Depressive syndromes

Depressive syndromes are characterized by three main symptoms of the so-called depressive triad: low mood, slow thinking and motor inhibition. The most constant and important component of the triad, especially for mild depression - hypotonia, often leading to suicide, is a low mood. Therefore, it is important to start the treatment of depression as soon as possible, to eliminate the risk of suicide attempts.
When hypotonia depressed mood is usually complaining of weakness, lethargy, laziness, weakness, depression, sadness. Patients do not believe in their strength, exaggerating the real difficulties and at the same time blame themselves for cowardice, the inability to "pull yourself together". Many of them simultaneously complaining of a painful impression of their mental of perversity. They say they lost the opportunity to enjoy various personal or social events, less fully perceive the surrounding lost to much interest. It is melancholy depersonalization. Light depression often accompanied tearfulness, irritability, price they, resentment. Brain activity while they slowed down, depleted, lost shaped component of thinking in the minds prevail involuntarily arise a painful in its content of thought, in which the past and the present is represented only as failures and errors, and the future seems pointless. Patients is difficult and sometimes even impossible to concentrate, to think, to remember anything else that is irrelevant to their present state of health.
If gipotonii sedentary patients, traffic slowed down. The consciousness of the disease, sometimes exaggerated, stored in these patients always.
With strengthening of painful disorders appears affect depression, and often accompanied by pain in the chest or abdomen,the so - called predserdnaya longing. Most often, patients describe their dreary mood with these words: "my soul", "soul to squeeze", "in the soul searing pain", "Tosca presses", "pressing melancholy", "soul of misery tearing to pieces". Changes and melancholic depersonalization. Patients are beginning to complain of a feeling of inner emptiness, indifference, the disappearance of all the senses, even to a close,the so - called agonizing mental anaesthesia. In this condition, patients suggest that turned rigid, stiff, became dumb, ruthless. This is anaesthetic depression.
In other cases, patients are saying about the feeling of perversity outside world - "the light faded, faded leaves, the sun began to Shine less brightly, all moved away and stood, time stands still" - the so-called melancholy derealization. Often depersonalization and derealization disorders coexist simultaneously. With the deepening depression varies and self-esteem. Samofraki replaced nonsense. Patients are beginning to blame yourself for various crimes, corruption, selfishness, callousness, require on a "fair trial" and "the deserved punishment", say unworthy of attention, for nothing take the place in the hospital - depressive nonsense self-blame and self-abasement. Kind of depressed Breda is also nonsense ruin and impoverishment, especially frequent in patients of older age - "not enough money for a living, food is spent irrationally, the economy went into decline", etc. are Often based depressive delirium may be some valid reason, but always miserable, not corresponding to that scared or what the charges themselves sick. Musculoskeletal disorders can be achieved in these cases the intensity of depressive subtopia and even stupor. The characteristic appearance of such patients - they are inactive, silent, inactive, spent hours in a stooped posture or lie still. Face sad and monotonous. If you turn to him with the question, answered in monosyllables, often in a whisper, after a pause. From depressive stupor it is necessary to distinguish apathetic state. Apathetic (adinamicheskoy, spontannyi) syndrome - no motives to work in conjunction with impotence and indifference as to the surrounding world and to their own state. When apathetic syndrome does not happen delirium, depression, hallucinations, how can it be in depressive stupor. Sick for days and can still silently to lie down or sit, almost without changing his position, not paying attention to others. On questions answer is usually "Yes, no, or Yes-or-no question. Often the patient vaguely aware of abnormality in their condition.
Particularly intense symptoms of depression - and in the lungs, and in severe cases - in the morning hours, while in the second half of the day or night can usually be objective and subjective feeling better. This distinguishes them from asthenic States, where health is deteriorating always in the evening.
Along with the above options depressive syndromes, which is typical, there are a number of atypical depressive syndromes.
Dysphoric depression (dysphoria) is characterized by a combination of low, lonely or sad and disturbing mood with variously expressed irritability, leading often to anger with aggressive actions. Able dysphoria patients do not find a place, experience an irresistible urge to move, become Intrusive and annoying, demanding, impatient, dissatisfied with everything. Often while dysphoria patients try to commit suicide. Usually mood changes when dysphoria emerge sharp and can disappear. Their duration varies usually from a few hours to several days, weeks. Occasionally dysphoria continue for several months.
When ajitirovanne depression anxiety-melancholy mood is combined with speech and motor excitation.
About the presence ajitirovanne depression testify first of all such statements patients, which suggests that either they themselves or their loved ones will soon suffer misfortune or disaster. The alarm can be non-objective - patient, remaining in ignorance of the future, all the while waiting for trouble; in other cases, the specific anxiety - "shot", "kill", "throw in the cold". Patients usually talk a lot. Their statements are extremely monotonous, their content reflects the prevailing mood and crazy ideas. It consists of short phrases and separate words, often accompanied by Ohanian, moans, lamentations. The constant tendency of patients to repeat anxiously many times in a row without a break a word or short phrase - alarming verberata. Motor excitation (agitation) is a restlessness, a constant walk, frequent change poses. Many patients say they can't find the place that their something "tempted" to walk. Recidivating excitation increases during conversations with patients. Sometimes agitation suddenly takes on the character of frantic excitement with self-torture and attempts to kill himself - melancholic raptus. Nerezko expressed ajitation important sign indicating its existence, is breaking sick fingers.
Agitated depression may be accompanied by a melancholic depersonalization, mental anaesthesia, brad self-blame, self-destruction and ruin. In addition, it has other delusional picture. Most often nonsense charges - patient plead guilty, but at the same time believes that his guilt is exaggerated and that it unfairly attributed to negative qualities and actions, it is not peculiar. Usually nonsense charges combined with the affective, i.e. arise only if depressed mood, illusions, primarily verbal (acoustic) - in the conversations of others patients hear the accusations. Occurs also hypochondriac nonsense. In some cases, especially in patients after 45-50 years, depressive nonsense takes on the character of the vastness and denial - the so-called delirium Kotar: the patient - "Judas, Cain, he destroyed the whole world, for him there is no harvest, all withered, cool Earth", etc., In other cases, denial and the amounts relate to the patient's body- "rotten intestines, brain, lungs, no blood, muscles, nerves, but nevertheless the patient believes that will not die and will be tormented forever.
Hypochondriac depression. Patients complain of unpleasant and painful sensations in different parts of the body, have expressed fears that the firm conviction that they have a serious somatic diseases - cancer, tuberculosis, syphilis. The mood is usually reduced - anxiety, irritability and resentment.
All depression is always accompanied by a distinct physical changes, which may occur long before the appearance of affective disorders. This is primarily the decrease appetite and taste even their loss, weight loss, deterioration of turgor of tissues. Therefore, patients with depressive syndromes look older than his years. Normal night of sleep disorders. Women constant menstrual irregularities.