paper, no matter how simple it may seem.
In order for the drug to act, it needs its sufficient and more or less constant concentration in the blood. Despite the obvious evidence of this requirement, in practice, the most frequent reason for the low effectiveness of treatment for depression is that the patient, at his discretion, changes the admission schedule or even stops it, but does not directly talk about it.
Another task of the patient is to regularly record changes in his condition. It is best to keep a diary, record daily, at the same time - do not regret 10-15 minutes in the evening before going to bed to describe how the day went, how you felt, how your mood changed, what changed with the start of the drug and etc. Always bring these records with you when you visit a doctor.
The first signs of improvement in the treatment with antidepressants usually appear not earlier than the end of the second - the beginning of the third week of taking the drug. A marked improvement usually occurs by week 4-6 (if this does not happen, this does not mean that the treatment is useless at all, but only requires a change of the drug). The full effect occurs by the 10th week of admission - the period of treatment of the acute phase of depression ends. In some cases, a period of supportive treatment is also needed, the purpose of which is to prevent a new relapse. During the treatment with antidepressants, it is forbidden to take any other medicines at all without the doctor's knowledge, even harmless ones, in your opinion.
PSYCHOTHERAPY
Undoubtedly, it is useful in the treatment of depression, but not in all cases can be used as the only remedy. It is best when it complements the treatment with antidepressants.
Not all methods of psychotherapy can be used for depression. Ineffective and even harmful is the use of hypnosis, a number of forms of group therapy, as well as various methods of so-called "brain biostimulation with healthy biocurrents," "TPP-therapy," and the like.
Help with depression can not any therapist, but only someone who has experience of treatment for this particular group of violations. In any case, one should not seek help from psychologists (depression does not belong to their sphere of competence), as well as folk healers, astrologers, bioenergetics, psychics, healers, etc.
Absolutely not proven effectiveness in the treatment of depression is curative fasting, minerals, seaweed, bee products, mummies, shark cartilage, etc. When a person can no longer eat normally and live, there is no question of treating depression. Long-term rest and changing of the situation (for example, a trip to the sea, a resort, a trip, etc.), which is often resorted to by people who are depressed, do not themselves have a therapeutic effect and often lead to a loss of time and later treatment.
TEN BARRIERS AT HELP FOR HELP
Probably, you already had a question: if there is an opportunity to effectively treat depression, why in real life do people who suffer it often do not rush to take advantage of this? Yes, indeed, there are a number of obstacles and barriers along this path.
1. Insufficient awareness - depression is regarded as "stress", "fatigue", "neurosis", "exhaustion" or reaction to everyday life difficulties.
2. Sometimes a person suffering from depression loses time to visit doctors of various specialties, examinations, taking unnecessary medications - heart, stomach, headache, laxatives, etc.
3. Fear of publicity of illness or even of the fact of the reference for the help.
4. Fear of possible social and occupational limitations due to seeking psychiatric care and accounting from a psychiatrist.
6. An irrational thought is one of the manifestations of negative thinking in depression: "My depression is incurable. No one will help me fight it." But the facts show the opposite!
7. Fear that prolonged use of antidepressants can cause addiction and addiction.
8. Another common misconception: antidepressants cause damage to internal organs. This is also incorrect, because the side effects from taking antidepressants usually disappear completely after a few hours or 24 hours after their reception stops.
So, if in a state of depression you or your loved one have resistance to immediately seek help, try to find out the real reason for this and discuss how it is justified.
HOW TO KEEP YOURSELF WITH THE CLOSE
The condition of a person experiencing depression for others is often incomprehensible, often there is a feeling that he purposely tries their patience, "he does not know what he wants." A vicious circle is created: because of the difficulties of communication, others try to avoid the patient, loneliness increases his symptoms of depression, which makes communication with him even more difficult.
To properly behave with the patient, it is important to understand that he really suffers that his condition is not a whim or a whim and he really needs help and support. You will be able to bring significant benefits to your loved one if you follow these rules:
1. Keep with the patient you need calmly, smoothly and without excessive emotionality. Avoid jocular gaiety, advice to "cheer up," "throw dope out of my head," etc. Be careful in expressing irony, because with a depression, a sense of humor often weakens or disappears altogether, and even the most innocuous jokes can injure the patient.
2. You can not advise the patient to "pull himself together" - a direct volitional effort, he can not change the development of depression - how to deal with it can be suggested only by specialists. As a result of your "support", the sense of guilt and worthlessness is even greater. When he wants to, let him talk freely. If he wants to cry, let him cry - it always brings relief.
3. Do not sink yourself into the disease with him, keep the distance between him and your mental state - you are useful to the patient when they are mentally healthy, self-confident and prosperous.
4. Try to spend more time with the patient, involve him, wherever possible, in any useful activity, and not remove from the cases.
5. Try to make sure that the patient's day had its own schedule and was planned in advance - lifting, eating, working, walking, resting, socializing, sleeping, etc. Do not allow him to lie in bed for a long time, before he went to bed, or spent the day alone. Positively reinforce even the smallest of his successes.
6. Do not allow any reproaches, criticism and remarks about the patient - a person in depression is helpless and vulnerable. Even in the most neutral, in your opinion, statements, he can hear confirmation that others regard him as bad and worthless.
7. Constantly remind the patient that depression is a temporary condition and necessarily passes without leaving any defects in the psyche.
8. For the period of depression, free the patient from the need to make important decisions (change jobs, dispose of a large amount of money, start repairs in the apartment, etc.). The adoption of any decisions for him is still painful. And if they are accepted, they are often erroneous and their consequences have to be removed after a long time.
9. If you are a sexual partner of the patient, remember that with depression these desires disappear. Do not provoke the patient to intimacy. this can increase his sense of guilt and insolvency.
10. In the process of treatment, you are an important link between the doctor and the patient. Know the scheme of taking medications, unobtrusively monitor their reception. If the depression is deep, give the medications to the patient and see if he has taken them.
TO DO NOT REPEAT IN THE FUTURE
The probability that the person who has suffered the first depressive episode, this condition in the future will repeat even once, is quite high - only in 30% of cases everything is exhausted by the only depressive episode. The frequency of depressive attacks can range from annual to 2-3 throughout life, the average duration between seizures is 3-5 years. The probability of recurrence of depression increases in spring and autumn. In women, it is higher than in men, the elderly are higher than the young.
By observing a number of measures, it is possible to significantly reduce the likelihood of new attacks of depression. Rules and advice are fairly simple and feasible, following them will require much less time and effort than treating the next state of depression.
1. Continue taking the antidepressant, forgetting about the phrase "I can not anymore". After exiting from the acute phase of depression, despite the fact that its external manifestations have disappeared or almost disappeared, the biological disturbances that led to it have been retained for some time. Therefore, a period of treatment is needed - continuation of the same antidepressant in the former or slightly lower dose for at least 4-6 months. This alone reduces the frequency of recurrence of depression over the next 5-year period by 3-4 times.
2. Carry out work on the analysis and verification of your basic beliefs - in this you will be helped by a psychotherapist, a medical psychologist.
3. Review your main life goals. One of the psychological reasons for self-dissatisfaction and low mood is that in a person's life there is often a gap between what he wants to achieve and what he actually spends his time and energy on. Write on the sheet a list of the 10 main goals that you would like to achieve in the foreseeable future, and rank them by importance. Take your time, think, make several options for such a list. And then think about how much time and effort you've spent in recent times to achieve each of these goals. Think about what should be changed in life, so that your activities coincide with the goals - from this life and work will bring more satisfaction.
4. Bring in your life more pleasures. Depressed people often keep themselves in an iron grip and do not tend to pamper themselves with even easily accessible joys. If this statement applies to you, the position needs to be changed. Always find the time and money to please yourself with a conversation with a pleasant person, good food, a glass of wine, an interesting film, the purchase of a new thing, a new acquaintance ...
5. Love yourself and try to maintain a high level of self-respect.
6. Do not be lonely! Choose among your environment a number of people with whom I would like to maintain a warm and friendly relationship, and do not spare the time and energy.
7. Maintain a good physical shape. Settle a dream. Correctly and regularly eat. Keep a constant weight. The better your physical shape, the less susceptibility to depression. Be careful with alcohol.
8. Watch your mental state. Depression does not begin in one day, and if you feel its early signs, it is better to visit a doctor once more and maybe to resume the antidepressant for a while.
DO NOT START ON THE SAME ROOTS!
Often people in search of an exit from a painful condition make the same mistakes:
1. Increase in alcohol consumption. Alcohol gives only a brief illusion of relief. If the intake of alcohol becomes more or less regular, the depression is noticeably deepened. Appearing gloomy thoughts: "I never get rid of depression, I can not anymore, how to deal with it, if life is so insignificant ..."
2. Overeating in general, and especially eating sweets. More common in women. Gives an even simpler relief than alcohol, but leads to fullness, loss of attractiveness, lower level of self-esteem and increased feelings of guilt.
3. Long lying in bed, looking at the ceiling, or frequent attempts to fall asleep during the day. Sleep usually does not come, the will weakens, the problems are not solved, the sense of guilt and hopelessness is growing.
4. Rolling hysterics and trying to break your bad mood around others. The result is obvious: the relief is zero, the relationship deteriorates, loneliness and guilt increase.
5. "Punishment" of himself after the listed erroneous actions - willful deprivation of pleasure, attempts to work hard to "make amends", etc. This behavior also does not provide relief, it is a manifestation of the disease, and it is based on the inherent depression of irrational thoughts and beliefs, which were discussed earlier.