How to treat depression
Depression/ideological problems
In the past, people were familiar with neurasthenia, but they were not familiar with medical terms such as "depression" or "depression".
A few years ago, people lacked understanding of depression. Depression is often associated with derogatory terms such as "thinking problems" and "weak will". At that time, if someone got depressed, people wouldn't think he was ill. Instead of mobilizing him to stay in the hospital, they sent someone to do his "ideological work".
Now, if someone suffers from depression and looks sad all day, people around him or some doctors often say, "There is nothing wrong with you, please relax and don't think about it", "Take more exercise" and "Take some vitamins" ...
It should also be noted that depression has some physical discomfort. For example, fatigue, heavy work pressure and sub-health are often mentioned in recent years. ...
In sub-healthy people, some symptoms are similar to depression. In clinical work, it is found that the sub-health of many "white-collar workers" is the manifestation of depression. We should change their "sub-health" hat to "depression" diagnosis.
There is a girl full of youthful vitality. But she said that in the last four or five years, she was sick all over, without a comfortable place and a happy day.
What are her symptoms?
She feels headache, dizziness, general weakness and abdominal distension almost every day. Also, yesterday was back pain, today is leg pain, and tomorrow's pain is uncertain. Her pain has no fixed position. She looks tired, weak, moves little, moves slowly and walks little. Sitting there, she bent down and bent her back. When she walked, her heart beat faster and she was short of breath. When she was active, she immediately felt chest tightness and shortness of breath. Her face was expressionless, her eyes were fixed and she was indifferent to the outside world. Seeing food, she asked you to cook a simple meal, or delicacies. She always took them as tasks, lost her appetite and was constipated for a long time.
During the day, she felt groggy and unable to lift her spirits, so she could barely finish the work. She often says, "I can't do anything. I only have an empty shell. Everything is over, only death ..."
What pains her most is sleep. I finally fell asleep, dreaming one after another, often having nightmares, scaring myself so much that I don't know what to do ... She woke up at four or five in the morning, lying in bed worrying about what? Worried about how to spend the new day. She feels that no one in the world is more tired than her, and it is better to die comfortably early. Every morning becomes the most painful moment of her day.
In recent years, the Millennium has become a frequent visitor to the hospital, but the report results of clinical examination are all written as "negative sign" (negative). The doctor's diagnosis is generally "neurasthenia", and some are written as "autonomic nerve dysfunction" and "neurosis", and some are simply written as "headache to be investigated".
Later, the doctor suggested that she go to our hospital for treatment, which was depression. Speaking of "God", since taking the medicine for depression, the symptoms mentioned above have gradually disappeared one by one, and her mood has quickly recovered, like a different person.
Then, her sleep improved, she ate better, gained weight and blushed. Even the tone of voice is eight degrees higher than before, and I am full of confidence in my future.
Etiological analysis of depression
Generally speaking, we may feel better if a disease has a definite cause. However, like many other serious diseases, depression can also occur without any triggering events or diseases. Depression is usually the result of complex interaction of various genetic, psychological and environmental factors. Read on to learn more about these factors.
1. Biochemistry When a person suffers from depression, there are often some chemicals called neurotransmitters in his brain that decrease. It is believed that if there is an imbalance between serotonin and norepinephrine, it will lead to depression or anxiety. The decrease of serotonin and norepinephrine often leads to depression, decreased motivation and changes in appetite and sexual desire.
2. Genetic factors Like many other diseases, depression often occurs in the family. If one parent suffers from depression, the probability of the child suffering from the disease will increase10% ~13%; In identical twins, the number is even greater. If one twin suffers from depression, the probability of the other twin suffering from depression in his life is 70%. However, among people with obvious family history of depression, many people have never suffered from depression even under constant tension. On the contrary, some people with depression have no family history of depression at all.
3. Social and environmental factors Some studies show that bad life events, such as divorce, serious illness or repeated misfortunes, can lead to depression. Daily stress also has invisible adverse effects on our bodies. In fact, it can lead to a wider range of diseases, including heart disease, colds and depression. People who are already prone to depression are more likely to suffer from this disease if they continue to be in violence, neglect, abuse or poverty.
4. Physical diseases Many physical diseases and conditions, such as stroke, heart disease, cancer, chronic pain, diabetes, hormonal disorders and terminal diseases, often lead to depression. If you or someone you know suffers from a physical illness, and has symptoms of apathy or cannot meet basic physiological needs, you should contact your doctor. These symptoms may be emotional or subjective reactions to physical diseases, or the person may suffer from depression that needs treatment.
5. People with pessimistic personality factors, low self-confidence, bad thinking mode, too much trouble or feeling almost unable to control life events are more likely to be depressed.
6. Other factors Some drugs can cause depression (such as reserpine). For more information, please consult your medical staff. In addition, frequent excessive drinking can sometimes lead to depression.
Although we have a new understanding of the causes of depression and will continue to move forward, throughout human history, people, regardless of age, wealth, celebrities and ordinary people, have suffered from depression. No matter who you are, you may have depressive symptoms at some stage in your life.
Depression is a kind of brain disease, which has its own occurrence and development law. For many years, the study of depression and antidepressants has been an important research field of contemporary psychiatry. Although the etiology and pathophysiology of depression are not very clear, it does not hinder the effective treatment of this disease.
There are many treatments for depression, such as psychotherapy, sleep deprivation therapy, phototherapy, electroconvulsive therapy, etc., but at present, medication is the main treatment, supplemented by psychotherapy. It should be pointed out that people with depression often have negative and pessimistic thoughts, and in severe cases, they have suicidal tendencies and world-weariness Doctors should be on high alert and warn their families to take strict precautions. If conditions permit, it is best to be hospitalized. Electrospasm therapy has direct resuscitation effect and should be used decisively and quickly.
Antidepressants are a large category of many psychotropic drugs, which are mainly used to treat depression and various depressive states. Here are only two drugs with definite curative effect and generally recognized:
1, the first generation of classic antidepressants: including monoamine oxidase inhibitors (maoi) and tricyclic antidepressants (tca).
2. The second generation of new antidepressants: Due to the rapid development of new drugs, new drugs emerge one after another, such as venlafaxine and nafazodone, but at present, selective serotonin (5- HT) reuptake inhibitors are still the main ones, and these drugs are also the most widely used in clinic. However, the antidepressant effects of some antipsychotic drugs, such as sulpiride, alprazolam, roller, buspirone and methylphenidate, are still controversial, so they are omitted.
There are two kinds of classic antidepressants in the first generation, namely monoamine oxidase inhibitors and tricyclic antidepressants.
1, single oxidase inhibitor
Isopropylhydrazine is the first antidepressant that came out in 1950s. Isopropylhydrazine is an anti-tuberculosis drug. 65438-0957 has been successfully tried in patients with depression because of its central excitatory effects such as talkativeness, hyperactivity, insomnia and euphoria. Animal experiments show that it can reverse the apathy and inactivity caused by reserpine, and at the same time increase the monoamine content in the brain. It is speculated that its central excitatory and antidepressant effects are due to the decrease of monoamine degradation caused by inhibition of brain singleton oxidase, which leads to the increase of singleton content in the sudden release gap. Therefore, the relationship between animal behavior and brain receptors is put forward, which has important theoretical and practical significance and lays a foundation for the study of psychopharmacology and etiology of mental diseases.
Also included in this category are isocarbohydrazide, phenelzine and amphetamine. These drugs used to be widely used, but they were soon eliminated because they interacted with certain foods and substances to produce serious adverse reactions such as hypertensive crisis and acute yellow liver atrophy.
In the late 1980s, a new generation of half-day oxidase inhibitors appeared, which is a subtype of reversible monoamine oxidase (mao-a). Its characteristics are: 1 has high selectivity to mao-a, but low selectivity to another isoenzyme mao-b, so it can still degrade coolamine in food, thus reducing the risk of hypertensive crisis. The inhibitory effect of 2 on mao-a is reversible, and it takes only 8- 10 hour to restore the enzyme activity, while the inhibitory time of old amine oxidase inhibitor is as long as 2 weeks, which reduces the risk of interaction with food. The main product is moclobemide, the dosage is 150-450mg/d, and it is taken in batches. It is said that the efficacy is equivalent to tricyclic antidepressants.
Although it is safer than the old half-day amine oxidase inhibitor, we should still pay attention to postural hypotension and the potential interaction between food and drugs, which are generally not the first choice.
2. Tricyclic antidepressants
It is another kind of antidepressant after monoamine oxidase inhibitor, represented by imipramine.
Its chemical structure is similar to chlorpromazine. People think that it may be a new antipsychotic drug, but the clinical trial results are unexpected. This drug has no effect on schizophrenia, but it can improve depression. Later, it was confirmed by a large number of double-blind placebo-controlled studies that replacing monoamine oxidase inhibitors became the first choice for depression treatment, monopolizing the antidepressant market for 30 years.
There are 10 kinds of tricyclic antidepressants. In addition to imipramine, there are amitriptyline, doxepin and clomipramine in China. Although maprotiline has a tetracyclic structure, its pharmacological effects are consistent with tricyclic antidepressants. The indications of tricyclic antidepressants are various types of depression, the effective rate is about 70%-80%, the onset time is 1-2 weeks, the dosage range is 50-250mg/d, and the dosage is slowly increased and taken in batches. Because of its strong sedative effect, the dosage should be large at night. The plasma concentrations of imipramine and amitriptyline are 50-250ng/ml.
Tricyclic antidepressants have been used for the longest time in clinic, and their pharmacological effects have been studied most and fully. In short, their main pharmacological effects are: 1 blocking the reabsorption of monoamine transmitters (mainly adrenaline and 5-ht), increasing the content of synapses and producing antidepressant effects. Blocking a variety of transmitter receptors has nothing to do with the therapeutic effect, which is the main cause of many adverse reactions, such as acetylcholine M receptor stagnation, which can cause dry mouth, blurred vision, sinus tachycardia, constipation, urinary retention, glaucoma aggravation and memory dysfunction; Blocking adrenaline a 1 receptor can enhance the antihypertensive effect of prazosin, causing postural hypotension, dizziness and reflex tachycardia. Yin stagnation of histamine h 1 receptor can strengthen central inhibition, sedation, drowsiness, weight gain and blood pressure reduction; Yin stagnation of dopamine d2 receptor may lead to extrapyramidal symptoms and endocrine changes.
If the side effects of antidepressants are serious, they should be reduced, stopped or switched to other drugs. Generally speaking, the combination of two or more antidepressants is not recommended. Because of the high recurrence rate of this disease, treatment should be maintained for 4-6 months after the symptoms are relieved to consolidate the curative effect and prevent recurrence.
Let melancholy see the rainbow again
I have no energy or ability to do anything. What's more, I feel that living is meaningless and have suicidal thoughts. In this state, most people can realize that their state is abnormal, but they don't think they have the ability to change. They often take a negative coping style, lying in bed and saying to themselves: When my mood gets better, I can. However, when will the mood get better? It seems out of your control.
Faced with this situation, people are often quite distressed, eager to get rid of it but don't know where to start, so they can only wait blankly. In fact, people's emotions, thinking and behavior are interrelated, with one moving and all three moving. Among the three, behavior is the easiest to change by self-control. Therefore, when the mood is bad, individuals can indirectly improve their mood by actively changing their behavior. Here, I want to introduce you to a behavioral therapy. As long as you can fulfill the requirements, your life will be beautiful again. It is worth noting that if you or your friends have no hope of improvement at all, or even have suicidal thoughts, then you'd better see a psychologist. )
Find something you have always liked but haven't done for a long time, make a practical plan and finish it, and gradually increase meaningful activities in your life. With the increase of activities, you will find that there are many things you can do and your interest in life will gradually recover.
1, set a practical goal.
This goal should be feasible, that is to say, both external conditions and their own conditions should be met. The initial plan is easier to implement and requires less time and effort. If this process takes too much time and energy, if you are not interested in anything, you are more likely to give up halfway. If you are ready to act enthusiastically as soon as you think of a certain goal, you don't have to look down. You are not the object that this article hopes to help. If you live in an inland province, don't plan to enter DaHai You yet: If you have only swam in the swimming pool, don't plan to cross the Qiongzhou Strait. These goals are too ambitious for you at present.
Now, let's assume that your goal is to learn to swim this summer. Is this goal feasible? Yes, because several of my friends learned to swim in one summer, and they are not sports geniuses; I know there is a swimming pool not far from home, which provides swimming lessons; I have money to go to swimming lessons; I have time this summer.
2. Define your goal accurately.
Only when the goal is clear can we judge whether we have achieved it. Otherwise, you can always say to yourself, "I failed." To regain your confidence in life, you need a successful experience. Therefore, in the process of implementing this kind of behavioral therapy, you should make sure that you will succeed again and again and convince yourself that you can do what you want. So, please define your success criteria accurately.
Learn to swim this summer. When does this summer mean? June to September 2004. What kind of swimming? What is learning in breaststroke? You can swim 100 meters without any auxiliary tools. Well, on September 30th, you can check whether your goal has been achieved according to these standards.
3. Divide your action plan into small enough steps to ensure that your plan can be completed.
Make a detailed plan for your goals, and the goals to be achieved in each step of the plan are small enough to ensure that you can achieve them. For example, your first goal may be to determine the time of swimming class. You may scoff at this goal and think it's too easy. But for some people with depression, it is not easy to think of it and do it. Remember, when determining each sub-goal, make sure that you can accomplish it. Every time you accomplish a goal, you win, and every success will gradually increase your confidence. If you set too big a sub-goal, you are bound to fail. Failure again and again will hurt your confidence. Perhaps, after several failures, you will completely lose interest and confidence in this plan, give up halfway and return to the state of doing nothing before.
4. Define success by your own behavior.
In other words, don't involve other people's behavior in the goal. If your goal is to associate with people, be careful not to make such a goal: to have coffee with Xiao Li after work. The mistake of this goal is that whether this goal can be achieved depends on whether Xiao Li accepts your invitation. You can control your own behavior, but you can't control the behavior of others. So your goal violates the previous principle, and you are not sure whether this goal can be achieved. According to the principle of ensuring success, you can modify your goal like this: invite Xiao Li to have coffee with you after work. You will succeed as long as you make an invitation. As for Xiao Li's reaction, it doesn't matter. Invitation skills are another problem.
Don't add emotional factors to your goals.
In this plan, what matters is doing, not how you feel in the process of doing it. You can control your behavior, but you can't directly control your emotions. In a depressed state, it is difficult for you to get a happy feeling from any activity. Emotion will be affected by behavior, but this effect is not immediate and takes some time. Therefore, if you must be happy for success, then you are likely to fail. Don't set such a goal: "I want to swim happily twice", just "I want to swim twice" is enough.
Well, the main principles are over, and you can start making and implementing your plan. If you fail at some point, don't worry, failure at the first attempt is inevitable. Look back at these five principles, find out your mistakes and correct them. I believe you will overcome your depression and live a colorful life.
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