Depression: modern approaches to treatment

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Depression: modern approaches to treatment

Section 1: Understanding Depression

Depression, also known as a large depressive disorder, is a common and serious mental illness that negatively affects feelings, thoughts and actions. She goes beyond the usual feeling of sadness or despondency. Depression is characterized by a persistent feeling of sadness and loss of interest, which leads to a number of emotional and physical problems. It affects the ability to function at work and at home.

Depression can occur at any age, but often begins in adolescence or adulthood. Women are more likely to develop depression than men.

1.1 Symptoms of depression

Symptoms of depression can vary from lungs to severe. It is important to understand that in different people, depression is manifested in different ways. To diagnose depression, symptoms must be present at least two weeks. The main symptoms include:

• A constant feeling of sadness, sadness or “voids”: This is a central sign of depression, often described as an all -consuming sadness that is not related to a specific event.
• Loss of interest or pleasure from activities that used to bring joy: Anghedonia is a key symptom, characterized by the inability to experience pleasure from a hobby, social interactions and other classes.
• Changes in appetite or weight: A significant loss or weight gain that is not related to the diet. Some people lose their appetite, while others eat more than usual.
• Sleep disorders: Insomnia (difficulties with falling asleep or maintenance of sleep), hypersonia (excessive drowsiness) or violation of sleep regime.
• Fatigue or loss of energy: A sense of constant fatigue and exhaustion, even after a sufficient rest.
• Anxiety, excitement or irritability: The inability to stay in place, excessive irritability or difficulties with concentration.
• Slow down thinking, speech or movements: A noticeable slowdown in cognitive and physical functions.
• Feeling guilt, worthlessness or helplessness: Unjustified guilt, self -criticism and confidence in their own uselessness.
• Difficulties with concentration of attention, memorization or making decisions: Reducing cognitive functions affecting everyday activity.
• Thoughts about death or suicide: Suicidal thoughts, suicide planning or suicide attempts.

Physical symptoms can also be present, such as headaches, abdominal pain, digestive problems and chronic pain.

1.2 Types of depression

Different types of depression are characterized by specific symptoms and causes:

• Great depressive disorder (BDR): It is characterized by a combination of symptoms that affect a person’s ability to work, study, sleep, eat and enjoy life.
• Persian depressive disorder (distility): The chronic state characterized by a depressive mood, lasting at least two years. Symptoms are less serious than with the BDR, but can significantly affect the quality of life.
• Postpartum depression: It develops after childbirth and can cause a feeling of sadness, anxiety and fatigue in the mother, which complicates the care of the child.
• Seasonal affective disorder (SAR): The type of depression associated with changes in seasons and a decrease in sunlight usually begins in autumn or winter and passes in spring or summer.
• Bipolar disorder: Although technically is not a type of depression, bipolar disorder is characterized by episodes of mania (excessive elation) and depression. Depressive episodes with bipolar disorder can be severe and long.
• Depression caused by the disease: Some medical diseases, such as hypothyroidism, cancer or chronic pain, can cause symptoms of depression.
• Depression caused by drugs: Some drugs, such as corticosteroids, beta-blockers and some antiviral drugs, can cause depression symptoms as a side effect.
• Premenstrual dysphoric disorder (PMDR): A heavier form of premenstrual syndrome (PMS), causing significant mood swings, irritability, anxiety and depression within a week or two before menstruation.

1.3 causes of depression

Depression has no single reason. It arises as a result of complex interaction of genetic, biological, environmental and psychological factors.

• Genetics: Heredity plays a certain role in the predisposition to depression. People with the family history of depression are more likely to develop this disorder. However, the presence of a depression gene does not necessarily mean that a person will necessarily get sick.
• Biological factors: Violations in neurotransmitters, such as serotonin, norepinephrine and dopamine, play an important role in the development of depression. These chemicals transmit signals between the nerve cells in the brain.
• Environmental factors: Traumatic events, such as physical or emotional violence, the loss of a loved one, financial difficulties and serious diseases, can provoke depression. Chronic stress is also a significant risk factor.
• Psychological factors: Negative models of thinking, low self -esteem, pessimism and tendency to self -criticism can contribute to the development of depression.
• Medical conditions: Chronic diseases, such as cancer, cardiovascular diseases and diabetes, are associated with an increased risk of depression. Hormonal changes associated with pregnancy, birth and menopause can also contribute to the development of depression in women.
• Abuse of psychoactive substances: Alcohol or drug abuse can cause or aggravate depression. The simultaneous presence of depression and dependence (related disorders) requires comprehensive treatment.

Section 2: Methods of treatment of depression

Treatment of depression usually includes a combination of psychotherapy, drug treatment and lifestyle changes. The choice of treatment method depends on the severity of depression, personal preferences and related diseases.

2.1 Psychotherapy

Psychotherapy, also known as conversational therapy, includes working with a psychotherapist or psychiatrist to identify and change negative models of thinking and behavior that contribute to depression. Various types of psychotherapy are effective in the treatment of depression:

• Cognitive-behavioral therapy (KPT): Helps people to identify and change negative thoughts and models of behavior that contribute to depression. KPT focuses on solving problems and developing skills to overcome difficulties. She teaches to recognize the distortions of thinking, such as catastrophization and generalization, and replace them with more realistic and positive thoughts. KPT also includes behavioral methods, such as activation of activity and behavioral experiments, to improve mood and behavior.
• Interpersonal therapy (MLT): It is focused on improving interpersonal relationships and solving problems related to relationships, such as grief, conflicts, transition periods and social insulation. MLT helps people understand how their relationship affects their mood, and develop more healthy and effective ways of communication and interaction with others.
• Psychodynamic therapy: Explores unconscious conflicts and past experience that can contribute to depression. It helps people to realize and understand the deep causes of their feelings and behavior so that they can better cope with current problems. Psychodynamic therapy often includes a dream analysis and free associations.
• Dialectical behavioral therapy (DPT): Initially designed for the treatment of a borderline personality disorder, DPT is also effective in the treatment of depression, especially in people who experience strong emotional changes and difficulties with the regulation of emotions. DPT teaches the skills of awareness, emotional regulation, interpersonal efficiency and tolerance of disasters.
• Therapy for acceptance and responsibility (TPO): It helps people to accept their thoughts and feelings, and not fight them, and focus on the actions that correspond to their values. TPO encourages the conscious adoption of difficult experiences and adherence to significant goals. It helps people live a full -fledged life, despite depression.

Psychotherapy can be carried out individually, in groups or with a family. The duration of treatment depends on the severity of depression and individual needs.

2.2 drug treatment

Antidepressants are drugs that can help alleviate the symptoms of depression. They act on neurotransmitters in the brain. It is important to note that antidepressants do not cause instant improvement. It usually takes several weeks to start acting.

There are several types of antidepressants:

• Selective inhibitors of the reverse capture of serotonin (SIOS): One of the most commonly prescribed types of antidepressants. SiOSS blocks the reverse capture of serotonin, increasing its availability in the brain. Examples of SIOOS include fluoxetine (prose), cerrallin (Zoloft), parksetin (paxil), citralopram (healer) and escitalopram (Lexadro). They, as a rule, have less side effects than older antidepressants.
• Reverse capture inhibitors of serotonin and norepinephrine (IOZSN): They block the reverse capture of both serotonin and norepinephrine, increasing their availability in the brain. Examples of IOZSN include wenlafaxin (effector), dulsetin (Simbalt) and Deswenlafaxin (Prostik).
• Tricyclic antidepressants (TCA): The older class of antidepressants that block the reverse capture of serotonin and norepinephrine. Titsa are effective, but they can cause more side effects than Sioz and IOZSN. Examples of tents include amitriptylin (elavil), Imipramine (Tofranil), and Nectriptylin (Pampelor).
• Monoaminoxidase Ingibitory (Had): The enzyme is blocked by monoaminexidase, which breaks down neurotransmitters, such as serotonin, norepinephrine and dopamine. IMAO is effective, but require compliance with a strict diet to avoid dangerous interactions with certain products and drugs. Examples of the IMAO include phenels (nartil), a trailcypromine (Parnat) and isocarboxazide (Marplan).
• Atypical antidepressants: They are a group of antidepressants that act with other mechanisms than Sioz, IOOSN, TCA and IMAO. Examples of atypical antidepressants include Bupropion (Vellbutrin), Mirtazapin (Remerron) and Traazodon (Desire).

The choice of antidepressant should be carried out by a doctor, taking into account individual characteristics, the history of the disease and possible side effects. It is important to inform the doctor about all the drugs taken, including over -the -counter drugs and supplements in order to avoid undesirable interactions.

Antidepressants can cause side effects, such as nausea, headache, insomnia, sexual dysfunction and weight gain. Not all people experience side effects, and the severity of side effects can vary. It is important to discuss possible side effects with a doctor and not stop taking antidepressants suddenly, as this can cause cancellation syndrome.

2.3 Other treatment methods

In addition to psychotherapy and drug treatment, there are other treatment methods that can be effective in the treatment of depression:

• Electronsorous therapy (EST): The procedure in which electrical impulses are passed through the brain to call a short -term seizure. EST is usually used to treat severe depression, which is not amenable to other methods of treatment. EST can cause side effects, such as memory loss and confusion, but they are usually temporary.
• Transcranial magnetic stimulation (TMS): A non -invasive procedure in which magnetic impulses are used to stimulate certain areas of the brain. TMS can be effective in the treatment of depression, especially in people who do not respond to antidepressants.
• State therapy: Used to treat seasonal affective disorder (SAR). It includes the effect of bright artificial light for a certain time every day.
• Additional and alternative treatment methods: Some people use additional and alternative treatment methods such as acupuncture, meditation, yoga and herbal supplements, to facilitate the symptoms of depression. Although some of these methods can be useful, it is important to discuss their use with a doctor, as they can interact with drugs or have side effects.

2.4 Changes in lifestyle

Changes in lifestyle can play an important role in the treatment of depression and maintaining mental health:

• Regular physical exercises: Endorphins that have a natural antidepressant effect release physical exercises. It is recommended to engage in physical exercises of moderate intensity of at least 30 minutes most days a week.
• Healthy nutrition: A balanced diet rich in fruits, vegetables, whole grain products and low -fat proteins can improve mood and general health. Avoid processed foods, sugar and excessive flow of caffeine and alcohol.
• Sufficient sleep: Strive by 7-9 hours of quality sleep every night. Follow the regular mode of sleep and wakefulness, create a relaxing atmosphere in the bedroom and avoid caffeine and alcohol before bedtime.
• Stress management: Use stress management techniques, such as meditation, yoga, tai-chi or deep breath to reduce stress.
• Social support: Maintain close ties with family and friends. Participate in social events and avoid social isolation.
• Awareness: Practice awareness to better realize your thoughts, feelings and sensations at the moment. Awareness can help reduce negative thoughts and improve mood.
• Avoid alcohol and drugs: Alcohol and drugs can aggravate the symptoms of depression. If you have problems with abuse of psychoactive substances, seek help.

Section 3: Diagnostics of Depression

Diagnosis of depression is usually carried out by a doctor, psychiatrist or psychologist. Diagnosis is based on the assessment of symptoms, medical history and physical examination.

3.1 Assessment of symptoms

The doctor will ask questions about your symptoms to determine whether they correspond to the criteria of depressive disorder. It can use standardized profiles or questionnaires to assess the severity of symptoms. Examples of questionnaires include a Bek depression scale (BDI) and a hospital scale of anxiety and depression (HADS). It is important to honestly answer questions so that the doctor can make the correct diagnosis.

3.2 medical history

The doctor will ask about your medical history, including mental disorders, medical diseases, medications taken and family history of mental disorders. This information will help the doctor determine the possible causes of depression and choose the most suitable treatment method.

3.3 Physical examination

The doctor can conduct a physical examination to exclude medical conditions that can cause symptoms of depression, such as problems with the thyroid gland or deficiency of vitamins. Blood tests can be prescribed to check the level of hormones and vitamins.

3.4 Differential diagnosis

It is important to exclude other conditions that can imitate depression, such as:

• Bipolar disorder: It is characterized by episodes of mania and depression.
• Alarm disorders: Anxiety and depression often accompany each other, but it is important to determine which disorder is primary.
• Adaptation disorders: They develop in response to a certain stressor or event.
• Schizophrenia: Severe mental disorder characterized by hallucinations, delirium and impaired thinking.
• Dementia: Progressive decrease in cognitive functions.

An accurate diagnosis is necessary for choosing the most effective treatment.

Section 4: Depression prevention

It is not always possible to prevent depression, but there are steps that can be taken to reduce the risk of its development or prevent relapse:

• Stress management: Use stress control techniques such as meditation, yoga or deep breathing to reduce stress levels.
• Regular physical exercises: Endorphins that have a natural antidepressant effect release physical exercises.
• Healthy nutrition: A balanced diet rich in fruits, vegetables, whole grain products and low -fat proteins can improve mood and general health.
• Sufficient sleep: Strive by 7-9 hours of quality sleep every night.
• Social support: Maintain close ties with family and friends.
• Limit the use of alcohol and drugs: Alcohol and drugs can aggravate the symptoms of depression.
• Seek for help at the first signs of depression: Early seeking help can prevent symptoms deterioration and improve the forecast.
• Continue treatment after recovery: After recovery from depression, it is important to continue treatment, such as psychotherapy or taking antidepressants in order to prevent relapse.

Section 5: Depression in different age groups

Depression can manifest itself differently in different age groups. It is important to understand these differences in order to provide adequate diagnosis and treatment.

5.1 Depression in children and adolescents

Depression in children and adolescents can manifest itself not like in adults. Symptoms may include:

• Irritability or anger: Instead of sadness, children and adolescents can be more irritable and quick -tempered.
• Mood swings: Frequent and strong mood swings.
• Loss of interest in activities: Refusal of hobbies and social interactions.
• Problems with academic performance: Reducing assessments, difficulties with concentration.
• Changes in appetite or weight: Significant loss or weight gain.
• Sleep disorders: Insomnia or hypersonia.
• Feeling guilt or worthlessness: Unreasonable guilt or low self -esteem.
• Physical complaints: Frequent headaches, abdominal pain or other physical symptoms.
• Thoughts about death or suicide: Suicidal thoughts or suicide attempts.

It is important to pay attention to changes in the behavior of a child or a teenager and seek help if there are suspicions of depression. Psychotherapy and drug treatment are effective in the treatment of depression in children and adolescents.

5.2 Depression in adults

Symptoms of depression in adults, as a rule, correspond to the main symptoms of depressive disorder, such as:

• A constant feeling of sadness, sadness or “voids”:
• Loss of interest or pleasure from activity:
• Changes in appetite or weight:
• Sleep disorders:
• Fatigue or loss of energy:
• Anxiety, excitement or irritability:
• Slow down thinking, speech or movements:
• Feeling guilt, worthlessness or helplessness:
• Difficulties with concentration of attention, memorization or making decisions:
• Thoughts about death or suicide:

In adults, depression can be associated with various factors, such as stress at work, problems in relationships, financial difficulties and medical diseases. Treatment of depression in adults usually includes psychotherapy, drug treatment and lifestyle changes.

5.3 Depression in the elderly

Depression in older people is often underestimated and not diagnosed. Symptoms of depression in older people can be similar to symptoms of other diseases or age -related changes, which complicates the diagnosis. Symptoms may include:

• Fatigue and weakness:
• Loss of appetite and weight:
• Sleep problems:
• Difficulties with concentration and memorization:
• Physical complaints such as pain and ailment:
• Feeling of hopelessness and pessimism:
• Social isolation:
• Loss of interest in activities:
• Thoughts about death or suicide:

In older people, depression can be associated with the loss of loved ones, chronic diseases, social isolation and financial difficulties. Treatment of depression in older people may include psychotherapy, drug treatment and social support. It is important to consider medical diseases and medications taken when choosing a treatment method. EST can be an effective treatment for older people with severe depression, who do not respond to other methods of treatment.

Section 6: Support and resources

If you or one of your friends suffers from depression, it is important to seek help. There are many resources that can provide support and treatment:

• Primary link doctors: They can evaluate your symptoms and direct you to a mental health specialist.
• Psychiatrists: Doctors specializing in the diagnosis and treatment of mental disorders. They can prescribe drugs and conduct psychotherapy.
• Psychologists: Specialists in the field of mental health who conduct psychotherapy and provide psychological support.
• Psychotherapists: Licensed specialists who conduct psychotherapy.
• Consultants: Specialists who have consultations and support in solving personal and emotional problems.
• Hot lines of mental health: Free and confidential hot lines that provide support and crisis assistance.
• Support groups: Groups of people who share experience and support each other.
• Online resources: Websites and applications that provide information about depression, self-help tips and resources for searching for treatment.

Support for family and friends is also very important. Open and honest communication about depression can help reduce the stigma and create a supporting environment.

Section 7: The latest research in the field of depression treatment

Scientific research in the field of depression is constantly developing, which leads to the development of new and improved treatment methods. Some of the latest areas of research include:

• Neurostimulation: The study of new methods of neurostimulation, such as transcranial magnetic stimulation (TMS), transcranial stimulation of direct current (TPP) and deep brain stimulation (fuel and lubricants), for the treatment of depression, which is not amenable to other methods of treatment.
• Ketamin and petabamine: Studying the use of ketamine and escatamine, anesthetics with an antidepressant effect, for the treatment of severe depression and suicidal thoughts. The escet was approved by FDA for the treatment of depression resistant to treatment.
• Psychedelic therapy: Studying the use of psychedelic substances, such as psilocybin and LSD, in combination with psychotherapy for the treatment of depression, anxiety and other mental disorders.
• Circus rhythms: The study of the influence of circadian rhythms (biological hours) on depression and the development of treatment methods aimed at restoring normal circadian rhythm, such as light therapy and chronotherapy.
• Intestinal microbia: The study of the relationship between the intestinal microbioma and depression and the development of treatment methods aimed at improving intestinal health, such as probiotics and dietary changes.
• Genetics of depression: The study of genetic factors that affect the risk of depression and the reaction to treatment in order to develop more personalized approaches to treatment.
• Mental health applications: Development and evaluation of the effectiveness of mobile applications and online platforms for monitoring symptoms of depression, providing psychotherapy and support.

These studies open up new prospects for understanding and treating depression, offering hope for improving the results for people suffering from this disease. It is important to keep abreast of the latest scientific achievements and discuss new treatment options with your doctor.