III. Psychomotor retardation

Mental and motor retardation is included in Kraepelin’s “triad,” i.e., it is the most specific and important symptom of the depressive phase of MDP. The range of their manifestations is wide: from mild lethargy to stupor, from subjective feeling some kind of slowness and “sluggishness” of one’s own thoughts to an almost complete inability to react to the environment, the inability to follow the words of the interlocutor, and formulate answers. However, in recent years, such pronounced inhibition has almost never occurred in patients with endogenous depression. It is rare to observe patients who, 2-3 decades ago, were described as the standard of melancholy: frozen, constrained facial expressions, mournful facial expression, bent posture, sharply slow movements, barely audible slow speech (the patient seems to have difficulty squeezing out a few words), desire to lie down all the time, etc.

With anxious depression, inhibition can be replaced by agitation, and in many works of the first half of our century, the term “agitated depression” was synonymous with anxious depression, and anxious depression was contrasted with inhibited, i.e., classic melancholia. However, experience in therapy with various psychotropic drugs has shown that anxiety is not always associated with agitation and that inhibition can also be a consequence of anxiety.

Thus, when treating patients with endogenous depression with antidepressants with a pronounced anxiolytic effect: insidon (opipramol) and amitriptyline, the dynamics of symptoms on a graduated scale showed that the decrease in motor retardation was more correlated with the regression of anxiety than with the regression of melancholy: after 1 week of therapy with amitriptyline, motor lethargy decreased by 39%, anxiety by 40%, and melancholy by 17.5%; when treated with insidon, regression of motor retardation was 35%, anxiety 30%, melancholy only 9%. However, the fact that motor retardation is caused not only by anxiety is shown by data obtained during treatment with desimipramine (pertofran, petilil), an antidepressant with a predominant stimulating component of action: regression of motor retardation reached 80%, melancholy 64.5%, and anxiety only 25 %.

More direct evidence of the participation of anxiety in the formation of motor retardation in patients with endogenous depression is the results of the use of benzodiazepine tranquilizers, the psychotropic effect of which is reduced to anti-anxiety, and among side effects muscle relaxation is observed, leading to a decrease in motor activity in mentally healthy people and experimental animals. However, in the majority of patients with endogenous depression with severe lethargy, intravenous administration of 30 mg of diazepam caused some reduction in stiffness (usually after a short sleep), and in some patients with depression with strong internal tension, sleep did not occur, but along with anxious tension, psychomotor retardation decreased or disappeared.

The effect of diazepam was especially evident in patients with “depressive stupor.” In 3 such patients (2 women and 1 man) with long-term bipolar MDP, intravenous administration of 30-40 mg of diazepam for 3-5 minutes caused a rapid reduction in motor retardation, mutism was replaced at first by barely audible, and then increasingly lively, albeit slow, speech. The patients said that, along with excruciating melancholy, they experienced strong, unaccountable fear and horror. Obviously, the positive effect of diazepam in these cases is due to the fact that the stupor was more anxious than actually depressive.

In the past, a solution of sodium amytal with caffeine was used to disinhibit patients with severe depression. Although barbiturates are known to have anti-anxiety effects, a clear explanation of the results has been complicated by their narcotic effects. However, in the case of benzodiazepine drugs with their pure anxiolytic effect, there are no such difficulties. The “anti-stuporous” effect of large doses of intravenously administered diazepam in patients with schizoaffective psychosis is especially clearly manifested, however, in this chapter we presented observations that relate only to undoubted MDP.

To choose the right therapy, it is necessary to distinguish psychomotor retardation, caused mainly by anxiety, from depressive retardation. Despite the fact that in anxious patients the slowing down of the rate of speech can reach the level of mutism, they can be distinguished by a number of external signs: by a tense, brilliant look, frozen tense facial expressions, but without an expression of grief, etc. If such a patient still utters several words, they come out with effort, as if overcoming an obstacle, while with depressive lethargy, each word is pronounced slowly, monotonously. The decisive differential diagnostic method is the diazepam test.

If inhibition caused by hidden internal anxiety is incorrectly assessed as a depressive decrease in activity, errors in therapy are inevitable. The prescription of antidepressants, for example melipramine, usually leads to a sharp exacerbation of anxiety, which can result in raptus, an influx of fear with impaired consciousness, a somatic catastrophe in the form of an attack of hypertension, a heart attack, etc.

When studying the content of biogenic amine metabolites in the cerebrospinal fluid using probeneside test1, it was found that in uninhibited patients with endogenous depression the content of homovanillic acid (a product of dopamine conversion) does not differ significantly from the control (healthy), while in inhibited patients it is twofold below. However, these data say little about the genesis of inhibition in depression, since dopamine deficiency may be associated with hypokinesia, and not with the main pathogenetic mechanisms of depression.

N. Laborit (1976) points out the connection between inhibition and anxiety: under stress, the secretion of ACLT and glucocorticoids increases, and ACLT, through a chain of biochemical reactions, facilitates the activity of the activating system and inhibits the inhibitory (cholinergic) system of the brain. Glucocorticoids have the opposite effect, activating the inhibitory system. Thus, inhibition or excitation in the stress response is determined by the relative predominance of the effect of ACTH on the activating or glucocorticoids on the inhibitory system. Since the mechanisms of the stress response underlie anxiety, in anxious depression either inhibition or agitation can be observed.

It is well known that almost immobile patients may suddenly experience attacks of sudden motor agitation. Since when endogenous depression from anxious to anergic regulation of glucocorticoid secretion is impaired, then, according to N. Laborit’s scheme, depression should occur with disturbances of psychomotor activity. Consequently, inhibition in patients with endogenous depression is caused by both the depressive mechanisms themselves and anxiety (anxious tension, “numbness”). A more detailed study of these mechanisms and an assessment of the contribution of anxiety to the inhibition of patients with endogenous depression require special research.

As mentioned above, several decades ago, endogenous depression in European countries more often occurred with severe psychomotor retardation. Now such patients have become much less common. However, according to the observations of E.D. Sokolova (1984), depression among representatives of the indigenous population of Chukotka is characterized by distinct motor retardation, mutism, and periods of fear, differing in this respect from the depressive states observed among the newcomer population. A similar picture is observed among representatives of the indigenous population of Nigeria.

Motor restlessness occurs only in patients with anxious depression and reaches varying degrees: from fidgeting and mild restlessness to severe agitation. It is more often observed in old age and in women.

When describing thinking disorders in the depressive phase of MDP, the main attention was paid to slowing down its pace. E. Kraepelin (1904) noted slowness and sluggishness of thinking in patients; thought progresses painfully, requires a special volitional effort, association, ideas are poor, one mental image is hardly replaced by the next, thinking becomes, as it were, “sticky”, viscous. Currently, such profound disorders are observed less frequently, although there are patients in whom mental retardation is disproportionately expressed compared to other components of the depressive syndrome, including motor retardation. Recognizing depression in such patients can be difficult. They give the impression of being confused; It is not possible to obtain from them descriptions of their painful experiences, including complaints of low mood. In some cases, they somewhat resemble pseudodementia patients. Only after the end of the depressive phase do they say that their mood was low, but that they could not explain anything due to the almost complete absence of thoughts in their heads. In some cases, there is amnesia for some periods of depression. In elderly patients with such symptoms, there is an assumption of the presence of a severe organic (vascular) disease of the brain, against the background of which depression has developed. However, in most of them, significant organic symptoms cannot be detected during the intermission period.

Thought disturbances in mild depression have been less studied. Often such patients, especially people of creative work, at the very beginning of the depressive phase notice that the thinking process does not proceed as smoothly as usual, and it becomes more difficult to formulate thoughts. Often they themselves explain this by overwork, however, with asthenia, the pace of thinking and the efficiency of execution psychological tests decrease gradually as fatigue increases, while with depression the pace of mental activity remains equally slow throughout the conversation, and sometimes even speeds up somewhat towards the end.

In cases of moderate severity of depression, disturbances in intellectual activity are determined not so much by a general decrease in its pace as by a peculiar inertia of thinking. The patient can cope with routine tasks for a relatively long time. Thus, people whose work takes place within a strictly limited stereotypical framework continue to perform it successfully, and their colleagues do not notice any changes, although in other areas of activity the growing depression has already led to decompensation. On the contrary, where a volitional decision is required, a choice between alternative possibilities, mental activity is sharply hampered. The patients themselves are well aware of this; they complain that insignificant everyday tasks, small issues that were previously solved automatically, acquire the meaning of complex, painful, insoluble problems. As one of them put it, “every little grain of sand along the way becomes a boulder.” In other words, where the patient’s activity follows a well-trodden track, he can still cope with it; Where volitional efforts and active choice are necessary, its inconsistency manifests itself.

By modern ideas, thinking, just like the work of a computer, is a continuous process of decision making. In a computer, the strategy for solving problems and processing incoming information is determined by the program embedded in the machine. A person chooses a decision path based on the stereotypes of thinking acquired in the process of life, the scale of values formed in him and accepted in his environment, emotional mood, etc. The bulk of continuous alternative elections happens subconsciously. In a patient with depression, this automatism is partially lost and a number of issues requiring resolution, which were previously almost unnoticed, begin to linger in the consciousness, filling it, increasing depression and anxiety.

The difficulties of choice in patients with depression are also indicated by an experimental study by E. Silberman et al. (1983). They found that decision-making strategies are impaired in depression. The subjects had to solve test problems, and during the experiment, possible approaches (hypotheses) were corrected. Patients with depression were difficult to correct; they did not discard hypotheses that turned out to be incorrect, but “clung” to them. This resulted in significant deterioration in decision-making, with the degree of deterioration being correlated with the severity of depression.

In the work of R. Cohen et al. (1982) showed that patients with depression, as well as healthy subjects, successfully performed simple cognitive and mental tests not related to mental stress. In tasks that required sustained effort, they lagged significantly behind the control group. The authors view these data as the result of a decrease in the level of motivation in depression. Indeed, patients with depression lose interest in almost everything that used to be important to them; the events that occupied them seem empty, “insipid”, unnecessary. Probably, the basis of thinking disorders in endogenous depression, as well as motivational processes, is the general decrease in mental tone inherent in this disease.

Patients with depression often complain of memory loss. In the above-mentioned work by R. Cohen et al. (1982) it was shown in the experiment that mnestic disturbances are detected in cases where sustained effort is required to complete a task. However, with endogenous depression, the decrease in memory turns out to be uneven: patients are better able to reproduce unpleasant events from the past, while everything bright and joyful seems to be erased from their memory. Therefore, when questioned about the duration and frequency of depressive states, they can mislead the doctor, claiming that life has been joyless all along, their mood has been depressive, although not long before they were in a good mood, had an interesting time, and worked successfully.

In a study by S. Fogarty and D. Hemsley (1983), these clinical observations find experimental confirmation: during the period of maximum severity of depression, words associated with pleasant experiences were reproduced much worse than those associated with negative events. As depression regressed, memorization of words from the first group gradually improved. The disturbances in thinking and memory characteristic of depression increase the feeling of helplessness and powerlessness and contribute to the formation of ideas of low value, and sometimes suicidal intentions.

www.psychiatry.ru

Lethargy– this is a decrease in the individual’s reaction speed, a slower flow of thought processes and the appearance of extended speech with long pauses.

In extreme cases, a person may completely stop reacting to others and remain in a daze for a long time. Inhibition may not be complex, but relate only to thinking or speech. In the first case it is called ideational, and in the second – motor.

Diseases accompanied by lethargy

Retardation is observed when:
inflammation of the brain (meningitis);
mental disorders (schizophrenia);
borderline states(depression, neurosis);
presence of a brain tumor;
hypoglycemia (decrease in blood glucose levels);
fatigue, exhaustion of the body;
intoxication with drugs or alcohol.

Causes of lethargy

As you can see, the reasons that cause this condition are usually associated with brain damage and pathology that interfere with its functioning.

Temporary effect of inhibition in speech and thinking occurs due to lack of sleep, when the body is already exhausted, or, as a result of using narcotic substances and alcohol, which depress thought and motor processes. That is, the reasons can be divided into those that block activities and those that reduce the possibilities for its implementation.

According to some versions of psychiatrists, inhibition is nothing more than a peculiar reaction to stress, in many ways similar to an anxious state, but acting in the opposite way. Proof of this is the disappearance of symptoms when patients use antidepressants and minor tranquilizers, which are supposedly aimed at reducing anxiety.

Symptoms of lethargy

The image of the patient fits into the classical description melancholic: lethargy, slowness, drawn out speech, every word seems to be squeezed out with effort. It feels like thinking takes a lot of strength and energy from this person. He may not have time to react to what is said or may completely plunge into a stupor.

An individual may have a desire to constantly lean on something or lie down. It is not necessary that all manifestations of inhibition be observed. Just one is enough to claim that a person needs medical attention.

Treatment of lethargy

First they try to determine the real reason this condition, and then treatment is prescribed. When lethargy is often attributed nootropic drugs (for example, Piracetam), which improves metabolic processes in the brain. In case of hypoglycemia, they try to restore the glucose level and maintain it with special substances.

In case of meningitis, they try to destroy the causative agent of the disease and eliminate inflammatory process, although after this you will have to undergo a restorative course of therapy. If the cause of inhibition is cancer, then all efforts are devoted to overcoming it.

Lethargy

Inhibition of a person’s mental processes and behavioral reactions can be caused by various reasons: fatigue, illness, exposure to tranquilizers that slow down organic processes, negative emotional states such as stress, depression, sadness, apathy.

Retardation is a decrease in an individual’s reaction speed, a slower flow of thought processes, and the appearance of protracted speech with long pauses. In extreme cases, a person may completely stop reacting to others and remain in a daze for a long time. Inhibition may not be complex, but relate only to thinking or speech. In the first case it is called ideational, and in the second – motor.

Suppression of thinking is scientifically called “bradypsychia”. Not apathy or inertia of thinking. These are completely different conditions that have different pathophysiological and mental foundations. Bradypsychia is a symptom that appears more often in old age. In any case, most people associate slow thinking with leisurely and eloquent elders. However, it can also occur in at a young age. Indeed, under each manifestation of ill health there are certain reasons hidden.

Causes of slow thinking

The pathophysiology of the process is extremely complex and not fully understood. Thinking, behavior, emotional background and many other achievements of the human mind are associated with the work of the limbic system - one of the sections of the nervous system. And the limbicus cannot be properly deciphered. Therefore, in everyday practice, we can only name conditions - diseases in which bradypsychia is noted, but cannot answer the question of why it appears.

Vascular pathologies. Acute, and more often chronic disorders of cerebral circulation, resulting from the progression of atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head, are the cause of destruction of the brain substance. In particular, the structures responsible for the speed of thinking also suffer.

Parkinsonism and Parkinson's disease. Narrower, but no less common pathologies, one of the manifestations of which is slowness of thinking. In addition to this depressing symptom for people around the patient (patients themselves in the later stages of development of this type of pathology do not notice any changes in themselves), there are many others that are no less unpleasant. For example, thoughts become not only slow, but also viscous, a person becomes clingy, annoying, speech is slow, often confused.

Epilepsy. In the later stages of the disease, when doctors note the destruction of the personality as a result of the progression of the disease, lethargy occurs, as do many other signs of a change in thinking.

Schizophrenia. Just as with epilepsy, in schizophrenia bradypsychia is not early sign pathology.

Depressive states and depression. A mental illness characterized by an abundance of symptoms, often disguised as somatic problems - even toothache or coronary disease hearts. Among them there is also lethargy of thoughts.

Hypothyroidism. Insufficiency of the thyroid glands. With this disease, the described symptom is extremely characteristic and is one of the first to appear.

Toxic bradypsychia. Of course, there is no such group of diseases in the international classification of diseases. But the name still describes as clearly as possible the reasons for the appearance of the symptom - intoxication of the body, be it alcohol, metal salts, drugs or microbial toxins.

Of course, with such a large number of diseases, the number of types of treatment should also be large. Unfortunately, until scientists have finally figured out how the brain works, there are not as many of these species as we would like. The temporary effect of inhibition in speech and thinking occurs due to lack of sleep, when the body is already exhausted, or due to the use of drugs and alcohol, which inhibit mental and motor processes. That is, the reasons can be divided into those that block activities and those that reduce the possibilities for its implementation.

The image of the patient fits into the classic description of a melancholic person: lethargy, slowness, drawn out speech, every word seems to be squeezed out with effort. It feels like thinking takes a lot of strength and energy from this person. He may not have time to react to what is said or may completely plunge into a stupor.

In addition to a decrease in the rate of speech and thinking, there is a muffledness of what is said - an extremely quiet and calm voice that occasionally breaks the silence. Lethargy is noticeable in movements and facial expressions, and posture is most often too relaxed. An individual may have a desire to constantly lean on something or lie down. It is not necessary that all manifestations of inhibition be observed. Just one is enough to claim that a person needs medical attention.

Diagnosis of bradyllalia

Persons with speech tempo disorders, including bradyllalia, need a comprehensive medical and psychological-pedagogical examination, which is carried out by a neurologist, speech therapist, psychologist, and psychiatrist. When examining a patient with bradyllalia, a detailed examination of the medical history regarding previous diseases and brain injuries is necessary; presence of speech tempo disorders in close relatives. In some cases, to clarify the organic basis of bradyllalia, instrumental studies are required: EEG, REG, MRI of the brain, PET of the brain, lumbar puncture and etc.

Diagnostics oral speech for bradyllalia, it includes an assessment of the structure of the organs of articulation and the state of speech motor skills, expressive speech (sound pronunciation, syllabic structure of the word, tempo-rhythmic aspect of speech, voice characteristics, etc.). Diagnostics of written speech involves completing tasks for copying text and independent writing from dictation, reading syllables, phrases, and texts. Along with a diagnostic examination of speech, for bradyllalia, the state of general, manual and facial motor skills, sensory functions, and intellectual development is studied.

When making a speech therapy report, it is important to differentiate bradylalia from dysarthria and stuttering.

Treatment of slow thinking

General preventive measures. The more the brain is loaded, the better it works. Nerve cells that are not used during life happily die off as unnecessary in the literal sense. Accordingly, the mental reserve decreases. Learning new things is possible at any age, but after thirty years it is significantly complicated by the slowdown in the development of new interneuronal connections. You can load your brain with anything, as long as it is not familiar to it. Learning a new language, solving mathematical problems, mastering new sciences, studying historical archives and understanding them. But! Solving crossword puzzles, scanword puzzles, and the like is like memorizing a large Soviet encyclopedia. Dry information only occupies cells responsible for memory, but not for thinking. Physical activity also helps keep the brain in working condition. It’s difficult to say what this is connected with.

Vascular therapy. It is impossible to bring the vessels to a state corresponding to the age of twenty, however, partial restoration is possible, which is what doctors use by prescribing appropriate medications.

Nootropics and neuroprotectors. A more specific treatment that helps nerve cells recover.

Before visiting a psychotherapist, the patient can only engage in prevention - all drug treatment has a significant number of contraindications, which the specialist takes into account when choosing one or another remedy. In case of bradypsychia, it is imperative to consult a doctor - there is not a single “easy” reason for such a mental state.

Forecast and prevention of bradyllalia

The prognosis for overcoming bradyllalia is most favorable with an early start of correctional work and psychological reasons for the violation of speech tempo. But even after developing normal speech skills, long-term observation by specialists and constant self-monitoring of the rate of speech are necessary.

To prevent bradyllia, it is important to prevent perinatal lesions of the central nervous system, head injuries, neuroinfections, and asthenic syndrome. It is necessary to take care of the normal development of the child’s speech, to surround him correct samples for imitation.

Is depression a disease or a condition of the body? Let's try to figure this out together. Medicine characterizes depression with the following symptoms:

depressed, depressed mood, loss of interest in loved ones, everyday activities, work;
insomnia, waking up early in the morning or, on the contrary, sleeping too long;
irritability and anxiety, fatigue and loss of strength;
lack of appetite and weight loss or sometimes, on the contrary, overeating and weight gain;
inability to concentrate and make decisions;
decreased sex drive;
feelings of worthlessness and guilt, feelings of hopelessness and helplessness;
frequent bouts of sobbing;
thoughts of suicide.

On the other hand, depression can be seen as a response to stress. We encounter stress almost constantly when solving certain problems. For example, a bad grade on an exam or failure to pass a test causes stress (strong negative emotions) to a greater or lesser extent. We may experience stress when standing in a long line, because of difficulties at work or problems in the family, when there is no mutual love, when we want to do a lot but there is no time for it, when there are unrealized opportunities, when we watch crime stories on TV every day, and many other reasons, the list of which can be continued almost indefinitely. And after stress, a response (protective) reaction of the body necessarily occurs - a state of depression. In response to every, even the smallest (insignificant) stress, the body responds with adequate depression. But a little stress is even beneficial for the body. They constantly train it, putting it into a state of activation or training (according to the terminology of the Canadian scientist Hans Selye). The greater the stress, the stronger (deeper) and longer the depression. Depression of moderate severity lasts up to two weeks. In severe cases (during severe stress, such as the death of loved ones), depression can last for several months or even several years. That is why the obligatory commemoration of the deceased after 3, 9 and especially 40 days (“farewell to the soul”) helps to first reduce stress and then get out of the depressed state of family members, relatives and friends. During stress, the body mobilizes and uses its energy as much as possible and directs it to protect the body. After stress, the body is in a state of “low battery”, exhaustion, i.e. depression, after which a gradual accumulation of energy begins (“recharging” the body) until the moment of complete restoration of strength and energy. The process (duration) of depression or inhibition of the body in time (duration) is approximately three times longer than the time of exposure to a stressful situation (the process of excitation of the body) and this must be taken into account when eliminating the consequences of any stress, large or small.

The graph shows the processes (two curves) of excitation and inhibition of the body under different stressful situations. The 1st graph reflects the body’s reaction to small (small amplitude and duration) stress that we encounter every day. Curve 2 reflects the body's response to severe stress. In the negative phase, the body is most energetically weakened and against this background various diseases can develop, especially during periods of prolonged depression. According to statistics, up to 70% of those who go to the clinic for somatic diseases have one form or another of depression.

And so, “bombardment” of the body with small stresses and protection with small and short-term depressions is a normal state of the body, accustomed to constant protection from environment. Severe stress takes a lot of energy from the body and causes deep (on the graph the depth of depression is marked by the segment BC) and prolonged depression (severe lethargy of the body with a significant decrease in activity). The body gradually accumulates energy, trying to return to the state of dynamic equilibrium that it had before stress, i.e. self-healing. I would like to draw your attention to the fact that the most difficult and dangerous time for the occurrence of other diseases for the body during depression does not come immediately after the end of the stress (point A, for curve 2), but after some time, from the end of the stress (point B ). During this period of time, you need to especially monitor your health. We can clearly conclude that the cause of all depression (depressive state) is stress. Depression is a nonspecific reaction of the body to stress. Minor depression, with mild stress, is a normal state of the body, which the body, as a rule, copes with on its own. Severe, deep depression is already a disease and you can’t do it without the help of a doctor.

As a rule, in melancholic people, stress reactions are most often associated with constitutional arousal, such as anxiety or fear, phobia or neurotic anxiety. Cholerics have a typical stress reaction - anger. That is why they more often suffer from hypertension, stomach ulcers, and ulcerative colitis. In phlegmatic people, under the influence of stress, the activity of the thyroid gland decreases, metabolism slows down and blood sugar may increase, which leads to a pre-diabetic state. In stressful situations, they “press” on food, as a result of which they can become obese. Sanguine people with their strong nervous system tolerate stress most easily.

Ideally, the body should not react to any stress at all or with a minimal reaction, but practically this does not happen in life and to achieve this, persistent and long-term training of the body is necessary. People who do not have a culture of health, especially young people, try to solve problems associated with stress and depression with the help of drugs (the fastest, easiest and accessible path to overcome stress or get out of depression, but also the most harmful to health). Subsequently, they develop an addiction (constant craving) to drugs such as tobacco, alcohol, marijuana, and so on, from which it is no longer possible to free themselves without outside help. And these problems are gradually moving from personal ones to state ones (the state’s fight against the drug mafia, treatment of drug addicts, etc.). Traditional medicine solves these problems with its own methods that are no less effective, but absolutely safe for health. And in order to minimize the effects of stress on the body, she developed certain recommendations and advice.

health.mpei.ac.ru

The effect of stress on sex life

It's not the first time people have been talking about the fact that sex helps get rid of stress. However, stress often does not have the best effect on intimate life, writes allwomens.ru.

First, let's define the terminology: what is stress? (We hope there are no questions about what sex is). The word stress itself in English means “impact, pressure, pressure.” External circumstances or internal problems put pressure in the literal sense - and the body reacts with all sorts of psychological and physical disorders. Disorders of sleep and appetite, or, on the contrary, drowsiness and the desire to eat boxes of candy, tearfulness, anxiety, irritability, or, conversely, lethargy - all these are reactions to stressful situations. And as a rule, under stress, most people, unfortunately, have no time for sex. But about 9% of the population still try to solve stressful situations with its help. Statistics are silent on how successful it is. It's better to check experimentally.

However, it is interesting that “good” stress, caused by strong positive emotions, only increases the amount of sex hormones, therefore it has a positive effect on sex. “Bad” brings in sexual relations There are many problems, but they manifest themselves differently in men and women. So, sex therapy for stress.

If a man is stressed

Most men keep their problems inside. They don’t talk for hours on the phone about their experiences, don’t vent their tension in hysterics, but accumulate within themselves the entire burden of unresolved problems.

Therefore, when a man is in a stressful situation, he withdraws into himself even more. Any questions or intrusive attention only irritates him. As for sex, there are two possible ways for the situation to develop.

If the stress is not prolonged and not too deep, it can even temporarily increase desire: according to experts, male sexuality is subconsciously associated with aggression, the desire to conquer, win, and show one’s strength and power. But unfortunately, physical release does not always coincide with moral release, and if the cause of stress is deeper than fatigue and a hard day at work, such sex will not bring relief. Moreover, it can turn out crumpled and cause additional frustration.

The second option for the development of the situation is indifference to the partner, decreased desire and even problems with erection. In this case, the man withdraws into himself even more and begins to avoid his partner, so as not to be caught in insolvency, citing fatigue and a large amount of work.

Of course, you first need to fight the cause of stress, and not the effect. As for intimacy itself, the partner needs to show maximum tact and patience. Any reproaches or, worse, jokes, barbs, although perhaps your tongue itches unbearably, are inappropriate. After all, he needs support and confirmation of his importance, and not vice versa.

If a man does not show initiative in bed, then new red lingerie with lace, candles and striptease are most likely useless.

Such a call will only cause fear of a possible fiasco or irritation. As an incentive, unobtrusive options are much better - a delicious dinner with aphrodisiacs, a massage. And most importantly: a loved one should feel that he is valued not only in the context of bed relationships.

If a woman is stressed

What's happening?

Unlike men, women are accustomed to pouring out their experiences. But there is no question of exacerbation of sexual desire; most of all, in a stressful situation, representatives of the fair sex need rest, peace and tenderness. Tactile contact - hugs, gentle caresses and care at such moments are simply necessary. But if a man mistakes the need for affection for a desire for violent and immediate sex, problems and resentments are possible, because in this case there is a misunderstanding. As a result, a man may feel rejected and unwanted, take all her experiences personally (due to natural self-centeredness), become withdrawn, offended, or even rashly express accusations of his partner’s lack of temperament and in general. Of course, all this does not contribute to either harmony in relationships or overcoming a stressful situation. However, depending on the situation, a gentle lover is, of course, able to switch his partner’s attention and her feelings to love.

How to behave?

You should not force yourself to have sex just so as not to offend your loved one; it will not bring joy to either you or him.

After such a concession, the woman will feel that she was used, while the man will feel dissatisfied with himself, because he will feel that he did not give pleasure to his partner. Therefore, it is better to say softly: “No, another time,” than to then lie silently and be offended by your partner for insensitivity and inattention. If the only thing you want after a hard day is to take hot bath and go to bed, allow yourself to relax and unwind. The main thing is to try to explain to your beloved man that it’s not about him, but about your experiences. And be sure to provide guidance for action that is clear and specific, without hints: “I need you to just hug me and listen to me.”

If the stressful situation is protracted and any thought about sex immediately causes rejection, you need to try to change your inner mood. We know that the main concomitant of stress is physical fatigue. Try to relax and get enough sleep, and perhaps soon you will want more than just healthy sleep in the bedroom.

Try to create a romantic atmosphere: taste comes with eating, and perhaps, having taken the initiative first, you yourself will want to continue.

And of course, when the stress is left behind and everything returns to normal, do not forget about regular anti-stress prevention. After all, sex, if it can’t always serve as a complete cure for stress, how can prophylactic simply magnificent! It provides complete physical release and relaxation, lifts your spirits and gives you self-confidence. Do it as often as possible, when everything is good, and then you will easily emerge victorious from any stressful situation.

Suppression of thinking is scientifically called “bradypsychia”. Not apathy or inertia of thinking. These are completely different conditions that have different pathophysiological and mental foundations. Bradypsychia is a symptom that appears more often in old age. In any case, most people associate slow thinking with leisurely and eloquent elders. However, it can also occur at a young age. Indeed, under each manifestation of ill health there are certain reasons hidden.

Causes of slow thinking

Vascular pathologies. Acute, and more often chronic disorders of cerebral circulation, resulting from the progression of atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head, are the cause of destruction of the brain substance. In particular, the structures responsible for the speed of thinking also suffer.
Parkinsonism and Parkinson's disease. Narrower, but no less common pathologies, one of the manifestations of which is slowness of thinking. In addition to this depressing symptom for people around the patient (patients themselves in the later stages of development of this type of pathology do not notice any changes in themselves), there are many others that are no less unpleasant. For example, thoughts become not only slow, but also viscous, a person becomes clingy, annoying, speech is slow, often confused.

Epilepsy. In the later stages of the disease, when doctors note the destruction of the personality as a result of the progression of the disease, lethargy occurs, as do many other signs of a change in thinking.
Schizophrenia. Just as with epilepsy, with schizophrenia, bradypsychia is not an early sign of pathology.
Depressive states and depression. A mental illness characterized by an abundance of symptoms, often disguised as somatic problems - even toothache or coronary heart disease. Among them there is also lethargy of thoughts.
Hypothyroidism. Insufficiency of the thyroid glands. With this disease, the described symptom is extremely characteristic and is one of the first to appear.
Toxic bradypsychia. Of course, there is no such group of diseases in the international classification of diseases. But the name still describes as clearly as possible the reasons for the appearance of the symptom - intoxication of the body, be it alcohol, metal salts, drugs or microbial toxins.

Symptoms of lethargy

Diagnosis of bradyllalia

Diagnosis of oral speech in bradyllalia includes assessment of the structure of the organs of articulation and the state of speech motor skills, expressive speech (sound pronunciation, syllabic structure of the word, tempo-rhythmic aspect of speech, voice characteristics, etc.). Diagnostics of written speech involves completing tasks for copying text and independent writing from dictation, reading syllables, phrases, and texts. Along with a diagnostic examination of speech, for bradyllalia, the state of general, manual and facial motor skills, sensory functions, and intellectual development is studied.

When making a speech therapy report, it is important to differentiate bradylalia from dysarthria and stuttering.

Treatment of slow thinking

Nootropics and neuroprotectors. A more specific treatment that helps nerve cells recover.

Forecast and prevention of bradyllalia

To prevent bradyllia, it is important to prevent perinatal lesions of the central nervous system, head injuries, neuroinfections, and asthenic syndrome. It is necessary to take care of the child’s normal speech development and surround him with the right role models.

Features of bradypsychia

Pathological inhibition of thinking is called bradypsychia. This phenomenon has no parallels with apathy or inertia of thinking, but suggests mental and pathophysiological disorders.

Bradypsychia is considered as a kind of neurological symptomatology, which in most cases develops in people in old age. But sometimes people at a young age, as well as children, experience inhibition in their thinking processes.

Poverty and insufficiency of mental processes is a symptom of many psychological or physiological pathological processes, manifested as a decrease in reaction speed, slow speech, slow thinking and motor activity. IN difficult situations the individual is unable to react to what is happening and remains for a long time in an apathetic state or stupor. The following types of inhibition are distinguished:

complex;
ideatorial;
motor.

Retardation also occurs in speech and thought, which has psychological factors. Weak and involuntary movements can cause motor retardation. Memory problems and failures appear. In many cases, such conditions are provoked by a neurological disease, constant fatigue, or psychological pathological processes.

Slowness of movements and emotional inhibition is a pathological process, the causes of which only specialists can detect. They also recommend proper therapy.

Associated disorders

Bradypsychia is the result of damage to the central nervous system, responsible for brain activity. Depending on the element, the lesions develop different types disorders. These include:

bradybasia - slow walking;
bradythymia - slowing down the change of emotions;
bradykinesia - slow pace and limited range of movements;
bradypraxia - slow direction of action;
Bradylexia – slow reading;
bradyphasia, bradyllalia is a slowdown in speech, at the same time it is almost always correct, observed both in adulthood and in childhood (bradylalia is often observed in patients recovering);
Impaired articulation may also develop, and during a long conversation the person may become tired.

When bradypsychia is a consequence of Parkinson's disease, it is necessary to focus on the symptoms of the underlying pathological process. These include feelings of fatigue, anxiety, sleep disorders, etc.

Provoking factors and diseases

The pathophysiology is very complex and not fully understood. It is only known that thinking, behavior, emotional component and other functions of the human brain are associated with the activity of the limbic system. In everyday practice, only conditions are identified - diseases, during which bradypsychia and accompanying deviations are observed:

The short-term effect of lethargy appears after lack of sleep, due to exhaustion of the body, or as a result of the use of drugs and alcohol that inhibit thinking and movement. The reasons can be divided into those that block brain activity and those that reduce the possibilities for its implementation.

Naturally, with such an abundance of provoking diseases, treatment can also be different.

What does it look like?

The image of a “inhibited” patient falls under the typical characteristics of a melancholic person: weakness, slowness, drawn-out speech, every word is pronounced with effort.

There may be a feeling that the thought process takes a large amount of strength and energy from a person who does not have time to react to information or is completely plunged into a stupor.

In addition to a decrease in the speed of speech and thought processes, muffled words are observed - a very quiet and calm voice, sometimes breaking the silence. Weakness is visible in movement and facial expressions; posture is often too relaxed.

A person has a desire to constantly find support or lie down.

Not all symptoms are always observed. Just one thing is enough to recommend a person to apply for medical care to specialists.

Diagnostic criteria and methods

People with speech rate disorders, including bradyllalia, need comprehensive medical, psychological and pedagogical diagnostics carried out by a specialized specialist. During the examination, the patient’s medical history should be studied in detail, which concerns previous illnesses and brain lesions, as well as the presence of disturbances in the rate of speech in relatives.

In certain situations, in order to find out the organic basis of the disease, it is necessary to conduct instrumental studies, including:

The study of oral speech involves assessing the structure of the organs of articulation and the state of motor skills, expressive speech (pronunciation of sounds, syllables, words, tempo-rhythmic side, voice characteristics, etc.). Diagnostics of written speech involves performing tasks such as copying text, writing from dictation, and reading. In addition to a diagnostic examination of speech function, a study of general condition, manual motor skills, sensory functions, and intelligence is carried out.

When making a diagnosis, it is necessary to differentiate this disease from dysarthria and stuttering.

What does modern medicine offer?

To carry out proper treatment of the disease, you must first consult with a specialist. He will recommend effective treatment, and will also warn about the presence of contraindications to the use of certain therapy methods or any medication.

The following methods of therapeutic and preventive action are used more often than others:

If emotional and mental retardation is caused by tranquilizers, then discontinuation of any drugs is required. In most cases, reactions recover over time.

Summing up

The prognosis is relatively favorable with an early start of correction and the presence of psychological causes of disorders of motor activity and speech motor skills. However, after regaining your skills, you should be observed by doctors for a long time and constantly independently monitor your movements and train of thoughts.

As preventive measures Damage to the central nervous system should be prevented, head injuries should be avoided, and asthenic syndrome should be detected in time.

Pathological inhibition of thinking involves various mental and pathophysiological disorders. This phenomenon should be qualified as a symptom that in most situations occurs in older people. But in certain cases, such a problem can manifest itself in childhood and among young people.

If you notice that your thinking processes are slow, you should immediately seek advice from a doctor. It is likely that this condition is the result of dangerous disruptions in the functioning of the central nervous system and requires special correction.

What is retardation?

In serious cases, a person completely stops reacting to the surrounding atmosphere and remains in apathy or stupor for a long time. There are several types of inhibition:

comprehensive;
ideational (thinking);
motor (motor).

Retardation can be verbal and mental, that is, it has psychological causes. Sluggish and untimely motor reactions are caused by motor retardation. Problems with memorization and memory lapses may occur. In most cases, such conditions are caused either by illness, chronic fatigue, or psychological pathologies.

Motor and emotional inhibition is a pathology, the causes of which only doctors can identify. They also prescribe adequate treatment.

Causes and symptoms of slow thinking

Human behavior, thinking, his psychological condition may be disrupted by pathologies of the nervous system and brain. Ideation inhibition is also caused by:

All of these diseases, the symptom of which is inhibition of thinking, must be diagnosed and treated. Temporary inhibition of movements and thinking appears after severe stress, fatigue, and prolonged lack of sleep.

Suppression of motor and mental processes typically manifests itself after drinking alcohol, even once. The same symptoms are sometimes caused by psychotropic drugs, as well as strong sedatives. When they are cancelled, the inhibition goes away.

Causes and symptoms of motor retardation

Motor, as well as mental retardation, manifests itself as a result psychological disorders, as well as all kinds of diseases. Lethargy is sometimes or always felt in the patient's facial expressions and movements. The posture is usually relaxed; there is often a desire to sit down, lie down in bed, or lean on something.

Severe motor retardation appears as a result of a stroke or cardiac pathology, when urgent hospitalization is necessary. People with mental disorders, parkinsonism, epilepsy, and chronic depression suffer from constant motor retardation. Such pathologies also require identification and therapeutic correction.

Lethargy in a child

This symptom is also typical for children. It can be chronic in some neurovegetative disorders, for example, cerebral palsy, or appear spontaneously at high temperatures, after severe stress or impression. Lethargy in children often results from:

vascular pathologies of the brain;
endocrine pathologies;
meningitis;
psychological disorders;
epilepsy;
encephalitis;
severe stressful situations.

Diagnosis of lethargy

In case of psychological disorders, as well as physiological pathologies caused by inhibition of mental, motor or speech reactions, a thorough diagnosis is necessary, that is, a medical and psychological examination.

Such patients are examined by speech therapists, neurologists, psychiatrists, psychotherapists and other specialists. It is necessary to accurately determine whether there are brain disorders, whether the person has had head injuries, hereditary diseases. To determine the organic nature of the disease, the following is prescribed:

PET and MRI of the brain;
blood tests.

Diagnosis of written and oral speech is also carried out. Perhaps the person suffers from stuttering, defects in sound pronunciation, which lead to speech inhibition. The patient’s intellectual development, the state of sensory functions, general motor skills, and the condition of joints and muscles are also studied.

Treatment of lethargy

Activation of thought processes. To do this, they read new books, master languages, engage in creativity or solve mathematical problems. Such actions train the brain and activate mental activity.
Neuroprotectors and nootropics. Drug treatment aimed at restoring and strengthening nerve cells and tissues.
Vascular therapy. The drugs help cleanse the walls of blood vessels, this is especially important for the brain. As a result, motor activity is activated, and mental retardation gradually recedes.
Psychotherapy. It complements drug treatment. Modern methods of psychotherapy help to cope with the consequences of stressful situations, correct personal assessment, and form the correct models of response to certain moments.
Sports and fresh air. Moderate physical activity and walks outside help the brain rest and nerve cells recover due to the additional flow of oxygen.

If the lethargy is temporary and caused by high fever, then you should take tablets or syrups that reduce the temperature. Temporary inhibition caused by medications and strong sedatives can be stopped by abandoning such drugs. Usually it passes without a trace, the body’s reactions are completely restored.

Inhibition of emotions and movements (video)

What is inhibition of emotions and movements? How to correctly identify and treat pathology, we will learn the doctor’s recommendations from the video.

Prevention of lethargy

The pathology usually goes away without a trace if treatment is started early stages when the underlying disease is identified. After competent psychological assistance and correct medication support, a person’s reactions improve, both emotional and physical.

Constant self-monitoring and visits to specialists are also necessary, especially if there have been head injuries, chronic vascular lesions of the brain or psychological disorders that have gone into remission. With proper treatment of lethargy, the prognosis is favorable. 0 comments

Suppression of thinking is scientifically called “bradypsychia”. Not apathy or inertia of thinking. These are completely different conditions that have different pathophysiological and mental foundations. Bradypsychia is a symptom that appears more often in old age. In any case, most people associate slow thinking with leisurely and eloquent elders. However, it can also occur at a young age. Indeed, under each manifestation of ill health there are certain reasons hidden.

Causes of slow thinking

Vascular pathologies. Acute, and more often chronic disorders of cerebral circulation, resulting from the progression of atherosclerosis, hypertension, embolism and thrombosis of the vessels of the head, are the cause of destruction of the brain substance. In particular, the structures responsible for the speed of thinking also suffer.
Parkinsonism and Parkinson's disease. Narrower, but no less common pathologies, one of the manifestations of which is slowness of thinking. In addition to this depressing symptom for people around the patient (patients themselves in the later stages of development of this type of pathology do not notice any changes in themselves), there are many others that are no less unpleasant. For example, thoughts become not only slow, but also viscous, a person becomes clingy, annoying, speech is slow, often confused.
Epilepsy. In the later stages of the disease, when doctors note the destruction of the personality as a result of the progression of the disease, lethargy occurs, as do many other signs of a change in thinking.
Schizophrenia. Just as with epilepsy, with schizophrenia, bradypsychia is not an early sign of pathology.
Depressive states and depression. A mental illness characterized by an abundance of symptoms, often disguised as somatic problems - even toothache or coronary heart disease. Among them there is also lethargy of thoughts.
Hypothyroidism. Insufficiency of the thyroid glands. With this disease, the described symptom is extremely characteristic and is one of the first to appear.
Toxic bradypsychia. Of course, there is no such group of diseases in the international classification of diseases. But the name still describes as clearly as possible the reasons for the appearance of the symptom - intoxication of the body, be it alcohol, metal salts, drugs or microbial toxins.

Symptoms of lethargy

Diagnosis of bradyllalia

Persons with speech tempo disorders, including bradyllalia, need a comprehensive medical and psychological-pedagogical examination, which is carried out by a neurologist, speech therapist, psychologist, psychiatrist. When examining a patient with bradyllalia, a detailed examination of the medical history regarding previous diseases and brain injuries is necessary; presence of speech tempo disorders in close relatives. In some cases, to clarify the organic basis of bradyllalia, instrumental studies are required: EEG, REG, MRI of the brain, PET of the brain, lumbar puncture, etc.

When making a speech therapy report, it is important to differentiate bradylalia from dysarthria and stuttering.

Treatment of slow thinking

Nootropics and neuroprotectors. A more specific treatment that helps nerve cells recover.

Forecast and prevention of bradyllalia

To prevent bradyllia, it is important to prevent perinatal lesions of the central nervous system, head injuries, neuroinfections, and asthenic syndrome. It is necessary to take care of the child’s normal speech development and surround him with the right role models.

It should be said that in most situations these disruptions are temporary and can be explained by natural factors: fatigue or nervous exhaustion. However, there are cases when awkwardness of movements, inhibition of thinking and mental sphere- a pathological process, the causes of which must be promptly identified and appropriate therapy selected.

Features of bradypsychia

Pathological inhibition of thinking is called bradypsychia. This phenomenon has no parallels with apathy or inertia of thinking, but suggests mental and pathophysiological disorders.

Poverty and insufficiency of mental processes is a symptom of many psychological or physiological pathological processes, manifested as a decrease in reaction speed, slow speech, slow thinking and motor activity. In difficult situations, the individual is not able to react to what is happening and remains for a long time in an apathetic state or stupor. The following types of inhibition are distinguished:

Thought processing can be impaired at any age

Slowness of movements and emotional inhibition is a pathological process, the causes of which only specialists can detect. They also recommend proper therapy.

Associated disorders

Bradypsychia is the result of damage to the central nervous system, which is responsible for brain activity. Depending on the element of the lesion, different types of disorders develop. These include:

bradybasia - slow walking;

Bradykinesia is characteristic of parkinsonism

Provoking factors and diseases

Vascular diseases of the brain. Acute, often chronic disorders of blood flow in the brain, which arise due to progressive atherosclerosis, hypertension, embolism and vascular thrombosis, are a factor in the destruction of substances in the brain. The structures that are responsible for quick thinking are also susceptible to disruption.
Parkinson's disease. A common cause, the characteristic manifestation of which is slow thinking. In addition to such depressing symptoms (patients at a late stage of development of this pathological process do not tend to notice any changes), there are a large number of other unpleasant manifestations. For example, thoughts will become not only slow, but also viscous; the patient will be characterized by importunity and slow, confused speech.
Epilepsy. At a late stage in the development of the disease, when experts observe the destruction of personality as a result of a progressive disease, inhibition may be noted, as well as other symptoms of altered thinking.
Schizophrenia. As with epilepsy in schizophrenia, bradypsychia is not considered an initial symptom of pathological processes, but develops gradually over time.
Depression. A mental illness that is characterized by a large number of symptoms, often disguised as somatic difficulties - including toothache or ischemia. These also include sluggish thinking.
Hypothyroidism. Improper functioning of the thyroid gland. With this disease, the symptoms are extremely pronounced and are one of the first to occur.
Toxic lesions. Such a subgroup of diseases does not exist in the international classification. However, the term best describes the causes of painful symptoms - intoxication of the body.

Naturally, with such an abundance of provoking diseases, treatment can also be different.

What does it look like?

The image of a “inhibited” patient falls under the typical characteristics of a melancholic person: weakness, slowness, drawn-out speech, every word is pronounced with effort.

There may be a feeling that the thought process takes a large amount of strength and energy from a person who does not have time to react to information or is completely plunged into a stupor.

A person has a desire to constantly find support or lie down.

Not all symptoms are always observed. Just one thing is enough to recommend a person to seek medical help from specialists.

Diagnostic criteria and methods

In certain situations, in order to find out the organic basis of the disease, it is necessary to conduct instrumental studies, including:

When making a diagnosis, it is necessary to differentiate this disease from dysarthria and stuttering.

What does modern medicine offer?

The following methods of therapeutic and preventive action are used more often than others:

Activation of thinking processes. For these purposes, you need to read new books, study foreign languages, engage in the creative process, or solve various puzzles. This technique helps train the brain and activate thinking.
Neuroprotectors and nootropics are prescribed. Drug therapy that is aimed at restoring and strengthening nerve cells and tissues.
Treatment of vascular pathologies. Products are used that make it possible to cleanse the vascular walls, which is necessary for proper brain function. As a result, mental and physical activity is activated.
Psychotherapy. She acts as an auxiliary drug therapy. Modern healing techniques contribute to counteracting the effects of stress, adjusting personality assessment, and forming the necessary models of response to specific situations.
Sports activities and walks in the fresh air. Moderate physical stress and walks give the brain the opportunity to rest and the nerve cells to recover thanks to the influx of oxygen.

If emotional and mental retardation is caused by tranquilizers, then discontinuation of any drugs is required. In most cases, reactions recover over time.

Summing up

As preventive measures, damage to the central nervous system should be prevented, head injuries should be avoided, and asthenic syndrome should be detected in time.

Pathological inhibition of thinking involves various mental and pathophysiological disorders. This phenomenon should be qualified as a symptom that in most situations occurs in older people. But in certain cases, a similar problem can manifest itself in childhood and young people.

This section was created to take care of those who need qualified specialist without disturbing the usual rhythm of your own life.

Lethargy

Lethargy is a symptom of certain diseases, usually of the central nervous system and brain, or a consequence of severe psycho-emotional shock. This state of a person is characterized by the fact that he has a decrease in the speed of reaction to actions addressed to him or performed by himself, a deterioration in concentration, more extended, with long pauses in speech. In more difficult cases There may be a complete lack of reaction to surrounding events.

This human condition should not be confused with apathy or a chronic depressive state, since the latter is more a psychological factor than a physiological one.

The true causes of lethargy can only be determined by a qualified doctor. It is strongly not recommended to carry out treatment at your own discretion or ignore such a symptom, as this can lead to serious complications, including irreversible pathological processes.

Etiology

Retardation of movements and thinking in a person can be observed in the following pathological processes:

In addition, a temporary state of slowness of reaction, movement and speech can be observed in the following cases:

under alcohol or drug intoxication;
with chronic fatigue and constant lack of sleep;
with frequent nervous overstrain, stress, chronic depression;
under circumstances that cause a person to feel fear, anxiety and panic;
with severe emotional shock.

Psychomotor retardation in a child may be due to the following etiological factors:

Depending on the underlying factor, this condition in a child can be temporary or chronic. It goes without saying that if such a symptom appears in children, you should immediately consult a doctor, since the cause of the pathology can be dangerous to the baby’s health.

Classification

Distinguish the following types lethargy according to the clinical picture:

bradypsychia – inhibition of thinking;
mental or ideational inhibition;
motor or movement retardation;
emotional inhibition.

Establishing the nature of this pathological process lies within the competence of only a qualified physician.

Symptoms

The nature of the clinical picture, in this case, will entirely depend on the underlying factor.

When the brain and central nervous system are affected, the following may be present: clinical picture:

drowsiness (hypersomnia), lethargy;
headaches, which will intensify as the pathological process worsens. In more complex cases, pain relief is impossible even with painkillers;
memory impairment;
decreased quality of cognitive abilities;
the patient cannot concentrate on performing usual actions. What is noteworthy is that it is the professional skills that are retained;
sudden mood swings, traits appear in the patient’s behavior that were not previously characteristic of him, most often attacks of aggression are observed;
illogical perception of speech or actions addressed to him;
speech becomes slow, the patient may have difficulty finding words;
nausea and vomiting, which is most often observed in the morning;
impaired coordination of movements;
unstable blood pressure;
rapid pulse;
dizziness.

In a child, the general clinical picture with this kind of pathology may be complemented by moodiness, constant crying or, on the contrary, constant drowsiness and apathy for usual favorite activities.

It should be noted that the above-described symptoms are also observed after a stroke. If you suspect that a person is having a seizure, you should call emergency medical attention and rush them to hospital. It is the urgency and coherence of primary medical measures after a stroke that largely determine whether a person will survive or not.

If the cause of a delayed reaction in an adult is a mental disorder, the following symptoms may be present:

insomnia or drowsiness, which is replaced by an apathetic state;
unreasonable attacks of aggression;
sudden change in mood;
causeless attacks of fear, panic;
suicidal mood, in some cases, actions in this direction;
state of chronic depression;
visual or auditory hallucinations;
nonsense, illogical judgments;
neglect of personal hygiene, sloppy appearance. At the same time, a person can be firmly confident that everything is fine with him;
excessive suspicion, the feeling that he is being watched;
deterioration or complete loss of memory;
incoherent speech, inability to express one’s point of view or specifically answer simple questions;
loss of temporal and spatial orientation;
feeling of constant fatigue.

You need to understand that this human condition can progress quickly. Even if the patient’s condition improves temporarily, it cannot be said that the disease has been completely eliminated. In addition, such a person’s condition is extremely dangerous both for him and for the people around him. Therefore, treatment under the guidance of a specialized doctor and in an appropriate institution is, in some cases, mandatory.

Diagnostics

First of all, a physical examination of the patient is carried out. In most cases, this should be done with a person close to the patient, since due to his condition he is unlikely to be able to answer the doctor’s questions correctly.

In this case, you may need to consult the following specialists:

Diagnostic measures include:

general clinical laboratory tests (blood and urine tests);
study of the level of pituitary hormones;
CT and MRI of the brain;
EEG and Echo-EG;
cerebral angiography;
psychiatric tests.

Depending on the diagnosis, the issue of hospitalization of the patient and further treatment tactics will be decided.

Treatment

In this case, the treatment program can be based on both conservative and radical methods treatment.

If the cause of such a person’s condition is a tumor of the brain or central nervous system, then an operation is performed to excise it, followed by drug treatment and rehabilitation. The patient will also need rehabilitation after a stroke.

Drug therapy may include the following drugs:

painkillers;
sedatives;
antibiotics if the disease is of an infectious nature;
nootropic;
antidepressants;
tranquilizers;
drugs that restore glucose levels;
vitamin and mineral complex, which is selected individually.

In addition, after completing the main course of treatment, the patient may be recommended to undergo a rehabilitation course in a specialized sanatorium.

Provided that therapeutic measures are started in a timely and correct manner and are fully implemented, almost complete recovery is possible even after serious illnesses - oncology, stroke, psychiatric illnesses.

Prevention

Unfortunately, there are no specific prevention methods. You should follow a rest and work schedule, protect yourself from nervous experiences and stress, and begin treatment for all diseases in a timely manner.

“Retardation” is observed in diseases:

Alalia is a speech function disorder in which the child cannot partially (with poor vocabulary and problems in constructing phrases) or speaking completely. But the disease is characterized by the fact that mental abilities are not impaired, the child understands and hears everything perfectly. The main causes of the disease are considered to be complicated childbirth, diseases or brain injuries received at an early age. The disease can be cured with long-term visits to a speech therapist and by taking medications.

Apathy is a mental disorder in which a person does not show interest in work, any activities, does not want to do anything and, in general, is indifferent to life. This condition very often comes into a person’s life unnoticed, since it does not manifest itself as painful symptoms - a person may simply not notice deviations in mood, since the causes of apathy can be absolutely any life process, and most often a combination of them.

Status asthmaticus is a prolonged attack of bronchial asthma, the progression of which causes severe respiratory failure. This pathological condition develops as a result of swelling of the bronchial mucosa, as well as spasms of their muscles. In this case, it is not possible to relieve an attack by taking an increased dose of bronchodilators, which, as a rule, are already taken by a patient with asthma. Status asthmaticus is a very dangerous condition that can lead to the death of the patient, so it requires emergency medical care.

Affective disorders (syn. mood swings) - not separate disease, but a group of pathological conditions that are associated with a violation of internal experiences and external expression of a person’s mood. Such changes can lead to maladjustment.

Bacterial endocarditis is an inflammatory process in the inner lining of the heart caused by the influence of pathological microorganisms, the main one of which is streptococcus. Often, endocarditis is a secondary manifestation that develops against the background of other diseases, but it is bacterial damage to the membrane that is an independent disorder. It affects people of any age group, which is why endocarditis is often diagnosed in children. Distinctive feature is that men suffer from this disease several times more often than women.

All over the world, many people suffer from a disorder called bipolar disorder. Characterized by the disease frequent changes mood, and a person’s mood changes not from bad to good, but from extremely depressive and sad, to a feeling of euphoria and the ability to perform feats. In a word, mood swings in patients with bipolar disorder are enormous, which is always noticeable to others, especially if such fluctuations are frequent.

Legionnaires' disease or legionellosis is a bacterial infection that most often manifests itself as severe form pneumonia. A characteristic expression of the disease is intoxication and dysfunction of the central nervous system and kidneys. Sometimes, during illness, damage to the respiratory and urinary systems occurs.

Acute intestinal infection caused by a bacterial environment and characterized by the duration of fever and general intoxication of the body is called typhoid fever. This disease is a severe ailment, as a result of which the main area of damage is the gastrointestinal tract, and when it worsens, the spleen, liver and blood vessels are affected.

Hypernatremia is a disease characterized by an increase in serum sodium levels to 145 mmol/L or higher. In addition, a reduced fluid content in the body is detected. The pathology has a fairly high mortality rate.

Hypersomnia is a sleep disorder characterized by increased rest periods and daytime sleepiness. In this case, the duration of sleep is more than ten hours. It rarely occurs as an independent disorder - it is often a complication of certain diseases. After a long sleep, there is no improvement in the general condition, but there is constant drowsiness and problems waking up.

Hypertensive crisis is a syndrome in which there is a significant increase in blood pressure. In this case, symptoms of damage to the main organs develop - the heart, lungs, brain, etc. This condition is very serious and requires emergency care, as otherwise serious complications may develop.

Mental disorders, characterized primarily by decreased mood, motor retardation and disruption of thinking, are a serious and dangerous disease called depression. Many people believe that depression is not a disease and, moreover, does not pose any particular danger, which they are deeply mistaken about. Depression is quite dangerous look diseases caused by human passivity and depression.

Diabetic coma is an extremely dangerous condition that develops against the background of diabetes mellitus. If it progresses, metabolic processes in the human body are disrupted. This condition threatens not only the health, but also the life of the patient.

Cardiogenic shock is a pathological process when the contractile function of the left ventricle fails, the blood supply to tissues and internal organs deteriorates, which often ends in human death.

Ketoacidosis is a dangerous complication of diabetes mellitus, which without adequate and timely treatment can lead to diabetic coma or even death. The condition begins to progress when the human body cannot fully use glucose as an energy source because it lacks the hormone insulin. In this case, the compensatory mechanism is activated, and the body begins to use incoming fats as an energy source.

Tick-borne encephalitis is a severe infectious disease that is transmitted to humans from encephalitis ticks. The virus makes its way into the brain and spinal cord of an adult or child, causing severe intoxication and affecting the central nervous system. Severe encephalitic forms without timely treatment can lead to paralysis, mental disorders and even death. How to recognize the symptoms of a dangerous pathology, what to do if you suspect a tick-borne infection, and what is the importance of vaccination in the prevention and treatment of a deadly disease?

False croup is a pathology of an infectious-allergic nature, causing the development of laryngeal edema with subsequent stenosis. Narrowing of the lumen respiratory tract, including the larynx, leads to insufficient air supply to the lungs and poses a threat to the patient’s life, so help for this condition should be provided immediately - within minutes after the attack.

Waldenström's macroglobulinemia (syn. primary macroglobulinemia, macroglobulinemic reticulosis) is extremely rare disease, in which a tumor consisting of lymphocytic and plasmacytic cells forms in the bone marrow.

Metabolic acidosis is a pathological condition characterized by an imbalance in the acid-base balance in the blood. The disease develops against the background of poor oxidation of organic acids or their insufficient removal from the human body.

Myxedema is the most severe form of hypothyroidism, which is characterized by the development of skin edema and subcutaneous tissue. The pathology begins to progress in the human body as a result of insufficient secretion of thyroid hormones. Women are most often susceptible to this disease during the period of change hormonal levels, that is, during menopause.

Cerebral edema is a dangerous condition characterized by excessive accumulation of exudate in the tissues of the organ. As a result, its volume gradually increases and intracranial pressure increases. All this leads to disruption of blood circulation in the organ and to the death of its cells.

Quincke's edema is usually defined as an allergic condition, expressed in its rather acute manifestations. It is characterized by the occurrence of severe swelling of the skin and mucous membranes. Somewhat less frequently, this condition manifests itself in joints, internal organs and meninges. As a rule, Quincke's edema, the symptoms of which can appear in almost any person, occurs in patients suffering from allergies.

A disease that is characterized by the formation of pulmonary insufficiency, presented in the form of a massive release of transudate from the capillaries into the pulmonary cavity and ultimately promoting infiltration of the alveoli, is called pulmonary edema. In simple terms, pulmonary edema is a situation where fluid stagnates in the lungs and has leaked through the blood vessels. The disease is characterized as an independent symptom and can develop on the basis of other serious ailments of the body.

Pancreatic necrosis of the pancreas is a dangerous and severe pathology in which the organ itself begins to actively digest its own cells. This, in turn, leads to certain areas of the gland becoming necrotic. This pathological process can provoke the progression of a purulent abscess. Pancreatic necrosis also negatively affects the functioning of other vital organs. If timely and complete treatment is not carried out, this disease often leads to the death of the patient.

Overwork is a condition that not only adults, but also children often face today. It is characterized by decreased activity, drowsiness, impaired attention and irritability. Moreover, many people believe that overwork is not a serious problem, and that it is enough to get a good night’s sleep for it to go away. In fact, it is impossible to get rid of such a violation long sleep. It's the other way around - a constant desire to sleep and the inability to regain strength after sleep are the main symptoms of overwork.

Hepatic encephalopathy is a disease characterized by a pathological process that occurs in the liver and affects the central nervous system. The result of this disease is neuropsychiatric disorders. This disease is characterized by personality changes, depression and intellectual impairment. You won’t be able to cope with hepatic encephalopathy on your own; you can’t do it without medical intervention.

Multiple organ failure is a severe pathological process that occurs as a result of severe injury, severe blood loss or any other condition. In this case, we are talking about disruption or complete cessation of the functioning of several systems of the human body at the same time. In 80% of cases, death occurs if the necessary medical measures are not taken in a timely manner to normalize the functioning of the organs. This high mortality rate is due to the fact that damage to systems or organs occurs at such a level that the ability to maintain the life of the body is lost.

A disease characterized by inflammation of the joints due to infectious diseases various organs and systems is called reactive arthritis. Often, inflammation of the joints occurs due to infection of the genital organs, urinary system, or even the gastrointestinal tract. After the body is infected with infections, the development of reactive arthritis may be observed in the second to fourth week.

Itsenko-Cushing syndrome is a pathological process, the formation of which is influenced by high performance levels of glucocorticoid hormones. The main one is cortisol. Therapy for the disease should be comprehensive and aimed at stopping the cause that contributes to the development of the disease.

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Through exercise and abstinence most of people can do without medicine.

Symptoms and treatment of human diseases

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Depression is a mental disorder characterized by a depressive triad, which includes decreased mood, disturbances in thinking (a pessimistic view of everything that is happening around, loss of the ability to feel joy, negative judgments), and motor retardation.

Depression is accompanied by decreased self-esteem, loss of taste for life, as well as interest in usual activities. In some cases, a person experiencing depression begins to abuse alcohol, as well as other available psychotropic substances.

Depression, being a mental disorder, manifests itself as pathological affect. The disease itself is perceived by people and patients as a manifestation of laziness and bad character, as well as selfishness and pessimism. It should be borne in mind that a depressive state is not only a bad mood, but often a psychosomatic illness that requires intervention from specialists. The sooner an accurate diagnosis is made and treatment is started, the more likely success in recovery is.

The symptoms of depression can be effectively treated, despite the fact that the disease is very common among people of all ages. According to statistics, 10% of people over 40 years of age suffer from depressive disorders, two thirds of them are women. People over 65 years old suffer from mental illness three times more often. Among adolescents and children, 5% suffer from depression, and adolescence accounts for 15 to 40% of the number of young people with a high incidence of suicide.

Depression history

It is a mistake to believe that the disease is common only in our time. Many famous doctors since antiquity have studied and described this disease. In his works, Hippocrates gave a description of melancholy that is very close to a depressive state. To treat the disease, he recommended opium tincture, cleansing enemas, long warm baths, massage, fun, drinking mineral waters from the springs of Crete, rich in bromine and lithium. Hippocrates also noted the influence of weather and seasonality on the occurrence of depressive conditions in many patients, as well as improvement in condition after sleepless nights. This method was subsequently called sleep deprivation.

Causes

There are many reasons that can lead to the disease. These include dramatic experiences associated with losses (of a loved one, social status, a certain status in society, work). In this case, reactive depression occurs, which occurs as a reaction to an event, a situation from external life.

The causes of depression can manifest themselves in stressful situations (nervous breakdown) caused by physiological or psychosocial factors. In this case, the social cause of the disease is associated with a high pace of life, high competition, increased levels of stress, uncertainty in the future, social instability, and difficult economic conditions. Modern society cultivates and therefore imposes a whole series of values that doom humanity to constant dissatisfaction yourself. This is a cult of physical as well as personal perfection, a cult of personal well-being and strength. Because of this, people have a hard time and begin to hide personal problems, as well as failures. If psychological as well as somatic causes of depression do not reveal themselves, then endogenous depression manifests itself.

The causes of depression are also associated with a lack of biogenic amines, which include serotonin, norepinephrine, and dopamine.

The reasons may be caused by sunless weather and darkened rooms. Thus, seasonal depression occurs, which occurs in autumn and winter.

The causes of depression can manifest themselves as a result of side effects of medications (benzodiazepines, corticosteroids). Often this condition disappears on its own after stopping the medication.

The depressive state caused by taking antipsychotics can last up to 1.5 years with a vital character. In some cases, the reasons lie in the abuse of sedatives and sleeping pills, cocaine, alcohol, and psychostimulants.

The causes of depression can be provoked by somatic diseases (Alzheimer's disease, influenza, traumatic brain injury, atherosclerosis of the cerebral arteries).

Signs

Researchers in all countries of the world note that depression in our time exists on a par with cardiovascular diseases and is a common illness. Millions of people suffer from this disease. All manifestations of depression are different and vary depending on the form of the disease.

Signs of depression are the most common. These are emotional, physiological, behavioral, mental.

Emotional signs of depression include sadness, distress, despair; depressed, depressed mood; anxiety, feelings of internal tension, irritability, anticipation of trouble, feelings of guilt, self-blame, dissatisfaction with oneself, decreased self-esteem and confidence, loss of the ability to worry, anxiety for loved ones.

Physiological signs include changes in appetite, decreased intimate needs and energy, sleep disturbances and intestinal functions - constipation, weakness, fatigue during physical and intellectual stress, pain in the body (in the heart, in the muscles, in the stomach).

Behavioral signs include refusal to engage in goal-directed activities, passivity, loss of interest in other people, frequent solitude, refusal of entertainment, and use of alcohol and psychotropic substances.

Mental signs of depression include difficulty concentrating, concentrating, making decisions, slowness of thinking, the prevalence of gloomy and negative thoughts, a pessimistic view of the future with a lack of prospects and thoughts about the meaninglessness of one’s existence, suicide attempts due to one’s uselessness, helplessness, insignificance .

Symptoms

All symptoms of depression, according to ICD-10, were divided into typical (main) and additional. Depression is diagnosed when two main symptoms are present and three additional symptoms are present.

Typical (main) symptoms of depression are:

Depressed mood, which does not depend on external circumstances, lasting two weeks or more;

Persistent fatigue for a month;

Anhedonia, which is characterized by loss of interest in previously enjoyable activities.

Additional symptoms of the disease:

Feelings of worthlessness, anxiety, guilt, or fear;

Inability to make decisions and concentrate;

Thoughts about death or suicide;

Decreased or increased appetite;

Sleep disorders, manifested in insomnia or oversleeping.

The diagnosis of depression is made when symptoms last for more than two weeks. However, the diagnosis is established even with more short period with severe symptoms.

As for childhood depression, according to statistics it is much less common than in adults.

Symptoms of childhood depression: loss of appetite, nightmares, problems with school performance, the appearance of aggressiveness, alienation.

There are unipolar depressions, which are characterized by preservation of mood within the reduced pole, as well as bipolar depressions, accompanied by bipolar affective disorder with manic or mixed affective episodes. Depressive states of minor severity can occur with cyclothymia.

The following forms of unipolar depression are distinguished: clinical depression or major depressive disorder; resistant depression; minor depression; atypical depression; postnatal (postpartum) depression; recurrent transient (autumn) depression; dysthymia.

You can often find in medical sources such an expression as vital depression, which means the vital nature of the disease with the presence of melancholy and anxiety, felt by the patient at the physical level. For example, melancholy is felt in the solar plexus area.

It is believed that vital depression develops cyclically and does not arise from external influences, but without cause and inexplicably for the patient himself. This course is typical for the disease bipolar or endogenous depression.

In a narrow sense, vital depression is called melancholy depression, in which melancholy and despair are manifested.

These types of diseases, despite their severity, are favorable because they can be successfully treated with antidepressants.

Vital depressions are also considered to be depressive states with cyclothymia with manifestations of pessimism, melancholy, despondency, depression, and dependence on the circadian rhythm.

The depressive state is initially accompanied by weak signals, manifested in problems with sleep, refusal to perform duties, and irritability. If symptoms intensify within two weeks, depression develops or relapses, but it fully manifests itself after two (or later) months. There are also one-time attacks. If left untreated, depression can lead to suicide attempts, refusal of many life functions, alienation, and family breakup.

Depression in neurology and neurosurgery

If the tumor is localized in the right hemisphere of the temporal lobe, melancholy depression with motor slowness and retardation is observed.

Melancholy depression can be combined with olfactory, as well as autonomic disorders and taste hallucinations. Patients are very critical of their condition and have a hard time experiencing their illness. Those suffering from this condition have reduced self-esteem, their voice is quiet, they are in a dejected state, the rate of speech is slow, patients quickly get tired, speak with pauses, complain of memory loss, but accurately reproduce events and dates.

Localization of the pathological process in the left temporal lobe is characterized by the following depressive states: anxiety, irritability, motor restlessness, tearfulness.

Symptoms of anxious depression are combined with aphasic disorders, as well as delusional hypochondriacal ideas with verbal auditory hallucinations. Sick people constantly change position, sit down, stand up, and get up again; They look around, sigh, and peer into the faces of their interlocutors. Patients talk about their fears of foreboding trouble, cannot relax voluntarily, and have poor sleep.

Depression in traumatic brain injury

When a traumatic brain injury occurs, melancholy depression occurs, which is characterized by slow speech, impaired speech rate, attention, and the appearance of asthenia.

When a moderate traumatic brain injury occurs, anxious depression occurs, which is characterized by motor restlessness, anxious statements, sighs, and tossing around.

With bruises of the frontal anterior parts of the brain, apathetic depression occurs, which is characterized by the presence of indifference with a tinge of sadness. Patients are characterized by passivity, monotony, loss of interest in others and in themselves. They look indifferent, lethargic, hypomimic, indifferent.

A concussion in the acute period is characterized by hypothymia (sustained decrease in mood). Often, 36% of patients in the acute period experience anxious subdepression, and asthenic subdepression in 11% of people.

Diagnostics

Early detection of cases of the disease is complicated by the fact that patients try to keep silent about the occurrence of symptoms, since most people are afraid of being prescribed antidepressants and their side effects. Some patients mistakenly believe that it is necessary to keep emotions under control, and not transfer them to the shoulders of the doctor. Some individuals fear that information about their condition will leak out at work, while others are terrified of being referred for consultation or treatment to a psychotherapist or psychiatrist.

Diagnosis of depression includes conducting questionnaire tests to identify symptoms: anxiety, anhedonia (loss of pleasure in life), suicidal tendencies.

Treatment

Scientific research has psychological factors, which help stop subdepressive states. To do this, you need to remove negative thinking, stop focusing on negative moments in life and start seeing good things in the future. It is important to change the tone of communication in the family to be friendly, without critical judgment and conflict. Maintain and establish warm, trusting contacts that will act as emotional support for you.

Not every patient needs to be hospitalized; treatment is also carried out effectively on an outpatient basis. The main directions of therapy in treatment are psychotherapy, pharmacotherapy, social therapy.

Cooperation and trust in the doctor are noted as a necessary condition for the effectiveness of treatment. It is important to strictly follow the prescribed treatment regimen, visit your doctor regularly, and give a detailed report of your condition.

The support of your immediate environment is important for a speedy recovery, but you should not plunge into a depressive state together with the patient. Explain to the patient that depression is only emotional condition, which will pass over time. Avoid criticism of patients, involve them in useful activities. With a protracted course, spontaneous recovery occurs very rarely and the percentage is up to 10% of all cases, while the return to a depressive state is very high.

Pharmacotherapy includes treatment with antidepressants, which are prescribed for their stimulating effect. In the treatment of melancholy, deep or apathetic depressive state, Imipramine, Clomipramine, Tsipramil, Paroxetine, Fluoxetine are prescribed. In the treatment of subpsychotic conditions, Pyrazidol and Desipramine are prescribed to relieve anxiety.

Anxious depression with moody irritability and constant restlessness is treated with sedative antidepressants. Severe anxious depression with suicidal intentions and thoughts is treated with Amitriptyline. Minor depression with anxiety is treated with Ludiomil, Azefen.

At poor tolerance antidepressants, as well as for high blood pressure, Coaxil is recommended. For mild to moderate depression, herbal preparations, such as Hypericin, are used. All antidepressants have a very complex chemical composition and therefore act differently. Taking them reduces the feeling of fear and prevents the loss of serotonin.

Antidepressants are prescribed directly by a doctor and are not recommended to be taken on your own. The effect of many antidepressants appears two weeks after administration; their dosage for the patient is determined individually.

After the cessation of symptoms of the disease, the drug must be taken for 4 to 6 months, and according to recommendations, for several years in order to avoid relapses, as well as withdrawal syndrome. Incorrect selection of antidepressants can provoke a worsening of the condition. A combination of two antidepressants may be effective in treatment, as well as a potentiation strategy, including the addition of another substance (Lithium, thyroid hormones, anticonvulsants, estrogens, Buspirone, Pindolol, folic acid etc.). Studies in the treatment of mood disorders with Lithium have shown that the number of suicides is reduced.

Psychotherapy in the treatment of depressive disorders has successfully proven itself in combination with psychotropic drugs. For patients with mild to moderate depression, psychotherapy is effective for psychosocial, as well as intrapersonal, interpersonal problems and related disorders.

Behavioral psychotherapy teaches patients to engage in enjoyable activities and eliminate unpleasant and painful ones. Cognitive psychotherapy is combined with behavioral techniques that identify cognitive distortions of a depressive nature, as well as thoughts that are overly pessimistic and painful, interfering with useful activity.

Interpersonal psychotherapy treats depression as a medical illness. Her goal is to teach patients social skills, as well as the ability to control mood. Researchers note same efficiency in interpersonal psychotherapy, as well as in cognitive versus pharmacotherapy.

Interpersonal therapy, as well as cognitive behavioral therapy, provide relapse prevention after acute period. After the use of cognitive therapy, those suffering from depression experience a relapse of the disorder much less frequently than after the use of antidepressants and are resistant to the decrease in tryptophan, which precedes serotonin. However, on the other hand, the effectiveness of psychoanalysis itself does not significantly exceed the effectiveness of drug treatment.

Treatment of depression is also carried out by acupuncture, music therapy, hypnotherapy, art therapy, meditation, aromatherapy, magnetotherapy. These helper methods must be combined with rational pharmacotherapy. An effective treatment for any type of depression is light therapy. It is used for seasonal depression. The duration of treatment is from half an hour to one hour, preferably in the morning. In addition to artificial lighting, it is possible to use natural sunlight at sunrise.

For severe, prolonged and resistant depressive states, it is used electroconvulsive therapy. Its purpose is to cause controlled seizures that occur by passing an electrical current through the brain for 2 seconds. Chemical changes in the brain release substances that improve mood. The procedure is carried out using anesthesia. In addition, to avoid injury, the patient receives medications that relax the muscles. The recommended number of sessions is 6-10. Negative aspects are temporary loss of memory, as well as orientation. Studies have shown that this method is 90% effective.

A non-drug treatment for depression and apathy is sleep deprivation. Complete sleep deprivation is characterized by spending time without sleep all night, as well as the next day.

Partial night sleep deprivation involves waking the patient between 1 and 2 am, and then staying awake for the rest of the day. However, it has been noted that after a single sleep deprivation procedure, relapses are observed after the establishment of normal sleep.

The late 1990s and early 2000s were marked by new approaches to therapy. These include transcranial magnetic stimulation vagus nerve, deep brain stimulation and magnetic convulsive therapy.

Causes, symptoms and treatment of endogenous depression

Endogenous depression is a mental disorder, the classic manifestations of which are low mood, motor inhibition and slow thinking.

This mental disorder is very difficult for patients to tolerate. The symptoms of the disease are so pronounced that they radically disrupt a person’s usual way of life.

Endogenous depression can be either an independent disease or one of the phases within manic-depressive psychosis.

Causes of affective disorder

Reduced adaptive capabilities of a person and dysregulation are transmitted hereditarily certain substances in the body, such as serotonin, norepinephrine, dopamine. With endogenous depression, there is a lack of these substances in the body.

The cause of endogenous depression is not only the pathology of certain genes. Even with the presence of such genes, a person living in favorable psycho-emotional conditions may not suffer from depression. The trigger for the development of the disease can be an external influence - a psychotraumatic situation, diseases of internal organs, taking certain medications, neurological pathologies.

But in the future, a depressive disorder, the development of which was triggered by an external factor, can worsen on its own. This is observed, for example, when autumn depressions, arising as a result of the change of seasons and accompanied by hormonal changes in the body.

Symptoms

The main symptoms of depression, as mentioned above, are low mood, slowed thinking and motor retardation. These symptoms are called Kraepelin's triad.

Depressed mood

Decreased mood (hypotymia) is the most characteristic feature this affective disorder.

A symptom close to hypothymia is an unbearable feeling of melancholy and mental pain, which for patients is equivalent to physical suffering. Sometimes people suffering from depression even show that sadness “sits” behind their sternum or in the head and neck area. At the same time, patients clearly distinguish the feeling of melancholy from the symptoms of diseases of internal organs, for example, the heart. Melancholy can also leave its mark on the perception of the world around us - everything around seems gray and unreal.

When describing the symptoms of endogenous depression, one cannot help but dwell on anhedonia - a decrease or complete loss of the ability to experience pleasure. Sometimes it is so pronounced that patients are bothered by a painful feeling of the absence of any desires or feelings.

Slowing down your thinking

Slowing down thinking is not a whim of the patient. The biochemical changes occurring in the body are reflected in such a way that a person begins to think and speak very slowly. Such patients are under no circumstances able to think or speak faster (be it a fire or something else).

In addition, patients are confident in their own worthlessness and guilt. Delusional ideas of self-blame may appear (a person thinks that if something doesn’t work out for his loved ones, then it’s all because of him), sinfulness (the patient considers himself a huge sinner), hypochondriacal (a patient with depression thinks that he is suffering from a fatal illness, for example , cancer).

Peculiar visions and ideas may arise in which a person commits some terrible actions, for example, accidentally stabbing a child or husband.

Motor retardation

With endogenous depression, patients perform all actions extremely slowly. Sometimes, against the background of motor retardation, agitation may occur, during which a person can injure himself or commit suicide.

Sleep disturbances may also occur - difficulty falling asleep, light sleep, early awakening, lack of feeling of recovery after sleep.

The signs of the endogenous process, compared to the symptoms of reactive depression, are more pronounced and lasting; they do not go away on their own and require drug treatment. If the patient does not receive the necessary help, the disease may become chronic, or the person may attempt suicide.

This disease is characterized by periodic relapses (exacerbations), which can occur independently, without any apparent external cause.

Treatment

The basis of treatment for endogenous depression is the use of medications. Endogenous depression is precisely the disorder for which special medications cannot be avoided, because the disorder is based on changes at the biochemical level.

Antidepressants are most often used. The choice of medication is based on the severity of the symptoms present. Best effect Modern antidepressants such as sertraline, fluvoxamine, cipramil, and fluoxetine also have minimal side effects.

While taking antidepressants, symptoms reverse. It must be taken into account that after 1-3 weeks from the start of treatment, motor retardation decreases, at the same time, decreased mood, delusional ideas of one’s own guilt and even suicidal thoughts may still persist. Therefore, this period is considered the most dangerous in terms of suicide attempts. It is necessary to carefully monitor the patient's behavior during this period. You may even need hospitalization.

Another group of drugs used both for treatment and as support is preventive therapy, especially within the framework of manic-depressive psychosis, are mood stabilizers. This group of drugs includes lamotrigine and finlepsin. Long-term use mood stabilizers help stabilize mood, prevent the development of depressive episodes, and even if they occur, they are not so severe. Mood stabilizers are also effective in preventing and treating symptoms of cyclothymia.

Psychotherapy is used only as an adjunct to drug treatment. Psychotherapy sessions help resolve existing problems and conflicts, but without antidepressants it is impossible to eliminate the metabolic disorder that occurs with endogenous depression.

Prevention and prognosis

With endogenous depression, the most important thing is to prevent the emergence of new depressive episodes. To do this, you need to take small doses of antidepressants and mood stabilizers, after consulting with a psychiatrist.

People suffering from this mental disorder need to avoid excessive stress on the psyche, work at night, do not abuse alcohol, and lead a healthy lifestyle.

The prognosis for endogenous depression is not very favorable compared to reactive depression. The cause of the disease lies inside the human body, so influencing the course of the disease is not so easy. However, the use of prophylactic doses of drugs can prevent the development of relapses of the disease, reduce their number, and reduce the severity of symptoms.

It seems to me that everything is happening to my father as described in this article. Although I read the articles on the active links - and again I find similar signs. Please help me figure it out! I am very worried about his condition! Especially that the cause is a genetic factor. Are there any laboratory tests that can identify this defective gene? Are there any studies that can reveal the level of serotonin, norepinephrine, dopamine?

I'm currently watching episode 4. The first was in the summer, when my father's mother had a stroke that paralyzed her. My parents went together to take care of my grandmother - and within 2 months THIS happened. I don’t remember how long it lasted, but until late autumn and the first snow - for sure. Somehow it went away on its own. Then we started renovations - in the apartment in which we lived (it was summer). We started off vigorously: everything was bombed, we literally lived in the hallway. And in the middle of the work THIS happened again. And it was necessary to somehow end this defeat, but my father sat in the middle of a concrete screed and could not find the strength to finish what he started. Relatives helped. We were terribly upset and angry. Mom poured cold water on my father, threatened him with divorce and broke plates - this briefly brought him out of his stupor. It ended on its own - and he even, hot on his heels, remade the work after his relatives - rearranged the laminate flooring, etc. It ended by autumn. The next episode - when I gave birth to my long-awaited daughter (mid-October) - I had 2 miscarriages and 3 years of visiting doctors - and here - such a long-awaited event! When we were taken from the maternity hospital, the grandfather sat motionless for 2 hours with his sleeping granddaughter on his lap, happy. When they were baptized - on the 40th day - my father stood dark-faced, thin, aloof - and I (in a series of sleepless nights before myself) - noticed that THIS was it again. It took place in February. Now my husband and I are on the verge of moving - we are finishing our own lengthy renovation. And for about a month now, my father sinks deeper and deeper into depression. Whether the renovation is our fault or the fall - but again THIS. My dad is the smartest, active, fair, he knows how to do everything with his hands and head. IN recent years 10 does repairs professionally. And now my repairs baffle him?? Now he can’t make a simple plasterboard box!

I bought a tonometer. We measured the pressure - noon 80-90. He exhaled in disappointment: the device is damaged - I feel that the pressure is higher. I go to the doctor - at least start with a therapist - but it doesn’t work. I bought without a doctor’s prescription, on the advice of experienced people, cardiomagnyl and some lowering pills in case sharp jump pressure - he put them aside. I see that he understands everything. But he pretends that he is not with us. During these periods, he avoids driving, freezes, wraps himself up, eats poorly (it seems to me that he is afraid to overeat us - in the previous period he always clarified: “does Marina have anything to eat?”), tries to drink less (and he really likes drink scalding hot tea) - half a mug here - and says that he sweats a lot from drinking. He can wash himself if you just remind him. Doesn't get a haircut. Shaves once every three days. At the same time, it “hangs” near the mirror. He fusses with his adored granddaughter, but not like a younger friend in kindergarten, as before, but all the time it seems to him that she will fall, get dirty, get sick, etc. like a warden, and swears all the time. It seems easier now than in previous periods. Mom takes him for evening walks every day. Makes sure he eats well. Insists on sexual contacts. And we are all already trained, we try to be affectionate and attentive with him (pouring cold water, of course, will not help the matter - he is not his own master). I’m very worried that he’s screwing himself up in his head, multiplying his stress, burning his nervous system - he’s already lost a lot of weight, he’s become haggard... As if he might fall ill with something even more serious. Mom is worried that if you go to a psychiatrist, they won’t treat you, and they won’t give you a driver’s license; they’ll register you, and what your friends will say if it gets leaked. What will they think about the children (and I also have a brother, he got married recently, the child is small, my wife’s family is not simple). I feel that even talking to a psychologist will not solve the problem. Waiting for spring, for the sun to shine, for him to get better, as in previous times, is an unbearably long time. And I want to help him somehow. He is a very smart person, with a higher education. He can do everything with his hands! Even sew on a machine! Loves to make something useful out of broken things. And now he’s standing in the middle of the apartment, as if he’s lost something. What to do?! Help me please!

urgent medical intervention is needed (a course of antidepressants), this is a violation of brain biochemistry, i.e. serotonin, norepinephrine and dopamine are not produced in the required quantities. You don’t cure a runny nose by talking, do you? So here too - moral support alone will not help here. This is precisely a disease (depression), it’s not scary because It is treated, and successfully and not for long. run to the pharmacy. If you cut your finger, you won’t try to persuade it to stop bleeding, will you? no, you will anoint it with something. in your situation you need medicine and everything will become normal again. I also had this condition, ANAFRANIL helped, and literally within a week (when medicinal substances accumulated in the body in sufficient quantities), after 3 weeks everything became much better, I took the course for 3 months (instead of six months), I highly recommend taking some kind of antidepressant, just read about contraindications and side effects on the Internet first to choose the right one. DRUG treatment is MANDATORY here; talking alone will not help

Lin, any antidepressant should only be taken if prescribed by a specialist. Under no circumstances should you self-medicate. The use of antidepressants can be complicated by many side effects. Therefore, you first need to assess the mental and somatic state of the patient, and only after that the drug is prescribed.

Marina, judging from your description, your father’s motor retardation, lack of motivation for any activity, lack of strength to carry it out come to the fore. Such symptoms can be observed with depression, including endogenous. In order to give your father a final diagnosis and prescribe treatment, in any case, it is impossible to do without an in-person examination.

I understand your reluctance to show your father to a psychiatrist, for fear of depriving him of his right to drive a car, but you must understand that in this condition your father cannot drive a car, he can be dangerous not only for himself, but also for pedestrians. Therefore, I strongly recommend that you do not wait until the disorder goes away on its own, but contact a psychiatrist.

I read the story and it gave me goosebumps... how many years your father suffered. I have the same thing. And now I’m also sick, but I hope for a speedy recovery.

It’s very scary when a person doesn’t realize what it is. This is real depression. And it needs to be treated, absolutely! Going to a psychiatrist is not at all a shame, and in general it’s not necessary for everyone to know about it. I wish you health.

Marina, it’s good that you’re worried about your father, I don’t want to scare you, but this is a very dangerous disease, I’ll emphasize this is a disease, if your dad doesn’t want to go to a specialist, then bring him home, maybe he says he doesn’t want to, but you can’t even imagine how difficult it is for the patient himself, as for people’s opinions, decide for yourself what is for you life is more important father or the opinions of neighbors from above... A friend of mine lost her son (26 years old, a handsome athlete - suicide) she was ashamed to send him for treatment for the reason “What will people say.” I will say from my own experience that this disease should not be underestimated... All the best!

Hello! Thanks everyone for your comments and advice. Almost six months have passed. Dad refuses to see a doctor because he doesn’t think he’s sick. Outwardly it has become better, but it still does not go away on its own, as it happened before. He goes to work, took his mother and daughter to the village, mowed the large yard, and dug in the garden. Yesterday I MYSELF (!) took out insurance and maintenance for the car.

I noticed myself that I needed to throw my clothes in the washing machine. I noticed myself that I needed to buy bread. I washed the dishes. I washed and shaved voluntarily. He notices that he eats, for example, something tasty if cooked and served. He lived unattended for two weekends - there was sour cream, gingerbread, untouched beer in the refrigerator - he did not cook for himself. Tea with a sandwich and that's it. All the sad talk. My son has an apartment of 120 meters: “Oh, it’s terrible, how much money is needed for repairs, how many things still need to be done,” we will move soon: “I don’t want you to move, how will it be in a new way,” we want to buy a car : “Why do you need it, where do you go on it, there are only traffic jams all around,” the daughter bought a bike: “an expensive double two scooter, she won’t ride it in the village, where can she ride there, I won’t have any luck,” “I have bald, see?”, “I wake up in the morning with weights on my arms and legs,” “second child? For what? to create poverty” (it’s just terrible, despite the fact that he and his mother had two children in their youth in really harsh conditions - a communal apartment, an engineer + a teacher, grandparents in another city... then perestroika, shortages... I watch a video of that period: pickles- jams, pies, fried potatoes, a house full of guests, dad dancing provocatively, playing around with the children... He always relied on his own strengths and was confident in himself, so he was positive. I return to this topic again, I am now the housewife at home, I have become see more clearly. Need help. Need a specialist. Do you think a Skype consultation, as a kind of compromise, can help? Anna, can you conduct such a consultation? I feel that you are a professional and a very sensitive person. The site is wonderful. Thank you!

Marina, thank you for your trust, but I am very busy at my main job, so I even respond to comments very late. It’s simply physically impossible to find time for Skype consultations. In addition, a Skype consultation will not completely solve the problem; if the question arises about drug treatment, write a prescription for necessary drug, so to speak, online, I simply physically cannot.

Therefore, I recommend that you seek advice from a neurologist or psychiatrist in your region. Of course, this requires a face-to-face visit from your father. As a last resort, if he flatly refuses to seek medical help, you can go to the doctor yourself, talk about the problem, and perhaps you can find some kind of compromise.

Is it necessary to take antidepressants for endogenous depression? Maybe it will go away on its own? Or just get by with some herbs and vitamins? I really don’t want to take serious pills, I’m afraid that they will make things even worse.

Zhenya, with endogenous depression, the cause of the disease lies in the genes, in the biochemical processes in the body that they trigger. And in order to normalize a person’s condition, it is necessary to take antidepressants.

Endogenous depression has some similarities with such endocrine diseases, like diabetes mellitus or hypothyroidism: the condition will not improve on its own, you need to take medications (hormones, antidepressants).

I have been suffering from endogenous depression for 12 years. For 3 of those years I didn’t understand anything about what was happening to me; I came out on my own, but it became unbearable and I decided to go to a psychiatrist, which I don’t regret. I was prescribed ANAFRANIL and I live a full life with it.

Julia, I'm happy for you.

I take beta blockers, but they don’t help with chronic insomnia, Yulia, and they don’t make anafranil anymore, they prescribed it to me too, but the cardiologist says it harms the heart….

Alexey, beta blockers themselves can lead to insomnia. If you have trouble sleeping, then you can try taking sedatives of herbal origin before bed, after consulting with your cardiologist. If there is no effect, I advise you to consult a psychiatrist.

Yes, well, in Russia we have the same treatment of the sick. They poured cold water on them and broke the plates. A man dies, and they yell at him. You yourself need to see a psychiatrist. And this is a philistine attitude. “I mowed the lawn and did some repairs.” That's all that can be said about loved one. No wonder he became depressed.

Misha, unfortunately, there are problems everywhere, not only in Russia. However, we need to talk about them, we need to look for ways to eliminate them in order to improve the lives of patients with mental disorders.

With endogenous depression it is impossible and sometimes even unrealistic to live. You simply exist and become dependent on someone or something and don’t feel the fullness of life. That’s why thoughts come that it’s better to die quickly, because the body is killing itself. It is very difficult to look at the problem from a different angle in such a state, it is very difficult, and the head remains far from reality. And there are also people who will help you not to care about your life, but you can’t look at it any other way, because you don’t have your own head, it’s inhibited and can’t find a way out. You just have to exist without integrity, sitting on antidepressants to maintain this existence

Irina, even with endogenous depression you can lead a normal life. The main thing is to choose good antidepressant(or even a combination). This does not always work out the first time, sometimes you need to change the drug 2, 3 or even more times, but the effect can be achieved! Do not be disappointed in the treatment, tell the doctor about your condition, be sure to tell them how you feel and whether there is any improvement.

Another important component is solving psychological problems and the ability not to focus on them. If you are constantly in a stressful situation and do not start looking for a way out of it (or do not change your view of it), then no antidepressants will help.

Hello. I'm 16 years old and I think I have ed. I tried to find ways to cope with this disease, but nothing helps. (It's been going on for three years or more) I think it's worth starting taking antidepressants, but for this you need to go to a psychiatrist. Questions:

Is it possible to make an appointment and see a psychiatrist on your own at 16? So that my mother doesn’t find out (because somehow by chance she saw cuts on my hand and said that she would tear my hands off if she saw this again, so I’m ashamed to tell her)

And will there be future problems with my career, etc., due to the fact that I will be registered with a psychiatrist?

Endogenous depression

Endogenous depression is a mental disorder, the classic signs of which are:

depressed, melancholy mood;
motor and mental retardation;
irrational anxiety;
slow speed of thinking;
depersonalization;
decreased appetite;
sleep disorders;
suicidal tendencies.

Persons suffering from this disorder characterize their condition as depressed with hopeless, oppressive melancholy. Although patients separate their feelings from natural sadness and sadness, they cannot explain what specific differences are endowed with the emotions they experience. The symptoms of this disease are pronounced and intense in severity; it has a strong painful effect on patients, forcing them to radically change their usual way of life.

In Russian-language medical literature, other names for endogenous depression are common: vital disorder, “dreary” depression. These expressions convey the peculiarity of the disease: the “vital” (life) characteristic of the disease with a predominance of clearly expressed low mood, melancholy, despair and inexplicable anxiety, felt by patients in the physical aspect, for example: in the form of “squeezing” pain in the heart area.

Anxiety in endogenous depression manifests itself in different ways depending on the severity of the disorder: from a feeling of the inevitability of a catastrophic event with vegetative symptoms to agitation - an anxious numbness that reaches a state of complete stupor. Moreover, patients often cannot distinguish between the state of panic anxiety and debilitating melancholy, since these sensations merge during illness and are characterized by stagnant pathological affects.

Endogenous depression occurs without the presence of external circumstances and outside influence, regardless of past or present events in the life of an individual. No favorable moments: positive news, pleasant events, activities that normally bring pleasure, have an impact on a person’s mood and well-being. Individuals suffering from endogenous depression are not characterized by tearfulness, but they are completely absorbed in painful ideas of self-criticism, self-blame and self-deprecation. It is, taking these facts into account, that experts distinguish the disease from a psychogenic disorder and diagnose endogenous depression.

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A feature of endogenous depression, which occurs in a mild form, is the daily cycle of mood changes, when, after waking up in the morning, a person feels the maximum peak of melancholy, while in the evening the sensations soften slightly. In severe forms of the disease, a syndrome of “perversion of the daily rhythm” is observed, when in the afternoon there is a noticeable decrease in mood and an increase in anxiety.

An important indicator for diagnosing endogenous depression is pronounced mental retardation: slowing down the speed of thinking and rate of speech. Patients take a long time to comprehend the information received; they need much more time than normal to formulate their answers and express their thoughts. Persons suffering from the disorder note that their thoughts and decisions have become illogical, inconsistent, and arise slowly with a colossal effort of will. In contrast to asthenic conditions, a slowdown in the rate of speech is observed throughout the entire dialogue with the patient. The decrease in physical activity is also constant and unchanged - patients describe feelings of fatigue, lack of strength and energy, fatigue, which do not disappear even after a long rest.

Even with all these manifestations, endogenous depression often remains without due attention; most patients do not consider themselves sick and, accordingly, do not consult a psychotherapist in a timely manner. This is because in this disorder there are no visible external reasons, there are almost always no physical ailments, somatic manifestations are rare and mild.

“Sad” depression can be either an independent mental illness or can act as one of the phases in the course of bipolar disorder (manic-depressive psychosis).

The leading place in the formation of the prerequisites for endogenous depression belongs to internal hereditary-genetic, biochemical and organosomatic factors, that is, the main reason for the occurrence of the disorder lies in individual characteristics human body. Most patients with this diagnosis have a hereditary burden of various mental disorders. It is extremely rare that the onset of the disease is provoked by a strong negative or positive stress factor, but quite quickly the connection between low mood and the stressful event is lost.

Endogenous depression is classified as major depressive disorder without psychotic symptoms (F31.2). Despite the severe course of the disease, these diseases are classified as predictably favorable, since they can be successful treatment medications (antidepressants).

The difficulty of treating this disorder lies in the absence of a real problem, since it is not clear exactly what needs to be dealt with and what should be corrected. Endogenous depression is associated with a high risk of suicide, and thoughts of suicide do not depend on the severity of the disorder.

Causes of endogenous depression

This disease is classified as a so-called disease of predisposition, since the main factor in the presence of a predisposition to the occurrence of the disorder is genetic inheritance. The transmission “by inheritance” of the body’s adaptive resources and the peculiarity of regulation of the level of mediators: serotonin, norepinephrine, dopamine have been established. With genetic pathology, there is a deficiency of these chemicals - mood regulators. Despite this hereditary predisposition, a person, being in a favorable psycho-emotional environment, may not suffer from depressive disorders.

Also, a lack of a number of important chemicals in the body can be caused by dietary patterns and natural age-related changes. Thus, a deficiency in the level of amino acids L-Tryptophan, L-Tyrosine, L-Glycine and L-Glutamine significantly reduces the body’s resistance to stress factors and is a factor in the inevitable development of depressive disorders.

The trigger for the development of endogenous depression can be external factors, such as:

traumatic event,
chronic somatic diseases,
pathology of the central nervous system,
taking certain medications.

Subsequently, a secondary depressive episode can occur independently, without outside influence.

Symptoms

Typical endogenous depression is represented by the Kremelin triad - a classic triad of main symptoms: depressed mood, slow speed of thinking, motor retardation.

The leading symptom and specific sign of this disorder is hypothymia - pathological vital melancholy. This protopathic nature of melancholy is inseparable from the physical sensations experienced by the patient and brings severe bodily suffering. Many people with the disorder can pinpoint their sensations to a specific area (usually the chest, head, neck). Moreover, patients clearly differentiate the sensation they experience from pain characteristic of somatic diseases and from experiences associated with real causes.
A characteristic primary symptom is ideation (mental) inhibition. Even being in an emergency, extremely responsible situation, the patient is not able to quickly make the necessary decision, accelerating the thought process through an effort of will.
With endogenous depression, motor retardation looks characteristic: the patient develops a peculiar facial expression, the so-called “melancholic face,” giving an expression characteristic of older people. Often motor inhibition reaches its maximum degree of numbness when the patient is in a depressive stupor. Occasionally, against the background of complete lethargy, patients experience a sudden, inexplicable and uncontrollable attack of despair, accompanied by intense excitation of motor skills, up to the risk of self-harm.
During a depressive episode, the phenomena of depersonalization and anhedonia often appear. Many patients note the appearance of a painful sensation in which there are no emotions or desires and a feeling of change in one’s own “I” arises. Derealization of what is happening often occurs: patients perceive what is happening as unreal, gloomy, dim, and there is a feeling of time slowing down.

Although a pronounced depressed mood may be accompanied by secondary (affectogenic) signs - delusional ideas of depression, in people suffering from endogenous depression, the prevailing belief in their guilt, insignificance, and hopelessness of the future. This disorder brings into public view the most important human concerns: concerns about healing the body, saving the soul, and material wealth. These primary fears form typical delusional manifestations: hypochondriacal ideas, thoughts of sinfulness, ideas of self-blame and self-abasement.

In a severe form of involutional melancholia, a stereotypical anxious-delusional syndrome is clearly manifested: depressed mood, gloomy state, anxious psychomotor agitation, panic fear, verbal illusions, delusions of condemnation. Without adequate treatment, the formation of irrational phobic anxiety occurs with incessant anxiety, a constant excited state, and various manifestations of delusional experiences appear in the form of the inevitability of punishment and death, hypochondriacal moods, and ideas of suicide. Characteristic hypochondriacal delirium is distinguished by its special fantasy whimsicality, absurdity and illogicality of content.

As a rule, having reached its peak, endogenous depression provokes the formation of a mental defect called “depressive weakness,” which is characterized by a decrease in mental and motor activity, constant depressed mood, a decrease in emotional and sensitive resonance, and various disorders in the intellectual sphere.

Melancholic depression affects a person’s supply of vitality and energy, and awareness of this fact causes the person the greatest anxiety. Vital symptoms include:

excessive fatigue;
severe apathy;
inability to exercise volitional efforts in the usual volume;
sleep disorders: waking up too early, alternating with problems falling asleep;
disturbances of appetite and disorders in the digestive system: lack of appetite or, conversely, excessive appetite, constipation, nausea, weight loss or gain;
problems with concentration;
painful sensations of a somatovegetative nature: “pressing” or “squeezing” pain in the chest, neck, head;
lack of sexual desire, loss of libido, inability to achieve orgasm;
feeling of irrational fear, panic attacks;
mood swings depending on the time of day.

This disorder is characterized by a decreased response to ongoing events, detachment from the surrounding reality, and unresponsiveness to information from the outside. In the physiological aspect, a decrease in reactivity is manifested in the absence of appropriate reactions after taking standard doses of medications.

Treatment of endogenous depression

The basis of treatment of endogenous depression is the use of drug therapy. For this disease, antidepressants are usually used. The choice and dosage of the drug occurs on an individual basis, taking into account the personal characteristics of the patient and based on the presence and severity of symptoms.

With drug therapy, symptoms gradually disappear. After 2-3 weeks from the start of taking antidepressants, motor and mental retardation decreases, while depressed mood, delusions and suicidal thoughts/attempts are still preserved. Therefore, the use of antidepressants must be carried out until all manifestations of the disease completely disappear, since sudden cessation of treatment is fraught with a deterioration in the patient’s condition and a return to a deeper depressive state.

Along with antidepressants, another group of drugs is used for the treatment and prevention of endogenous depression - mood stabilizers. Long-term, continuous use of these medicines helps stabilize mood and prevents the occurrence of new depressive episodes.

Psychotherapy is carried out only as a secondary addition to drug therapy. Modern psychotherapeutic techniques help to identify and eliminate the true cause of the disorder, form a new model of response to stressful situations, and correct personal assessment. However, without the help of antidepressants, it is impossible to restore the metabolism and concentration of neurotransmitters disrupted during endogenous depression.

Persons predisposed to this mental disorder need to periodically carry out preventive measures, avoid excessive mental stress, observe a work and rest schedule, do not abuse alcoholic beverages, and adhere to a healthy diet.

Psychogenic depression is a disorder that occurs under the influence of external negative or positive factors (both long-term and one-time) after situations of loss/change of values that are significant to a person. Individuals suffering from this disorder are characterized by increased sensitivity, impressionability, timidity, suspiciousness, and pedantic traits. Psychogenic depression can develop immediately after a traumatic situation, although in some patients a depressive episode occurs after a period […].

Depression: concept, general ideas

Depression is a mental state that is experienced by a person as an irresistible, oppressive sadness with intense anxiety.

There is a direct connection between alcohol dependence and depressive disorders: depression also affects the worsening of alcoholism, just as excessive drinking of alcohol causes anxious, melancholic, manic states.

What are the ten characteristics of depression? Depression: Is common; Often “masked” under the guise of various somatic diseases; Easy to diagnose if you look for it; Often occurs in severe form; Having taken a chronic course, it often worsens; Causes significant financial costs; Makes changes to the patient’s lifestyle; Fundamentally changes the preferences, principles, values, views of the individual; “Forces” to stop and reconsider your views on life; Fine […].

Cyclothymia is a mental disorder manifested in frequent pathological change mood: chronic, mildly expressed dysthymia (depression) and weak hyperthymia (excitement), often of a hypomanic nature. Fluctuations in the emotional background consist of alternating sequential or double periods of persistent melancholy mood and static high spirits, which can be separated by a spontaneous and abrupt interval of stable mental well-being. The term “cyclothymia” […].

The phases of the disease are clearly expressed only in some depressive disorders. So in case of severe mental illness - manic depression(bipolar affective disorder) there is a wave-like alternation of affective states. The disorder is characterized by a change in phases: depressive (with pronounced anxiety, melancholy, lethargy) and manic (with a predominance of hyperactivity, agitation, euphoria). Bipolar affective disorder has several varieties, differing from each other in cyclicity and […].