According to WHO, currently up to 10% of the adult population of the Earth suffers from depressive disorders of various origins and severity. And in the elderly, this pathology is noted in about 59% of people. At the same time, the analysis of the structure of morbidity indicates that there are statistically significant gender differences. Exposure to depression in women is about 2 times higher than that of men. These differences are most pronounced in late reproductive and pre-climactic ages, somewhat smoothed over to the elderly and senile life-period.
- 1What is meant by depression
- 2Why is this so important?
- 3Causes of Depression
- 4The main signs of depression
- 5Other manifestations of female depression
- 6What to do
What is meant by depression
Depression refers to mental disorders of the affective spectrum. Under this name unite different in etiology, symptomatology and prognosis of the state, the key feature of which is a persistent pathological decline in mood. In most cases, they have a non-psychotic level, with a significant proportion accounting for neurotic register disorders.
But is a bad mood always a depression? In modern society, there is a tendency to use this term to refer to any depressed affect. In fact, depression (more precisely, depressive disorder) is a disease, and not just a reaction to some kind of failure or unfulfilled expectation. And it is based on persistent and rarely self-correcting functional disorders of the neurons of the brain.
The main criteria for a depressive disorder of any degree of severity are a persistent decline in mood, a decrease in general tone (energy), and deactivation of former interests. For the diagnosis, at least 2 of these signs must be present for at least 2 consecutive weeks, in combination with 2 or more additional symptoms of the cognitive and / or somatic spectrum.
Why is this so important?
Depression (depressive disorder) is considered a disease of modern civilization. The urgency of this problem is connected not only with a steady increase in the incidence rate. The negative influence of depression on the course of many somatic diseases, the adherence of patients to the prescribed therapy and the duration of the rehabilitation period is proved. It can serve as the first symptom of some neurological pathology: for example, Parkinson's disease and Alzheimer's disease.
Affective disorders often lead to temporary and even persistent disability. About 13% of cases of disability are caused by persistent or often recurrent depression. And the average duration of temporary incapacity for such affective disorders is at least 40-60 days, and in many cases suffering from depression of the patient before long enough time receive treatment within the framework of the medical network.
Untimely diagnosis of depression is one of the most important factors of patient dissatisfaction with the quality of the medical care, the appointment of a variety of different studies and ineffective therapy.
After all, often patients with affective disorders make complaints not at all on a bad mood. To the physician they are led by physical discomfort and deterioration of the quality of life. At the same time, an expert who is not sufficiently informed about possible symptoms of depression will conduct a diagnostic search for a somatic orientation, losing time and leaving a woman without proper treatment.
And the patients themselves in our country often avoid treatment to a psychiatrist. This is largely due to the mentality and fears about possible negative social consequences.
Causes of Depression
The main causative factors of depression in women include:
- Psychogeny - different in strength and duration of stressful events. The depressive disorder developing at the same time is referred to as reactive states or to adaptation disorders.
- Endogenous mental illness: bipolar affective disorder (formerly called manic-depressive syndrome), unipolar recurrent depressive disorder, schizotypy, schizophrenia (especially its neurosis-like variant).
- Pathological climacteric syndrome, which occurs with pronounced psychovegetative and metabolic-endocrine disorders. The pathogenetic factor of developing with this depression is the inadequacy of adaptive mechanisms against the background of the progressive deficiency of estrogens.
- Neurological diseases with the defeat of various structures of the brain. The most likely depression in patients with Parkinson's disease, chronic vascular cerebral ischemia, multiple sclerosis, after a stroke. Affective disorders are secondary and are caused by deficiency and imbalance of various neurotransmitters.
As a psychogenic factor, acute mental trauma can occur in connection with the death of a loved one, death fetus in utero and in childbirth, violence, natural and domestic cataclysms, massive trauma with loss of limbs. Acute stress can be the dismissal or change of place and nature of work, obtaining information about the incurable disease of any location, adultery and many other situations.
Chronic stress is also often the cause of depression. At the same time, only personally significant situations become traumatic, provided that it is impossible to adequately solve the problem or even fully emotionally respond to it. Therefore, depressive disorders are often detected in women whose husbands and children suffer from various addictions or severe disabling and immobilizing diseases. Of great importance are also the performed radical operations, especially those involving the removal of a part of the limb, breast and other visible parts of the body.
Often there is depression in the first months after the birth of a child. The mechanism of its development can be caused by a sharp change in the endocrine status, forced disabilities the daily rhythm of sleep and wakefulness, asthenia, a neurotic reaction to a dramatically changed lifestyle. In the early postpartum period, depression is often the onset of endogenous mental illness and reaches the depth of affective psychosis.
The main signs of depression
The classic depressive syndrome includes several key components:
- Actually affective disordersin the form of persistently reduced background of mood. In this case, as complaints most often appear joylessness, pessimism, loss of interest in any occupation and professional activity, increased sensitivity to negative events and news, tearfulness. Quite often occurring daily fluctuations do not lead to normalization of affect. Pleasant external stimuli, too, do not contribute to a clinically significant improvement in the condition.
- Ideator (intellectual) inhibition.A person with classical depression is slower to comprehend events, worse learns new information, often experiencing difficulties with keeping attention and switching from experiences to external factors. He looks immersed in his own thoughts. With deep depression, the severity of this ideator component can reach the degree of pseudodementia, which can lead to an erroneous diagnosis of a debilitating disease of the brain.
- Motor retardation. Manifestations of such an engine component of depression are impoverishment of mimicry and gestures, a tendency toward low mobility up to freezing. A person with deep depression usually lies awake in bed for most of the day, for a long time sits in one pose. He can refuse even to meet basic daily needs.
- Affective change in thinking: the idea of self-deprecation and guilt, pessimism, a decline in self-esteem, suicidal thoughts, hypochondria.
- Violation of vital functionswith the advent of somatic symptoms. These include worsening of appetite, propensity to constipation, autonomic dysfunction with unstable blood pressure. Most patients develop insomnia (sleep disturbances), which can be manifested by insomnia, daily inversion of sleep with its shift to daytime, lack of a sense of sleep. In women of reproductive age, the menstrual cycle is often violated.
The most pronounced are all these signs with true endogenous depression. Such a disorder is most often apathetic, blind, with obvious ideomotor and somatic components. It is characterized by daily fluctuations in the state with some relief in the afternoon. Suicidal attempts are possible, crazy ideas of the nihilistic plan, excruciating senselessness.
But a woman with a neurotic and neurotic-like affective disorder looks different. Signs of her depression are often mistaken for other diseases or considered secondary, which is the reason for the late onset of treatment.
Other manifestations of female depression
Depressive disorder in women can occur without a characteristic apparent disturbance of mood. The decreased affect in this case fades into the background, the prevailing are the somatic symptoms. This depression is called masked, larvated, somatized. It is classified as a group of psychosomatic disorders.
A woman with this type of depression is treated long and unsuccessfully by a therapist, cardiologist, gastroenterologist, neurologist or other specialist. Medical statistics show that at least 10% of repeated applications to the general practitioner in the outpatient network are due to psychogenically conditioned somatic disorders. In this case, the reason for visits to the clinic most often become fluctuations in blood pressure, chronic back pain, digestive disorders, headaches. Rarely as the main complaint are indomitable pruritus, dysuria, loss or perversion of taste.
Depressive disorder in a woman can also take the form of hypochondria - excessive concern for her health with the search for new symptoms and fears of having an incurable disease. Persistently low mood in this case even doctors explains the patient's poor state of health. And sometimes depression takes the form of pronounced psychasthenia with fast fatigue, irritable weakness, distraction of attention, emotional lability.
Eating disorders are another common "mask" of female depression. This is usually bulimia, compulsive overeating, a tendency to regular excessive consumption of high-carbohydrate and fatty foods. It is also possible to abuse alcohol, which is fraught with the development of alcoholism.
What to do
Depressive disorders (depressions) in women are a heterogeneous group of affective disorders in the etiology and symptomatology. It is important to understand that this is not just a bad mood, but a disease requiring treatment. In a number of cases it is carried out by specialists engaged in the therapy of the underlying disease. Patients with neurotic and mild reactive depressions may be enough help from a therapist. And severe, repetitive, protracted and accompanied by suicidal thoughts affective disorders require treatment to a psychiatrist.
At the same time, the use of traditional methods of treatment is not enough, and the expectant tactics for depression is inexpedient. In most cases, drug therapy is necessary, while the selection of drugs, the regimens and the duration of their administration should be determined only by the doctor. Unauthorized correction of medical recommendations is fraught with the return or inversion of symptoms, the subsequent development of resistance to medications, prolonged course of the disease.
Health-saving channel, a specialist tells about the peculiarities of depression in men and women:
Watch this video on YouTube
Watch this video on YouTube