Depression sets in in the morning. How to deal with morning depression. symptoms of real depression

We all know the feeling of sadness that comes in the morning. Heaviness in the soul, irritation and bad mood usually disappear after a few hours. But if this continues day after day, we begin to wonder what is wrong with us.

Fortunately, in most cases, nothing terrible happens. Of course, a sharp drop in mood at certain times of the day can be a sign of a depressive or anxiety disorder, but it usually occurs for other reasons: both physiological and psychological.

Physiological causes

1. High cortisol levels.

This hormone has a huge impact on how our brain works. Cortisol's "job" is to warn us of danger, and thanks to it, we tend to exalt small problems to the level of disaster. The next time the day seems to bring dangerous events that are difficult to cope with, remember that this is the body's natural reaction to rising cortisol.

2. Low blood sugar (hypoglycemia).

No matter how you set yourself up in a positive way, low glucose levels are closely related to mood. Hungry humans (like other mammals) rarely look "pleased". This is how our body works: the search for food is a priority for it. While you sleep, your blood sugar levels gradually drop. If the last meal was a few hours before bedtime, then you have not eaten for quite some time.

With physiology, everything is relatively clear, but the question is: “Where do the problems with glucose and cortisol go when we are on vacation?” It is rare that anyone experiences "morning depression" while traveling or relaxing in the country. That is why the greatest attention should be paid to psychological causes.

Unwillingness to deal with reality

Waking up in the morning, a person is immediately involved in a process that can be described in two words: “Who am I?” or "Where am I?"

When reality is too far from the dream, all the things we don't like come crashing down like one snowball. Fear makes it difficult for the brain to think rationally, but we can do something for it.

1. Before going to bed, decide what your first thought will be after waking up.

It should be positive, but not "made up". Fantasies on the theme "How everything is fine" will not help. But a reminder of your personal abilities (albeit small ones) will give a good mood. Even simply stating the fact that you can dance well or make delicious tea activates the part of the brain that releases dopamine. "Extinguish" the fire that kindles cortisol by throwing a "bucket" of dopamine at it.

2. As soon as you get out of bed, think about what you are doing every minute: “I get up, put on slippers, make the bed, go to the bathroom ...”

Add adjectives: “The slippers are soft and comfortable, the soap is fragrant…”

Fight the urge to use "unprintable" words or negative characteristics like "the floor is cold" or "the coffee doesn't taste good." If things are really bad, and it’s impossible to find anything pleasant, just state the fact: “I brush my teeth, wash my face, drink coffee.” The main thing is to focus on the present moment and not think about your feelings. You can not lie in bed and let the brain "wander through the labyrinth of unfulfilled hopes."

You can choose other methods: a dialogue with yourself or a morning ritual that resonates most with your inner self. As a last resort, remind yourself that a bad mood in the morning is a natural state, and in an hour or two it will end anyway.

Very soon, such actions will become a habit, and you will be able to automatically stop the morning alarm cycle.

Is it true that with depression there can be no good mood at all?

No, it's not exactly there. Sometimes bright and joyful events (a party with friends, a date, a holiday, a trip) give an experience of elation and pleasure, but when the event passes, everything returns to normal. First of all, the fact that the depressed mood persists is significant. about most of the time - days, weeks, months.

In addition, experts argue that short-term mood swings occur with atypical depression. So pay attention, first of all, to the depth of the experience of longing and depression.

I often feel better in the evenings. I feel in good shape and have time to do a lot. Does this mean that I am not depressed, but simply lazy and weak-willed?

It is impossible to make a diagnosis in absentia, as well as to refute it. But for depression evening improvement is very characteristic. For two or three hours, a person seems to return to normal, and in the morning he again experiences despondency and fatigue. If we are talking about an anxiety-depressive disorder, the opposite picture can be observed - an improvement in the morning.

My relatives often tell me that if I did hard physical labor, I would quickly recover. That all my depressions come from thinking too much. This is true?

There is no evidence that hard physical work cures depression, just as the habit of "thinking a lot" provokes it. Depression is treated with psychotherapy and antidepressants, and nothing else. But in the process of treatment, feasible physical activity in the gym (or walking on the street) really improves the condition.

Sometimes I feel like there just isn't enough joy in my life. If more good things happened to me, I wouldn't be depressed.

I don't know if you really have depression (perhaps you are healthy and you actually lack positive emotions), but it is already known that a large number of stressful events predispose to this disease. And then it turns into a vicious circle: the lost ability to rejoice leads to the avoidance of familiar and favorite forms of activity, which in turn increases melancholy.

When I read about the symptoms of depression, it seems to me that everything is not so bad with me. But in fact, I am far from the norm - the mood is not right, I don’t want anything. What happened with me?

Only a doctor can give a reasoned answer to your question after talking with you. I can only mention dysthymia, a sub-depressive condition in which low mood, low self-esteem and an inability to enjoy pleasure are observed for a long time. Dysthymia also requires treatment.

Is it true that antidepressants make you fat?

No, it's not.

Do they cause addiction?

If I start taking antidepressants, will I become a completely different person?

Antidepressants do not affect the personality in any way and, therefore, do not change anything in a person. But they effectively remove the symptoms and give strength for fruitful psychotherapy.

If I'm already diagnosed with depression and not treated, will it get worse?

According to available data, depression is often chronic, and each subsequent episode in the absence of treatment is more prolonged and severe. Russian psychiatrists also claim that once a depressive episode has begun, if it is not treated, in 40% of cases it does not go away even after a year.

Is it possible to cure depression to the end - so that it will never happen again?

Yes, you can. This requires not only antidepressants, but also a full-fledged psychotherapy, during which you will begin to understand and hear yourself much better than before, and in addition, learn how to help yourself. This means that even if individual symptoms of depression make themselves felt (and none of us are immune from difficult situations that provoke this disorder), you can quickly and effectively stop them at the very beginning, preventing the development of the disease.

How long and how often will I need to see a psychologist?

Each person is unique, and therefore it is impossible to predict in advance how much time it will take him to cope with depression. This will depend on many factors, including the severity of the disease, and its duration, and life history, and attitude to psychotherapy, and readiness or unwillingness to work independently. But it is better to count on several months of therapy with one visit per week.

Is depression always accompanied by weight loss?

No. With depression, both weight gain and no change in this indicator can also be observed.

Why do some people gain weight when depressed?

There are several possible reasons. For example, atypical depression causes increased cravings for fast carbohydrates. This disorder is also usually accompanied by a decrease in activity, including motor activity - a person sits at home more, refuses to walk and play sports. Improvement in the evening hours can provoke late dinners. In addition, for many people with depression, food remains almost the only source of pleasure - no wonder that you want to eat more than usual.

I read that people with depression sleep little and wake up early. But I want to sleep constantly and I am ready to do it 12 hours a day. Why is it so?

Sleep disturbance in depression is not always insomnia and early awakenings. Rather, it is more appropriate to say that sleep habits are changing. For example, there is an increased need for sleep, often combined with the feeling of "no matter how much I sleep, I still don't get enough sleep." Scientists cannot yet give an exact answer why this is so, but it can be said with certainty that as you recover, you will return to your norm.

When I look back, I see a continuous series of failures. It seems to me that I will never get out of this state, no matter how much you treat me.

Depression is insidious in that it forms a very unpleasant and painful vision of one's own life - its past, present and future. It is important to understand this point and consciously refrain from any assessments until the disorder has receded. Now the most important task for you is to be as active as possible in the search for specialists who will help you, and active cooperation with them. And you will think about your past later, when you recover.

What is Cognitive Psychotherapy for Depression?

Cognitive psychotherapy is a scientific approach that has been proven to be highly effective in treating illness in a matter of months. It is based on working with thoughts and beliefs, which, as experts have found out, have a huge impact on our feelings and actions. This approach is recommended for those who are determined to quickly fight depression and to cooperate with a psychologist "on an equal footing", since it implies the most active position of the patient himself.

If you did not find the answer to your question, you can write to me by mail or at the reception. ©

Everyone is very fond of the word "depression" these days. Some even know exactly what it is, but knowledge alone is not enough to make such a diagnosis.

This article is a kind of test of whether you have depression and whether you need to seek help with this problem. As you read the text, mark on the sheet the points for the symptoms that you noted in yourself, then calculate the total points and read the interpretation of the results at the end of the article.

30 symptoms of real depression

We divide all the symptoms into three groups. The first - "cost" of 3 points, that is, the most indicative symptoms, the second - 2 points, the third - 1 point.

"Three-point" symptoms

Symptom #1: Loss of enjoyment of life, anhedonia. Previously, the patient's favorite activities that brought him pleasure now seem meaningless and may even cause disgust.
Symptom #2: Depersonalization is the loss of an adequate perception of oneself. The patient begins to perceive his own "I", his body as something sharply negative.
Symptom No. 3: Derealization is a change in the perception of the world. In the case of depression, reality appears grey, cold: "I'm in my cold little hell."
Symptom #4: Self-aggression, self-harm, suicidal thoughts and attempts.
Symptom No. 5: The future is presented to the patient only in gloomy colors, he does not see prospects, life seems to be over.
Symptom #6: There may be a pronounced anxiety syndrome. This is groundless, irrational (as psychiatrists sometimes jokingly say - "existential") anxiety, from which the patient cannot find a place for himself. A person rushes about restlessly, reflexively presses his hands to his chest or throat, groans.
Symptom #7: The condition worsens in the morning and improves in the evening.

Symptom No. 8: The patient stops responding to events that previously caused him a vivid emotional response. For example, a mother may stop worrying if her son stays longer than usual with friends, although she used to go crazy with anxiety.
Symptom #9: A depressed person constantly engages in self-deprecation, feels guilty, even if it is unfounded.
Symptom No. 10: When talking, patients often look out the window or at a light source - this is a very characteristic sign of depression, which is the first to catch the eye on examination.
Symptom No. 11: Patients with depression are characterized by a special posture, the so-called “submission posture”, a kind of gesticulation directed towards oneself, lowered corners of the mouth and a specific sweetness of the upper eyelid hanging at the outer corners of the eyes.
Symptom No. 12: Both subjective and objective impairment of mental activity, pseudo-dementia. Patients often feel that they are beginning to develop something like Alzheimer's disease. This is facilitated by the availability of information resources on the Internet and some similarities between the clinic of severe depression and this pathology.

"Two-Point" Symptoms

Symptom #13: Difficulty concentrating, subjective feeling of difficulty remembering.
Symptom #14: Decreased appetite, especially in the morning. By the evening appetite can be normalized. At the same time, patients often refuse their usual food and eat only sweet or other high-calorie carbohydrate foods.
Symptom #15: Weight loss, which is sometimes significant. On the other hand, this is not a permanent symptom, since it also happens vice versa if the patient eats a lot of carbohydrate foods, more often in the evening, when the condition improves and appetite is restored.
Symptom No. 16: From the onset of the disease, patients begin to wake up several hours earlier than usual, but, as a rule, do not get up, waiting for the morning in bed.
Symptom #17: There may be insomnia or even a feeling that the desire for sleep does not appear at all. Unlike a similar symptom in manic disorders, here insomnia is very burdensome for the patient.
Symptom No. 18: Hypochondria appears - thoughts about the diseases existing in the patient. Even if they are not present, the patient will find their symptoms, and, in the end, they may well actually appear. Senestopathy is also characteristic - non-existent discomfort in the internal organs.
Symptom #19: Depressed patients often speak slowly, they can turn any conversation to their own problems, memories from the past.
Symptom #20: Quiet voice, long pauses between words. The voice loses all directiveness (ordering intonation).

Symptom No. 21: The patient cannot immediately, clearly and clearly formulate his idea. In the worst case, he generally says that no ideas have crossed his mind for a long time.
Symptom No. 22: Self-esteem drops sharply, self-confidence disappears, even if there are no objective reasons for this.
Symptom No. 23: There may be a very painful feeling for the patient of inferiority, of his own inferiority. This feeling is directly related to the ideas of self-blame that are so characteristic of any depression.
Symptom No. 24: Lethargy, the desire to remain alone, if possible.

"Single point" symptoms

Symptom #25: Decreased sex drive. This symptom is not found in all patients, since another option is also possible - sexual satisfaction sometimes alleviates anxiety somewhat, in which case libido remains normal or even increases (this, of course, is not typical for severe depression).
Symptom No. 26: Sometimes self-hatred can develop in patients into aggression towards others. This symptom is most common in adolescence.
Symptom No. 27: Dark, nightmarish dreams that patients remember well and then can scroll through their thoughts over and over again.
Symptom No. 28: Time seems endless, any expectation is very difficult for patients.
Symptom No. 29: Patients with great difficulty force themselves to get out of bed in the morning. In severe depression, a person may even simply not do this, not paying attention to the fact that they need to do some business.
Symptom No. 30: Patients stop caring for themselves, pay less attention to themselves than before.

Interpretation of results

Calculate the total number of points and determine which of the four groups you belong to.

A. Group 1, 50-66 points or at least three 3-point features: You have a major affective disorder that is unlikely to be post-stress in nature or associated with a life event. You are absolutely shown the earliest possible appeal to a psychiatrist to correct your condition. In your case, treatment with the appropriate group of antidepressants, sedatives, normalization of the lifestyle and, of course, individual psychotherapy is necessary.

B. Group 2, 30-49 points: you have many signs of depression, and this is most likely it. Also, your condition may be a manifestation of dysthymia if it lasts more than a month, but, in this case, dysthymia is severe. You should definitely contact a psychiatrist, who has an additional specialization of a psychotherapist, in order to comprehensively correct your condition with the help of psychotherapy and medications.

C. Group 3, 11-29 points: perhaps you are just a very impressionable person and overreact to any adverse circumstances. Your condition can hardly be called depression, maximum hypothymia, but you can contact a psychotherapist or medical psychologist who will definitely help you get rid of your problem.
D. Group 4, 0-10 points: You are most likely not depressed at all and should not be worried.

Many people have developed morning depression in recent years. Quite often it becomes hard to wake up in the morning, even a cup of coffee cannot help to get out of the state of somnambulism, life seems gray and boring, work is just terrible, and personal life is once and for all failed.

And such a negative state of mind should be fought without fail, because otherwise the whole day may go down the drain, and then these days will become habitual, and soon a person may forget that he once felt peace and joy.

Traditionally, such a state of mind is aggravated in autumn and spring. And autumn and winter weather in itself evokes sad thoughts and is associated with boredom, emptiness and death.

Such a diagnosis as depression denotes a mental disorder, which is characterized by a feeling of longing, a decrease in mood, a feeling that life is over.

In some cases, this condition is characterized by inhibition of movements, slow thinking, in some cases, excessive excitement. Appetite may be disturbed, libido may decrease, sleep disturbance may be observed.

It should be remembered that in some cases, at the initial stage, depression can be overcome by adopting some good habits.

You need to remember that right now you are the center of the universe, and it depends on you what your life will become.

First of all, in order to have a great mood and well-being in the morning, you should get as much sleep as possible. At the same time, you should sleep for at least eight hours in a row. It is with healthy sleep that mental and physical health begins.

Try to be positive in the morning. You should stretch, then yawn, pull your hands and feet back and forth, and then they need to be rotated.

The next step in awakening the body is to massage and blink. You need to blink with effort, quickly. Then the palm should be circled around the hips, chest, stomach. It is also necessary to massage the head a little in a circular motion, as well as the ears, in which there are almost all nerve endings.

Then you should go to the window, open it and breathe in fresh air. In this case, you need to exhale through the mouth, inhale through the nose. You need to breathe deeply so that the air is in the lower parts of the lungs.
Such breathing exercises allow the brain and heart to receive enough oxygen - and depression will recede.

The shower should be cool, but you should not immediately make ice water, as this will be stressful for the body. Water should be gradually made colder.

Also, a good auto-training will be the opportunity to express your concerns. To do this, you can take a regular sheet of paper and write down all your negative thoughts. Then you need to think about what was written, remember the moments of happiness and joy in the past, realize that life itself is beautiful.

In addition, one can imagine a situation that is much worse than the current one, and thus it is possible to realize that many problems can actually be solved.

Depression is a mental disorder that is accompanied by a feeling of melancholy, apathy, and a negative mood. Morning depression occurs in many people. This may be due to the change of seasons, for example, autumn or spring melancholy occurs very often. A person can mope and return to normal mental balance, or he can fall into a deep depression. There can be many reasons for this. If after a week or two a person does not return to his normal life, then he needs professional help.

Clinical picture

It is important to remember that depression is a serious illness that requires treatment.

Like any disease, depression has its own symptoms. The main signs of depression are:

In addition to the emotional symptoms, there are also physical signs of depression that can present with a wide range of symptoms. Depression can cause many physical illnesses. Insomnia, loss of appetite, disturbances in the functioning of the gastrointestinal tract, headaches, decreased libido, nervousness, malfunctions of the cardiovascular system and many other pathologies may indicate the development of a depressive state in a person.

Treatment for depression

The approach to getting rid of depression should be comprehensive. The patient can independently try to restore peace of mind with the help of all the means known to him that brought him joy. If such therapy does not bring results for a long time, it is better for the patient to start taking drugs, the choice of which should be made by the doctor. Self-selection of drugs is prohibited, because. There are many contraindications and side effects. Treatment should be carried out strictly under the supervision of a specialist.

Prevention

Morning depression can occur simply as a sign of systematic sleep deprivation. A busy day at work, constant stressful situations, malnutrition and deficiency also contribute to the development of mental disorders.

The first method of dealing with depression in the morning should be sound sleep, which is at least 8 hours. After waking up, the patient will benefit from a contrast invigorating shower. The contrast should not be too sharp, it is better to start with slightly cool or warm water.

A nutritious, balanced diet will help you feel better. A lack of vitamins can significantly reduce performance. Physical activity will be helpful. For example, regular gymnastics in the morning or a morning run will help improve blood circulation, metabolism and the production of all the necessary hormones. A fulfilling sex life is also an integral part of the prevention of depression.

It is important that a sick person has the opportunity to do what he loves, which gives him joy. The support of loved ones and loved ones significantly contributes to the patient's recovery. It is desirable that communication brings positive emotions to the patient.

Finally

It should be remembered that there is no universal cure for depression. Some patients cannot get rid of depression for years. It is important that the patient himself realizes the need for treatment and makes efforts. A quick recovery from depression is almost impossible, so the patient and his family should prepare for a long recovery period.

With any kind of depression, sleep is disturbed: an oppressed psyche causes a sleep disorder, and vice versa, chronic lack of sleep leads to a depressed state.

By According to statistics, sleep goes wrong in 83% - 100% of people prone to this disease. Patients reasonably complain about the duration of which is not much less than that of healthy people, but its structure is thoroughly disordered.

Common features of sleep in depression:

falling asleep is difficult and tiring,
nocturnal awakenings are more frequent and prolonged than in a normal healthy state,
light sleep stages predominate over deep sleep stages,
rapid eye movements in REM sleep are more frequent,
the fourth stage of the slow phase of sleep is half as long as usual,
fast (paradoxical) sleep is replaced by drowsiness,
electroencephalogram in REM sleep registers sleep spindles, and in wakefulness - delta waves inherent in deep sleep,
waking up earlier in the morning.

Depression, depending on the cause of occurrence, is divided into endogenous and reactive:

Reactive - provoked by a traumatic situation,
Endogenous - internal causes.

With endogenous depression

a person falls asleep safely, but suddenly wakes up at night and spends the rest of it in a gloomy state, tormented by a vague and very heavy feeling of fear, guilt, longing and hopelessness. This mood can cause suicidal thoughts.

Patients complain about the lack of normal rest, the head is constantly occupied with thoughts. Apparently these thoughts are the “thoughts” of superficial sleep. Normal falling asleep gradually also goes wrong and the patient has to use.

Their wakefulness is replaced by a prolonged drowsiness with frequent awakenings, or immediately by a fast sleep. In the morning they doze or stay awake, while healthy people sleep fast and dream.

In depression, the sleep picture demonstrates increased activity of awakening mechanisms and suppression of the fourth phase of non-REM sleep. With a severe degree of the disease, paradoxical sleep occurs more often than usual, but due to repeated awakenings, it cannot be fully realized.

After treatment, he returns to normal, but the fourth stage often does not return and sleep remains superficial.

It should be noted that endogenous is the most severe of the 59 types of depression. This is due to hereditary factors and metabolic disorders.

Latent depression

Hidden or masked (bodily) depression is often undiagnosed. However, early morning awakenings, a "broken dream", a decrease in vitality and expression of active emotions are characteristic symptoms even in the absence of a painful mood.

The main complaint with this form of the disease is. The name is fully justified - depression is masked by physical ailments, often severe.

seasonal depression

This type of disease has a seasonal orientation: it manifests itself with a reduction in daylight hours in autumn and winter in people prone to this, more often in women. Seasonal depression affects 5% of the world's population.

Typical symptoms:

increased morning and daytime sleepiness,
overeating, desire for sweets. The result is an increase in body weight.
the duration of sleep, compared with the summer period, is increased by 1.5 hours,
night sleep is incomplete and does not bring rest.

Sleep pattern in various depressive syndromes

dreary depression characterized by:

a breakdown at the end of the day (feelings akin to a hangover),
difficult falling asleep, lasting about an hour, accompanied by painful thoughts and bitter reflections,
sensitive sleep, control over the outside world does not weaken, which does not give a feeling of rest,
very early awakening (2-3 hours earlier than usual),
unwillingness to get up after waking up, the patient lies for a long time with his eyes closed,
broken state after lifting.

Such an abnormal dream increases the feeling of hopelessness and oppressive pain, it does not bring a feeling of freshness and relaxation. As a result, wakefulness proceeds sluggishly, often with headaches.

Apathetic depression:

waking up 2-3 hours later than usual
constant sleepiness - morning and afternoon,
the boundaries between wakefulness and sleep are blurred.

Patients are ready to spend the whole day lying in bed, calling drowsiness laziness. Sleep does not bring proper rest, but this is not considered a problem.

Anxious depression:

drowsiness is reduced
disturbing thoughts cause long falling asleep,
shallow sleep, restless dreams,
frequent awakenings, sudden awakenings are possible, accompanied by sweating and shortness of breath from an unpleasant dream.
Early awakenings (1 hour -1.5 earlier than usual).

Most patients complain that sleep does not bring rest.

The nature of dreams in various depressions

With any type of depression, REM sleep, which is responsible for dreams, is disturbed. This affects the character and plots:

dreary state- rare dreams are painful, gloomy and monotonous, filled with stories about an unsuccessful past life.

Apathetic state- rare, isolated dreams are poorly remembered and emotionally scarce.

anxiety state - plots change frequently, events are fleeting, directed to the future. Dreams are filled with catastrophic events, threats and persecution.

CLASSIFICATION OF THE CAUSES OF SLEEP DISTURBANCES
(proposed A.M. Wayne, an outstanding Russian somnologist, and K. Hecht, a German scientist)

Psychophysiological.
Insomnia in neuroses.
With endogenous mental diseases.
With abuse of psychotropic drugs and alcohol.
When exposed to toxic factors.
With diseases of the endocrine system (diabetes, for example).
Organic diseases of the brain.
Diseases of the internal organs.
As a consequence of syndromes that occur during sleep (sleep apnea).
As a consequence of the disruption of the wake-sleep cycle (suffering of owls and larks, shift workers).
Shortened sleep, constitutionally conditioned (Napoleon and other short-sleeping personalities. However, it is a stretch to classify them as suffering from lack of sleep).

The materials of the book by A.M. Wayne "Three Thirds of Life".

For relaxation, I propose to see how beautiful our Earth is.

Elena Valve for the Sleepy Cantata project.

“I absolutely do not want to get out of bed in the morning. I don’t want to go to work, I’m in a bad mood, I don’t want to communicate with anyone”

“I don’t want to eat anything, I’ve lost weight, I think all the time that I’m a loser. Colleagues say that I am appreciated at work, but I am sure that I am about to be fired. ”

“Often my head hurts, everything became completely uninteresting. I began to sleep badly.
I can't figure out what's wrong with me"

What unites these people? All of them suffer from depression in one form or another. Now this word can be heard very often, but what is depression really?

What is depression?

First of all, depression is a disease. But how do you distinguish depression from just a bad mood?

In a state of depression, a person’s mood decreases for a long time, what used to be pleasurable and interesting ceases to be such. Physical weakness appears, sleep is often disturbed and appetite disappears, weight decreases. Ideas of guilt arise, the future looks bleak, self-esteem and self-confidence are reduced.

Not all mood swings are depression. To make a diagnosis, this condition must last at least 2 weeks. In a chronic course, periods of depression can last for 6 months or more. Depression varies greatly in severity, from low mood to severe depression, in which a person cannot get out of bed. Depression is often combined with anxiety, this is the so-called anxious depression.

Sometimes a person does not feel a depressed mood at all, but instead complains of bodily symptoms - heartaches, migraines, skin and gastrointestinal tract diseases. This happens when a person does not know how to respond to a situation with their emotions.

What is the cause of depression?

“It all started for me for no reason, like everything in my life was normal, and suddenly depression”

In fact, depression does not happen without a cause. It’s just that in some cases, the reasons for it are obvious - some kind of serious life shock (divorce, loss of a loved one, loss of a job), while in others depression occurs without an apparent external reason. But even in this case, there are reasons.

Scientists now believe that depression is caused by a combination of several factors. In some patients with depression, genetic factors play a role, ie. predisposition to depression can be inherited. But it is not depression itself that is transmitted, but only a predisposition. If you have a predisposition to depression, it means that it can manifest itself only under certain unfavorable circumstances. An important role in the development of depression is played by psychological factors, in particular upbringing, family environment, severe stress during childhood (for example, separation from parents).

A major factor in the development of depression is a particular style of thinking that contributes to depression.

Thinking patterns that contribute to depression

“I've been with the company for 3 years now. He rose to the rank of department head. But I feel like a complete loser, because I set myself the goal of becoming a deputy director ... "

“I failed the interview. I feel like people like me don't get hired."

Let's take a closer look at some of the features of thinking that can lead to depression.

Perfectionism. You are sure that you should achieve only the best result in everything. Depressed people are rarely satisfied with what they do because they set very high standards for themselves. Perfectionism makes them work with overexertion, which causes severe exhaustion and constant anxiety about the result.
Black and white thinking. You think on the principle of "all or nothing" - "If I did something halfway, then I did nothing", "Either I won or I lost." This way of thinking is very dangerous, because it does not allow a person to see intermediate options for the development of events.
Catastrophization. When some minor trouble happens, it seems to you that a catastrophe has occurred. “If my child got a deuce at school, then this means that he will not be able to study!” Catastrophic thinking causes great anxiety and takes a lot of energy.
"I should". You constantly tell yourself that you should: be a good husband/wife, parent, employee, always get things done, don't get mad at other people… The list is endless. The so-called "tyranny of duty" does not allow a person to enjoy life and take time for himself.

These are far from all the thoughts that contribute to the development of depression. Any person has many of them, but in patients with depression they take up most of the time. Psychotherapy can help you combat these thoughts and learn to think more realistically.

How to treat depression?

If you suffer from depression, the first thing you should do is contact a psychiatrist. Unfortunately, very often in our country people are accustomed to turning to psychics and fortune-tellers rather than to medical specialists. Only a psychiatrist can properly diagnose you and decide if you suffer from depression.

Depression is treated with the help of psychotropic drugs - antidepressants prescribed by a doctor, and with the help of psychotherapy (it can be carried out by a psychotherapist or clinical psychologist). In severe depression, treatment with antidepressants is absolutely necessary, because. in this state, suicidal thoughts and suicide attempts are not uncommon. It is best when antidepressant treatment is accompanied by psychotherapy. In milder forms, psychotherapy alone can be dispensed with.

“The doctor prescribed me antidepressants, but I am very afraid to take them, I heard that they are addicted to drugs, and they also make you very fat”

Antidepressants are medicines for depression. Now there are many types of antidepressants. Modern antidepressants are much easier to tolerate by patients and have fewer side effects. Only a psychiatrist should prescribe and cancel antidepressants. He will also tell you about the features of taking and the effects of these drugs.

The notion that antidepressants cause addiction is a big misconception. With proper treatment under the supervision of a psychiatrist, this does not happen. It is very important that you are in constant and regular contact with your doctor. Don't be afraid to ask questions about your treatment, how the drug works, and about side effects. Various side effects of antidepressants are quite easily eliminated and reversible.

“I started taking antidepressants, I drank for three days with no result - I quit”
“When I got better, I stopped the pills and everything started again,” - this is often heard from patients. The fact is that antidepressants begin to act gradually, accumulating in the body and the full effect appears after about 2 weeks. You can not cancel antidepressants on your own and change the dose on your own.

Do not think that you will have to take these medicines for the rest of your life. With proper treatment, after a while you will be able to do without them. But at the same time, you should tune in to a long process of treatment. It is also important to understand that there can be some ups and downs in the treatment of depression. If you feel worse for a while despite taking antidepressants and psychotherapy, do not despair. Such periods are associated with both external circumstances and the individual action of the antidepressant. Contact your doctor so that he can change the treatment regimen if necessary. If you are undergoing psychotherapy, do not be afraid to tell the therapist about the deterioration in order to develop further strategies.

What is psychotherapy?

What is psychotherapy? Simply put, psychotherapy is a treatment with a word. A psychotherapist helps a person to independently understand what dictates his feelings and actions. Precisely on their own, because many people have a misconception about a psychotherapist as a person who will give specific instructions on how to live correctly. In fact, many people can give advice, but they rarely make life easier, since they are most often based on the adviser's experience. And the role of a psychotherapist is completely different - he creates conditions in which a person makes decisions himself, begins to better understand what is actually behind his problems.

The most recognized and widespread throughout the world are two types of psychotherapy - psychoanalytic psychotherapy and cognitive-behavioral psychotherapy.

Psychoanalytic psychotherapy is the oldest form of psychotherapy currently in use. One of the main ideas of this type of psychotherapy is the existence of an unconscious sphere of the psyche. Thoughts and desires that are unacceptable to us are often not realized by us. For example, you cannot understand why, for no apparent reason, you have a strong dislike for someone. This person may remind you of someone significant to you, but this similarity is not realized. Until you remember who you are really angry with, it will be quite difficult to get rid of irritation.

Relationships are another important target of psychoanalytic therapy. Often they are built on the basis of the experience of previous relationships (early childhood experience plays a particularly important role). Most often, in adults, memories of childhood are greatly distorted and their connection with current relationships is not obvious. Moreover, it is very difficult to recognize some recurring stereotypes in adult relationships. For example, some women constantly enter into close relationships with men who suffer from alcoholism. During psychotherapy, these stereotypes are realized and their connection with past experience is established.

Psychoanalytic Therapy- lengthy procedure. It can last for several years with a frequency of two to five times a week. There are relatively short-term forms - 1-2 classes per week for several months to a year.

Cognitive Behavioral Therapy- a younger trend in psychotherapy. The main idea of CBT is the dependence of a person's emotions and behavior on his thoughts.

All people have so-called automatic thoughts. These are thoughts that come to our mind automatically and are not challenged by us. For example, a patient says that her mood deteriorated greatly after her boss looked at her. After analyzing this situation, it turned out that an automatic thought flashed through her: “If the boss looked at me, then he is not pleased with me!”, And it was she who spoiled the woman’s mood.

If you learn to capture these thoughts, check their correctness (“What does it say that my boss is unhappy with me?”), And challenge them, then you can get a powerful means of regulating your own emotional state. Behind automatic thoughts are deep beliefs about yourself, about people, about the world around you, which are formed in childhood and are often not realized. You can also work with them, realizing and changing, if necessary. In CBT, a system of homework and behavioral exercises is widely used. CBT is shorter term than psychoanalytic therapy (20-40 sessions once a week).

What happens if depression is not treated?

“Bad mood, you’ll think that now it’s being treated for every trifle”, “You’re a man, pull yourself together, what are you up to?”,- this can be heard all the time. Many people suffering from depression do not seek help because they feel it is embarrassing to deal with problems on their own. This is a very big mistake. Why?

Firstly, it is difficult to cope with depression on your own, and advice to pull yourself together will not help here. Asking for help is not weakness, on the contrary, it takes a lot of courage to admit your problems and fight them. Seeing a specialist is your first step on the road to recovery. Turning to a specialist, you make a conscious choice in favor of health.
Secondly, depression without treatment leads to serious consequences:
- People who do not receive treatment for depression for many years may lose their jobs, lose friends. They also often have family problems, up to the destruction of the family.
- If a person has suffered from depression for many years without receiving any help, their treatment may be more difficult and lengthy.
- A dangerous consequence of depression without treatment can be alcoholism. According to some reports, up to half of people suffering from alcoholism are diagnosed with depression, but have never received appropriate treatment. Alcohol has a short-term antidepressant effect. But over time, it only increases depression, not to mention the emergence of dependence on alcohol.
- Finally, the most dangerous consequence of depression without treatment is suicide attempts. If you have suicidal thoughts, see a psychiatrist immediately.

Can you work while being treated for depression?

“The doctors diagnosed me with depression. I decided not to work, because overexertion, stress at work is harmful to me. I have been sitting at home for two years, mortal longing "

“I decided to fight depression. I thought that if I work more, there will be no time to think about nonsense. I loaded myself with work, but I realized that I couldn’t cope”

So after all, what is more correct - to work or not? In fact, for a person suffering from depression, moderate activity is simply necessary.

It is very important to try to entertain yourself, go to the store, go for a walk, meet friends, even if it does not bring the former pleasure. The following paradoxical principle is important here - "For some time I will have to live with depression." This means that you do not have to wait until you are fully recovered in order to start doing something. Many patients say: “When I feel that I have recovered, then I will move mountains, but now I am not capable of anything.” It is not right. You need to start trying to do some things while in a state of depression.

If you are being treated for mild or moderate depression, you may well be able to work. But it is very important to adjust your work schedule. Avoid unrealistic deadlines and rush jobs. Try not to work overtime. Do not try to cope with depression by loading yourself with a large number of cases. This can lead to rapid exhaustion and worsen your condition. It is important to understand that depression is not a time for big changes and decisions. Give yourself permission to take small steps.

If you are undergoing treatment for severe depression and are unable to work, do not despair. Let your treatment become your work for a while.

In any case, discuss work-related issues with your doctor or psychotherapist.

Can you help yourself?

As mentioned above, depression is a disease treated by specialists. And your first task is to find those who will provide you with qualified assistance. But you must understand that without your efforts, the results of treatment will be much worse or appear more slowly. So what can you do to help treat depression?

Follow the routine of the day
- It sounds trite, but in fact, the correct sleep and rest regimen is very important for improving your condition. Try to go to bed and get up in the morning at the same time.
- Avoid self-administration of sleeping pills (without the recommendation of your doctor). Although sleeping pills help you fall asleep quickly, this sleep is different and less beneficial for you. If you take sleeping pills uncontrollably, increasing the dosage, after a while you will not be able to do without them.
- Don't go to bed too early. If you have been going to bed at one in the morning all your life, do not try to fall asleep at 22.00.
- Try not to sleep during the day for more than 20 minutes, so as not to disturb the night's sleep.
Go about your daily business
Often people in a state of depression completely stop doing everyday activities, to the point that they stop taking care of themselves. And the longer they stay away from their day-to-day activities, the less confidence they have that they can handle life. As already mentioned, start taking small steps, without waiting for the depression to end.
- Start doing things that bring you pleasure - read magazines, go for walks, do your own hobbies. An important principle is to do it even if you don't enjoy it as much as before.
- Take care of yourself. Take a shower, do at least a minimal exercise. Try to cook your own food at least once in a while. Even if you have severe depression, doing your daily activities will help you feel that you are able to cope with them. An important principle is not to demand too much of yourself.
Keep in touch
Yes, when a person is depressed, it can be difficult to communicate. However, if you maintain relationships with people, the process of your recovery will go faster. You will feel that you are not alone and you will be able to find someone who understands you.
- Do not hide from loved ones that you suffer from depression. Try contacting them for support. The constant mask of good mood and the fear of appearing weak take away your strength and increase your depression.
- Try to keep in touch with your friends. The principle already mentioned is also important here - do it, even if it does not yet bring former pleasure. Try to take an interest in their life, this will help you break away from the constant fixation of your own problems.
Avoid alcohol, drugs and stimulants
As already mentioned, alcohol brings temporary relief, but subsequently only increases depression and ruins your life. The same thing, only more so with drugs. It is also important to limit your caffeine intake as Excessive stimulation of the nervous system can subsequently cause an increase in depression.

One well-known psychotherapist asked a patient "Who recovers from depression?" He answered: “The one who is treated recovers.” Remember this principle, and you can return to normal life.

Kochetkov Ya.A., Moscow Research Institute of Psychiatry
Scientific and methodological center of psychoendocrinology
psyend.ru/pub-depress.shtml

Depression is a mental disorder that is accompanied by a feeling of melancholy, apathy, and a negative mood. Morning depression occurs in many people. This may be due to the change of seasons, for example, autumn or spring melancholy occurs very often. A person can mope and return to normal mental balance, or can fall into a deep depression. There can be many reasons for this. If after a week or two a person does not return to his normal life, then he needs professional help.

Clinical picture

It is important to remember that depression is a serious illness that requires treatment.

Like any disease, depression has its own symptoms. The main signs of depression are:

In addition to the emotional symptoms, there are also physical signs of depression that can present with a wide range of symptoms. Depression can cause many physical illnesses. Insomnia, loss of appetite, disturbances in the gastrointestinal tract, headaches, decreased libido, nervousness, malfunctions of the cardiovascular system and many other pathologies may indicate the development of a depressive state in a person.

Treatment for depression

Prevention

Morning depression can occur simply as a sign of systematic sleep deprivation. A busy day at work, constant stressful situations, malnutrition and lack of physical activity also contribute to the development of mental disorders.

The first method of dealing with a depressive state in the morning should be sound sleep, which is at least 8 hours. After waking up, the patient will benefit from a contrast invigorating shower. The contrast should not be too sharp, it is better to start with slightly cool or warm water.

Finally

They would be happy to rejoice, but depression interferes with them. We cure depression - and they will no longer be depressed, and a good mental disposition of the patient is the key to the success of any therapeutic treatment.

MAIN SYMPTOMS

body system

Disease

Endocrine system

Diabetes mellitus, thyrotoxicosis, Cushing's disease, Addison's disease

Cardiovascular and respiratory systems

Ischemic heart disease, bronchial asthma, chronic circulatory failure, chronic cardiopulmonary failure

Digestive system

Peptic ulcer of the stomach and duodenum, enterocolitis, hepatitis, cirrhosis, cholelithiasis

Joints and connective tissue

Systemic lupus erythematosus, rheumatoid arthritis, scleroderma

Pernicious anemia

Oncological diseases

Cancer, sarcoma, disseminated carcinomatosis

The immune system

Gynecological pathology

uterine fibroids

genitourinary system

Chronic pyelonephritis

organs of vision

Glaucoma

Whoever is not given to be deeply mistaken, he is content with a trifle.

L. L. Krainov-Rytoe

Being wise means knowing what to ignore.

William James

DEPRESSION

Symptoms of depression are divided into "primary" and "additional". What is their difference? The main symptoms of depression are observed in everyone who suffers from depression, although in varying degrees. Additional symptoms only complement, diversify, color the picture of the disease - in each case, some of them are present, and some are not. We will, of course, start with the main symptoms of depression. However, first a small disclaimer. Doctors, by their common agreement and understanding, make a diagnosis of depression only if the following symptoms are observed in a person for more than two weeks in a row.

So, essential symptoms of depression these are:

low mood, feeling of despondency, depression, melancholy;

loss of interest, ability to experience pleasure;

decreased energy, activity, increased fatigue.

Let's study them in order.

The main sign of depression is low mood, by and large it does not exist at all. The world seems gray and empty, and the sense of the meaninglessness of what is happening makes you so sad that even climb into the noose. A person’s sleep is disturbed, appetite decreases (often to the point of complete disgust for food), he loses weight and literally melts before our eyes. Internal tension can be unbearable, or complete apathy can begin. Former joys seem fasting, pleasure - something mysterious and unattainable. A person suffering from depression either unsuccessfully tries to occupy himself with something, hoping to somehow get rid of painful thoughts, or goes to bed and does not want to do anything. He may become angry and irritable, he may cry for days on end, or he may not cry at all, but this makes him worse. Thoughts swarm in my head, revolve around one topic - failures in life, disappointment in work or family, some begin with a variety of physical ailments. That's depression close up.

Decreased mood, feelings of despondency, depression, melancholy

Mild depression. If we have depression that has developed against the background of acute or chronic stress, that is, neurotic depression, then our mood, as a rule, decreases moderately. We begin to look at life pessimistically, we do not experience the former feeling of joy, but more and more - fatigue. More often in this case, the mood decreases in the evening, when all the work has already been done and the person, without being distracted by anything, gives himself up to depressive reasoning about how bad, unlucky, stupid, etc. everything is.

As a rule, with such depression, a person experiences anxiety, it is difficult for him to relax, stupid thoughts about some future troubles constantly climb into his head. Somewhere in deep down, he still believes that everything will end well, that problems will be resolved, but his statements on this subject will be very mean.

Average depression. If in when depressive genes come into play, our mood decreases quite significantly, especially at night and in the morning (some improvement occurs in the afternoon, but it can be difficult in the evening). Attacks "may appear tearfulness, and attempts to cope with it are not always successful.

A person in such a state begins to be weary of life, does not want to get better, does not believe in the possibility of improvement, and often thinks that the only way out or the right step is to commit suicide. Anxiety here, as a rule, is very high, strong internal tension does not give a person peace, despite the fact that there seems to be no strength. It is almost impossible to amuse such a person, he ignores any optimistic remark of others, sometimes, however, with an ironic smile.

Severe depression. If our depression, God forbid, came from nowhere, without serious stress, for no reason, as if by itself, most likely it is a depression of a genetic nature. Decreased mood in this case is manifested, as a rule, by depression, melancholy is felt literally as physical pain. At the same time, the person himself often does not consider his mood to be lowered, he simply does not think that this can be of any importance against the background of the general hopelessness and meaninglessness of his existence.

Anxiety may not be felt at all, or it may seem prohibitive, sometimes such patients say that they are as if squeezed in some kind of vise and either they themselves will be crushed, or the vise will not withstand. They have an expression of sorrow on their faces, the corners of the mouth are lowered, the upper eyelid is broken at an angle in the region of the inner third, there is a characteristic fold on the forehead, the posture is hunched, the head is lowered. Suicidal intent is quite clear.

Worst of all is to think of yourself as an addition to your own furniture.

V. O. Klyuchevsky

Literary evidence:

"The circle of my impotence is closed..."

With these words ends the story "Ruth" from the book "The Fall" by the amazing modern writer Lilia Kim about a young, suddenly widowed woman. The state of her heroine perfectly reflects the mental confusion of a person, when his anxiety becomes depression, and depression becomes anxiety:

“My life ended with Chilion's last breath. I hung between that world and this, unable to be in either of them. Life had never been more meaningless, but I still didn't have the guts to commit suicide, perhaps in part because Chilion's last words were, "Please live happily." He was very fond of asking me for some unthinkably complicated trifle.

Don't worry, you're still young, you don't have children. You will still get married. I made repairs in your com-

here. It will be necessary to agree to transport things - my mother is making plans for my life.

I only heard: “You have no children” and burst into tears. My mother began to reassure me, but her face is annoyed that I don’t understand how she thought up and arranged everything so well.

And I don't want to live! I don't want to live anymore! Mother! Do you hear! I, your daughter, do not want to live! - a cry is heard inside me, continuing with a hysterical echo, turned into a black hole left from my soul, where I am more and more immersed.

To clean one, you have to dirty something else; but you can stain anything you want and still not clean anything.

Lawrence J. Peter

Loss of interest, ability to experience pleasure

Scientifically, this symptom is called "anhedonia" (loss of a sense of pleasure), in a simple way - this is when you don’t want to do anything, you only have the strength to lie down and look at the wall. The processes of inhibition in the brain have prevailed over the processes of excitation: a person suffering from depression is not only not pleased with anything, but is not impressive either. What used to be a pleasure now seems insipid, empty, stupid. However, the severity of depression and the severity of this symptom varies greatly.

Mild depression. In the case of a depressive neurosis, of course, we can become interested in something, although the circle of our interests will be significantly reduced, and even the interest that arises will quickly fade. The feeling of pleasure seems to be smoothed out and disappears earlier than usual. This is especially clearly realized in the sexual sphere - there is no desire, no desire, no fascination. But if you take a closer look, you will notice that there are no more interesting programs on television, and fascinating books have disappeared, and work is a yoke, and rest is a whirlpool. There are still some pleasures, of course, but there is little pleasure in them, little. A characteristic feature is the patient's loss of interest in their appearance; women, for example, stop using cosmetics or do it completely automatically, that is, out of habit, and not out of a desire to please and impress.

Average depression. If a person has mixed depression - from stress and from genes, then all his interest is limited to the subject of painful experiences. If he is worried about the situation at work, then he will fixate on some of its nuances - relations with the boss, with partners, colleagues. Moreover, fixation is painful, selective, as if, apart from these few problems, there is nothing at all in his life.

People suffering from this form of depression remain passive, a kind of neutrality, even when those around them actively express joy or interest. The feeling of loss of pleasure covers the widest layers (food loses its taste, the world seems "gray", etc.). This experience becomes painful, painful, there are constant comparisons of oneself with normal people: “What are they happy about? .. What can be interesting for them in this?” Ultimately, such a person comes to the conclusion that he himself is already “good for nothing”,

has changed a lot, does not look like himself at all, “has become different”.

Severe depression. If a person’s depression is genetic, then the loss of interest and pleasure can even reach a complete rejection of any activity. Patients' statements about this sound frightening, they wonder how it is possible to experience interest and pleasure at all. They can ask the doctor: “Can you be happy about something? What?!” What used to give pleasure, delight or interest, now seems meaningless, absurd, absurd, monstrous. Such a person may have the feeling that he has never experienced pleasure or interest in his life. So depression can change not only our sense of the present, not only our ideas about the future, but even our memories of the past.

Decreased energy, activity, increased fatigue

The predominance of inhibition processes over excitation processes, of course, also affects the activity of people suffering from depression - this queen of depression and melancholy. Once in the power of depression, we not only quickly get tired, we often cannot engage in any purposeful activity at all; and if we nevertheless begin to do something, it will be purely automatically, detached, without a sense of belonging.

Mild depression. In the case of a depressive neurosis, we will look tired and twitchy, strangers may say that we are somehow unnecessarily passive. Our anxiety, however, will not allow us to “surrender” completely. It is possible that it will even make us too active and energetic, but only in fits. Braking, however, every time, although, perhaps, not immediately, but wins.

Average depression. With an average severity of depression, passivity acquires the features of stiffness. A person rarely changes his posture, his facial expressions are poor and monotonous. It can be seen that he moves with difficulty, thinks about the question for a long time, cannot always gather himself to answer fully and clearly. With such depression, a person often complains of fatigue, but this is not just fatigue, he is “tired of life”, “everything weighs on him”, “no strength, complete decline”, etc. He gets tired of talking, reading, watching TV shows: “I can’t figure it out”, “I don’t understand what they are talking about”, “I’m losing the thread”. However, it would be a mistake to assume that we are talking about fatigue. In the brain of a person suffering from such depression, there is simply not enough excitation, it is quickly suppressed by inhibition.

Severe depression. In a person with severe genetic depression, the activity may be

triggered by an anxiety attack. At times there is agitation, intense excitement, accompanied by aimless actions. For the rest

while he resembles a deflated balloon, it seems that life has left him. It's not just lethargy, it's crushed. The movements of such patients are slow, extremely stingy, performed only when absolutely necessary, the so-called "depressive stupor" may develop. Patients speak quietly and with difficulty, instantly get tired of communication or any other activity.

According to modern astronomers, space is finite. This is a very comforting thought - especially for those who can never remember where he put anything.

Woody Allen

ADDITIONAL SYMPTOMS OF DEPRESSION

Additional symptoms of depression, although called additional, sometimes cause a person even more suffering than the main symptoms of the disease. The fact is that both a low mood, and a loss of a sense of pleasure, and general passivity are difficult to “internal development”, and depression is, first of all, internal suffering when we think and rethink some of our misfortunes.

In addition, the main symptoms of depression, oddly enough, are more difficult to notice than some of its particular manifestations. You may notice that you have lost weight, that you feel insecure or suffer from sleep disorders. However, to understand that your mood is lowered if it has consistently decreased over several months, it is much more difficult to notice.

Additional symptoms of depression cows:

difficulty, if necessary, to concentrate, hold attention;

decreased self-esteem, the emergence of a sense of self-doubt, ideas of guilt and self-abasement;

a gloomy and pessimistic vision of the future,

ideas or actions of self-harm and suicide;

sleep disturbances (usually early morning awakenings);

appetite changed (in any direction);

decreased libido (sex drive);

somatic complaints without organic causes, as well as hypochondriacal mood.

Let's consider them in order.

Difficulty focusing and sustaining attention when needed

In order to keep attention on some business for a long time, the brain must form the necessary dominant. But how to form a dominant, for example, to watch a TV show, if your entire brain is subject to depression and, accordingly, is under the control of a depressive dominant? Yes, it's hard enough. In fact, the only possible focus of excitation in the brain of a person suffering from depression is painful and fatal thoughts about the meaninglessness and failure of life.

In depressive neurosis, we focus on our own pessimistic experiences. With depression of moderate severity, a person communicates with us as if through some kind of wall - he is fenced off, focused on something else, as if he is hardly distracted from what he is doing the rest of the time. It seems that at times he "turns off" and loses the thread of the conversation. When communicating with a person who has become a victim of genetic depression, there is a feeling that he is somewhere in a completely different world, from which we hear only some echoes and fragments of phrases. The reasons for these impressions are that the very act of such a conversation cannot occupy and captivate a person suffering from severe depression.

Loneliness is bad because few people can bear themselves.

Laszlo Felek

Decreased self-esteem, occurrence

feelings of self-doubt, ideas of guilt and self-abasement

Being in a state of depression, we begin to think either about the failure of the world around us - it is “bad”, “unfair”, “cruel”, “stupid”; or about our own failure, that we ourselves are “bad”, “stupid”, “not capable of anything”, “guilty of everything and everything”. Moreover, because of our depression, we really cannot cope with stress, do work that requires concentration, dedication, etc. So it’s quite easy to find arguments in favor of our failure, and blaming ourselves for anything is not difficult at all, because perfect people do not exist, and it is impossible to do things and not make mistakes. So you can always consider yourself a "bad mother" or "useless father", "ungrateful child or comrade."

However, the guilt that develops in depression, according to various studies, is more characteristic of Americans. Russians, on the other hand, experience guilt in a very peculiar way; they often feel awkward or ashamed. However, as depression deepens, guilt really begins to compete with self-abasement, although it does not completely replace it.

A person suffering from depression can attribute various vices to himself, consider himself the culprit of various misfortunes and crimes, call himself "a criminal who ruined people's lives." At the same time, as “evidence”, he will remember some minor mistakes and mistakes that, in a state of depression, will seem terrible and monstrous to him.

Avoid making final and irrevocable decisions when you are tired or hungry.

Robert Heinlein

A gloomy and pessimistic vision of the future

In a sense, it is simply difficult for a person with a depressive disorder to think about the future; He, by and large, lacks the desire to live in order to think about the future, especially since any unknown is frightening, and to frighten a person who is depressed means to aggravate his condition, once again emphasizing her role as an “anxiety absorber”. In combination with a self-deprecating assessment, all prospects really seem futile to a person.

The fact that everything will be bad is only a judgment, it becomes a symptom of an illness only in cases when such a conclusion begins to determine a person's behavior. This symptom is especially characteristic of depressive reactions to acute and severe stress, depressive neurosis that developed against the background of a chronic psycho-traumatic situation, as well as in classical forms of manic-depressive psychosis.

Ideas or actions of self-harm and suicide

In suicidology - the science of suicide - there are several options for suicidal behavior:

suicidal thoughts (which, in principle, being an abstract judgment, can also occur against the background of relative mental health);

suicidal intentions (a clear desire to commit suicide when the patient purposefully thinks through possible options for suicide);

suicidal actions (direct suicide attempts, preparation for suicide);

and finally, the suicide itself (suicide). A person suffering from depression, as a rule, does not regret that he will have to give up his life. On the contrary, he sees suicide as a release from suffering. And it is restrained, on the one hand, by a natural unwillingness to experience physical pain, and on the other hand, thoughts about loved ones. However, if it seems to a person that he only interferes with his loved ones, and his inner, mental pain is unbearable, these obstacles cease to protect his life.

Fortunately, with severe depression (due to the severity of inhibition processes), patients, as a rule, lack the internal forces to form specific plans for suicide, and even more so to implement them. Sometimes this can create the illusion of a relatively good condition of the patient, while in fact it indicates his transcendent severity.

In any case, if a person develops depression, one must be aware of the risk of a similar outcome of this disease, take his statements seriously and understand that in reality he does not want to kill himself, this is what his depression wants, and she is very persistent.

Sleep disorders

During the development of depression in the human brain, certain chemical processes occur, namely, a decrease in the amount of substances that play a primary role in the transmission of nerve impulses from one nerve cell to another. One of these substances is serotonin. And here's the trick... The fact is that this substance (more precisely, its lack) plays a significant role in the development of depression, and its lack has an extremely unfavorable effect on the state of our sleep. This is why so often a depressed person goes to the doctor not because of their depression directly, but because of sleep disorders.

Sleep disorders can be very different, which I described in detail in the book "Insomnia Remedy", published in the "Express Consultation" series. Here we will only clarify a few important details. Depressed people have different sleep problems. A person can toil all day, experiencing unbearable drowsiness, but at the same time all his attempts to fall asleep are in vain. It seems paradoxical, but in fact there is nothing strange about it. It's just that what he perceives as drowsiness is largely just the general lethargy that is characteristic of a depressed patient. And his sleep is disturbed due to a lack of serotonin caused by depression itself.

However, patients with severe genetic depression often fall asleep well, but wake up early in the morning, before the alarm clock, and always with a sense of anxiety and inner tension. By evening, they are somewhat "diverge" and feel better. Apparently, during the day, depression is partly overcome due to the constant influx into the brain of excitation from human affairs and other events. At night, however, the number of these stimuli decreases, and the brain again finds itself in its painful, semi-inhibited state. As a result, sleep becomes superficial, extremely sensitive, disturbing, dreams seem to a person not natural and spontaneous, but “made”. In the morning, he may think that he did not sleep at all, feel overwhelmed, tired, with a heavy head.

There is, however, another explanation for these depression-specific sleep disturbances. Since anxiety is an emotion, it is localized in the deep layers of the brain, and during sleep, mainly the “upper” part of it falls asleep. Apparently, this is why people suffering from depression often fall asleep quite well, but after 3-5 hours of sleep they suddenly wake up, as if from an internal shock, experience vague anxiety and anxiety. That is, the lower layers of the brain wait until its upper layers fall asleep, and then the anxiety that is always hidden behind depression suddenly erupts. After such an awakening, it is usually difficult to fall asleep, and if sleep does return, it becomes superficial and disturbing.

In depressive neurosis, on the contrary, the process of falling asleep is more often difficult: a person turns in bed, does not find a place for himself, cannot lie down, at times wants to get up and start doing something. He constantly thinks that he cannot sleep, and the next day he will feel bad. Such reasoning, of course, significantly delays his sleep, which is in no way consistent with an anxious state. It is possible, by the way, against the background of depression and nightmares, as well as nightly awakenings associated with them.

One way or another, but the symptom of sleep disturbance, although located here almost at the very end of the list, is one of the most significant signs of depression. It is almost impossible to imagine depression without sleep disturbances. And therefore, if you sleep well, then, fortunately, you should not qualify for a diagnosis of depression, at least not yet.

"Sleep is heavy, who is dejected by grief."

Russian proverb

I think, therefore I cannot sleep.

Laszlo Felek

Literary evidence:

"All Kinds of Danger"

In my book How to Get Rid of Anxiety, Depression and Irritability, I told the story of Konrad Lorenz, an eminent researcher of animal behavior, No. Belevsky Prize and generally a wonderful person. How are you it is clear that he also suffered from a fairly severe depression, which, however, was expressed in him mainly by violations mi sleep. Here is what he writes about this in his famous book "Beyond the Mirror".

“When I wake up, as I usually do, for a while in the very early hours, I am reminded of all the unpleasant things that I have had to deal with lately. I suddenly remember an important letter that I should have written long ago; it occurs to me that this or that person did not behave towards me in the way I would like; I find errors in what I wrote on eve, and above all in my mind there are all sorts of possible dangers that I must immediately prevent tit. Often these sensations besiege me so strongly that, taking a pencil and paper, I write down the obsession I remember. concerns and newly discovered dangers, so that they are not to be. After that, I fall asleep again, as if calmed down; and when I wake up at the usual time, all this heavy and threatening seems to me to be far less gloomy. nym, and besides, effective protections come to mind measures, which I immediately begin to take.

It remains to be noted that this truly legendary man century, suffering from depression, did not succumb and break under its onslaught. He fought all his life (as can be seen from this passage from his book) for his mental health, for his right to live a happy and fulfilling life, which causes him even more respect than even his truly brilliant discoveries in the field of animal psychology.

With a full belly, it's hard to think, but loyal,

Gabriel Laub

Change in appetite

When we say that appetite during depression can change in any direction, this probably seems strange. And if you know how our body works, then this is even logical. Indeed, in a person suffering from depression, the appetite can both increase and disappear. Loss of appetite, on the one hand, is explained by the predominance of inhibition processes over excitation processes in the brain, since those centers of the brain that are responsible for the feeling of hunger also fall under inhibition.

On the other hand, the autonomic nervous system is included in the matter - that part of the human nervous system that is responsible for the regulation of cancer. bots of all internal organs of the body. Anxiety strengthens the autonomic nerve noah system, which improves the functioning of the food system rhenium (this is the so-called sympathetic division of the autonomic nervous system). If the body is in alarm, then the work of only those organs that are necessary for a living being to escape from danger is selectively increased - the work of the heart is activated, blood pressure rises, the rhythm of breathing changes, etc. For escape and attack, the stomach is not needed , and therefore, during these periods, his work is simply suspended.

A person who develops acute depression (for example, as a reaction to severe stress) can lose up to 10 kg in one month. And the number of lost kilograms in a sense can be considered as a criterion for the severity of a depressive disorder.

However, the increase in body weight in depression, paradoxically, we also owe to this second of the two described mechanisms. There is a kind of conflict here. If a person suffering from depression and being in a state of anxiety still manages to eat something, then the following situation may arise. The food he absorbs affects the corresponding receptors, which leads to the activation of the brain centers responsible for digestion. The initiative, as they say, comes from below.

Activation of the parasympathetic division of the autonomic nervous system (which is an antagonist of the sympathetic division that is activated during anxiety) reduces sympathetic influences. Blood, figuratively speaking, flows to the stomach, the heart rate decreases, blood pressure normalizes, and this automatically leads to a decrease in anxiety. Thus, eating can become a kind of defense mechanism that reduces anxiety. It becomes easier for a person, and such a reflex is formed in his brain: if you eat, you feel better.

As a result, a person suffering from depression, sometimes gaining up to two or three dozen kilograms in six months, can go to the doctor with complaints of zhor, and not depression. And do not be surprised that the usual time for attacks of zhora in such patients is at night, when anxiety threatens to wake up and disrupt sleep. Moreover, as their favorite “food anti-anxiety agents”, they use bakery products that can quickly swell in the stomach and thus have the maximum effect on the corresponding receptors, as well as traditional irritants of digestive activity - spices, seasonings or, for example, lemon.

Finally, it does not do without the desire to please oneself: a person tries to cheer himself up by leaning on food. Soon, as depression develops and the ability to feel pleasure is lost, the corresponding goal can no longer be achieved in this way. But the person continues to chew "on the machine", supposedly being distracted from heavy thoughts.

Ignore minor flaws; remember: you also have large ones.

Benjamin Franklin

If you read the inscription "buffalo" on the cage of an elephant, do not believe your eyes.

Kozma Prutkov

A case from psychotherapeutic practice:

"Pancakes with Lemon"

Now I remember one very remarkable case from psychotherapeutic practice. Diseases, generally speaking, rarely give cause for fun, and depression even more so, but my patient herself spoke about what happened with humor (despite the depressive decrease in mood, humor does not disappear anywhere in people with a good sense of humor, however, it acquires a very specific - cold-ironic - color). So...

A sweet plump woman of forty-three years old appeared on the threshold of my office. Her appearance did not betray her as a depressive patient. She looked more like a healthy Russian woman, descended from the pages of Nekrasov's myth-making about our people: "She will stop a galloping horse, enter a burning hut!"

After our acquaintance with her, I asked: “What, in fact, brought you to me?” She, already rosy-cheeked, blushed even more, lowered her eyes and said a strange: "Pancakes." "Pancakes?! - I was surprised. - With this and to a psychotherapist? However, my surprise was short-lived. Within ten minutes, everything fell into place - my patient went to the address.

However, I will not retell the whole story, but will tell only about one symptom of depression: a change in appetite in any direction, in this case - upward. The situation looked like this. Every night, at the fourth hour of sleep, exactly at two in the morning, this charming lady woke up, as if from some kind of internal shock. Anxiety, usually activating us for fight or flight, made her immediately get up and start doing something to keep herself occupied.

And my patient had a strict ritual prepared for this occasion: she went to the kitchen and began ... What would you think? Yes, cook pancakes! Having baked a kilo and a half of pancakes, she sat down at the table and began to drink tea with pancakes. “Moreover, tea,” she made a reservation with surprising and at the same time comical seriousness, “must be with lemon!” Further, having eaten "from the belly", she felt the pleasant sweetness of sleep rolling over her and carefully swam back to bed. By four in the morning she was already sleeping like a baby. However, six months later, this "baby" found in himself two dozen extra pounds.

So why did she go to a psychotherapist? Of course, in order to reduce weight! What did the therapist find out about her? Given the title of the book - it's understandable: depression. Indeed, this woman had a classic symptom of early awakenings (if she went to bed not at ten, as she did, but at twelve, she would wake up at the classic time for depression - at four or five in the morning). These early awakenings, as expected, were accompanied by anxiety attacks, and this, if you remember the physiology, is the result of the activation of the sympathetic division of the autonomic nervous system.

And then there was what should be called the "classic defense mechanism", which this patient of mine resorted to absolutely unconsciously. What did she do? First, she went to the kitchen and squandered her overflowing anxiety on an active "useful" activity: whipping dough, and then juggling pancakes - this is a serious physical activity that can absorb the excess of internal tension that distinguishes anxiety. At the same time, she had to carefully monitor that the dough beat well, the pancakes did not burn, and she herself did not burn herself. In short, all this forced her to switch from internal experiences to external activities, which naturally significantly reduces the level of anxiety10.

Then she proceeded to the “highlight” of the program: she began to absorb lush, fatty pancakes, washing them down with tea, “always with lemon.” Carbohydrates (and pancakes are primarily carbohydrates) are quickly absorbed by the body, pancakes themselves, swelling in the stomach, put pressure on its walls, lemon causes such salivation that Pavlov's dog never dreamed of. In short, this sweet woman, without knowing it herself, was doing a great thing: she activated the parasympathetic division of her autonomic nervous system in every possible way and forcibly.