Depression

Introduction to depression Depression is a form of seizure of manic depression. It is characterized by low mood, slow thinking, and reduced speech movement. Depression seriously afflicts patients' lives and work, and places a heavy burden on families and society. About 15% of depressed patients die from suicide. A joint study by the World Health Organization, the World Bank and Harvard University shows that depression has become the second most common disease burden in China. According to the third edition of the Chinese Classification and Diagnostic Standards for Mental Disorders (CCMD-3), according to the degree of social impairment, depression can be divided into mild depression or major depression; according to the presence or absence of "illusion, delusion, or tension syndrome" "Psychiatric symptoms", depression is divided into depression without psychotic symptoms and depression with psychotic symptoms; according to whether there is another depressive episode before (at least 2 months before), depression is divided For the first time depression and recurrent depression. basic knowledge The proportion of sickness: 0.16% Susceptible people: no special people Mode of infection: non-infectious Complications: loss of libido constipation anxiety disorder schizophrenia insomnia

Cause of depression

Genetic factors (10%):

The genetic epidemiological survey of large sample populations shows that the closer the blood relationship to the diseased person, the higher the probability of illness. The probability of a first-degree relative being sick is much higher than that of other relatives, which is consistent with the general pattern of genetic diseases.

Biochemical factors (25%):

Catecholamine hypothesis: mainly refers to the occurrence of depression may be related to the decreased concentration of neurotransmitters serotonin (5-HT) and norepinephrine (NE) in the synaptic interstitial space; due to many antidepressants, such as selective 5- After serotonin reuptake inhibitors (SSRI) or selective serotonin and norepinephrine reuptake inhibitors (SNRI), although the concentration of these neurotransmitters in the synaptic cleft increases rapidly, antidepressant The effect usually takes about 2 weeks to work, so there is a hypothesis that 5-HT and NE receptor sensitivity increase (hypersensitivity).

Psycho-social factors (25%):

The sudden occurrence of various major life events, or long-term persistence, can cause a strong or (and) persistent unpleasant emotional experience that leads to depression. So far, the etiology and pathogenesis of depression are still unclear, and there are no obvious signs and abnormal laboratory indicators. Generally speaking, the results of biological, psychological and social (cultural) factors interact. It is also because the cause of depression is unknown, and there are many hypotheses.

Depression prevention

Because of a large group of "cardiac" depression caused by mental stimulation, it should be said that it can be effectively prevented. If life is alive, it is impossible not to encounter external stimuli, and there will be no psychological contradiction. It is impossible to eliminate the stimuli fundamentally. That is to enhance the resistance to stimuli and strengthen the ability of psychological immunity, thus greatly reducing the incidence of psychogenic depression.

Even for "internal depression", medicine is not completely powerless. Preventive work can start from three aspects: "prenatal and postnatal care, quality improvement; acute development, early treatment; consolidation of rehabilitation, prevention of recurrence".

Prenatal and postnatal care, improve quality:

Many families are very concerned about whether a depressed patient can have children. I often ask such questions. Of course, there is no legislation that mandates that such patients are infertile, but from a medical point of view: the birth of patients with endogenous depression needs to be Control, if there is more than one depression in the family, or a high-incidence family, the genetic predisposition is obvious; there is cross-inheritance between manic depressive affective disorder and schizophrenia, and patients with depression marry other mental patients. If one party is sick, the genetic probability will increase significantly. Both couples suffer from a genetically predisposed mental illness. It is appropriate to sterilize and not have children.

From the point of view of psychosocial factors, some people with depression are affected by improper parenting and poor family environment in childhood, which leads to quality defects and personality disorders. Therefore, excellent problems, especially childhood education during the development of personality, are very important. Parents are over-spoofed and loved by children, improper methods of discipline, or different opinions of parents. They do not care about children's growth and are laissez-faire. They are very harmful to children's mental health. Some children become TV fans and go from TV to TV. Lonely, not interacting with people, foreign countries call "TV autism", after the boyhood, it is easier to find their idols on TV, imitate worship, like Lin Daiyu or Cinderella, will bring some sadness to their character, Foreign countries attach great importance to parent-child relationship and early education. Family atmosphere plays an important role. Divorce, single parent raising, etc. are all shadows cast on children's minds, causing their hearts to be hurt and distorted. Reactive depression is mainly caused by psychological factors. , the incidence of various neurosis is also related to psychological factors, but the same psychological thorn Many people are tolerant, while others are ill. Therefore, the above symptoms are considered to be forms of psychological reaction based on personality defects. Both psychogenic depression and depressive neurosis have susceptibility qualities. The traits are not necessarily brought by the fetus, but related to the early education and influence of the parents. These factors are not irrelevant to the onset of depression. However, in the superior education, it is necessary to pay attention to prevent the defects of personality. And deviation.

Eugenics, excellent education, excellent education, and good physical and mental quality are an effective and feasible countermeasure for the prevention of depression.

Depressive complications Complications, libido, constipation, anxiety, schizophrenia, insomnia

(1) Sexual desire is significantly reduced;

(2) slow thinking, reduced activity, that is, memory loss, slow brain response, often alone;

(3) There are many physical symptoms such as fatigue, palpitations, chest tightness, gastrointestinal discomfort, constipation;

(4) Accompanied by anxiety and guilt (worry to increase the burden on the family);

(5) sleep disorders, with early wake-up as a typical performance;

(6) Self-destruction, disgusting or suicidal psychology.

Depressive Symptoms Common Symptoms Introverted Thinking Recurrent Depression Depression Sympathy Self-harming Behavior Seasonal Emotion Depression Sudden-like Trauma Thinking Difficulty Postpartum Extreme Behavior

[The three main symptoms of depression]

Many people are no stranger to depression, but depression is essentially different from the general "unhappy". It has obvious characteristics. There are three main symptoms in combination: low mood, slow thinking and exercise inhibition.

Emotional depression is not happy, always sad and sad, and even pessimistic and desperate. In the "Dream of Red Mansions", Lin Xiyu, who is full of sighs and sighs all day long, is a typical example.

Slow thinking is the conscious mind is not good, can not remember, thinking difficult, the patient feels empty, stupid.

Exercise inhibition means not loving activities, being lazy, walking slowly, and having less words. Seriously, you may not eat or move, and you cannot take care of yourself.

[Other symptoms of depression]

Patients with the above typical symptoms are rare. Many patients only have one or two of them. The severity varies from person to person, mood depression, anxiety, loss of interest, lack of energy, pessimistic disappointment, and low self-evaluation. It is a common symptom of depression, and sometimes it is difficult to distinguish it from the general short-term mood. Here is a simple method: If the above discomfort is serious in the morning and there is partial relief in the afternoon or evening, then You are more likely to suffer from depression. This is the so-called heavy rhythm of depression.

[The most dangerous symptoms of depression]

People with depression are depressed and pessimistic, and they are prone to suicidal thoughts when they are serious. Because the patient's thinking logic is basically normal, the success rate of suicide is also high. Suicide is one of the most dangerous symptoms of depression. According to research, The suicide rate of depression patients is 20 times higher than that of the general population. More than half of the social suicide population may be depressed. Some unexplained suicides may have suffered from severe depression before they were born, but they were not discovered in time. Since suicide occurs when the disease develops to a certain degree of severity, early detection of the disease and early treatment are very important for patients with depression. Don't wait until the patient has committed suicide before thinking that he may have depression.

Many people with depression think of using death to relieve pain. Patients often end up with the thoughts and behaviors of death in order to end the pain, suffer sin and confusion.

[Physical symptoms of depression]

Depression is mainly caused by depression, slow thinking and decreased will activity. In most cases, there are various physical symptoms.

(1) Depressive mood: The basic characteristics are low mood, distressed and sad, uninterested in interest, pessimistic and desperate, painful and painful, with the feeling that life is as good as death, often used to be meaningless, happy to be happy, etc. to describe their inner experience, typical Depressive mood, heavy night light, often coexist with anxiety.

(2) Slow thinking: the process of thinking association is suppressed, the response is slow, and the mind does not turn. It shows that the active speech is reduced, the speech rate is slowed down, the thinking problem is laborious, the response is slow, and it takes a long time to wait under the influence of depression. Low self-evaluation, inferiority, sense of uselessness and worthlessness. I feel that life is meaningless, pessimistic and suicidal, and self-blame. I believe that living becomes cumbersome, committing a big crime, and having a discomfort on the basis of physical discomfort. The idea is that I am suffering from an incurable disease.

(3) Decline of will activities: active activities are significantly reduced, life is passive, and they are reluctant to participate in activities of interest to outside peace. They are often alone, life is lazy, and development is silent, up to the degree of rigidity, the most dangerous is Repeated suicide attempts and behaviors.

(4) Somatic symptoms: Most depressed patients have physical and other biological symptoms, such as palpitations, chest tightness, gastrointestinal discomfort, constipation, loss of appetite and weight loss, prominent sleep disorders, and more difficult to fall asleep.

(5) Others: There may also be hallucinations during depressive episodes, disintegration of personality, disintegration of reality, coercion and horror symptoms, due to significant delay in thinking association and memory loss, which may affect the cognitive function of elderly patients, and depressive pseudo-dementia .

Mild depression often has dizziness, headache, weakness and insomnia, etc. It is easy to be misdiagnosed as neurasthenia. The latter has certain psychosocial factors before the onset, such as long-term tension, excessive brain use, and emotions are mainly anxiety and fragility. The main clinical phase is the mental fatigue, nervousness, troubles and irritability associated with mental excitement, and other physiological symptoms such as muscle tension and sleep disorders. The self-knowledge is good and the symptoms are passive. Desire for depression, with depression, mainly with slow thinking, low self-esteem, self-sin, want to die, and biological symptoms (such as emotional circadian, appetite, decreased sexual desire, etc.), self-knowledge is often lost, not active Seeking treatment can be identified.

Occult depression is an atypical form of depression, mainly characterized by repeated or persistent physical discomfort and autonomic symptoms such as headache, dizziness, palpitations, chest tightness, shortness of breath, numbness and nausea, vomiting, etc. Emotions are often concealed by physical symptoms, so it is also called depression allergies. Patients often do not seek psychiatrists, but go to other departments for treatment. Physical examinations and auxiliary examinations often have no positive performance and are easily misdiagnosed as neurosis or other physical diseases. Symptomatic treatment is generally ineffective, and antidepressant treatment is effective.

[early symptoms of depression]

1. Depressed mood is different, ranging from mild mood to sadness, pessimism, despair, patients feel heavy, life is boring, happy, unhappy, unhappy, painful, unable to extricate themselves, some patients may also have anxiety Excited, nervous and upset.

2. Loss of interest is one of the common symptoms of depressed patients, loss of past life, enthusiasm and fun of work, interest in everything, experience of family fun, disdain for past hobbies, often staying alone, alienating relatives and friends To avoid socializing, patients often complain that "no feelings", "emotional numbness", "happy not up".

3. Loss of energy, fatigue, weakness, washing, dressing and other small things are difficult and difficult, and patients often use "mental collapse" and "defeated ball" to describe their situation.

4. Self-evaluation is too low: patients tend to over-deprecate their own abilities, and look at their present, critical, negative and negative attitudes. In the past and in the future, this will not work. It is not right. It is nothing to say and the future is dark. Strong self-blame, guilt, uselessness, worthlessness, helplessness, and serious self-crime and doubtfulness.

5. The patient showed significant, persistent, general depression, difficulty in attention, memory loss, slow brain, occlusion of mind, and slow movement, but some patients showed anxiety, anxiety, nervousness and agitation.

6. Negative pessimism: The heart is very painful, pessimistic, desperate, feeling that life is a burden, not worthy of nostalgia, to solve the problem by death, can produce strong suicidal thoughts and behaviors.

7. Physical or biological symptoms: Depressed patients often have biological symptoms such as loss of appetite, weight loss, sleep disorders, sexual dysfunction and mood fluctuations, which are common, but not every case.

8. Loss of appetite, weight loss: Most patients have loss of appetite, symptoms of poor appetite, delicious food is no longer tempting, patients do not think about tea or food tasteless, often accompanied by weight loss.

9. Sexual dysfunction: Loss of libido can occur in the early stages of the disease, men may have impotence, and female patients have a loss of sex.

10. Sleep Disorder: The typical sleep disorder is early waking, 2 to 3 hours earlier than usual, and does not return to sleep after waking up, and falls into a sad atmosphere.

11. Day and night changes: The patient's mood changes with a slight night, and the mood is low in the morning or morning, and gradually improves in the afternoon or evening. It can make brief conversations and meals. The incidence of day and night changes is about 50%.

Depression check

Depression is a functional disease. In general, laboratory tests may have a reduction in urine (serotonin) delivery and a decrease in cerebrospinal fluid serotonin levels, but clinically need to rule out depression caused by encephalitis, brain tumors, cerebrovascular disease, and Parkinson's disease. At the same time, it is necessary to rule out depression caused by physical diseases, such as hypothyroidism, chronic hepatitis, systemic lupus erythematosus and so on.

Diagnostic diagnosis of depression

[Diagnosis of depressive neurosis]

There are certain psychosocial factors as incentives, chronic onset, affirmative but less serious depression with neurological symptoms, work, communication, life ability is less affected, there is desire for treatment, personality is complete, the course of disease lasts for more than 2 years The main basis for the diagnosis of depressive neurosis, the following 10 items can be used as a reference for the diagnosis of depressive neurosis:

(1) Depressive personality before the illness;

(2) induced by mental factors;

(3) Mental exercise inhibition is not obvious;

(4) No biological symptoms such as weight loss and anorexia;

(5) mood depression is the main symptom;

(6) accompanied by anxiety symptoms;

(7) No serious self-blame;

(8) Psychotic symptoms such as delusions, hallucinations;

(9) have active treatment requirements;

(10) There was no seizure in the past.

Exclusion criteria:

1. Does not comply with brain organic mental disorders, physical illnesses and psychoactive substances and non-dependent substances caused by mental disorders;

2. There may be some schizophrenic symptoms, but it does not meet the diagnostic criteria for schizophrenia. If it meets the diagnostic criteria for schizophrenia, the differential diagnosis can refer to the diagnostic criteria for schizoaffective psychosis.

Mainly identified with the following diseases:

1. Endogenous depression: including unipolar depression, bipolar disorder (both depressive and manic episodes), and depression associated with schizophrenia.

2, body-related depression: caused by a variety of physical and neurological diseases, including drugs and various harmful substances.

3. Psychogenic and reactive depression: Cardiac depression usually only occurs once in a lifetime. If it occurs twice, it should be regarded as a deviation from the normal personality, or it is simply endogenous depression.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.