Recurrent depressive disorder: the main symptoms and treatment

Recurrent depressive disorder is a symptom complex that manifests itself in recurring episodes of depression without recorded cases of upbeat mood and hyperactivity similar to mania. The prevalence of this disease among the world population is about two percent of the total number of inhabitants.

Disease history

Information about depression as a disease appeared recently. In the time of Hippocrates, melancholia was associated with a predominance of "black" bile in the body. Of course, gradually the methods of diagnostics were improved, and by the middle ages theologians had come to the conclusion that people subject to despondency are possessed by the devil. Accordingly, they experienced on poor people all their wide arsenal of means for carrying out the rite of exorcism. Holy water, prayer, fasting, and even torture were used.

Fortunately, the Renaissance came, and together with it the second life and such fundamental sciences as medicine, physics, and mathematics received. To all the scientific approach was encouraged. Since that time, neurology and psychiatry have begun to consider a depressed mood, like recurrent depressive disorder. The history of the disease has many centuries. Different approaches to the solution of the problem were suggested, but until the end it was not possible to cure it.

Causes of development

Specify the cause of the disease is quite difficult. Here we need an exclusively individual approach to assessing symptoms and collecting an anamnesis. For this, a medical history of psychiatry is written. Recurrent depressive disorder can be caused both by internal imbalance of hormones, and by external causes - psychological trauma, neuroinfection, severe intoxication, TBI (craniocerebral trauma). The first episode can be triggered by psycho-traumatic circumstances, but subsequent phases already appear by themselves, not related to what is happening in the surrounding space.

Pathogenesis

As a rule, a person reaches adulthood when he is diagnosed with a "recurrent depressive disorder". Symptoms appear after forty years and can last from three months to a year, and light intervals should be at least eight weeks. The older the patient, the more likely that the disease will go to a chronic form. The duration of the attack is directly proportional to the length of the illness, sometimes it takes a seasonal character.

Great symptoms

In psychiatry, there are such concepts as basic and additional symptoms. They are combined in various combinations, forming a recurrent depressive disorder. ICD 10 provides clear criteria for diagnosing this disease:
- Depressive mood (lack of positive emotions);
- a decrease in interest in previously pleasant things or actions, lack of satisfaction from the work done;
- weakness, lethargy, increased fatigue.

Minor Symptoms

In addition to at least one major symptom, there should be several secondary symptoms. They are present in almost all mental patients, and not only in patients with a diagnosis of recurrent depressive disorder. ICD indicates the following characteristics:
- low self-esteem;
- feelings of guilt, self-condemnation and self-blame;
- suicidal moods;
- decreased attention and concentration;
- hopeless description of the future;
- violation of sleep and appetite.

Diagnostics

A psychiatrist should collect a thorough medical history not only from the patient, but also from his relatives, in order to have a complete picture of the number, frequency and nature of seizures. Often the patient does not remember when he had the first signs of depression, but his relatives can indicate, if not exact, then at least an approximate date. Recurrent depressive disorder manifests itself by at least two episodes of mood reduction, which last more than two weeks. They should be separated in time by light intervals (when the symptomatology is completely absent). The doctor does not exclude that the patient may have a manic condition, even if there is a significant length of treatment from depression. In this case, the diagnosis changes to BAP (bipolar affective disorder).

In medical records, a recurrent depressive disorder is designated F.33, indicating the type of the current condition, and the nature of the previous episodes. If there is such information.

Degrees of expression

1. The mild degree includes two main and two additional symptoms. In addition, it can be accompanied by somatic disorders, aggravating the course of the disease. Allocate:
   - mild degree with minor somatic manifestations;
   - mild degree with severe physical illnesses.
2. The average degree of severity is put in the presence of two main and three or four auxiliary symptoms. And just like in an easy degree, there are somatic disorders.
3. A severe degree of depressive disorder implies the presence of all major symptoms and at least four secondary symptoms. Usually there are all of the above. Complication of this degree is the presence of psychogenic signs, such as delirium, hallucinations, stupor.

Recurrent depressive disorder must be distinguished from schizoaffective disorder and organic changes in the psyche. In the first case, in addition to depression, there are still symptoms of schizophrenia, and in the second - there is a major disease that will be revealed in laboratory-instrumental diagnostics.

Treatment

In order to prescribe a therapy, you must first have a complete picture of the patient's body. This is done during the registration of the patient in the appropriate hospital. In this sense, recurrent depressive disorder was no exception. Treatment of it consists in taking antidepressants and neuroleptics, as well as sleeping pills. Use sleep deprivation or ECT (electroconvulsive therapy) if the disease is resistant to medical intervention. Group and individual psychotherapy help.

It is impossible to make this diagnosis at home, based only on fragmentary knowledge and indirect symptoms. This should be handled by a specialist.

The need for quality assistance

In most cases, a person can not correctly assess the complexity of the process that occurs to him. It seems to him that this is just a bad mood, spleen and fatigue, nothing more. In fact, the changes affect deep biochemical levels of regulation that require correction to restore mood.

The second problem that prevents patients in time to seek help is their weak character, lack of criticism for their condition and moral strength to make a decision. This further exacerbates the picture of depression.

In this connection, it becomes clear why the assistance of a professional, rendered in a timely manner, can minimize the harm that caused the person recurrent depressive disorder. The forecast in this case can be considered favorable. Ignoring the symptoms only aggravates the situation and translates the disease into a chronic form.

The disease significantly affects the social ties of man. He may lose his job, family and friends. Get injured or even commit suicide. Therefore, patients should not entertain themselves with illusions about sudden healing, but they need to go to a doctor who can correctly assess a person's condition and prescribe appropriate treatment for him. The success of therapy depends not only on the actions of the doctor, but also on whether the patient wants to recover or not. Psychosomatic problems often occur only under the influence of conversations with a psychiatrist, even without the use of drugs.

Prevalence

At least once in a lifetime, each of us experienced a state of depression. But hardly anyone bothered to address a doctor for such an insignificant cause. Nothing hurts, and okay. In developed countries, depression is one of the main causes of disability of the population. This diagnosis is more common among residents of large cities, because in the "human anthill" as anywhere you can feel lonely. Boredom, poor ecology, permanent stress, excessive demands on oneself and the desire to succeed inevitably put pressure on the human psyche, causing it to experience overload. Another factor that plays a role is that people living in cities often decide to go to a doctor and find out their diagnosis.

Somatic, especially neurological diseases increase depression. Constant headache or heart pain can push a person to the idea of an imminent death. An important role is played by overly strict education, stress and trauma in early childhood, episodes of domestic violence. Heredity also plays a role. So, if close relatives have such conditions as BAP, schizoaffective disorder or depression, then the probability of it in offspring is much higher.