What is endogenous depression, the main causes of its occurrence, diagnostic criteria. Modern treatment regimens for this disease. Endogenous depression is a very common mental illness, the main symptoms of which are depressed mood, motor retardation and inhibited thinking. Very often it develops in the midst of complete well-being and inflicts an irreparable blow, both on the person himself and on his relationship with his family, on his work and hobbies.
Causes of Endogenous Depression
Depression as a mental disorder is divided into two main groups: reactive and endogenous. Reactive ones arise as a result of the powerful influence of a traumatic situation, traumatic brain injury or other external influences, they are also called exogenous. Endogenous depression is much more difficult to find a cause. The predominant absence of visible triggers makes it difficult to diagnose the disease, but scientists were still able to identify the causes of endogenous depression. They are hidden in the neurochemical structures of the brain and are triggered by a cascade of reactions.
Impaired neurochemical balance
A person's mood is formed from the quantitative ratio of three main substances in the brain, they are called neurotransmitters. If the synthesis of one of them slows down and its level in the blood drops, then corresponding changes should be expected. Normally, their ratio can fluctuate at an insignificant level, thus creating a mood, giving out emotions and various other feelings.
To understand the essence of the neurochemical process, it is necessary to know the role of each neurotransmitter that is related to the onset of endogenous depression:
- Serotonin … The so-called hormone of happiness is known to everyone. It is able to influence all the cells of the brain (neurons), thereby more powerfully influencing the sensations and behavior of a person. Serotonin is synthesized in the nuclei of the brain stem, and there its concentration is quite high. In addition, the human body has another spare synthetic apparatus for serotonin. It can be produced by cells in the lining of the gastrointestinal tract. There, serotonin is synthesized in much smaller quantities, but it is also able to maintain the necessary balance. It is very difficult to overestimate the importance of this neurotransmitter for the human body. Heading to specific areas of the brain, serotonin is able to activate cognitive functions, thanks to which a person acquires the ability to reflect the world around him and even learn. It can also affect the neurons of the spinal cord, regulating the motor activity of skeletal muscles. Most importantly, serotonin improves mood and is able to protect the body from the stress response. In conjunction with other hormones, we get more unique feelings, such as affection and even love. Lack of serotonin is manifested by depression and bad mood, which can cause real stress.
- Dopamine … Another very common hormone in the human body. If we summarize all the functions of this substance, then it is responsible for cardiac and motor activity, for pleasure. The concentration of this neurotransmitter is greatest when a person eats or has sex. Any satisfaction of needs is accompanied by the release of a significant amount of dopamine into the blood. Modern research shows that even the expectation of some kind of pleasure inevitably leads to an increase in dopamine synthesis. Thinking about something enjoyable for yourself can increase your pleasure hormone levels. If its amount is synthesized at an insufficient level, a specific feeling of dissatisfaction arises. It is also called anhedonia. This condition is characterized by an inability to enjoy any kind of work. Lack of dopamine in the body leads to a decrease in motivation for activity, when a person does not expect recognition and reward for the work done, because it turns into a routine for him.
- Norepinephrine … One of the top three neurotransmitters of mood. He is responsible for rage, anger and emotional outbursts. Naturally, a person cannot be happy and satisfied all the time, there is another productive side of the mood - this is rage. To be able to express your anger, discontent, norepinephrine is required. In the case of its decrease, a person is not able to say "no", is not able to defend his point of view and himself. If norepinephrine decreases in combination with other hormones (serotonin + dopamine + norepinephrine), then a person cannot throw out his discontent and closes with it. Then negative emotions accumulate and can reach the level of auto-aggression when suicidal thoughts appear.
Decreased levels of these three neurotransmitters are associated with depressive symptoms.
Genetic factors
A predisposition to depression is essential. If parents, grandfathers or grandmothers have suffered at least one depressive episode in their lives, it means that the propensity for this is transmitted to children. Not only depressive episodes in the family history are important, but also any other mental disorders, because they are also accompanied by a violation of the neurochemical balance of the brain. This does not mean that every child in the family will experience such disorders. The factor is transmitted at the level of propensity to develop. Any traumatic situations, brain trauma, infectious diseases that can affect the neural network, can trigger a cascade of depressive reactions. All these factors, combined with genetic predisposition, can lead to the development of the disease. Stress is not a cause; it is only a trigger for depression.
Endogenous depression symptoms
The symptoms of endogenous depression fit into three main groups: depressed mood, slowing down of motor processes and thinking. In psychiatry, this symptom complex is called the Kraepelin triad. Each of the groups has its own specific symptoms, the severity of which directly depends on the depth of the depressive state.
Let's take a closer look at the symptoms of endogenous depression:
- Depressed mood … This manifestation of neurotransmitter imbalance occurs most often at the very onset of the disease and is the first sign of an incipient disorder. A person is not happy about anything, is not interested in anything. Any news is perceived with a bad mood. A negative side is seen in everything, a scheme of self-accusations is being built. In such a state, a person is not able to experience pleasure. All his thoughts focus on a negative interpretation of the events taking place, delusional ideas of sinfulness are possible. He blames himself in many ways, is pessimistic about the future. Autoaggression in the form of suicidal attempts is observed upon entering and exiting depression. This is due to the fact that during a fully developed depressive state, a person is simply physically unable to commit suicide. When entering and exiting depression, motor deceleration is not so pronounced, and bad mood and confidence in a pessimistic outcome unfold into a clinical picture. The person is suicidal. You should be alert to such things and do not stop taking medications until you see improvement. Otherwise, there may be irreparable consequences.
- Deceleration of motor function and motor skills … A person feels a significant loss of strength, does not feel the need to rush somewhere, to do something. He believes that everything is already lost or in the worst possible way. At the onset of the disease, the ability to move and even work is not lost, but over time the disease progresses. With an expanded clinical picture of depression, a person is already in bed most of the time. At this time, appetite is lost, physical activity decreases - you don't want to get up and walk. All movements are slow and not too targeted. The desire to take care of oneself, to eat, to clean the room disappears. Detachment affects all aspects of life. A person experiences a constant feeling of unreasonable melancholy when all kinds of desires and reasons for action are excluded. Nothing matters anymore and does not bring pleasure.
- Slow down thinking … At the beginning of the disease, a person is able to think at a sufficient level, but all attention is occupied by thoughts about how bad everything around him is. He begins to engage in self-flagellation and blames himself for everything he can imagine. His answers are short, one-word, he ponders the answer for a long time. The voice is low, low. Delusional ideas of guilt and wickedness are not a constant symptom, but they are observed in most cases of the disease. Most often, these symptoms can be found in mild to moderate forms of depressive disorder. The severe form is characterized by an almost complete absence of any answers to questions. The person is silent and does not say a word, even if it is necessary to report any physiological needs. Severe depression has an extremely negative effect on a person and often leaves behind a changed personality that is unable to adapt in society.
A characteristic feature of a person's depressive states is a specific facial expression that helps to identify such patients. There is a mask of sorrow on the face: the corners of the lips are lowered, a fold of Veragut between the eyebrows. One gets the impression that the person is about to cry. This state has its own daily fluctuation. Typically, these people wake up a few hours before the time they need to get up, and their symptoms worsen. By the evening, the condition improves slightly.
The consequences of endogenous depression
Endogenous depression rarely has a malignant course. Subject to proper treatment and adherence to all therapeutic measures, a person quickly gets out of this state.
As a rule, the disease manifests itself again when the stress factors of its occurrence are repeated, the complex therapy of the first episode was not carried out, the treatment was incorrect or was not carried out at all. If a person ignores this condition and perceives it not as a disease, but as melancholy or fatigue, neglected options can significantly complicate life and it is much more difficult to stop. You cannot try to adapt to this way of life, you must immediately identify life priorities for yourself and achieve them.
If you accept the depressive state, you can easily succumb to suicidal thoughts, which can lead to fatal results.
Features of the treatment of endogenous depression
A comprehensive approach is required for quality treatment of endogenous depression. It is difficult to cure the disease with medication alone, but psychotherapy without medication will not be of any use. The environment where the patient stays during the treatment period has a huge impact. Support from family and friends will help you adapt to society as quickly as possible.
Drug therapy
Given the complexity of the pathogenetic mechanisms of the disease, a natural question arises of how to treat endogenous depression. For complex treatment, the following groups of drugs are used:
- Antidepressants … Essential drugs for this disease. Depending on the course of endogenous depression, only a doctor can choose the best remedy. It is impossible to cure endogenous depression with antidepressants alone, but in combination with other medications, adequate therapy stops the episode well.
- Normalizers (mood stabilizers) … This is the second line of drugs that are needed to level and stabilize mood swings within one day. They are also used to prevent recurrent attacks of the disease.
Important! Self-medication can lead to a worsening of the condition and even fatal consequences.
Psychotherapy
For a person in this state, there is no task more important than how to defeat endogenous depression. In addition to basic medications, psychotherapy is also used. With the help of this method of treatment, it is possible over time to form a certain model of reaction to stressful situations, which will exclude cases of recurrence of the disease. However, without the help of drug therapy, even an experienced psychotherapist will find it difficult to correct the human psyche, especially in severe cases.
Prevention of endogenous depression
To prevent this disease, it is necessary to take a maintenance dose of medications that can balance a person emotionally. The support of a psychologist is recommended, who will help to develop schemes of a persistent attitude to life situations, analyze in detail the real problems and try to help solve them. A healthy way of life and adherence to some rules are of great importance:
- Do not drink alcoholic beverages;
- Do not take any psychotropic drugs other than those prescribed by the doctor;
- Do not use drugs;
- Avoid stressful situations and any excessive stress;
- Adhere to a regime of rest and work;
- Eat a balanced and rational diet.
How to treat endogenous depression - watch the video:
Endogenous depression is a rather complex disease, which is very dangerous to carry "on your feet." At the slightest sign, you should consult your doctor. Self-medication with psychotropic drugs or neglect can negatively affect health.
