Hereditary narcissistic personality
Reactive depression is a pathological disorder of the mental sphere that occurs as a reaction to an extremely negative situation or as a result of prolonged exposure to several less significant stressors.
In contrast to the body's own depression, the daily fluctuations in the emotional background are not so pronounced in this disorder: The background of the mood in people can be described as stable low. Patients differ from their surroundings by their appearance: lowered shoulders, head lowered to the chest, drooping gaze, bent back.
The thought process of people with reactive depression can be described as an aimless, hopeless, and useless analysis of tragic events. A person is overwhelmed with a sense of his own guilt, sin, remorse for his actions, and the subject of the disaster that has occurred becomes the dominantly extremely valuable idea.
In their minds, patients try to restore the calamity that has happened down to the last detail, exhausting themselves and those around them with a dilemma: what could be done to prevent tragedy? Though their thoughts are made up of past events, they are focused on the future, for example: The feeling of suffering the loss of a loved one is made through reflections on the "damned" perspective of living a lonely life and experiencing suffering , added. All wishes that arise concentrate on the painful need to “discuss” the tried and true strokes of fate in the form of a monologue, and people pursue, albeit an unconscious and unintentional, but specific goal: to achieve understanding, sympathy and empathy.
The slightest mention of the unfortunate situation triggers a sense of despair in a person, which is often expressed in hysterical tears. Many patients notice the fear of sleep, as the drama experienced overwhelms them in nightmarish dreams. However, with reactive depression, patients maintained a critical assessment and understanding of the causes of their condition.
The mental and motor inhibition often occurs in the form of a depressive numbness: The person is always in a "frozen" position and does not react to events and statements directed at him. In some cases, reactive depression occurs in the form of hysterical demonstrativity: the patient poses theatrically, gestures intensely, sobs loudly, arranges suicide attempts in front of the public.
Sometimes, against the background of increasing depression, delusional ideas of persecution are combined with irrational fear limited to misinterpreting the actions of others. In some cases, the depressive arousal reaches the level of a melancholy raptus (a sudden, short-term explosion of "sadness effects"), which manifests itself externally as throwing, rolling on the floor, loud sobs and moans and suicidal tendencies. In contrast to the hysterical demonstrativity with depressed raptus, it is also not important for a patient whether others are watching him or whether he is alone.
Reactive depression: causes
Reactive depression can develop in two ways: acute (short-term, lasting up to 1 month) and prolonged (lasting from 1 month to 2 years) reaction, which occurs for various reasons and for which specific symptoms are characteristic.
- Short-term (acute) reactive depression occurs immediately or immediately after a short period of time after exposure to a person with critical stressors. The events that have occurred are usually of an extremely negative color and individually significant for the individual, are perceived with the intensity of the mental trauma and have a significant influence on the further course of life.
- Persistent reactive depression arises under the influence of long-lasting, but insignificant, chronic stress. "Slow" negative events are not viewed by the person as total crisis and do not result in an immediate response from the body - shock, the subsequent phase of confrontation, and the response to "avoid" the problem (as in acute depression). However, factors that a person interprets as negative force him to remain in constant emotional tension, which gradually turns into a state of apathy, pessimism and detachment. And the resulting depression acts as some kind of element in the process of overcoming and eliminating negative stimuli.
The American researchers T. Holmes and R. Ray developed a scale that determines the strength of the stress factors LCU (Life Change Units). This table of “crises” contains global events that most people perceive as tragic calamities - catastrophic “strokes of fate”. The patient's high indices of influence indicate the likely risk of developing serious mental illness in the near future.
Specialists calculate an individual risk indicator using the scale below, adapted to the needs of Russian citizens. If the patient's score exceeds 300 points in the last 12 months, it can be assumed that they have reactive depression.
Depressive reactions and depressive neuroses
Preliminary remarks on the term "depression". Depression means depressed mood. The word "depressed" can explain various phenomena: appropriate behavior after a painful loss, a conflict reaction and neurosis, a personality structure and an illness. Depressive symptoms occur in reactive depression (depressive reaction or depressive conflict reaction), depressive neurosis (neurotic depression), endogenous depression (melancholy), depressive syndrome in schizophrenia or organic psychosis. This is reported in the relevant chapters. Simply speaking about "depression" would be an unforgivable oversimplification. The diagnostic differentiation is used for targeted therapy. "Depression" means nothing without a more precise definition. The prevalence of depressive disorders is generally around 4-6% and in outpatient practice it is at least 10-20%.
Frequency and delimitation. "Normal", or rather, an adequate situation, a disturbance in the sad, mind-suppressing motives, is defined as depression or deprivation. Reactive depression also makes the patient sad about something lost, lost, or taken away. The reactive depression differs from the "healthy" adequate sadness by a more intense and longer lasting picture (with temporary somatic complaints) that occurs after an irresistible conflict.
A depressive neurosis is not aimed at a specific conflict, but at the far-reaching harmonious pleiad of conflicts. A depressive character neurosis and a depressive personality structure are about the same. There are broad transitions to depressive reactions.
Melancholy (or endogenous depression) differs significantly from reactive and neurotic depression in terms of origin, symptoms and course; These are essentially other mental disorders, but such people also experience them.
Reactions of sadness. When a person suffers grave loss, such as the death of a loved one, a painful mental adjustment process occurs. Acute grief often occurs with somatic complaints and autonomic disorders such as impotence and exhaustion, especially gastrointestinal disorders. The mental responses to sadness include alienation and irritability. There is often a sense of guilt behind hostility. Like painful sadness, they try to overcome it. But only a correct assessment of loss and sadness, reconciliation with loss (in the sense of active sadness) can lead to overcoming a difficult situation and to a reorientation. This is defined as the work of sadness "after which the fullness of self is again free and weakened" (Freud).
Talk about the pathological or pathogenic situation of grief when it is delayed (often for months or even years).
There are various reasons for this: Forced residence in a society, which inhibits expressions of fear, often unbearable loneliness and the lack of a conversation partner, as well as complacency due to real or perceived errors in caring for the dead and thus causes problems Ambivalent attitudes and suppressed aggressiveness play a special role Role; on the other hand, the explicit friendships that have so suddenly broken off. In detail, these reactions of grief are as diverse and varied as the life situations of people in general.
When patients become petrified and encapsulated due to their normal sadness, they suffer from passivity and loss of interest, sometimes sad or aggressive behavior towards others. Mood disorder is already losing touch with the loss. The painful reaction of sadness is accompanied by significant vegetative disorders and corresponding hypochondriac fears, which are often associated with the deceased's disease when choosing the organ (tendency to identify). Gastrointestinal psychosomatic disorders can lead to ulcerative colitis. Alcohol and drug abuse are common.
The painful response of sadness is commonly viewed as the pattern of the depressive response. It occurs not only in the event of death, but also in the event of the loss of a loved one due to separation, divorce, etc. When making a differential diagnosis, it should be borne in mind that other mental illnesses such as melancholy can cause profound losses.
Depressive reactions occur with sudden changes in living conditions, the loss of the usual way of life and a confidential atmosphere (e.g. during emigration and flight) as well as changes in the field of activity after moving, retiring, even after taking a vacation. The decisive factor here is not the external situation, but the experience of change, loss of cover and the uncertainty in the new situation. Depressive reactions are often based on deeply hidden resentments and self-assessment crises.
Depressive neurosis. The reason why many people find themselves in a threatening state as a result of the loss of security arises from their life story, from the subject of painful childhood experiences and not only from the loss of the atmosphere of love after saying goodbye to their mother or breaking family ties. Lack of warmth, home fires and a “broken home” are often just overrated popular words. It can also be pathogenic that anxious parents, who bind the child to themselves and protect them from the influence of the surrounding world, are overly cared for. Therefore, it is difficult to build confidence and persistence.
This “overprotection” reflects mistrust and expresses the mother's suppressed aggressive tendencies towards her child. Thus a person with "greenhouse education" remains dependent and needs support and reacts depressively to minor changes. When parents become the only constant support and the possibility of the manifestation of aggressive impulses is not addressed, the prohibition on the manifestation of real feelings in problematic situations is enshrined. The only thing that is allowed to appear in the mind is fear and guilt.
Depressive neurosis is a character neurosis or personality disorder. If they are weak, they speak of a depressive personality structure in the sense of persistent mental abnormalities. The depressive-neurotic development, which (from a psychoanalytical point of view) begins with the oral development phase, can lead to hidden depressive moods (neurotic depression) for a lifetime. In this case, the actual trouble is the cause, not the cause. The development of other diseases, especially drug addiction and anorexia, is associated with a depressive-neurotic structure.
Oral restraint in neurotic depression can be a regressive response to this early phase with a primary sense of security. If there is no initial certainty, unfree addiction and fear of separation develop, and in later life the loss of love and separation (and even fear of separation) always translates into a deep narcistic resentment. Hence, there are aggressive motives in relation to another person that are in some ways inflexible. Since the neurotic cannot recognize his aggression, he transfers it to his own person (the opposite happens for healthy people - shock and sadness turn into anger and anger).
Psychoanalytically, self-reproach and suicidal impulses are interpreted through introjection and autoaggression: They are based on accusations and impulses to murder others. The ambivalence between a strong need to bond and aggressive behavior is a conflict in neurotic depression.
The concept of borderline personality disorder. Severe depressive neuroses (as well as other neuroses and personality disorders) are referred to as limit states from a psychoanalytical point of view. This is not so much a new diagnosis (and not cases bordering neurosis and schizophrenia), but a model building that combines early childhood experiences with subsequent painful personal development in the exploration of the phases of life: the objects of the world are divided into good and bad (similar to their split is the term) This does not mean splitting the schizophrenia scholarship. A certain weakness of the ego is characteristic as "an expression of a general inadequacy with normality in the other functions of the ego" (Kernberg). This deep psychological structure of the borderline personality organization applies not only to depressive neuroses, but (unspecifically and beyond the diagnostic range) also to other mental disorders, as confirmed therapeutically, not to mention the psychotherapy of severe neuroses described. Such patients are subjected to more protective psychotherapy, which is mainly psychodynamic-integrative. In this case, the psychotherapist should act more actively (less deterrent or evasive), but rather “build bridges” for the patient (Kernberg) and pay particular attention to the countertransference. This experience is based in part on psychotherapy for schizophrenia.
Children often have a chronic, personality-dependent depressive mood. It does not manifest itself in everyday life, in relationships with children, it is covered with inconspicuous behavior, but clearly shows itself in a number of situations and in projective tests. Most often this is the result of severe disadvantage in early childhood.
Classification According to ICD 10, sadness and other depressive reactions as well as adjustment disorders are coded in F43.2, depressive neuroses in dysthymia (F34.1).
Therapy Psychotherapy is shown with the reactions of sadness, but of course only when the sadness becomes strong and the patient cannot overcome it without help. The most important thing is the close relationship between patient and doctor, also to protect against suicide attempts. Compassion for the sad events of the past should be in the foreground without their meaning dominating. The task of the therapist (not only the doctor, but also the executor, relatives or friends) is to define the relationship between the patient and the deceased. help to build new interpersonal bonds. The latter is also useful for depressive reactions in immigrants.
In depressive neuroses, thorough analytical psychotherapy is shown to get to the bottom of the roots of pathological development. At the same time, mood disorders can initially intensify and the suicidal impulses escalate. Such patients are particularly sensitive to separation fears.
Behavioral therapy, especially in its cognitive direction, is quite successful in depressive neuroses.
Antidepressants are only indicated for deep mood disorders as part of depressed neurotic states. Its therapeutic effect is clear, but less than that of melancholy. The same applies to the indications at this stage of wakefulness therapy. Tranquilizers can be used briefly in severe sleep disorders. These types of somatotherapy are not a substitute for psychotherapy, but they can help to improve the situation, especially they help patients in a crisis situation.
The prognosis for depressive neurosis is better than for other forms of neurosis, despite the high suicidality of the patient.
People's Response to Depression
Reactive depression is a mental disorder that occurs in response to a person's extremely traumatic situation or prolonged exposure to a combination of several less significant stressors. This depression has the maximum number of factors that provoke its occurrence and affect the human psyche in one way or another. The traumatic events that she cannot endure become catalysts that trigger the destructive process of negative personality change.
Persistent reactive depression, in addition to its own extremely unpleasant symptoms, is dangerous in that it can provoke neuroses, anxiety and astheno-depressive syndrome, perceptual pathologies and manic psychoses. It is impossible to ignore this type of depression, it does not go away on its own, so professional treatment is required to restore health.
Causes and forms of reactive depression
The reasons for the development of this type of depression are negative, severe changes in a person's life, which lead to severe or prolonged stress and, as a result, to the appearance of symptoms of the disease. This could be: serious or persistent illness or the loss of a close relative. The reasons can also be: separation from a husband or wife, a loved one, large financial losses, problems at work, problems in one's own family, imprisonment, bad habits, the death of a beloved pet.
In addition, the occurrence and development of reactive depression have an impact on:
- genetic predisposition;
- Features of education;
- Irregularities in the chemical balance of the brain;
- Features of the constitution;
- chronic somatic diseases;
- organic brain damage.
The intensity of depression is determined using a special scale that includes the very traumatic events that are perceived as serious tragedies by the absolute majority of mentally normal people.
This form of depression can appear in two ways: as an acute response that lasts for up to a month and lasts from a month to two years. Brief reactive depression usually develops very quickly and immediately after stressing a person's mental sphere.
Persistent reactive depression manifests itself in baseless crying, a pessimistic attitude towards the present and future, an extremely depressed mood, a sharp drop in energy, ideas of self-blame, and hypochondriacal thoughts. The behavior of the patients is characteristic: they are weak-willed, apathetic, focused on inner experiences, lose interest in the fulfillment of duties and entertainment.
Real depressive disorder
This form of reactive depression is characteristic of those who are constantly in a sad, boring and indifferent state (apathy), not eating and almost not getting enough sleep. They are also characterized by other symptoms: despair and unwillingness to somehow change the current uncomfortable situation, delusional thoughts and ideas that lead to self-torture and thoughts of suicide.
Anxiety Depressive Disorder
The main feeling that patients with this form of reactive depression experience is fear, which turns into panic, which only exacerbates the symptoms of depression, makes it difficult to have a positive perception of the world, and is accompanied by attacks of aggressiveness and anxiety as it progresses. Patients constantly live in a strong emotional tension under the influence of stress hormones, which negatively affect the immune system and an unstable psyche.
Reactive depression develops much faster in people with the following risk groups: unmarried and unmarried people who live alone and cannot communicate well; Executives or decision makers exposed to chronic emotional exhaustion; People who are used to keeping all emotions in themselves and people with addictions. With these conditions predisposing to the development of reactive depression, the likelihood of its occurrence increases significantly.
Reactive Depression Symptoms
Reactive depression begins with a classic state of shock associated with individual symptoms that differ depending on a person's constitutional characteristics: excitability, emotional instability, critically reduced mood, depression, tendency to view the world with skepticism and cynicism. The patients perceive the environment in black colors, are not happy and have no fun, but rather fall into great despair and all-embracing melancholy. They become extremely irritable, angry at the loved ones' efforts to talk to them, cry almost constantly for no reason.
In reactive depression, the patient's general emotional state can be defined as consistently low. They are so depressed it even affects their appearance:
- they have lowered their shoulders;
- bent back;
- bowed head;
- drooping look.
Patients with this depression react very differently to external stimuli: either they freeze, not reacting to events around them and the words addressed to them, or they show their feelings too emotionally, scream loudly, gesticulate desperately, arrange demonstration theater scenes.
For those suffering from reactive depression, mental activity aims at an excessive and aimless analysis of the tragic events that have happened to them and which they cannot forget and trigger. Often times, they also blame themselves for what happened and find some kind of secret pleasure in it.
By focusing their thoughts on the traumatic event, trying to remember it down to the smallest detail, they tire themselves and those around them with suggestions of what could be done to prevent a negative event. At the same time, they want genuine understanding, empathy for their problem, and genuine compassion.
The emotionality of the patients is so heightened that each time the tragedy is mentioned, they experience a new wave of despair and pain, which manifests itself in excessive tearfulness. Many of them are even afraid to fall asleep because the traumatic event will not let them go to sleep. Sometimes, when this type of depression is aggravated, the patient's inexplicable anxiety is accompanied by paranoia.
Reactive depression can be expressed by agitation, panic attack, tachycardia and heart pain, rapid breathing, muscle weakness, low blood pressure, disorientation, severe dizziness, and hyperhidrosis.
The main symptoms of reactive mental depression are:
- a feeling of utter despair and deep despair;
- a feeling of hopelessness and the hopelessness of the future;
- Violation of normal mode and duration of sleep;
- change previously selected meal preferences.
Reactive depression is complicated by the fact that when the patient reaches his maximum, he develops various phobias, thoughts of suicide, and sometimes auditory hallucinations arise. These symptoms suggest a profound mental impairment and require immediate treatment.
Treatment of reactive depression
Reactive depression that is not neglected responds well to treatment with psychotherapeutic methods even without the use of medication. The aim of psychotherapy is to teach a person to overcome their own fears and conflicts, normalize the psycho-emotional background and restore an optimistic attitude towards life. But if the depression became acute, the patient would have panic attacks or thoughts of suicide and drug therapy would be required.
A good effect in this depression is achieved by the following drugs:
- Antidepressants (drugs from the group of SSRIs) that perfectly stabilize and lift the mood, lower the level of anxiety and eliminate feelings of panic and anxiety. The minimum duration of therapy with these drugs is 3 weeks.
- Benzodiazepine sedatives with excellent drowsy, muscle relaxant, sedative and sedative effects;
- Neuroleptics that remove too much psychomotor restlessness and anxiety;
- Hypnotics to relieve stress and normalize sleep.
The combination of medication and cognitive as well as rational psychotherapy in combination with hypnosis sessions offers an excellent effect in the treatment of depression of the reactive type.
Reactive depression is a very serious mental disorder. If left untreated, it will continue to develop, which will only increase its negative effects. However, it is also impossible to self-medicate. Any depression should be treated by a doctor with the necessary knowledge and experience.
How To Prevent Depression: Prevention
To prevent reactive depression from spoiling life and not coming back, you need to prevent:
- Sleep at least 8 hours a day to allow the brain to relax and the body to replenish the energy reserves in the cells.
- communicate more with family and friends without hiding their problems from them;
- eat properly;
- alternate work and rest, not overwork;
- Switch work to a lighter one;
- Eliminate bad habits.
All of these measures, if not neglected, reduce the likelihood of reactive depression and depression in general, help maintain mental health, and make it unnecessary to think about how and how to treat such illnesses.
So we agree, these are the peculiarities of our psychological protection and our personal response to various stressors that cause some people to have increased pressure in response to stress, others to have a heart attack or even a stroke, but most of them become depressed .
There is an opinion that depression is a disease of the intellectual, a kind of "reward" for people for intellectual work. This is not the case. Any person can suffer from real, ie endogenous, depression, but depressive responses to stressful effects are indeed most often given by people who are not physically active but mentally active. Correspondingly, the depressive risk groups include drivers, dispatchers, troops working in trouble spots and, in our country, also business people.
Of course, stressful strikes cannot only be economic in nature, stress can also be purely personal - the death of a loved one, betrayal, breaking up of relationships, etc. In our days, stress related to the so-called public has become more common when a person something dangerous is threatened. In this case, the stress itself can often already be heard, the stressful situation can be resolved, and depression lingers and deepens, dragging on for many weeks and even months. In such cases, you should seek help from a psychotherapist or even a neuropsychiatrist, and treatment for such depression is mostly drug treatment.
If the stressful situation has not yet reversed and you do not want to develop any depressive experiences yourself, the recommendations from this and several subsequent sections of this book will help you.
It is impossible not to say here that depressive manifestations can appear in response to various diseases, with chronic intoxication (poisoning) - for example, with alcohol, as well as with some organic brain lesions. But in such cases, the main concern is the treatment of the underlying disease (in combination, of course, with the elimination of depressive manifestations through psychotherapeutic and medical methods).
The discussion initially focuses on self-help techniques for depressive reactions that occur in response to a breakup with a loved one.
Oh how hard it is in such cases. After all, after a break in relationships with a loved one, many people feel the breakdown of their entire life, feelings of their own uselessness and helplessness. Longing and loneliness literally torment the soul and the heart. And sometimes decadent thoughts fill your mind ...
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Reactive depression: causes, symptoms, treatment
Reactive (psychogenic) depression is a serious mental disorder caused by a high level of stress or a combination of traumatic events.
This disease has the greatest number of provoking factors that act to varying degrees in a person with a certain intensity and duration. Tragic accidents, catastrophic "strokes of fate" and protracted crises act as catalysts that trigger the process of personality destruction.
Differences from common depression
Reactive depression is a complex psycho-emotional response to the effects of various negative factors.
A person can be pushed to him both by minor problems that gradually accumulate and express themselves at the most inopportune moment, as well as by severe stressful situations, which causes almost irreparable damage to the psyche.
At the same time, the daily or seasonal character of the fluctuations in the emotional background is weakly expressed, there is a consistently low mood.
Depressed people "give out" physical signs:
- Matte appearance;
- bent back;
- lowered shoulders;
- painful bluish skin tone;
- gaunt face and absent look.
Their consciousness is filled with guilt, ideas of their own sin, wild longing and dejection.
The reasons are often caused by many factors that determine whether negative emotions turn into depression and whether a person can prevent the disease from further developing.
The main reason is changes in life that bring severe stress and push a person out of the comfort zone.
The main causes of depression
- Death of a close relative;
- personal serious illness;
- Divorce from a spouse or separation from a loved one;
- financial collapse;
- Layoff or loss of a stable source of income;
- sexual problems;
- Problems in family;
- Loss of a pet;
- Death idol;
- Debt mine;
- the presence of dependencies.
The changes in life are perceived negatively by a person, they have a personal touch and are an individual "catastrophe". They have a significant impact on all areas of life.
Options for the development of the disease
- If the reaction to a traumatic event occurs immediately, it is called acute depression (short-term, no longer than a month).
- If the disease develops as a result of constant but not intense exposure to negative factors, it is called prolonged depression with a total duration of one to two years.
- Genetic and psychosomatic predisposition - the presence of mental disorders and own illnesses in previous generations;
- Age changes;
- Character accentuation;
- organic brain damage;
- constitutional characteristics.
Given the circumstances, people who are directly affected by certain risk factors are more likely to develop depression:
Social role and self-actualization
According to scientists, lonely people are more likely to manifest reactive depression than people in a relationship. This is explained by the fact that there is no one who expresses themselves trivially, with whom one can exchange experiences and relieve one's burden when one is alone. And a person who has not realized himself and his wishes - an unhappy person as a result.
People who have a great deal of responsibility due to their professional activity are constantly exposed to strong emotional influences.
It affects not only the physical condition, but also the mental state. It is irritating and affects the central nervous system. As a result, a person often cannot be accountable for their actions.
Culture of education
Since childhood they have been imposing behavioral norms under which one cannot show one's negative emotions, but it is necessary to "keep everything within".
How do you recognize depression and differentiate it from depression? First, by definition and symptoms. There are truly depressive, anxious-depressive disorders, and depressions of hysterical personalities. Look at each in order.
Real depressive disorder
This diagnosis is appropriate if the depressed state is observed over a long period of time, accompanied by typical symptoms of depression: sadness, discouragement, apathy, depression, loss of appetite and sleep. The patient is desperate at the hopelessness of his position and the inability to influence the course of events in any way. All of this can be accompanied by nonsense in its various forms, as well as ideas about one's own sinfulness and guilt, even self-torture and suicidal thoughts.
Anxiety Depressive Disorder
The patient overcomes the fear that can later turn into panic. Panic anxiety only exacerbates depression and blocks the normal view of the world, sometimes accompanied by attacks of unjustified aggression and unreasonable fear.
The main symptoms are:
- heavy sweating;
- Chest pain;
- Lack of air;
- Shortness of breath;
- Fluctuations in body temperature;
- Numbness of limbs;
- Manifestation of hidden phobias;
- animal primitive fear;
- Fear of death and fear of something unimaginable and inexplicable overnight.
Depression of hysterical personalities
Depression as a character trait is revealed through personal interviews and discussions with a specialist. It can be accompanied by melancholy and reflection. At the same time, with a deterioration in well-being and persistent depression that does not tend to self-healing, psychotherapy is used for people with an accentuated character.
Forms of disorder
There are two forms of reactive depression:
- Explicit, open form - in which the symptoms of the disease are pronounced and protracted.
- Dimistic, hidden - in which the signs of the disease are masked (hidden). The patient does not have any deviations, but this does not mean that they are absent. Often times, the manifestation of suicidal tendencies in a person comes as a real surprise to his loved ones. In the implicit manifestation of symptoms, somatized depression resembles the des-stimulatory form of reactive depression.
Reactive depression is preceded by a state of shock with side effects:
- Psychomotor restlessness;
- Panic fear;
- Heart pain;
- blue skin;
The symptoms of the disease itself have a variable number, which can be divided into two conditional categories: general, inherent in almost every patient, and individual, which appear depending on the constitutional characteristics of the person.
- Emotional instability, depression and abnormal mood weakness. The patient sees the world through the prism of cynicism and skepticism. Previous joyful and happy events no longer trigger radiant feelings and emotions, but are replaced by all-consuming longing and original dejection. A person becomes irritable and reacts with outbursts of anger at the attempts of their relatives to find out the reason for their bad mood.
- The eyes are wet. Any memory from the past can provoke a howling attack and even a real tantrum. A person becomes very vulnerable, at the slightest mention of a tragic event he remains more and more trapped in himself and scrolls through the situation again and again. The annoying question appears: "What would have happened if ...?". From a rational point of view, it has no value, but only enhances the process of introspection and self-blame.
- Human behavior changes. The patient is no longer interested in the former, he becomes apathetic and completely sluggish.
It is important to understand that, as such, depression manifests itself in different ways. Overnight, some symptoms can be blurred while others can be excessive.
The individual manifestations of depression vary depending on temperament, personality traits, and personality. In general, however, these are:
- Irrational fear at the mention of tragedy;
- Ideas of personal guilt for what happened and deep regret;
- Thoughts of their helplessness and insignificance;
- Try to avoid talking on a sore subject;
- Periods of insomnia followed by reflection and melancholy;
- Decrease and even loss of appetite, severe physical exhaustion;
- the disappearance of sexual attraction;
- decreased self-esteem;
- Autonomous disorders: temperature gradation, shortness of breath, excessive sweating, etc.
Some symptoms may be short-term and may go away after psychotherapy without taking any medication. If suicidal tendencies or painful depression occur, urgent medical help is to be sought.
Reactive Depression: Causes, Symptoms, and Treatment of This Disease
Reactive depression is a serious violation of a person's mental and emotional state that develops in response to a traumatic event.
Causes of diseases
As the name suggests, reactive depression is a response to mental trauma or prolonged exposure. In other words, a patient develops a depressed state after a certain event or series of such situations occurs in their life that they found negative.
It is understood that this disease does not occur for some "standard" reasons. The extent to which an event is traumatic for the human psyche is determined by many factors - from social to hereditary. In fact, it depends on these factors whether grief or other negative feelings are transformed into depression.
In the presence of predisposing circumstances, the likelihood of abnormal psycho-emotional depression is much higher:
- Belonging to a certain occupation. People who are often exposed to excessive stress due to their professional activity or who have to bear responsibility for the health and life of other people (doctors, firefighters, law enforcement agencies, etc.). In this case, the obvious familiarity with stress and resistance lies in the nature of a “mask” under which processes constantly take place that weaken the nervous system and depress the psyche.
- Social Status Individuals are more prone to depression, including more reactive ones. According to experts, this is due to the inability to discuss the event that caused mental pain with anyone and thus help yourself reduce the level of anxiety associated with expressing their thoughts.
- Alcohol addiction. As the most powerful depressant, alcohol has a negative effect on the human nervous system. In this regard, the level of psycho-emotional reactions is inadequate to the actual state, and in the presence of a major traumatic event, the emotions are completely out of control.
- Hereditary predisposition The tendency to psycho-emotional disorders can be passed on from parents to children, which for the latter becomes a risk factor for the development of depressive states.
- Features of education. People who grew up in families where expressing emotions is viewed as a weakness and people who have experienced domestic violence are more prone to depression.
Important: Reactive depression often develops after a traumatic event that is generally defined as severe (financial breakdown, divorce, death of a loved one).
But sometimes this condition arises as a reaction to a negative or tragic development of a personal situation for the patient.
This can be the loss of a pet, the death of an idol that a person has never met, etc. Therefore, an assessment of the severity of psychological trauma should not be made against generally accepted standards.
Symptoms of the disease
Symptoms that manifest this type of mental disorder are very diverse and variable. However, it is more useful to describe it to appeal to the patient's family and friends. This is due to the fact that a person suffering from this condition may not be aware of the changes that have occurred in them. Usually he notices that something has "broken down" in his life and worldview after a certain event, but he regards this as a natural manifestation of grief, sadness, longing and other negatively tinged emotions. And for those close to the patient, it takes time to see signs that a loved one needs help.
Symptoms of reactive depression can be divided into general (typical of any person with the disease) and individual symptoms (based on a number of characteristics of the patient's personality).
Common symptoms are as follows:
- Emotional depression. If you compare emotions and feelings to the colors of the rainbow, then in reactive depression they are dragged through a thick haze. Colors are muted, manifestations of joy or fun are distorted - the patient appears skeptical or even cynical about any positive aspects. He sincerely does not understand the reasons for someone's joy, considers it unnecessary and even angry.
- Change habitual behavior. The patient no longer experiences joy in the lessons for which he likes to spend time; his interests are anchored in the traumatic event and everything related to it. If the cause of depression was the death of a loved one from a heart attack, then the person may be seriously interested in the methods of treating this disease, statistics on mortality, and so on.
- Crying A person with reactive depression has their eyes literally in a “damp place”. Any detail that may seem insignificant at first sight can lead to a fit of crying in a patient. The same applies to any memories of the traumatic event, and the memories can become things, sounds, smells, etc. that only the patient himself associates with a negative or tragic situation. The thought of the death of a loved one can even be called on the door, and the patient explains this as "He (the deceased) never called like that."
- External, visible changes. A person suffering from depression often has a hunchback and the preferred posture is sitting in a chair with the back bent. Often times, the patient clenches their palms tightly into fists and clamps their jaws together without even realizing it. From the outside it looks like extreme tension.
Individual manifestations of reactive depression depend directly on the personality of the patient and can vary widely:
- A person avoids any form of communication, becomes independent and when he tries to start a conversation with him, he answers short and monosyllabic and does not support the conversation
- The patient tries whenever possible to talk about the event that hurt him, clearly trying to relive it and building the conversation on the expected evolution of the situation when the circumstances were different ("If I would have called an hour earlier "," If I hadn't called ") I overslept at work" etc.);
- The emotional picture is dominated by a sense of guilt expressed in regret that something was not done that could change the course of events. With a reasoned statement that the patient is not to blame for what happened, he finds new "application points" to confirm his guilt;
- The patient feels an irrational fear that the traumatic event will occur again. He's always waiting for bad news to be reported to him (about someone's death, refusal of employment, etc.).
If reactive depression is prolonged, symptoms of other health disorders, not just mental disorders, may appear. As a result, people with depression often develop insomnia - from difficulty falling asleep to chronic insomnia. Patients have decreased or no appetite, develop gastrointestinal disorders (dyspepsia, stool disorders, etc.), decreased libido, etc. Autonomous disorders are manifested in attacks of profuse sweating, palpitations, etc. A person's state of health can vary widely.
For all the variety and variability of manifestations, this type of depression has only two truly "unique" features that distinguish it from other similar conditions:
- Changes in behavior and emotional state always occur after an event that is closely related in time to the onset of changes.So if the loss of a loved one occurred several months before the first symptoms of depression appeared and the job was done - within a few weeks, then it was very likely the second case that caused change. An exception can be situations where after the first traumatic event (e.g. separation from someone) a person has not stopped being exposed to excessive psycho-emotional stress, and one of them (in our example loss of job) the Played the role of the "last drop" and caused depressive changes.
- Emotional responses and behavioral changes exceed the significance of the event and / or their duration exceeds the duration of normal reactions. This is what differentiates, for example, reactive depression from grief. After a while (usually 2-3 weeks after the tragic event), the grieving person accepts the fact of death, reconciles with it, re-establishes social ties, and generally returns to the normal way of life. A patient with reactive depression does not have a sufficient assessment of the situation; he is fixated on a traumatic event and, figuratively speaking, continues to live in it, neglecting work and family duties and his own health.
Important: The symptoms described can be combined in different ways and in the event of a long course of depression or suppression of their emotions by the patient, they can go completely unnoticed. Only a professional can tell, for example, grief or the natural adjustment process of financial collapse from depression.
In treating this disease, the most important thing is how long a person has suffered from this disease and the manifestations of psycho-emotional depression.
Let's take a closer look at effective methods.
Depending on the severity of symptoms, the following groups of drugs can be prescribed:
- Antidepressants (sertraline, fluvoxamine, etc.) that relieve the manifestations of depression, increase positive emotions, and eliminate the motor symptoms of depression (stiffness, stiffness, obsessive repetitive movements, etc.).
- Sedatives (diazepam, alprozolam, etc.) relieve anxiety, relieve anxiety, and improve the quality of sleep.
With a prolonged or severe course of such depression and the resulting autonomic disorders, drugs can be prescribed to normalize the heart rhythm, blood pressure, appetite, etc.
Important: Only the attending physician can select the medication, its dosage and duration of treatment. When choosing medication, the patient's professional and daily activities are of great importance. This is due to the fact that a number of drugs impair concentration and are dangerous for those who drive, look after young children, and work in other areas where decreased alertness is a potential threat to themselves or others.
This disease requires an integrated approach and in order to recover as quickly as possible it is extremely important to “live” the traumatic event and leave it in the past - something that the patient cannot cope with on her own.
The psychotherapeutic help in the form of individual or group courses, which is carried out under the control and guidance of an experienced doctor, provides invaluable help.
The general goals of the classes are:
- the elimination of negative experiences with the traumatic event;
- learn to control anxiety and fear;
- Restoring adequate psycho-emotional responses;
- a return to normal social and personal life;
- Learning the rules of psychological hygiene that will prevent this from happening in the future.
If necessary, the psychotherapist complements the general course of psychotherapy with coursework and training in order to remove the so-called “blockages” that “block” the problem at the subconscious level. In some cases, hypnotherapy can be used with the patient's consent.
Important: Psychotherapy is the most powerful tool for treating this type of depression. If medical methods are the "first line of defense" with which you can quickly eliminate acute manifestations of depression, psychotherapy is the most important stage of treatment to restore a person's quality of life and prevent complications from depression.
You can also read about the methods of psychotherapy, such as the cognitive-behavioral care model, existential psychotherapy and narrative therapy.
The author of the article: psychiatrist Natalia Polenova
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