Depression is a depressed, very depressed emotional state. Often it is accompanied by catatonia - a phenomenon in which a person simply does not react to the events taking place around him. This condition is considered pathological and requires appropriate treatment.
Some information
Involutional depression is a type of depression that is characterized by a person's numbness over an extended period. A patient in this state can be constantly silent, just lie down for days on end and not show any reaction to everything that happens.
Several years ago, catatonia was even classified as a type of schizophrenia. But modern doctors believe that such a condition can be accompanied by various psychological problems, including depression, split and personality disorder.
Symptoms of involutional depression
Treatment of such a pathology can only begin after an accurate diagnosis, which requires the presence of at least three of the 12 signs:
- excessive excitement andanxiety;
- echopraxia - meaningless repetition of the movements of another person;
- catalepsy - being in a trance state for a long time;
- mutism - refusal to communicate;
- echolalia - meaningless repetition of other people's speech;
- ritual, stereotypical movements, such as crossing arms and legs, rocking;
- wavy flexibility, in which a person does not react at all to words and does not change his original position;
- unaccustomed, abnormal habits, movements or words;
- grimacing - a facial expression that creates the feeling that a person is in pain;
- negativism - behavior that is absolutely the opposite of a person's emotions, for example, he wants to eat, but at the same time refuses the offered food;
- prolonged stupor or deterioration of normal response to stimuli, such as during a conversation;
- posturing, taking unnatural postures for a long time.
A person in this state may also experience classic signs of hopelessness, hopelessness, sadness and depression.
However, the most common symptoms of involutional depression that might suggest a problem are numbness and excessive silence.
Such a disease, among other things, can affect a person's appetite, concentration, sleep and mobility.
Reasons
Treatment of involutional depression almost always takes place according to the standard scheme, regardless ofwhy it arose. And the thing is that psychotherapists still cannot say exactly what exactly provokes the development of pathology. True, there are many hypotheses in this regard. According to doctors, the main cause of involutional depression is the depletion of dopamine, a neurotransmitter responsible for mood, which is located in the brain.
In general, such a pathology can be triggered by a combination of several conditions, among which it is worth highlighting:
- family history of psychological defects;
- critical life changes, such as divorce or the death of a relative;
- abnormal changes in the structure of the brain or its activity, as a result of which it becomes more susceptible to the produced hormones;
- all sorts of medical conditions, including insomnia, chronic pain syndrome, long-term illness or attention deficit disorder.
In addition, people suffering from drug or alcohol addiction are at increased risk.
Features of the flow in old age
According to the dynamics of its development, this pathology most often turns out to be a single protracted depressive period. Usually, women in the menopausal period, that is, approximately 45-55 years old, and men 5-10 years older, experience it.
In old age, involutional depression most often proceeds atypically, while the main symptoms of the disease are fear of the future,excessive anxiety, restlessness. With effective treatment, the acute phase of the disease passes quite quickly, although in some people it can last for a year.
In most elderly patients, the initial symptoms of catatonia remain unchanged for several years. In other words, in different periods of the disease, the clinical picture is monotonous. In general, there is monotonous anxiety, combined with restlessness, expressed in movements, as well as constant depression.
Diagnosis
Usually a person with involutional depression does not respond at all to questions asked by a doctor. That is why close people should take part in the survey and talk about their own observations. The specialist, among other things, will have to make a differential diagnosis with other similar pathologies, for example, neuroleptic malignant syndrome. This disease has similar symptoms and can occur if a person has a negative reaction to antipsychotics.
In addition, the psychotherapist can refer the patient to auxiliary instrumental research. This is necessary in order to exclude the possibility of a tumor in the brain or other defects that favor the development of catatonia.
Therapy
To treat involutional depression, doctors usually prescribe benzodiazepines,For example, Lorazepam. This drug has a sedative and relaxing effect. It is most often administered intravenously, but in some cases it can be taken in the form of tablets.
If medical therapy is unsuccessful, the specialist may recommend electroconvulsive therapy to the patient, which is carried out under general anesthesia. This treatment is effective in about 80-95% of cases.
With involutional depression, doctors can resort to other techniques aimed at stimulating the brain. For example, magnetic therapy and activation of the deep brain are often used - such activities usually allow you to get rid of the manifestations of catatonia. After the symptoms of involutional depression subside or completely disappear, the patient is additionally prescribed appropriate antidepressants and psychotherapy sessions.
Probable Complications
In the absence of proper treatment, people suffering from involutional depression may face a number of negative consequences. Possible complications include:
- appearance of bedsores;
- occurrence of blood clots;
- development of contracture or pathological contraction of tendons and muscles.
Patients with this diagnosis may need continued therapy even after improvement in well-being and elimination of symptoms of depression.
