1, depressed
Mainly manifested as significant and lasting depression, depression and pessimism. Lighter people are unhappy, have no sense of happiness, and their interest declines. Heavy people are miserable, pessimistic, desperate and dying. The typical patient's depression mood has the rhythm change of morning weight and night light. On the basis of depression, patients will have a low self-evaluation, resulting in a sense of uselessness, hopelessness, helplessness and worthlessness, often accompanied by self-blame, severe paranoia and hypochondria, and some patients will also have hallucinations.
Step 2 think slowly
The patient's thinking association speed is slow, the reaction is slow, the thinking is blocked, and he consciously "the brain is like a rusty machine" and "the brain is like a layer of paste". Clinically, active speech is reduced, speech speed is obviously slowed down, voice is low, and it is difficult to answer. In severe cases, communication cannot be carried out smoothly.
3. The activity will decrease.
The patient's will activity was significantly and permanently inhibited. Clinical manifestations are slow behavior, passive and lazy life, unwilling to do things, unwilling to contact with people around, often sitting alone, or staying in bed all day, living alone behind closed doors, alienating relatives and friends and avoiding socializing. In severe cases, even the physiological needs such as eating and drinking, personal hygiene, etc. are ignored, unkempt, and even develop into silence, immobility, and no eating, which is called "depressive stupor". However, after careful mental examination, the patient still showed pain and depression. Anxiety patients may have symptoms such as fidgeting, scratching their fingers, rubbing their hands and stamping their feet or pacing back and forth. Severe patients are often accompanied by negative suicidal thoughts or behaviors. Negative and pessimistic thoughts, self-blame and guilt, and lack of self-confidence will all sprout desperate thoughts. They believe that "ending one's own life is a relief" and "living in the world is a redundant person", which will make suicide attempts develop into suicide. This is the most dangerous symptom of depression, so be vigilant.
Depression 4, cognitive impairment
Studies have shown that people with depression have cognitive impairment. Mainly manifested in recent memory decline, attention disorder, prolonged reaction time, increased alertness, poor abstract thinking ability, learning difficulties, poor language fluency, spatial perception, hand-eye coordination and poor thinking flexibility. Cognitive impairment leads to social dysfunction and affects the long-term prognosis of patients.
5. Physical symptoms
There are mainly sleep disorders, fatigue, loss of appetite, weight loss, constipation, pain in any part of the body, loss of libido, impotence, amenorrhea and so on. Physical complaints can involve various organs, such as nausea, vomiting, palpitation, chest tightness, sweating and so on. Symptoms of autonomic nervous dysfunction are also common. The chief complaint of physical illness before illness is usually aggravated. Sleep disorder is mainly manifested as waking up early, generally 2 ~ 3 hours earlier than usual, and can't sleep again after waking up, which is of characteristic significance to the onset of depression. Some show difficulty in falling asleep and lack of sleep; A few patients showed too much sleep. Weight loss is not necessarily proportional to loss of appetite, and a few patients may have increased appetite and weight gain.
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Drug treatment of depression.
First, medication.
Depression tends to recur. Therefore, there are two purposes of treatment: controlling acute attack and preventing recurrence.
1, drug selection:
At present, TCAS is still the first-line drug for the treatment of depression, and the second generation of atypical antidepressants is the second-line drug, followed by MAOIS.
2. The treatment of bipolar depression is basically the same as that of unipolar depression, but the antidepressants used by bipolar patients may turn into hypomania, so antidepressants and lithium salts are often used in combination.
Antidepressants alone may not be effective in the treatment of psychotic depression, and antipsychotics such as perphenazine and sulpiride are often needed.
3, course of treatment and dosage:
In addition to correct diagnosis and reasonable drug selection, course of treatment and dosage are crucial to the success of treatment. The common mistake is that we don't know enough about the risk of recurrence and suicide of depression, so the dose is often small and the course of treatment is short.
The treatment of depression can be divided into three stages (three-stage treatment):
(1) Acute treatment period with the goal of controlling symptoms: sufficient until the symptoms disappear.
(2) Continuous treatment period with the goal of consolidating curative effect and avoiding disease recurrence; It takes about 4 to 9 months from the disappearance of symptoms to full recovery. If the symptoms are not fully recovered, the condition is easy to repeat.
(3) Preventive treatment period aimed at preventing recurrence. The latter two stages are not easy to be completely separated, and are often collectively referred to as maintenance treatment. It is generally believed that the following situations need maintenance treatment: ① depression authors have three or more times; ② Previous seizures, such as the first seizure under 20 years old; Two severe seizures in 3 years or two frequent seizures in 1 year and a positive family history. The duration and dose of maintenance depend on the number and severity of attacks.
Second, cognitive therapy.
The basic principle of depression treatment developed in 1960s is that patients with depression have negative views on themselves, the world around them and the future. Due to cognitive bias, both positive and negative events are treated with a negative attitude. The purpose of treatment is to make patients realize their wrong reasoning mode, so as to actively and consciously correct it. The course of treatment is 12 ~ 15 weeks, and there is no significant difference between the curative effect and the drug. If used together, the curative effect may be better. In recent years, computer-assisted cognitive therapy has been adopted.
Third, find another way
1, electroshock therapy
It is a fast and effective treatment method, which uses a certain amount of current to pass through the brain, stimulate the discharge of the central nervous system, and the muscles of the whole body twitch rhythmically. Under the operation of professional doctors, you can hardly feel pain, and can quickly relieve depressive symptoms and emotions, with a total effective rate of 70%-90%.
Usually, after electroconvulsive therapy, psychological therapy and drug therapy are often continued.
2. Alternative therapy
For depression that can't be treated by traditional western medicine, alternative therapy can be adopted, including a series of means from diet and exercise to social environment and lifestyle. Including acupuncture, intention guidance, yoga, hypnosis, herbs, massage, relaxation therapy, spice massage therapy, spinal acupressure therapy and biofeedback therapy. Substitution therapy alone can only be effective for mild depression, but not for severe depression.
3. Experimental therapy
Experimental therapy is usually not carried out by doctors, and its safety and effectiveness have not been proved.
4. HRT for female hormone replacement therapy
The proportion of women suffering from depression is higher than that of men. Before and after menopause, women's hormones will change, leading to emotional changes, often causing premenstrual syndrome, premenstrual discomfort and postpartum depression. This method can relieve menopausal symptoms, such as night sweats and hot flashes. Hormone replacement therapy itself may also lead to depression. If you have ever suffered from depression, you should tell your doctor before considering using this therapy.
Exercise therapy for depression. reflexotherapy
Reflexive therapy is a technique in which practitioners exert pressure on the fixed parts of patients' hands and feet. Reflexologists believe that the human body has the function of self-repair, and the nerves of hands and feet are connected with other parts of the body. By stimulating some parts of hands and feet, diseases can be treated by using the principle of reflection.
6. Exercise therapy
Different forms of exercise can help people reduce stress, relax, relieve depression, make you full of energy, increase balance and flexibility. Generally speaking, exercise therapy is safe, effective and simple, but you must consult your doctor before starting a new exercise plan.