Endogenous depression

From year to year, an increasing number of people are faced with such a concept as endogenous depression - this is a state where everything in the world is seen in a dark color, nothing brings joy, no mood, no rest, no work.

Most often, this pathology has a protracted course, requires drug treatment under the supervision of a medical specialist.

ICD Code 10

• F33.0 - Recurrent depressive disorder, mild degree.
• F33.1 - Recurrent depressive disorder, moderate degree.
• F33.2 - Recurrent depressive disorder, severe, with the exception of psychotic signs.
• F33.3 - Recurrent depressive disorder, severe, with psychotic symptoms.
• F33.4 - Recurrent depressive disorder, remission period.
• F33.8 - Other recurrent depressive disorders.
• F33.9 - Recurrent depressive disorder, unspecified.

Causes of endogenous depression

An important role in the development of endogenous depression is played by genetic predisposition, but the chances of a depressive disorder increase in people with certain traits:

• with a heightened sense of duty and justice;
• with a sense of responsibility;
• with a sense of fear of making a mistake or doing something wrong.

Actually, the causes of the disease can be divided into three main categories:

1. Biological category: involves the disruption of biological metabolic processes in the brain (exchange with the participation of norepinephrine, dopamine and serotonin). When the depressive state develops, the level of the listed substances in the synapses (the areas of neuronal attachment to each other) decreases.
2. Genetic category: when someone is depressed, someone from their next family members gets a chance to get sick from other family members.
3. Psychological category: provides for the impact of severe life circumstances, health problems, loss of loved ones, frequent failures, unsettled personal life.

Nevertheless, stressful situations and discontent with life can not be the main reason - this is just a "triggering mechanism" of depression. Undoubtedly, even before the onset of the disease, the first prerequisites gradually appeared, which were not so pronounced as to attract the attention of the patient and his environment.

Experts believe that the pathogenesis of endogenous depression is associated with the development of prednevroz - the previous state, when protective capabilities in the body decrease, and mental activity is disrupted.

Thus, if the patient claims that the cause of the depressive disorder is a family problem, stress or other pathology in the body, then he will not be completely right. The traumatic situation only aggravated the problem and accelerated the development of depression, which allowed the hiding current to fully manifest itself.

[1], [2], [3], [4], [5]

Symptoms of endogenous depression

The first signs of endogenous depression are frequent negative mood, inhibition, reluctance to rejoice, even if there are good reasons for that.

• The mood of the patient is not affected by either positive or negative events. He absolutely does not care what is going on in his environment, because personally any of his events drove into depression. Nevertheless, the main characteristic sign of this pathology is the variability of mood in relation to the time of day: in the morning the mood is more oppressed, and closer to the evening the state more or less normalizes.
• You can notice mental and motor retardation. The patient is able to stay in one position for a long time, not wanting to move and somehow violate his idyll. He takes all information seriously, he has poor concentration of attention and memory.
• The patient suffers from insomnia and chronic fatigue syndrome. At night, he turns around a lot, next morning feels "broken", weak, quickly tired. Often observed dizziness, pain in the heart, nausea, thirst, muscle pain, digestive system disorders. Characterized periodically exacerbated chronic pathologies. Women may suffer a violation of the monthly cycle.
• The appetite is broken, weight changes - the patient may suffer from bulimia or anorexia.
• The patient often suffers from a sense of guilt, his self-esteem is understated.
• The patient develops annoying thoughts about suicide, which he does not share with anyone. However, in most cases, he lacks the strength and determination to commit suicide.

A person with the symptoms listed above should be treated, and always under the supervision of a doctor, to prevent the patient from committing a fatal error.

Endogenous depression in pregnancy

In the current fussy time, endogenous depression in pregnant women develops in every fifth case. Such a number of depressed states is explained by the high level of unplanned conceptions, unsatisfactory economic situation and social situation. Many are afraid to become pregnant for aesthetic reasons - say, the figure will deteriorate, I will grow fat, I will not need anyone, etc.

Most often, this type of depression becomes a consequence of exacerbation of prednevroz, which was hidden before pregnancy. Factors in the emergence of a pre-neurological syndrome may be disagreements in the family, lack of understanding on the part of the partner, financial problems, etc.

What is the manifestation of such depression:

• tearfulness;
• low mood;
• apathy;
• feeling of own uselessness and inferiority;
• complaints about inattention to others;
• eating disorders (bulimia, loss of appetite);
• insomnia;
• irritability, lethargy.

Emotional dissonance is more evident in the first half of the gestation, but in some cases can continue until childbirth and even more. The diagnosis is established by the therapist at the reception, after examination and questioning of the patient.

[6], [7]

Effects

If you do not attach importance to the disease, the patient can go deep into the problem so much that he will have suicidal thoughts and even actions - he is able to inflict physical damage, commit suicide.

Suicidal complications are a peculiar way of a sick person to relieve their relatives and loved ones from the problems associated with it. To avoid such possible consequences, one should not only take timely treatment, but also provide full support and understanding of the surrounding native people.

Transition of the disease into a chronic form is fraught with prolonged sluggish symptoms that do not go away on their own, but with time only worsen. Diseases are characterized by recurring recurrences (acute periods) that appear on their own, without a specific cause.

[8], [9], [10], [11], [12], [13]

Diagnosis of endogenous depression

Diagnostic procedure number 1 is a clinical dialogue with the patient. The doctor pays attention to the patient's statements, his conclusions and experiences. The style of this conversation is determined by the experience and qualifications of the doctor. During the conversation, the patient must understand that they are trying to help him, and he should completely trust the specialist and follow his advice.

In addition to collecting information about the degree of the disease, the dialogue between the patient and the doctor may also be the initial stage of psychotherapeutic treatment. This approach will at first calm the patient, ease his emotional unrest and reduce the possibility of attempting suicide.

Among the diagnostic measures often used are the so-called "graduated scales", for example, the well-known psychopathological scale for assessing the depressive state of Hamilton. This method is used not only for diagnosis, but also for grouping and determining the severity of depression.

Differential diagnosis is performed after using the scale: most often, endogenous depression differentiates with a neurotic depressive state.

Instrumental methods of diagnostics are also important. For example, in some examinations, specialists detected an expansion of the lateral and lack of symmetry of the cerebral ventricles in patients. Among the additional possible signs, there is also a change in bioelectric brain activity, especially during sleep. In addition, help to establish the correct diagnosis of hormone levels in the body.

[14], [15], [16], [17]

Treatment of endogenous depression

Psychotherapy plays a major role in the treatment of depressive conditions. The specialist conducts psychological conversations, trying to slow down the subdepressive state. The doctor's goal is to adjust the patient to positive thinking, to eliminate the cycle of dark life moments and to focus his attention only on the search for the good.

It is important to communicate with relatives and friends of the patient: the atmosphere within the family should be good, non-conflict, without excessive criticism from the household. Native people should provide any emotional support and at any time support the patient.

Treatment is not always carried out in a hospital. Often the home environment is more conducive to recovery - the patient takes medication prescribed by the doctor at home, while regularly visiting his doctor.

Antidepressants in endogenous depression are prescribed for stimulating effects on the body. With such preferential signs, as melancholy or apathy, apply Imipramine, Clomipramine, Fluoxetine, Cipramine, Paroxetine. To eliminate the subpsychotic syndrome, use drugs such as Pyrazidol, Desipramine, which relieve anxiety.

The sensation of anxiety, which is accompanied by irritability and moody mood, frequent bouts of anxiety, can be treated with antidepressant drugs with a soothing effect. These drugs include Amitriptyline - it successfully eliminates a significant degree of anxious depressive state with thoughts of suicide. Amitriptyline is taken immediately after a meal of 25 mg 2-3 times a day. At the discretion of the doctor, the dosage can be increased, however, all tricyclic antidepressant prescriptions are performed only on an individual basis, taking into account the severity of the disease. Usually, the improvement of the condition is observed during 3-4 weeks from the beginning of admission. If no improvement occurs, the drug is canceled and another is prescribed, according to the indications.

Minor manifestations of the disease with a depressed mood stop with the help of Lyudomil or Azefen.

If the use of antidepressants is accompanied by severe side effects or an increase in blood pressure, it is recommended to switch to the use of the drug Coaxil, and in relatively mild cases, plants of plant origin, for example, Hypericin, may be used. Treatment with drugs can be combined, as all drugs in this group have different chemical composition and act to eliminate depression in different ways.

After the main signs of the disease have been eliminated, treatment is recommended to continue for another 4-6 months. This will serve as a good prevention of repeated exacerbations or withdrawal symptoms.

Alternative treatment

With endogenous depression, experts of alternative medicine recommend eating fruits and vegetables of bright colors, mainly orange ones - citrus fruits, carrots, persimmons, berries, etc.

Also we offer to your attention a few simple and effective recipes that can be used to get rid of the mild course of the disease, and also as an addition to the basic medication.

• A good effect is observed from the use of alcoholic tincture of St. John's wort (20 g of grass for a glass of 40% alcohol, insist for up to 3 weeks). Take tincture of 20 drops in the morning and at night. When expressed insomnia in St. John's wort, it is recommended to add mint leaves, valerian or motherwort, and dosage before going to bed is increased to 40 drops.
• You can prepare herbal tea on the basis of leaves of rosemary, St. John's wort, Melissa and blueberry leaves. For one tablespoon of plant mass take 200-250 ml of boiling water, insist up to 20 minutes and drink instead of tea. For taste, you can add honey.
• A wonderful effect is provided by relaxing baths, especially if they are carried out at night. Grind the needles of young fir or pine, pour water and boil for half an hour under the lid. Take off from the fire, insist about 10 hours. This broth is added to the bath, taking it once in 2 days.
• Exorcist depresses and cheers up the cucumber grass (1 tablespoon - 250 ml of boiling water, insist 2 hours). This infusion is drunk throughout the day.
• It is useful to add fennel, lavender, anise to tea, both separately and in combination with each other.
• With a mild depression, it is recommended to drink warm tea based on lemon balm, adding a bit of natural honey and lemon juice.
• A wonderful and tasty remedy for a depressive state is a portion of hot chocolate with the addition of cinnamon. For cooking, boil 500 ml of milk, cool and add 1 tablespoon of whipped cream. Put the same melted chocolate (to taste) and slowly warm up until the chocolate dissolves completely (do not boil). Next, pour the drink into a cup and sprinkle with a small amount of cinnamon.
• Tea with cinnamon and cherry juice will help to relax and improve mood. It is necessary to prepare usual black or green leaf tea, add cinnamon on the tip of the knife. After 5 minutes, pour a little cherry juice, sprinkle with lemon zest and pour sugar to taste. Infuse another 1-2 minutes, after which you can drink.
• Specialists recommend adding chamomile, mint leaves and melissa, hops, rhizomes of valerian and angelica, color of lavender to tea.
• Some products stimulate the production of serotonin, a hormonal substance responsible for a good mood. These products should be enough on the table of a patient suffering from depression: strawberries, bananas, dried apricots, chocolate (mostly dark), melon, dates, cocoa, honey. Also useful are nuts (especially walnuts, cedar and cashew).

Treatment with herbs is used for mild disease, or with only a nascent depression. In more severe and neglected cases, you can not rely on alternative treatment, it is necessary to consult a specialist.

[18], [19], [20], [21], [22]

Homeopathy

Natural components and a natural approach to treatment are offered by homeopathic specialists. Of course, there is no panacea for all diseases, but homeopathic remedies often demonstrate a good effect against the background of the absence of side effects and contraindications. But even such drugs can not be prescribed independently: it is important to take into account the individuality of the disease course, the characteristics of the patient, and also to know and understand the effects of a particular component of the drug.

Of the many drugs that are registered and approved for use in our country, a number of the most effective in endogenous depression are distinguished.

• Ignacy Gommakord (Heel, Germany).
• Climatic heel.
• Klimaktogran (NGS, Ukraine).
• Mulimen (Heel).
• Nevocheel.
• Notta (BITTNER, Austria).
• Snoverin (Arnica, Ukraine).
• Sleep norm (NHS, Ukraine).
• Cerebrum compositum helium.

The use of drugs is usually long, at least a month. Coordination of treatment with a doctor is mandatory.

Prevention

If you have the prerequisites for the development of depression (heredity, deterioration of well-being, etc.), then it is better to take preventive measures in advance. What needs to be done for this?

• Cancel complicated business for 2-3 weeks ahead, take more time to rest.
• It is necessary to postpone the decision of important tasks for the near future, because the state of your health is incommensurably more important.
• Do not let your loneliness, communicate with good people. If the company or person "strains" you, do not allow a conflict situation, find for yourself more suitable interlocutors.
• Try to find a reason for positive emotions - see a good movie, read a book, stroll through the forest or park.
• Do what you love. It can be a sport or a favorite hobby.
• Welcome to sports games in the fresh air, swimming.
• Eat less simple sugar and caffeine, eat more natural products - vegetables, fruits, dried fruits, berries, greens.
• In the mornings take a contrast shower, and at night - a soothing bath.
• Listen to your favorite music.
• Buy a multivitamin drug, which includes vitamins of group B, in the pharmacy.
• Smile more often, even to your reflection in the mirror.
• If possible, change the situation - go to the sea, to the mountains, to a sanatorium, or just with friends for fishing or hiking.
• Follow the listed tips, and already during the first week you will feel the recovery and increased mood.

Forecast

Depressive state in all people can proceed in different ways. However, in many respects the success in treatment depends on the patient and his environment, as the therapy of the disease is usually long and requires a lot of strength and patience.

Often patients arbitrarily abolish medication, which inevitably leads to an exacerbation of the disease. For this reason, doctors should explain to patients that there are certain rules with the use of antidepressants:

• antidepressants should be taken after the disappearance of symptoms of depression. Depending on the indications, their admission may last several months and even years;
• You can not stop taking medications abruptly - the withdrawal should be gradual, with a slow decrease in dosage and the frequency of medication intake;
• If depression has a chronic course, then in most cases, drugs are taken throughout life.

Staying in such a state as endogenous depression, the patient often can not bring himself to join the fight against the disease. This should be remembered: therefore, support of relatives and friends during treatment is extremely important. In the process of therapy, the patient will feel better and better, the main thing is not to give up, not to succumb to "dark" thoughts and learn to wait and see the world positively. The more patient will be adjusted to recovery, the faster it will come.

[23], [24], [25], [26]