Endogenous depression

From year to year, more and more people are faced with such a concept as endogenous depression - a condition when everything in the world is seen in a dark color, nothing brings joy, there is no mood, neither rest nor work.

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

ICD 10 code

• F33.0 – Recurrent depressive disorder, mild.
• F33.1 – Recurrent depressive disorder, moderate.
• F33.2 - Recurrent depressive disorder, severe, with exclusion of psychotic features.
• F33.3 – Recurrent depressive disorder, severe, with psychotic features.
• F33.4 – Recurrent depressive disorder, period of remission.
• F33.8 - Other recurrent depressive disorders.
• F33.9 – Recurrent depressive disorder, unspecified.

Causes of endogenous depression

Genetic predisposition plays an important role in the development of endogenous depression, but the chances of developing a depressive disorder increase in people with certain character 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.

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

1. Biological category: involves a disorder of biological metabolic processes in the brain (metabolism involving norepinephrine, dopamine and serotonin). With the development of a depressive state, the level of the listed substances in synapses (areas where neurons connect to each other) decreases.
2. Genetic category: if someone in your immediate family develops depression, the chances of other family members developing the disease increase.
3. Psychological category: involves the influence of difficult life circumstances, health problems, loss of loved ones, frequent failures, and an unsettled personal life.

However, stressful situations and dissatisfaction with life cannot be the main cause - this is just a "trigger" 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 are confident that the pathogenesis of endogenous depression is associated with the development of preneurosis - a preceding condition when the body's defenses are reduced and a failure in mental activity occurs.

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

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Symptoms of endogenous depression

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

• The patient's mood is not affected by either positive or negative events. He absolutely does not care what is happening in his environment, because any events personally make him sad. Nevertheless, the main characteristic sign of this pathology is considered to be mood variability depending on the time of day: in the morning the mood is more depressed, and closer to the evening the condition is more or less normalized.
• Mental and motor retardation can be observed. The patient is capable of staying in one position for a long time, not wanting to move or somehow disturb his idyll. He has difficulty accepting any information, he has poor concentration and memory.
• The patient suffers from insomnia and chronic fatigue syndrome. He tosses and turns for a long time at night, feels "broken" and weak in the morning, and tires quickly. Dizziness, heart pain, nausea, thirst, muscle pain, and digestive disorders are often observed. Periodically worsening chronic pathologies are typical. Women may suffer from menstrual cycle disorders.
• Appetite is disturbed, weight changes – the patient may suffer from bulimia or anorexia.
• The patient often suffers from feelings of guilt and has low self-esteem.
• The patient develops persistent thoughts of 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 above symptoms should be treated, and always under the supervision of a doctor, to prevent the patient from making a fatal mistake.

Endogenous depression during pregnancy

In today's hectic times, endogenous depression develops in pregnant women in every fifth case. Such a number of depressive states is explained by the high level of unplanned conceptions, unsatisfactory economic and social conditions. Many are afraid to get pregnant for aesthetic reasons - they say, my figure will deteriorate, I will gain weight, no one will need me, etc.

Most often, this type of depression is a consequence of the exacerbation of preneurosis, which was latent even before pregnancy. The factors that can cause preneurotic syndrome include disagreements in the family, lack of understanding on the part of the partner, financial problems, etc.

How does this type of depression manifest itself:

• tearfulness;
• low mood;
• apathy;
• a feeling of uselessness and inferiority;
• complaints about the lack of attention from others;
• eating disorders (bulimia, loss of appetite);
• insomnia;
• irritability, lethargy.

Emotional dissonance is more pronounced in the first half of pregnancy, but in some cases it can continue until birth and even longer. The diagnosis is established by a psychotherapist at an appointment, after examining and questioning the patient.

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Consequences

If the disease is not given attention, the patient may become so immersed in the problem that he will have suicidal thoughts and even actions – he is capable of causing physical harm to himself, committing suicide.

Suicidal complications are a peculiar way for a sick person to relieve his relatives and friends from problems related to him. In order to avoid such possible consequences, it is necessary not only to undertake timely treatment, but also to provide full support and understanding to the surrounding relatives.

The transition of the disease into a chronic form is fraught with long-term sluggish symptoms that do not go away on their own, but only worsen over time. The disease is characterized by periodically recurring relapses (acute periods), which appear on their own, without a specific reason.

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Diagnosis of endogenous depression

Diagnostic procedure No. 1 is a clinical dialogue with the patient. The doctor pays attention to the patient's statements, his conclusions and experiences. The style of such a 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 must completely trust the specialist and follow his advice.

In addition to collecting information about the degree of the disease, the patient's dialogue with the doctor can also be the initial stage of psychotherapeutic treatment. This approach will calm the patient down at first, ease his emotional distress and reduce the possibility of a suicide attempt.

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

Differential diagnostics are carried out after using the scale: most often, endogenous depression is differentiated from a neurotic depressive state.

Instrumental diagnostic methods are also important. For example, during some examinations, specialists found dilation of the lateral ventricles and lack of symmetry of the cerebral ventricles in patients. Among additional possible signs, they also highlight changes in bioelectric brain activity, especially during sleep. In addition, tests for hormonal levels in the body help establish the correct diagnosis.

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Treatment of endogenous depression

Psychotherapy plays a major role in the treatment of depressive states. The specialist conducts psychological conversations, trying to slow down the subdepressive state. The doctor's goal is to set the patient up for positive thinking, eliminate fixation on dark moments in life and direct their gaze only to the search for good.

It is important to communicate with the patient's relatives and loved ones: the atmosphere within the family should be kind, non-conflictual, without excessive criticism from household members. Relatives should provide any emotional support and support the patient at any time.

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

Antidepressants for endogenous depression are prescribed for a stimulating effect on the body. For such predominant symptoms as melancholy or apathy, Imipramine, Clomipramine, Fluoxetine, Cipramine, Paroxetine are used. To eliminate subpsychotic syndrome, drugs such as Pirazidol, Desipramine are used, which relieve anxiety.

The feeling of anxiety, which is accompanied by irritability and gloomy mood, frequent attacks of anxiety, can be treated with antidepressant drugs with a calming effect. Such drugs include Amitriptyline - it successfully eliminates a significant degree of anxious depressive state with thoughts of suicide. Amitriptyline is taken immediately after meals, 25 mg 2-3 times a day. At the discretion of the doctor, the dosage can be increased, but all prescriptions of tricyclic antidepressants are carried out only on an individual basis, taking into account the severity of the disease. Usually, an improvement in the condition is observed within 3-4 weeks from the start of treatment. If there is no improvement, the drug is canceled and another is prescribed, according to the indications.

Minor manifestations of the disease with depressed mood are relieved with the help of Ludiomil or Azefen.

If taking antidepressants is accompanied by pronounced side effects or increased blood pressure, it is recommended to switch to the drug Coaxil, and in relatively mild cases, herbal remedies, such as Hypericin, can be used. Treatment with drugs can be combined, since all drugs in this group have different chemical compositions and act differently to eliminate depression.

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

Folk remedies

For endogenous depression, traditional medicine specialists recommend eating fruits and vegetables of bright colors, primarily orange - these are citrus fruits, carrots, persimmons, berries, etc.

We also offer you several simple and effective recipes that can be used to get rid of a mild course of the disease, as well as an addition to the main drug treatment.

• A good effect is observed from the use of alcohol tincture of St. John's wort (20 g of the herb per glass of 40% alcohol, leave for up to 3 weeks). Take 20 drops of the tincture in the morning and at night. In case of severe insomnia, it is recommended to add mint leaves, valerian or motherwort to St. John's wort, and increase the dosage before bed to 40 drops.
• You can make herbal tea using rosemary leaves, St. John's wort, lemon balm leaves, and blueberries. Take 200-250 ml of boiling water per tablespoon of the herbal mixture, let it brew for 20 minutes, and drink it instead of tea. You can add honey for flavor.
• Relaxing baths have a wonderful effect, especially if they are taken at night. Grind the needles of a young spruce or pine, pour water over them and boil for half an hour under a lid. Remove from heat and leave for about 10 hours. Add this decoction to the bath, taking it once every 2 days.
• An infusion of borage (1 tbsp – 250 ml of boiling water, leave for 2 hours) will help to banish depression and lift your spirits. Drink this infusion throughout the day.
• It is useful to add fennel, lavender, and anise to tea, both separately and in combination with each other.
• For mild depression, it is recommended to drink warm lemon balm tea, adding a little natural honey and lemon juice.
• A wonderful and tasty remedy for depression is a portion of hot chocolate with cinnamon. To prepare it, boil 500 ml of milk, cool it and add 1 tablespoon of whipped cream. Put melted chocolate there (to taste) and slowly heat until the chocolate is completely dissolved (do not boil). Then pour the drink into a cup and sprinkle with a small amount of cinnamon.
• Tea with cinnamon and cherry juice will help you relax and improve your mood. You need to prepare regular black or green leaf tea, add cinnamon on the tip of a knife. After 5 minutes, pour in some cherry juice, sprinkle with lemon zest and add sugar to taste. Let it brew for another 1-2 minutes, then you can drink it.
• Experts recommend adding chamomile flowers, mint and lemon balm leaves, hop cones, valerian and angelica rhizomes, and lavender flowers to tea.
• Some products stimulate the production of serotonin, a hormonal substance responsible for a good mood. A patient suffering from depression should have enough of these products on his or her table: strawberries, bananas, dried apricots, chocolate (mostly dark), melon, dates, cocoa, honey. Nuts are also useful (especially walnuts, pine nuts, and cashews).

Herbal treatment is used for mild cases of the disease or for depression that is just beginning. In more severe and advanced cases, you cannot rely on folk treatment alone; you must consult a specialist.

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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 preparations often demonstrate a good effect against the background of the absence of side effects and contraindications. But even such preparations cannot be prescribed independently: it is important to take into account the individual course of the disease, the characteristics of the patient, as well as to know and understand the action of this or that component of the drug.

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

• Ignace Gommacord (Heel, Germany).
• Climact heel.
• Klimaktogran (NGS, Ukraine).
• Mulimen (Heel).
• Nevoheel.
• Notta (BITTNER, Austria).
• Snoverin (Arnica, Ukraine).
• Sleep is normal (NGS, Ukraine).
• Cerebrum compositum heel.

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

Prevention

If you have predispositions to developing depression (heredity, deterioration of health, etc.), then it is better to take preventive measures in advance. What should be done for this?

• Cancel difficult tasks 2-3 weeks in advance, devote more time to rest.
• You will have to postpone solving important tasks for the near future, because the state of your health is incomparably more important.
• Don't allow yourself to be lonely, communicate with good people. If a company or a person "stresses" you out, don't allow a conflict situation, find more suitable interlocutors for yourself.
• Try to find a reason for positive emotions - watch a good movie, read a book, take a walk in the forest or park.
• Do something you love. It could be a sport or a favorite hobby.
• Outdoor sports and swimming are welcome.
• Consume less simple sugar and caffeine, eat more natural products – vegetables, fruits, dried fruits, berries, greens.
• Take a contrast shower in the morning and a soothing bath at night.
• Listen to your favorite music.
• Buy a multivitamin supplement containing B vitamins from a pharmacy.
• Smile more often, even at your reflection in the mirror.
• If possible, change your environment – go to the sea, to the mountains, to a sanatorium, or just go fishing or hiking with friends.
• Follow the above tips and within the first week you will feel your strength restored and your mood improved.

Forecast

Depressive states can progress differently in different people. However, success in treatment largely depends on the patient and his environment, since therapy for the disease is usually long-term and requires a lot of effort and patience.

Often patients voluntarily stop taking medications, which inevitably leads to an exacerbation of the disease. For this reason, doctors should explain to patients that there are certain rules for using antidepressants:

• Antidepressants should be taken even after the symptoms of depression have disappeared. Depending on the indications, their use can continue for several months or even years;
• You cannot suddenly stop taking medications - the withdrawal should be gradual, with a slow reduction in dosage and frequency of taking the drugs;
• If depression is chronic, then in most cases medications are taken throughout life.

Being in a state such as endogenous depression, the patient often cannot force himself to fight the disease. This must be remembered: therefore, the support of relatives and friends during treatment is extremely important. During the therapy, the patient will feel better and better, the main thing is not to give up, not to give in to "dark" thoughts and learn to wait and look at the world positively. The more the patient is determined to recover, the faster it will come.

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