The human nervous system reacts very subtly to the surrounding psychogenic environment. Even the mechanisms worked out for thousands of years do not always work. Of course, all this is reflected in the state of he alth. A huge number of neuropsychiatric diagnoses today does not bother anyone. In a huge list of diseases, it is worth noting separately depressive neurosis. This disorder is not present in all medical classifications. It, according to ICD-10, refers to affective states.
Brief description of the problem
Depressive neurosis should be understood as a type of neurotic disorder, which is characterized by a constantly sad mood, lethargy and severe physical inactivity. He has vegetative-somatic disorders and problems with sleep. On the other hand, there is an optimistic outlook on the future and the preservation of the ability to professional activity, the absence of profound personality changes. Described clinical picture in fullcharacterizes depressive neurosis.
The history of the disease goes back to the 19th century. Since 1895, another term has been used in neurology and psychology to describe the disorder - "neurotic depression". This concept was introduced into medical practice by K. Kraepelin. A little later, scientists made an attempt to single out the disease as a separate form of a neurotic disorder, but colleagues did not support it. Therefore, in the ICD of the 9th revision, it still acts as an independent disease. However, there is no mention of neurotic depression in the latest published American classification.
Development of a neuropsychiatric disorder
To better understand the essence of the disease, it is necessary to present a typical clinical picture for it. A person can be in a psychogenic environment for a long time. For example, he has constant quarrels at work or in the family. There may also be an internal conflict caused by dissatisfaction with one's own life. Not finding the strength to change the current situation, he begins to experience constant stress and psycho-emotional stress.
As a result, chronic fatigue develops. The ability to think effectively decreases, and performance decreases. All these symptoms point to impending neurosis. If we add to it a bad mood and an inability to enjoy life, we can talk about depressive neurosis. At the beginning of the development of the disease, general weakness is sometimes supplemented by somatic disorders: changes in blood pressure, poor appetite,dizziness.
Main reasons
Every day a person is forced to face many problems. They can concern both the family and personally him. Depressive neurosis is not a neglected form of a nervous breakdown; it does not appear on its own. Also, research scientists do not find confirmation in the genetic predisposition.
When conducting conversations between a psychotherapist and a patient, it becomes clear that the role of a provocateur of most problems is a serious psychological trauma. Various events that carry an emotionally unfavorable connotation should also be taken into account.
The causes of neurosis can be anything: the death of relatives, conflicts at work or dismissal, alcoholism of parents, the impossibility of one's own realization. Psychotherapists say that this disorder is often the result of problems in childhood. It begins to develop actively if traumatic circumstances affect a person for a long time. The situation that has arisen seems hopeless to him. He spends all his time trying to hide his emotions rather than looking for a way out.
Clinical picture
Among the main symptoms of neurotic depression, doctors note lethargy, depressed mood and decreased activity. First, the patient complains of a deterioration in general well-being and the appearance of weakness. Then the clinical picture is supplemented by vegetative-somatic signs of the disease. These include the following:
- blood pressure drops;
- dizziness;
- palpitations;
- loss of appetite.
Patients rarely seek medical help in a timely manner, as many of them are not even aware of the diagnosis of "depressive neurosis". Symptoms of vegetative-somatic disorders make them go to the doctor, at whose appointment they learn about the presence of the disease.
Clinical picture after a course of therapy
After undergoing a course of symptomatic treatment, not all patients fully recover. Often their state of he alth worsens, there is a feeling of weakness, persistent hypotension develops. The psycho-emotional state of the patient is also aggravated. He is constantly sad. Gradually, the clinical picture is supplemented by meager facial expressions and a decrease in motor activity.
Depressive neurosis is almost always accompanied by sleep problems. They are manifested by frequent nocturnal awakenings and difficulty falling asleep. In the morning, patients feel weakness and weakness, severe fatigue. Some are worried about anxiety attacks, various phobias.
Compared to normal depression, the symptoms are less pronounced. Patients always retain the ability to soberly assess the environment, do not lose self-control. They never have suicidal thoughts. They are quite optimistic about various life situations.
Features of the disorder in young patients
Depressive neurosis in children is characterized by a fuzzy clinical picture. They most often meetcalled depression equivalents. They manifest themselves in the form of increased excitability, irritability, uncontrollable behavior. Such children show anger towards others, including their own parents. For example, even in the primary grades, a student with severe physical disabilities is the most cocky and hooligan. He offends everyone who accidentally looked at him. It seems to him that those around him are constantly mocking his defects.
In adolescence, depressive neurosis is manifested by isolation and a desire for solitude. These children usually have reduced academic performance. They are constantly haunted by headaches, insomnia and discomfort in the region of the heart. They are frequent patients of all kinds of doctors, willingly take prescribed medicines.
Methods of diagnosis and treatment
In order to correctly diagnose and select therapy, the doctor must first collect the patient's history. At the same time, special attention is paid to information about mental and somatic pathologies among close relatives. The specialist needs to know what changes in the patient's life preceded the change in his state of he alth.
The diagnosis of "depressive neurosis/neurotic depression" is confirmed in the following cases:
- patient is concerned about mood swings and other symptoms associated with the disorder;
- he is not impaired in his ability to assess his own condition;
- behavior meets generally accepted norms;
- disorder is persistent, notis a single response to stress.
Even an experienced doctor is sometimes difficult to make a correct diagnosis, since the manifestations of neurosis are similar to many signs of somatic ailments. In this case, the patient is recommended to consult a psychoneurologist. To exclude the somatic etiology of the disorder, a number of examinations are additionally prescribed: ECG, ultrasound, EEG.
Treatment involves psychotherapy sessions, which is complemented by taking pharmacological drugs.
Drug therapy
The basis of such treatment is various antidepressants. The following drugs are especially effective: Moclobemide, Mianserin, Imipramine. Depending on the characteristics of the course of the disorder, therapy is supplemented with antipsychotics, sedative nootropics, and tranquilizers. Even well-chosen drug treatment gives only a temporary improvement in the condition.
Psychotherapeutic impact on the disorder
Depressive neurosis cannot be overcome solely through drug therapy. Therefore, very often patients are prescribed various methods of psychotherapeutic influence.
The most common treatment is hypnosis. Its use has a beneficial effect on the mental state of the patient, and with regular use gives a positive result. Hypnosis sessions help to bring the patient out of a depressive state. The number of visits to a specialist depends on the stage of the disorder, the individual susceptibility of the organism. Thethe method of exposure is recognized as absolutely safe.
Procedural treatment
What else can a doctor prescribe for a diagnosis of "depressive neurosis" treatment? Sedative drugs or antidepressants are used only at the initial stage of the development of the disorder. Drug therapy is considered an adjunct to the main treatment. It is based on psychotherapeutic effects and various physiotherapy.
As for the latter, exercise therapy, darsonval, reflexology and electrosleep have proved their effectiveness in practice. Ayurvedic, classical and acupressure types of massage are also considered useful. To improve overall well-being and get rid of a bad mood, doctors recommend walking, yoga and meditation.
Prognosis for recovery
Depressive neurosis, the symptoms and treatment of which were described just above, is not considered a serious illness. Therefore, the prognosis for most patients is favorable. They have every chance of returning to their usual rhythm of life and full recovery. However, if the disorder is started and left untreated, it can transform into a more dangerous problem - a neurotic personality disorder.
