The use of antidepressants. Side effects from antidepressants. Who should not take antidepressants
In people, especially residents of large cities, it began to occur quite often. This is facilitated in many ways by the rapid rhythm of life along with disturbed ecology and constant stress. Some try to treat depression with alcoholic beverages. But this approach, of course, is fundamentally wrong. It will not be possible to solve the problem in this way, but it is quite possible to gradually turn into an alcoholic. Depression is a disease and should be treated with drugs such as antidepressants. The side effects of these drugs will be discussed in the article.
Antidepressants and the mechanism of their action on the body
Currently, pharmacies sell a variety of antidepressants, which belong to different categories of drugs. But the impact on the body of most of them is the same and is always directed to a change in the amount of certain chemical elements in the brain tissues, which are called neurotransmitters. Their deficiency leads to all sorts of disorders of the psyche and nervous activity, in particular this causes the development of depression.
As with any medication, antidepressants also have side effects. More on that below.
The effect of such drugs is that they increase the content of neurotransmitters in the brain or make cells more receptive to these elements. It is customary to prescribe any antidepressants for quite long courses. This is directly related to the fact that they do not show their effect immediately. Most often, the positive effect of the use of such a drug begins to develop only a few weeks after the start of its administration. In those situations where it is required that the effect of the drug manifest itself faster, doctors prescribe it by injection. According to reviews, antidepressants are considered very effective drugs. Their use reliably eliminates such manifestations of depression as a sense of hopelessness along with a loss of interest in life, apathy, sadness, anxiety and longing. But do not forget about the side effects of antidepressants.
Antidepressants do not help, what to do?
You can often hear that it does not make sense to take these medicines because of their ineffectiveness. But most often, the lack of results lies in the fact that people buy antidepressants in pharmacies without a medical prescription, and, therefore, without consulting a specialist. In this situation, the medicine may simply not be suitable for the person, or he may take it in the wrong dosage. It is necessary to consult a doctor who will prescribe the required treatment.
In addition, do not forget that in order to get a result from therapy, they should be taken for a long time, at least three months. Are there antidepressants without side effects? Many patients are concerned about this issue.
Is it worth it to buy cheap drugs?
Often patients refuse treatment with antidepressants because of their high price. True, in pharmacies you can almost always buy cheaper analogues that will not be inferior to the main product in terms of their effectiveness, in addition, quality or safety. Cheap antidepressants, according to patient reviews, affect the body no worse than their counterparts, which are significantly superior in price. But in the event that there are still doubts, then you can always consult on the choice of a drug with your doctor.
How long should the treatment last?
As a rule, doctors prescribe antidepressants for long courses, which range from several months to one year. You can not independently refuse treatment until the completion of the course, which was recommended by the doctor.
Side effects from antidepressants are much more common in women. In addition to the main reactions, their interest in sex most often decreases, it is also difficult to achieve orgasm, lubrication decreases (vaginal dryness appears).
Some drugs, in addition to relieving the symptoms of depression, also have a psychostimulant property. Against the background of their use, patients often have problems falling asleep. But even in this situation, it is impossible to refuse further treatment. It is advisable to contact your doctor with a request to change the scheme of therapy. For example, your doctor may recommend that you take your prescribed medications at lunchtime and in the morning.
Side effects
Taking any medication, including antidepressants, can lead to side effects. Drugs in this group, according to reviews, can often cause a slight feeling of nausea along with problems with falling asleep. Very rarely, they lead to violations in the sexual life. As practice shows, all of the listed side effects are observed in the first few days of admission, and then they disappear on their own, and no additional treatment is required. The attending physician usually advises antidepressants with a minimum of side effects.
Most of today's anti-depression medications have little to no interaction with other medications they take. But in the event that a person buys antidepressants without a prescription and takes any other drugs, including dietary supplements, it is certainly important to consult with a specialist about the safety of joint use.
Side effects of the antidepressant "Fluoxetine" are abound. The drug is also known under the name "Prozac". It is important to note that it can be highly addictive. "Fluoxetine" has an extremely negative effect on the central nervous system. With prolonged uncontrolled intake, this leads to:
- dizziness and headaches;
- nightmares;
- euphoria;
- anxiety;
- psychomotor agitation;
- neuroses;
- thought disorder;
- loss of coordination of movements;
- attention disorder;
- lethargy.
In addition, there is a risk of drug overdose.
It is impossible to completely exclude any complications even against the background of the use of psychotropic drugs that have a sparing effect. The greatest likelihood of side effects as a result of the use of antidepressants occurs among patients suffering from somatic diseases, in addition, in the elderly, who have an increased sensitivity to psychotropic drugs.
The most common side effects of tricyclic antidepressants include anticholinergic disorders along with disorders of the nervous system. Plus, there may be malfunctions in the work of the heart and blood vessels, in addition, sometimes there are complications in the hematopoietic organs, as well as metabolic and endocrine changes associated with an increase in body weight and allergic reactions.
Side effects and complications from antidepressants, as a rule, manifest themselves in the initial stages of taking in the first couple of weeks. They sometimes persist for one month of therapy, after which they undergo reverse development. Against the background of persistent and at the same time overly pronounced disorders, it is advisable to reduce the dose, and if necessary, a complete cessation and refusal of therapy is required. So, among the main side effects that can develop against the background of the use of antidepressants, the following conditions are most often observed in patients:
- The appearance of nausea.
- Feeling of dryness in the mouth.
- Decreased or complete lack of appetite.
- Presence of vomiting.
- Development of diarrhea or constipation.
- Frequent dizziness.
- Insomnia along with headaches.
- Increased feelings of anxiety.
- The appearance of nervousness along with a feeling of internal tension.
Under the supervision of a doctor, it is possible to choose an antidepressant without side effects for your body.
myths
Many people are very wary of antidepressant treatment, as they believe that these drugs can deprive them of all human emotions, thereby turning them into soulless robots. In fact, this is completely true. According to reviews, antidepressants minimize feelings of fear, longing, and anxiety. They have absolutely no effect on any other emotions.
Another equally common myth about antidepressants is that once started treatment with these drugs, a person will have to continue using them for the rest of his life. In fact, antidepressants do not cause any physical addiction, let alone mental dependence. Just for the effectiveness of treatment, it is necessary to prescribe them to patients for long courses.
Antidepressants with minimal side effects
Available for purchase without a prescription, have a minimum of side effects:
- The tetracyclic group is "Maprotiline" ("Ladiomil").
- Tricyclic group - "Paxil" ("Adepress", "Plizil", "Cirestill", "Plizil").
- Selective inhibitors - "Prozac" ("Prodel", "Fluoxetine", "Profluzak").
- If you need to give up long-term bad habits, for example, smoking - "Zyban" ("NowSmok", "Wellbutrin").
- Herbal preparations - "Persen", "Deprim", "Novo-Passit".
Antidepressants and exercise
Against the background of sports training in the human body, hormones of joy begin to be intensively produced, which are scientifically called endorphins. They do an excellent job of reducing the severity of depression, improving mood. For this reason, regular exercise is ideally combined with antidepressant therapy, reducing the duration of courses and reducing the dosage of the drugs used.
Thus, if you have mild depression, it is best to go to the pool or the gym instead of buying antidepressants from a pharmacy without a doctor's prescription. So a person will be able not only to improve his condition without the use of medicines, but it will also bring many benefits to the whole organism as a whole.
Completion of antidepressant therapy
In the event that a person has begun a course of treatment with antidepressants, then you should never stop it on your own without the permission of a doctor. This is because any withdrawal of antidepressants must be done slowly and gradually. Against the background of a sharp refusal of further therapy, depressive symptoms will almost immediately return again. In addition, the symptoms may become even stronger than they were before the start of the course of treatment. That is why the abolition of antidepressants should occur strictly according to the indicated scheme, which was recommended by the attending physician.
Now we will find out what ordinary people who happened to undergo treatment with these drugs think about the use of antidepressants.
Feedback on the side effects of antidepressants
People respond differently to antidepressants, but in general they are satisfied with the effect that can be achieved thanks to their intake. In particular, it is reported that taking these drugs actually helps to change your life for the better when depression sets in and it starts to seem that everything is so bad that you don’t even want to live.
Almost all the comments that people leave on the Internet about certain antidepressants are accompanied by such words and phrases as "helps", "saves", "manages to get out" and so on.
There is a wide variety of information about the speed of obtaining the result. So, some write that they were able to notice the effect after the first few days of taking it, while others report the result only after one month.
Among the dissatisfied reviews, there is often a statement that the antidepressant withdrawal syndrome is extremely difficult for patients. On this basis, apathy and depression overcome a person in full. In addition, they talk about the appearance of uncontrollable anger. Therefore, many say that they began to feel even worse than before taking the medication. As part of a commentary on such reviews, it should be recalled that antidepressants, including those with the least side effects, are not a toy at all, and they should be taken only as directed by a doctor.
Not infrequently, people talk about such a side effect as insomnia. On top of that, for some, taking pills is accompanied by a decrease in libido. Some say that they did not tolerate the course of taking in general, and also that antidepressants increase blood pressure.
People are also dissatisfied with the fact that it takes too long to take such pills in order to achieve and maintain a positive effect. Quite often there are complaints about the cost of antidepressants, which for some drugs can reach up to two thousand rubles per package.
So, in conclusion, let's name the main advantages that people who used antidepressants talk about:
- Drugs change lives for the better, helping to get out of difficult situations.
- Eliminate the feeling of depression, tearfulness, anxiety, irritability and so on.
The following are the disadvantages:
- High price.
- development of side effects. Most often it is insomnia and decreased libido.
- The need for long-term use.
- Some worsen their depression.
- withdrawal syndrome.
Thus, today antidepressants are a good solution in case of depression. In most reviews of antidepressants and side effects, people report their effectiveness. But it is extremely important to undergo a course of treatment with these drugs only in accordance with medical recommendations, since otherwise, with self-therapy, your condition can only be aggravated.
The side effects are largely the same. But the main difference is that the former are addictive, while the latter are not.
Thank you
The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
What are antidepressant medications?
Antidepressants called a group of pharmacological drugs that act on the central nervous system and eliminate the cause and symptoms of depression. In some cases, these drugs are also used to treat other diseases, but their effectiveness is significantly reduced.The main action of antidepressants is to change the levels of serotonin, dopamine and norepinephrine in the cells of the central nervous system. In patients with depression, they eliminate apathy, stimulate interest in physical and intellectual activity, and improve mood in general. It should be noted that in people who do not suffer from depression, this effect may not be felt.
What is the difference between tranquilizers and antidepressants?
Tranquilizers and antidepressants are different pharmacological groups, since these drugs have different effects on the central nervous system ( CNS). Almost all tranquilizers have a pronounced sedative ( sedative) action. They can cause drowsiness, apathy, inhibit physical activity. Their main task is to relieve psychomotor agitation if the patient is overly active or aggressive.Antidepressants also combine a fairly wide range of therapeutic effects. Only a few drugs in this group give effects more or less similar to those of tranquilizers. Basically, they relieve symptoms and eliminate the causes of depression - they activate the emotional sphere, raise internal motivation, give strength ( in the psychological aspect).
In addition, antidepressants and tranquilizers have a different chemical structure, interact with different mediators and other substances in the body. In some pathologies, doctors may prescribe a parallel intake of drugs from these two groups.
Is it possible to buy antidepressants in a pharmacy without a prescription and a doctor's prescription?
There are a number of antidepressants that have fewer side effects. Most of these drugs also give a weaker therapeutic effect. In the complex, their action is considered to be “softer”, therefore, in many states they are allowed to be dispensed at a pharmacy without presenting a prescription from a doctor.It should be noted that even these drugs, which are, in principle, freely available, should not be used for active self-treatment. The problem lies not in the direct harm from these antidepressants, but in unforeseen situations that can occur in rare cases.
There is a certain risk of self-administration of any antidepressants for the following reasons:
- Possibility of an allergic reaction. Almost any drug can cause an allergic reaction. It depends on the individual characteristics of the patient's body, and no specialist can predict such a complication in advance. If the patient has a predisposition to allergies ( to other substances), it is better to warn your doctor about this and not to take any new drugs on your own.
- Possibility of misdiagnosis. Not always the patient can correctly diagnose the problem. This is especially difficult to do in the case of mental and emotional disorders. If the diagnosis was initially made incorrectly, antidepressants may not only not have a therapeutic effect, but also exacerbate the problem. That is why it is better to take any drug after consulting a specialist.
- Possibility of drug interactions. As a rule, in the instructions for a particular drug, the manufacturer indicates various undesirable interactions with other drugs. However, each drug has many trade names, and patients often do not go into details. Because of this, a “harmless” over-the-counter antidepressant can be harmful when combined with another medication the patient is taking. In the case of consultation with a qualified specialist, this risk is minimized.
Which doctor writes a prescription for antidepressants?
In principle, the main specialized doctors who often prescribe antidepressants in their practice are psychiatrists ( enroll) And neurologists ( enroll) . It is these specialists who are most closely associated with disorders in the work of the central nervous system ( both structural and functional). In addition, other doctors usually refer patients with depression or similar disorders.If necessary, antidepressants can be prescribed by other specialists. Usually these are emergency doctors, therapists ( enroll) , family doctors, etc. It should be noted that they usually prescribe weaker drugs that do not require a prescription to purchase. However, legally, any doctor with a valid license has the right to write a prescription to a patient for a more potent drug. At the same time, he takes responsibility for familiarizing the patient with the rules of admission and for the possible consequences.
What are the "prohibited" and "allowed" ( over-the-counter) antidepressants?
Antidepressants, like all medications, in principle, can be divided into two large groups. These are “permitted” drugs that anyone can freely purchase at a pharmacy, and conditionally “prohibited” drugs that are sold by prescription.In each country, the list of permitted and prohibited drugs is slightly different. It depends on the health policy, current legislation, the prevalence of narcotic and semi-narcotic drugs.
OTC antidepressants tend to have a weaker effect. They do not have such a wide range of side effects and practically cannot cause serious harm to the patient's health. However, the effectiveness of these drugs in severe depression is very low.
OTC antidepressants in most countries include the following drugs:
- Prozac;
- zyban;
- maprotiline;
- deprim and others.
Conditionally "prohibited" antidepressants are called so due to the fact that their distribution is limited by law. This is partly for the safety of the patients themselves. These drugs have a large number of side effects, and their independent use can cause serious harm to health. Also, some drugs in this group can be equated to narcotic drugs and become addictive. In this regard, a prescription for them is written by a specialist who will first make sure that the patient really needs this medicine.
The "forbidden" antidepressants with a stronger effect include the following drugs:
- imipramine;
- maprotiline;
- anafranil, etc.
Classification of antidepressants
The classification of antidepressants is a very difficult task, since various criteria can be taken as a basis ( chemical structure, mechanism of action, etc.). Currently, it is customary to distinguish between two main groups of these drugs. The first affects the capture of neurotransmitters between the membranes of nerve cells. The second neutralizes the action of the enzyme, which releases the receptors. In practice, these two groups of drugs are used almost equally. It should also be noted that such a division is very conditional, since each representative of any of these groups has its own characteristics. That is why the vast majority of antidepressants are prescribed by a specialist who is familiar with the subtleties of the action of each drug.Chemical and pharmacological groups of antidepressants
From a practical point of view, the most convenient classification of antidepressants is based on the chemical structure of the drug in combination with the mechanism of action. In most countries, specialists are guided by these criteria. They allow, if necessary, to replace an intolerable or ineffective drug with another one that is closest in action.The following groups of antidepressants are distinguished by chemical structure:
- Tricyclic. In the chemical structure of tricyclic antidepressants, there are so-called "rings" or "cycles". These are groups of atoms united in a closed chain, which largely determine the properties of the drug.
- Tetracyclic. There are four cycles in the structure of tetracyclic antidepressants. There are significantly fewer drugs in this group than in the tricyclic group.
- Another structure. For convenience, this group included substances that do not have cycles in their chemical structure ( rings), but having a similar effect on the central nervous system.
Tricyclic antidepressants
Tricyclic antidepressants belong to the first generation of antidepressants and have been used in medical practice for several decades. In the chemical structure of these substances, three interconnected "rings" or cycles are common. The drugs of this group are non-selective reuptake inhibitors of a number of substances in the central nervous system. Their reception eliminates anxiety, fear or depression, and also causes a general "rise" of mood. Currently, tricyclic antidepressants are still widely used in many psychiatric disorders. The main disadvantage of this group is a large number of side effects. This is due precisely to the indiscriminate effect on various processes in the brain.The most common members of the tricyclic antidepressant group are:
- amitriptyline;
- imipramine;
- clomipramine;
- trimipramine;
- nortriptyline etc.
Tetracyclic antidepressants ( first generation antidepressants)
This group is represented by substances that have four "rings" of atoms in the composition of the molecule. In medical practice, they are used much less frequently than tricyclic antidepressants.The most common representatives of tetracyclic antidepressants are:
- mianserin;
- mirtazapine;
- pirlindol, etc.
Selective serotonin reuptake inhibitors ( SSRIs)
SSRIs are one of the most common and popular groups of antidepressants in modern medical practice. The mechanism of action of these drugs is to selectively block certain enzymes in the central nervous system ( CNS). This allows you to achieve the desired therapeutic effect with greater accuracy. It also reduces the risk of various side effects from the use of drugs. This group includes serotonin reuptake inhibitors, but, in principle, for each neurotransmitter ( substances - the transmitter) found their drugs in the nervous system. A specialist who can accurately diagnose and determine disorders in the work of the central nervous system selects the medicine.For various neurotransmitters, the following reuptake inhibitors exist:
- Serotonin- cipralex, fluvoxamine, etc.
- Norepinephrine Nortriptyline, maprotiline, etc.
- Dopamine- diclofenzin.
What is the difference between different groups of antidepressants?
Antidepressants, like most other drugs, are divided into pharmacological groups, which have some characteristic differences. This is necessary for the convenience of the practical use of drugs in treatment. The chemical structure of the molecules in this case is most often of secondary importance. The main criterion is the mechanism of action of the drug.Antidepressants of various groups have the following differences:
- Mechanism of action. Each group of antidepressants has a different mechanism of action. Drugs of different groups interact with different substances in the central nervous system, which ultimately leads to a similar effect of taking the drug. That is, the action of drugs is similar, but the chain of biochemical reactions that occur in the body is very different.
- The strength of the drug. The strength of the drug is determined by how effective the blocking of enzymes in the central nervous system is. There are stronger antidepressants that give a pronounced and stable effect. They are usually available by prescription due to the risk of severe side effects. Drugs with a weaker effect can be purchased at the pharmacy on their own.
- Transformation of the drug in the body. The set of chemical transformations that a drug molecule undergoes in the body is called pharmacodynamics or drug metabolism. In this regard, almost every drug has its own characteristics. For example, the duration of blocking of any enzyme may be different. Accordingly, the effect of one drug will last a long time ( up to a day), and the other only a few hours. This determines the receive mode. There is also a time to remove the drug from the body after administration. Some substances are excreted naturally quickly, others can accumulate during the course of treatment. This should be taken into account when choosing a medicine. The mechanism of drug excretion is also important. If the substance is ultimately excreted in the urine through the kidneys and the patient has renal failure ( Difficulty filtering blood and making urine), then the drug will accumulate in the body, and the risk of serious complications is greatly increased.
- Side effects. Depending on the specifics of the action of a particular antidepressant on the body, it can cause various side effects. It is important for specialists to know them in order to notice their symptoms in time and take the necessary measures.
- Interaction with other drugs. Drugs in the human body interact with various substances. The simultaneous use of several drugs can enhance or weaken their effect, and sometimes give other, unpredictable effects. In the instructions for each of the antidepressants, manufacturers usually indicate with which drugs this substance can interact.
- Possibility of developing an allergic reaction. Each antidepressant has its own chemical structure. An allergic reaction in a patient can be almost any drug ( with different probability). If you are allergic to one drug, you need to consult a doctor and change it to another drug that differs in chemical structure, but is similar in therapeutic effect.
- The chemical structure of the molecule. The chemical structure of the molecule determines the properties of any drug. It is because of this that each antidepressant has its own advantages and disadvantages. In addition, the features of the chemical structure underlie the classification of antidepressants.
Are there natural antidepressants? natural herbs)?
In folk medicine, there are not many recipes that could provide real help in the fight against depression. This is largely due to the complexity of the processes that occur in the central nervous system. If antidepressants act selectively, affecting certain substances ( neurotransmitters, enzymes, etc.), then their natural counterparts do not have such selectivity. Their effect will be much weaker, and the likelihood of side effects increases ( neither decoctions nor infusions allow you to isolate only the active substance from a particular plant). That is why, with severe depression and other serious psychiatric diseases, it is recommended, first of all, to contact a specialist, and with his consent, start taking folk remedies. Most often they will have to be combined with certain pharmacological drugs.The following herbs have a weak effect, similar to the action of antidepressants:
- Lure rhizome. The crushed rhizome is poured with medical alcohol ( 70% ethanol solution) in a ratio of 1 to 10 and insist for several hours. Infusion take 1 teaspoon 2 times a day.
- Aster chamomile flowers. For 1 tablespoon of dried flowers, 200 ml of boiling water is needed. Infusion lasts at least 4 hours. The resulting remedy is taken 1 tablespoon 3 times a day.
- Highlander bird. 3 - 5 grams of dried mountaineer is poured into 2 cups of boiled water and insisted until the water cools on its own to room temperature. Infusion drink half a cup before meals ( 3 times a day).
- Aralia Manchurian. The crushed roots of aralia are poured with medical alcohol in a ratio of 1 to 5 and infused for 24 hours. The resulting tincture is taken 10 drops 2-3 times a day, diluted in boiled water.
- Ginseng root. Dried ginseng root is crushed and poured with an alcohol solution ( 50 – 60% ) in a ratio of 1 to 10. The mixture is infused for 2 to 3 days in a closed vessel. The resulting tincture is drunk 10 - 15 drops 2 times a day.
Properties and action of antidepressants
Antidepressants, as a separate pharmacological group, have certain common properties. First of all, it concerns the predominant effect on the central nervous system. Any antidepressant affects the transmission of nerve impulses in the brain, and its effect on other organs and systems will be secondary. Otherwise, most of the drugs in this group have their own characteristics. So, for example, from antidepressants, drugs can be isolated that give a sleeping pill or, conversely, an invigorating effect. Side effects can affect almost any organ or system. This is explained by the fact that the brain, one way or another, regulates the vital activity of the whole organism, and any changes in its work will inevitably affect the organism as a whole.Mechanism of action of antidepressants
To better understand the mechanism of action of antidepressants, you need to imagine in general terms the principle of the human central nervous system. The brain consists of many nerve cells, neurons, which perform the most important functions. Neurons have a large number of different processes that connect to other nerve cells. As a result, a kind of network of cell contacts is formed. Impulses entering the brain are distributed in this network in a certain way, and the brain reacts to the information received. Each part of the brain is responsible for regulating certain processes in the body. Depression, as well as various nervous and mental disorders, are primarily the result of excitation of certain parts of the brain. Antidepressants affect the junctions of nerve cells, speeding up or slowing down the transmission of nerve impulses in various ways ( depends on the specific drug).The transmission of nerve impulses in the brain occurs as follows:
- The impulse is formed in the nerve cell as a result of chemical interactions and goes along one of the processes to the junction with another nerve cell.
- The junction of two nerve cells is called a synapse. Here, two cell membranes are located at a very close distance. The gap between them is called the synaptic cleft.
- The nerve impulse reaches the presynaptic membrane ( cells that transmit impulses). Here are the bubbles with a special substance - a neurotransmitter.
- As a result of excitation, enzymes are activated, which lead to the release of the mediator from the vesicles and its entry into the synaptic cleft.
- In the synaptic cleft, neurotransmitter molecules interact with receptors on the postsynaptic membrane ( cell membrane that "receives" the impulse). As a result, a chemical reaction occurs, and a nerve impulse occurs, which is transmitted through the cell.
- The mediator molecules that have carried out the transfer of impulses between cells are captured back by special receptors and concentrated in vesicles or destroyed in the synaptic cleft.
Antidepressant molecules interact with certain receptors, mediators or enzymes, and affect the mechanism of impulse transmission in general. Thus, there is an excitation or inhibition of processes in various parts of the brain.
What are the side effects of antidepressants?
The vast majority of antidepressants have a fairly wide range of side effects that greatly limit the use of these drugs. Most often, such phenomena occur due to the parallel effect of the drug on receptors in the peripheral nervous system. This affects the work of many internal organs. However, there are other mechanisms for the development of side effects.Side effects from taking antidepressants can be divided into the following groups:
- Dose dependent. This group of side effects includes problems that occur when the therapeutic ( medical) doses. They are in all medicines without exception. Many of these side effects can be interpreted as signs of an overdose. In the case of tricyclic antidepressants, for example, this may be a hypotensive effect ( lowering blood pressure). As a rule, all such effects disappear when the dose is reduced.
- Dose independent. This group of side effects appears, as a rule, against the background of long-term treatment. A drug with a similar structure and action affects the functioning of certain cells or tissues, which, sooner or later, may cause a variety of problems. For example, when using tricyclic antidepressants, leukopenia is possible ( low white blood cell count and weakened immune system), and in the treatment of serotonergic antidepressants - inflammation and pain in the joints ( arthropathy). In such cases, lowering the dose will not solve the problem. It is recommended to stop treatment and prescribe drugs from another pharmacological group to the patient. This gives the body time to recover a bit.
- Pseudoallergic. This group of side effects resembles common allergic reactions ( hives, etc.). Such problems are quite rare, mainly against the background of taking serotonergic antidepressants.
Possible side effects when taking antidepressants
Affected organs or systems | Complaints and violations | Possible ways to solve the problem |
The cardiovascular system | Decreased dose of antidepressant. If not possible, drugs to relieve symptoms ( at the discretion of the cardiologist). |
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Cardiac arrhythmias ( on the electrocardiogram) |
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An increase in blood pressure ( sometimes harsh) |
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A strong change in blood pressure with a change in body position ( orthostatic hypotension) |
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Digestive system | Reducing the dose of the drug. Changing the receive mode ( more often, but in smaller doses), a gradual increase in dose at the beginning of treatment. If jaundice occurs, it is recommended to stop treatment or change the drug. |
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Bitter taste in the mouth |
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Blood and hematopoietic system | An increase or decrease in the level of leukocytes ( respectively leukocytosis or leukopenia), decreased platelet count ( thrombocytopenia), elevated levels of eosinophils ( eosinophilia). These disorders are detected in a general blood test. | Termination of treatment, change of drug. |
central nervous system | Lethargy and drowsiness in severe cases and confusion) | At the discretion of the attending physician psychiatrist or neurologist) you can reduce the dose, stop taking the drug or prescribe symptomatic treatment in parallel ( lithium salts, antipsychotics, phenobarbital, beta-blockers - depending on the symptoms present). |
Nervous excitement, increased activity |
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Irritability |
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Hives |
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Swelling and pain in the joints |
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A sharp increase in blood pressure (hypertensive crisis) | ||
Nausea and vomiting |
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General disorders and symptoms | Decreased sex drive | |
Hormonal disorders |
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Hearing loss |
In principle, if any unusual symptoms begin to appear in a patient against the background of a single or long-term use of antidepressants, you should seek the advice of your doctor. Many of the above side effects indicate poor tolerability of the drug. If treatment is not stopped, the patient may develop very serious damage to organs or systems that will require additional treatment.
Also, the side effects of many antidepressants include addiction, and, as a result, the withdrawal syndrome that occurs after stopping treatment. In these cases, treatment tactics may be different. Treatment is prescribed by a specialist who leads the patient.
Are there antidepressants without side effects?
In principle, any pharmacological drug has the potential to cause certain side effects. Among antidepressants with a very wide spectrum of action, there are no drugs that would be ideal for all patients. This is due to the characteristics of the underlying disease ( Antidepressants aren't just for depression) and individual characteristics of the organism.To reduce the likelihood of side effects when choosing a drug, you should pay attention to the following points. First, newer drugs ( "new generation") have a narrow effect on the body and usually have fewer side effects. Secondly, over-the-counter antidepressants have a weaker effect on the body as a whole. That is why they are freely available. As a rule, serious side effects in the case of their use occur much less frequently.
Ideally, the selection of the drug is carried out by the attending physician. To avoid serious side effects, he conducts a series of tests and better learns the characteristics of the body of a particular patient ( concomitant diseases, accurate diagnosis, etc.). Of course, there is no 100% guarantee in this case either. However, under the supervision of a doctor, you can always change the drug or choose an effective symptomatic treatment that will eliminate complaints and allow you to continue the course of treatment.
Compatibility of antidepressants with other drugs ( neuroleptics, hypnotics, sedatives, psychotropic, etc.)
Simultaneous administration of several drugs in medicine is a very urgent problem. In the case of antidepressants, it should be noted that they are often used as part of complex therapy. This is necessary to achieve a more complete and rapid effect in a number of mental disorders.The following combinations of antidepressants are very relevant in psychiatry:
- tranquilizers- with neuroses, psychopathies, reactive psychoses.
- Lithium salts or carbamazepine- in affective psychoses.
- Antipsychotics- with schizophrenia.
In general, the combination of antidepressants with many other pharmacological drugs often has negative consequences. Unexpected side effects or decreased effectiveness of a drug may occur ( no expected therapeutic effect). This is due to several mechanisms.
Negative combinations of antidepressants with a number of drugs can be dangerous for the following reasons:
- Pharmacodynamic interactions. In this case, we are talking about difficulty in the absorption of drugs. After taking an antidepressant ( in the form of tablets) the active substance should be normally absorbed in the intestines, get into the liver, connect with blood proteins. Taking other pharmacological drugs can disrupt this chain at any stage. For example, many drugs are converted in one way or another in the liver. Taking several drugs that interact with the same enzymes can weaken the action of each of them individually or cause some complications from the liver itself. To avoid such complications, the doctor prescribes drugs, taking into account the time of their assimilation, specifying the regimen.
- Pharmacokinetic interactions. In this case, we are talking about the impact of several drugs on the same body system ( the same target cells or enzymes). Antidepressants work at the level of nerve junctions in the central nervous system. Taking other drugs that affect the nervous system can enhance their effect or, conversely, neutralize it. In both cases, the expected therapeutic effect will not be, and the risk of side effects will greatly increase.
Do antidepressants have a stimulating effect?
In principle, most antidepressants have some degree of CNS stimulant effect. Depression itself is accompanied by a state of depression. The patient is passive, as he has no desire to do anything. A properly selected antidepressant returns the desire to do something and, thus, gives strength.However, the stimulating effect of antidepressants should not be confused with the effect of energy drinks or certain narcotic drugs. The stimulating effect is manifested more in the emotional and mental sphere. Physical fatigue is reduced due to the removal of some "psychological block". Drugs contribute to the emergence of motivation and interest in various activities.
MAO inhibitors have the greatest stimulating effect in this regard ( monoamine oxidase). However, even in them this effect develops gradually, as the corresponding enzymes and mediators accumulate in the body. You can feel the changes in 1-2 weeks after the start of taking the drug ( provided that it is correctly selected and taken in the required dose).
There are also antidepressants that have hypnotic and sedative effects. They stimulate mental and emotional activity, but the physical condition of a person changes little. These include, for example, amitriptyline, azafen, pyrazidol. Thus, the patient may not get the expected result. In order not to be mistaken, it is better to consult with a specialist in advance, who will be able to explain in detail what effect he expects from treatment with this or that drug.
Do antidepressants have an analgesic effect?
The main action of antidepressants is to relieve the patient of the symptoms and signs of depression, including drowsiness, passivity, lack of motivation, mental and emotional depression. None of the drugs in this group has a pronounced analgesic effect in the conventional sense. In other words, with an obvious source of acute pain ( inflammation, injury, etc.) taking antidepressants will not alleviate the patient's condition.However, some drugs from the group of antidepressants are successfully used to combat chronic pain. The fact is that chronic pain often accompanies long-term depressive states. Mental disorders are not the only source of pain, but they may well intensify it and, thereby, greatly worsen the patient's condition. Experts have noticed that a number of antidepressants can alleviate such chronic pain. In this case, we are talking more about reducing the perception of pain than about the analgesic effect.
In the treatment of chronic pain syndromes, the following antidepressants can be used:
- venlafaxine;
- amitriptyline;
- clomipramine;
- desipramine.
Antidepressants can relieve symptoms of depression, but are antidepressants free of side effects? The answer is unequivocal: like all medicines - there are! The vast majority of people who take antidepressants have at least once had the unfortunate experience of having antidepressants cause side effects and complications. Most of them are minor and usually go away on their own. Particularly bothersome side effects of antidepressants are treated with medication or by reducing the dose, changing the timing, or switching to another drug.
Are there antidepressants without side effects?
Practice shows that antidepressants should be taken with caution, with full awareness of the risks and close attention to side effects. However, antidepressants have been used safely by millions of people for decades.
Antidepressants and side effects
Side effects common with most (if not all) antidepressants include:
Gastrointestinal disorders: nausea and diarrhea are dose dependent and usually resolve within the first two weeks of antidepressant treatment. Starting the medication at low doses or starting antidepressants at the same time as meals can reduce nausea and diarrhea.
Weight gain: depressions are often associated with appetite suppression and weight loss. Weight gain during antidepressant treatment can either be a sign of improvement in symptoms or a side effect of antidepressants. Weight gain can occur after taking almost all antidepressants, due in part to an increase in appetite and "thirst" for carbohydrates.
Some antidepressants are slightly more likely to cause weight gain than other drugs in this class. For example, tricyclic antidepressants (TCAs) and possibly monoamine oxidase inhibitors (MAOIs) may be more likely to cause weight gain than selective serotonin reuptake inhibitors (SSRIs) or newer generation antidepressants, with the exception of Remeron. SSRIs tend to cause loss of appetite early on, sometimes due to side effects such as nausea. While others may cause weight gain with long-term use (eg Paxil). Some antidepressants, such as Wellbutrin and Effexor, are less likely to affect weight.
The degree of weight gain depends largely on the specific drug dosage and duration of treatment. Prevention is the ideal strategy to manage weight gain and usually includes healthy eating habits and physical activity.
Sleep disorders: if you get insomnia or drowsiness while taking antidepressants, this can be corrected by prescribing a different medication, changing the dose or time of taking the antidepressants. Some patients report nightmares or surprisingly vivid dreams, but these side effects often resolve within a few weeks and rarely result in a change in medication.
Sexual Dysfunction: Sexual dysfunction is a reversible side effect. It is typically characterized by delayed ejaculation, decreased libido, or anorgasmia (inability to achieve orgasm), which occurs in men and women taking antidepressants. Negative effects can be alleviated by reducing the dosage, switching to another drug, or adding another drug to overcome the sexual side effects. It is important to remember that mental illness itself can affect sexual desire and ability to have sex.
Serotonin syndrome (serotonin intoxication): Serotonin syndrome is a rare but serious drug reaction that occurs when two serotonergic drugs (drugs that increase serotonin levels in the brain) are taken at the same time. Serotonin syndrome is associated with side effects such as:
- Changes in mental status (agitation, anxiety, delirium, euphoria, manic syndrome, hallucinations, confusion, mutism, coma).
- Symptoms of autonomic dysfunction (abdominal pain, diarrhea, hyperthermia, headaches, lacrimation, dilated pupils, nausea, tachycardia, tachypnea, fluctuations in blood pressure, chills, increased sweating).
- Neuromuscular disorders (akathisia, bilateral Babinski's symptom, epileptiform seizures, hyperreflexia, incoordination, myoclonus, horizontal and vertical nystagmus, oculogeric crises, opisthotonus, paresthesia, muscle rigidity, tremor).
Antidepressant withdrawal syndrome: after abrupt discontinuation of these drugs, patients may experience dizziness, nausea, weakness, insomnia, restlessness, irritability, and headache. These symptoms usually go away within a week. Gradually reducing the dose of antidepressants and practicing relaxation techniques should help avoid antidepressant withdrawal.
Suicidal thoughts or actions: antidepressants may increase suicidal thoughts or actions in some children, adolescents, and young adults when the drugs are first given. Depression and other mental illnesses are the most important causes of suicidal thoughts and actions.
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Side effects of different types of antidepressants
Monoamine oxidase inhibitors: MAO inhibitors associated with daytime sedation often cause dizziness, orthostatic hypotension (changes in blood pressure when moving from horizontal to vertical position), dry mouth, nervousness, muscle pain, paresthesia (tingling sensation), insomnia, weight gain, sexual dysfunction and difficulty urinating.
Tricyclic antidepressants: tricyclic antidepressants tend to have more side effects than other antidepressants. Including - headaches, drowsiness, significant weight gain, nervousness, dry mouth, constipation, bladder problems, sexual problems, blurred vision, dizziness, drowsiness, skin rashes and changes in heart conduction.
Selective serotonin reuptake inhibitors: SSRIs are generally well tolerated. Transient side effects of SSRIs: nausea, vomiting, diarrhea, headache, fatigue, nervousness, dry mouth. Some of the more persistent, chronic side effects include daytime fatigue, insomnia, sexual problems, and weight gain.
Selective norepinephrine reuptake inhibitors: side effects are similar to those of SSRIs. The most common side effects of these antidepressants include nausea, dizziness, insomnia, drowsiness, dry mouth, and sexual dysfunction. Selective norepinephrine reuptake inhibitors can increase blood pressure, especially at high doses.
Side effects of atypical antidepressants
- Trazodone usually causes sedation, dizziness, orthostatic hypotension, dry mouth, nausea and headache.
- Wellbutrin usually causes insomnia, headache, restlessness, irritability, agitation. Wellbutrin has a low risk of sexual side effects, fatigue, and weight changes compared to all antidepressants. Higher doses of Wellbutrin are associated with seizures.
- Remeron usually causes fatigue, dizziness, sedation, weight gain. Less common, but still can cause insomnia, sexual side effects, and nausea.
People react differently to antidepressants and it's not uncommon to have to experiment before you find the drug that works best. Careful monitoring of any side effects you experience is required. See your doctor right away if your symptoms get worse - he will most likely prescribe you another drug. Management of side effects can improve the success of antidepressant therapy.
Principles of drug correction of depression - what the patient needs to know
- The dose of the drug is selected strictly individually, taking into account the severity of the depressive disorder, the patient's age, body weight and the presence of concomitant diseases.
- When choosing a drug, one should take into account the presence of an additional effect: stimulating, anti-anxiety, hypnotic, and others.
- The dose should be absolutely sufficient: some side effects should be ignored during the dose selection period - they usually disappear on their own after 1-2 weeks of taking the medication.
- The clinical effect of antidepressants develops only 2-3 weeks after the start of their administration. The effectiveness of the prescribed drug should be evaluated after at least 2 weeks of drug use.
- The patient should be warned about the undesirability of driving a car or other mechanisms while using antidepressants.
- The fight against unwanted side effects is carried out exclusively by reducing the dose of the drug - in no case should you abruptly "throw" the medication.
- Antidepressants from the SSRI group, due to the long elimination period, cause the least pronounced withdrawal syndrome.
Denial of responsibility: The information provided in this article about side effects of taking antidepressants is for the information of the reader only. It cannot be a substitute for the advice of a health professional.
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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!
Use of antidepressants
Antidepressants For many years, they have been widely used in medical practice not only for the treatment of depressive conditions, but also as part of the complex therapy of other diseases. Their effect on metabolic processes in the central nervous system is used in psychiatry, neurology and some other areas of medicine. This is partly due to the fact that many antidepressants have quite strong secondary and side effects. Some of them, in addition to the antidepressant action, cause drowsiness, others eliminate the feeling of anxiety and fear. Of course, the use of drugs with such a wide spectrum of action is possible only as prescribed by specialists.Indications and contraindications for antidepressants
The main indication for the use of antidepressants, based on their name, are depression of varying severity. All drugs in this group effectively eliminate the symptoms, manifestations, and sometimes the causes of this mental disorder. However, antidepressants are often prescribed for other pathologies associated with mental or nervous activity.In certain cases, the following diseases can be considered indications for the use of antidepressants:
- some hormonal disorders, etc.
Since antidepressants have a wide range of side effects and affect, to one degree or another, the work of many organs and systems, they have quite a few contraindications. Not all contraindications are indicated in the instructions for specific drugs. That is why specialists conduct a thorough diagnosis before prescribing an antidepressant and when choosing the optimal dose. This is necessary to identify associated health problems ( of which the patient is sometimes unaware) and avoid the most serious complications.
Most antidepressants are contraindicated for the following health problems:
- Individual intolerance to the drug. The immune system of each person has its own characteristics. With individual intolerance to certain chemical compounds, the patient may develop an allergic reaction to the prescribed drug. If the patient has already had an allergy to the drug of this group in the past, this may be considered a contraindication to the appointment.
- Glaucoma. Glaucoma is an eye disease in which intraocular pressure increases. Critical elevation can lead to damage to the optic nerve and permanent blindness. Some antidepressants can provoke an attack, so they are not prescribed to patients ( usually the elderly) with glaucoma.
- Recovery after myocardial infarction. Some antidepressants can cause heart problems. In people after a myocardial infarction, the heart muscle is weak, and such a load can endanger their health and life. They try to prescribe antidepressants 4 to 6 months after a heart attack. These patients should be consulted prior to use. cardiologist ( enroll) .
- Structural damage to the brain. Trauma, stroke, and some infections can leave patients with structural damage to nerve tissue in the brain. This makes predicting the effects of antidepressants much more difficult.
- Disorders of the innervation of the intestine. The smooth muscles of the intestine are responsible for its contraction and partly for the normal digestion of food. Some antidepressants affect the nerves that regulate smooth muscle. Therefore, problems such as irritable bowel syndrome, chronic constipation or diarrhea may worsen while taking them.
- Urination disorders. The innervation of the ureters and bladder is also regulated by smooth muscles. Taking antidepressants can cause urinary retention or urinary incontinence. Patients with similar problems antidepressants are prescribed with caution.
- Severe renal or hepatic failure. The liver and kidneys are vital organs that are responsible for the biochemical transformation and excretion of many substances, including drugs. Severe violations of their work are a serious contraindication to taking many antidepressants, since the medicine will not be normally absorbed by the body.
- Problems with blood pressure. Taking antidepressants can cause an intermittent increase or decrease in blood pressure ( as a side effect). Patients with hypertension ( high blood pressure) they should be prescribed with caution, under the supervision of specialists.
- Pregnancy and lactation ( for some drugs). For some antidepressants, pregnancy and lactation are an absolute contraindication, as these drugs can cause serious harm to the health of the child.
- Age up to 6 years ( for some drugs). A number of antidepressants are harmful to a growing body. In principle, for serious mental disorders, some drugs in this group can be used up to 6 years, but only under the supervision of specialists.
It should be noted that not all of the diseases listed above are an absolute contraindication to treatment with antidepressants. In case of severe depression, treatment will still be prescribed, just the doctor will select exactly the drug, dose and regimen that will not give serious complications. Also, during the course of treatment, additional consultations, tests or examinations may be necessary.
How and in what doses to use antidepressants ( instruction)
The vast majority of antidepressants are designed for long-term use ( months, years), so a single dose of the drug will not give any visible improvement. As a rule, the patient selects the drug, the dosage regimen and the dose together with the attending physician. In addition, each drug is supplied with instructions for use, which necessarily indicate the optimal doses, as well as the maximum dose, the excess of which is fraught with poisoning and serious side effects.The dose and mode of administration of the drug depend on the following factors:
- The severity of the depression. In the case of severe prolonged depression, doctors usually prescribe stronger drugs, increase the dose and frequency of administration. This allows you to achieve a higher concentration of the drug in the blood and makes the therapeutic effect more noticeable.
- drug tolerance. Sometimes patients do not tolerate the prescribed drug. This can manifest itself in the form of severe side effects or allergic reactions. In this case, the doctor may, at his discretion, reduce the dose or change the drug.
- The risk of developing addiction. Some antidepressant drugs can become addictive over time. To reduce the risk of such a complication, doctors select the optimal dose and regimen. If necessary, they are adjusted during treatment ( for example, some antidepressants at the end of the course of treatment are not canceled immediately, but by gradually reducing the dose).
- Convenience for the patient. This criterion is taken into account in cases where other criteria have already been selected. Some people find it more convenient to take antidepressants once a day ( and sometimes less). For them, doctors select drugs with a long ( prolonged) acting at higher doses.
Withdrawal syndrome and its symptoms in case of addiction and dependence
The withdrawal syndrome is understood as a set of symptoms that appear in a patient with a sharp withdrawal of the drug, to which addiction has developed. Not all antidepressants are so addictive. Moreover, taking drugs in doses prescribed by a specialist rarely gives such a complication. In other words, the risk of being addicted to an antidepressant is not that great.In most cases, addiction occurs in patients treated with strong antidepressants for several months. However, this addiction is very different from drug addiction. Indeed, with a sharp cessation of taking the drug, the nervous system does not have time to rebuild, and various temporary disturbances may appear. However, there is still no serious health risk in this case.
Withdrawal syndrome when taking antidepressants may be accompanied by the following symptoms:
- general psychological discomfort;
- moderate muscle pain and joint pain;
- sometimes - nausea and vomiting;
- rarely - sudden pressure drops.
To avoid withdrawal syndrome, most experts recommend that you end the course of treatment by gradually reducing the dose of the drug. This allows the body to adapt more slowly to new conditions, and no symptoms will occur at all. In rare cases, when the patient is still concerned about the state of health after the end of the course, you should contact a specialist who will accurately determine whether it is a withdrawal syndrome or other health problems.
Overdose and poisoning with antidepressants
Taking an excessive dose of an antidepressant can cause very serious disorders in the body, which sometimes endanger the life of the patient. For each drug, the critical dose is slightly different. It is indicated by the manufacturer in the instructions. However, in some cases, when the patient's body is weakened, even a smaller dose can lead to poisoning. Also, the risk of overdose is higher in children.Symptoms of overdose and poisoning affect the work of many organs and systems, as the work of the central nervous system, which controls them, is disrupted. Diagnosis is usually made on the basis of presenting symptoms and disorders. If any atypical reactions of the body appear after taking a large dose of the drug, you should immediately seek medical help.
The most common symptoms of severe antidepressant poisoning in patients are:
- sudden drowsiness or loss of consciousness ( up to pre-coma);
- cardiac arrhythmias ( more often with increased rhythm, tachycardia);
- violations of the rhythm of breathing;
- deterioration in coordination of movements, sometimes - convulsions;
- drop in blood pressure ( indicates severe poisoning and requires urgent medical attention);
- dilated pupils ( mydriasis);
- deterioration of bowel function and urinary retention.
Treatment of such poisoning is carried out in intensive care in the toxicology department. First of all, doctors will take care of maintaining the basic vital signs. Self-administration of emetics in this case is prohibited, since the organs do not work well and the patient's condition may worsen ( entry of vomit into the respiratory tract). In the hospital, special agents will be prescribed that will lower the concentration of the drug in the blood and neutralize its toxic effect on the central nervous system.
Can antidepressants be used in children and adolescents?
In principle, depression is not only an adult disease. Psychiatrists note that 6 to 8 percent of children and adolescents also suffer from its various manifestations. In some cases, children may be prescribed antidepressants as treatment. It is believed that the minimum age for most drugs in this group is 6 years, but some, the weakest, can be prescribed to young children.In the case of the treatment of depression in children, the main groups of antidepressants are prescribed as follows:
- Tricyclic antidepressants. Due to the large number of side effects, drugs in this group can have a detrimental effect on a growing organism. They are prescribed to children extremely rarely, only under the strict supervision of doctors.
- monoamine oxidase inhibitors. These drugs are also quite powerful and can lead to a variety of problems in children. They are rarely used.
- Serotonin reuptake inhibitors. The drugs in this group have a selective effect, so they do not have such a wide range of side effects. Most specialists try to prescribe them for children with depression.
- drugs of other groups. Drugs are prescribed selectively, sometimes in combination with other drugs.
Is it safe to use antidepressants during pregnancy and lactation ( breastfeeding)?
Among antidepressants, there is a fairly large selection of drugs that are approved for use during pregnancy and lactation. As a rule, this point is indicated by the manufacturer in a separate column of the instructions. Sometimes the trimester of pregnancy is noted, in which the use of the drug is especially dangerous.In general, taking antidepressants during pregnancy is always better to coordinate with your doctor. It is important to assess the risks of using or not using a drug and compare them. Self-administration of strong antidepressants often leads to various complications of pregnancy, as it poses a threat to the child.
Self-administration of antidepressants during pregnancy can be dangerous for the following reasons:
- Possibility of malformations. Malformations occur in a child in cases where the drug passes the placental barrier between the blood of the mother and the fetus. Some substances inhibit the division and growth of certain cells. It has been noted, for example, that a number of drugs from the SSRI group ( selective serotonin reuptake inhibitors) can lead to developmental disorders of the respiratory system. Other substances can similarly cause irreparable harm to the cardiovascular or nervous system.
- risk of pregnancy complications. In addition to harm to the fetus, there is a certain risk of complications in a pregnant woman. Changes in metabolism in the body can change the cellular composition of the blood, lead to the accumulation of toxic substances. As a result, a woman's chronic diseases may worsen, often there is a threat of miscarriage or premature birth.
- Decreased effectiveness of the drug. Due to hormonal changes in the body, some antidepressants may be less effective for pregnant women than for other patients. It is very difficult to predict this in advance, and the doctor evaluates the effectiveness of the treatment after the start of the course.
Do I need to take any tests or undergo examinations before prescribing antidepressants?
In principle, patients undergo tests and examinations in order to confirm a particular diagnosis and detect various health problems. Based on this information, the specialist decides whether to prescribe a particular drug. Antidepressants are designed to fight depression and a number of other mental problems that may accompany it. In the field of psychiatry, laboratory tests and instrumental examinations are of secondary importance. Mental abnormalities can be observed even in completely healthy ( according to the results of analyzes) of people. In this case, the opinion of a qualified specialist is decisive.However, if long-term use of antidepressants is necessary, the doctor will usually prescribe a series of tests and examinations to patients. Most often, this is necessary to detect comorbidities ( apart from depression). Almost all drugs from the group of antidepressants have many side effects associated with the work of the heart, gastrointestinal tract or other internal organs. If you do not take into account the presence of chronic pathologies, taking the drug can seriously damage the health of the patient.
To detect comorbidities, your doctor may prescribe the following tests before you start taking antidepressants:
- general blood analysis ;
- blood chemistry;
- electroencephalography;
- allergic tests;
- ultrasound examination of internal organs ( ultrasound) and etc.
What is the danger of self-administration of antidepressants at home?
Most strong antidepressants with a pronounced therapeutic effect are dispensed by prescription from a specialist. This measure is intended to limit self-medication with these drugs, as it may pose a risk to the patient. In general, antidepressants have a very diverse effect on the body. The effect of their reception can be reflected in the work of many organs and systems. This explains the possibility of developing serious side effects that the patient is not able to predict.Self-medication with drugs from the group of antidepressants can be dangerous for the following reasons:
- Wrong diagnosis. Antidepressants can be prescribed for various diseases, but only a qualified specialist can make an accurate diagnosis. The patient himself cannot accurately classify his condition. Depression can be combined with other mental disorders, and not all of them can be corrected by taking antidepressants. Such medication ( in the absence of evidence) will not give a therapeutic effect, and the risk of various complications increases significantly.
- The presence of chronic diseases and contraindications. Many patients do not know all their health problems. Some pathologies do not manifest themselves and can only be detected during special examinations. At the same time, such diseases are often contraindications to taking antidepressants. That is why these drugs should be prescribed by a doctor after a full examination of the patient, and self-medication can be dangerous.
- Possibility of drug interactions with other drugs. Often, patients take several drugs at the same time for different diseases. This combination of drugs can have negative consequences. On the one hand, the therapeutic effect can be weakened or enhanced. On the other hand, the risk of side effects and serious complications increases. The instructions for the drug do not indicate the entire list of unwanted drug interactions. To exclude a dangerous combination of drugs, it is better to consult a doctor.
- Incorrect dose selection. The calculation of the dose required to treat a patient and the regimen of taking the drug depends on many factors. The doctor, prescribing this or that medicine, is guided by the results of a preliminary examination. Patients themselves, seeking to quickly achieve a therapeutic effect, can significantly exceed the allowable dose.
- Lack of expert supervision. Most antidepressants need to be taken under the supervision of a specialist ( in the hospital or at periodic consultations). This will allow you to evaluate the therapeutic effect, notice the appearance of side effects in time and more accurately calculate the required dose of the drug. Self-administration without the supervision of a specialist is fraught with a delay in treatment, a high risk of side effects and the development of drug dependence.
It should be noted that antidepressants, which can be purchased at a pharmacy without a doctor's prescription, do not pose such a serious threat to the patient. However, their use without prior consultation can in some cases lead to serious consequences. For example, when taken simultaneously with some other psychoactive drugs, their effect on the body may increase, and the patient will overdose.
How long does a course of antidepressant treatment last?
The duration of treatment with antidepressants is determined by the disease that caused them to be prescribed. In most cases, the drug is prescribed for several weeks, after which the doctor evaluates its effect on the body, tolerability and effectiveness. If the patient does not experience side effects and there is a tendency to improve the condition, antidepressants may be prescribed for several months. In the case of each individual drug, the duration of the course of treatment may be different. As a rule, drugs of this group are drunk for at least 2-3 weeks ( and often several months). Otherwise, it will be difficult to evaluate their effectiveness.The duration of antidepressant treatment depends on the following factors:
- established diagnosis;
- the patient's condition while taking the drug ( should be positive);
- the presence of side effects;
- presence of contraindications chronic diseases);
- treatment conditions ( in the hospital or at home);
- possibility of regular consultations with a specialized specialist.
Does long-term use of antidepressants harm the body?
Taking antidepressants almost always involves a long course of treatment, which can be associated with some complications. The most serious of them is the development of drug dependence. It can appear when taking certain drugs for several months. After the end of the course of treatment, there will be certain difficulties with the complete withdrawal of the drug ( withdrawal syndrome and its symptoms).Other complications are rarely associated with long-term use. As a rule, problems with the digestive, nervous or cardiovascular system occur within a few weeks after the start of treatment. They are associated with the individual sensitivity of the body to a particular drug.
How soon can I drink alcohol after taking antidepressants?
In principle, there is no consensus among experts regarding the compatibility of alcohol and antidepressants yet. It is believed that some drugs in small doses can be combined with alcohol, but for each patient this small dose varies significantly. It depends on the individual characteristics of the body, the type of alcohol and other factors. It is almost impossible to foresee them all in advance and predict exactly what effect the combination of alcohol with antidepressants will give.In general, the effect on the body of alcohol and antidepressants is almost the opposite. Despite the similar effect alcohol at the first stage liberates and cheers up), the processes occurring in the CNS are very different. Pharmacological preparations have a selective effect on a certain system, and even in the presence of side effects, they have a more stable and directed effect. Alcohol affects many organs and systems. For example, inhibition of liver function leads to a deterioration in the metabolism necessary for the nervous system. In addition, the circulation of water in the body is disturbed. This partly explains the appearance of insomnia after prolonged use of alcohol.
Thus, the simultaneous use of antidepressants and alcohol will most often have negative consequences. For example, an antidepressant will not have the proper effect on enzymes, while the risk of side effects will increase. There may be more serious consequences associated with severe violations in the work of the central nervous system. In severe cases, patients can quickly develop problems with heartbeat, breathing. There is also a high risk of psychoses, neuroses and other acute psycho-emotional disorders. In this regard, it is considered safest to consume alcohol a few days after the end of antidepressant treatment ( a more precise period can be suggested by the attending physician). Alcohol abuse during the course of taking the drug simply negates the benefits of taking it.
How long do antidepressants last after use?
The tangible effect of taking most antidepressants does not occur earlier than a few weeks after the start of the course of treatment. Sometimes this period can last several months. Such a belated therapeutic effect is due to the peculiarities of the action of these drugs. In most cases, a single dose of the drug is not felt, since a sufficient concentration of the antidepressant has not yet accumulated in the blood and nerves. Over time, with proper and regular use, there is a "restructuring" of the nervous system. From this point on, the patient begins to feel an improvement in his condition. The therapeutic effect lasts throughout the course of treatment, as long as the patient continues to take the medicine.After the end of the course and discontinuation, there may be several options:
- Full recovery. With mild depression, a properly selected drug can lead to a complete recovery in a few weeks or months. After the end of the reception, the patient no longer faces this problem and leads a normal life.
- long-term remission. This treatment outcome is the most common. After the end of treatment, the patient's nervous system functions normally for a long time. The period without depression is called remission. It can last from several months to several years. Unfortunately, in many patients, sooner or later ( usually due to stress or other factors) again develops severe depression, and the course of treatment has to be repeated.
- The return of depression. Unfortunately, this outcome is quite common. With serious mental disorders, in principle, it is very difficult to achieve a full recovery. Severe depressions may return and require a new course of treatment to resolve them. Some patients are forced to take antidepressants for years to maintain a normal state.
Which antidepressants are non-addictive and non-addictive?
Dependence on any antidepressant is not an inevitable complication of treatment. Strong addiction to the drug occurs under the condition of long-term use, a certain dose and some individual predisposition of the body. In addition, when prescribing a particular drug, doctors always try to choose a treatment regimen that will minimize the risk of addiction.In general, not many antidepressants are highly addictive. At the legislative level, their distribution is limited. In other words, almost all prescription antidepressants sold in pharmacies can be addictive under certain conditions. Lighter drugs that can be purchased independently do not have this property. If they help well with depression, then the dependence may be more psychological, and after stopping the drug, the patient will not have a withdrawal syndrome.
You can clarify the risk of addiction to a particular drug from your doctor. This is especially important for people who have suffered from severe addiction in the past ( drug addiction, alcoholism, etc.). In any case, they should consult their doctor before starting antidepressants. psychiatrist ( enroll) or narcologist ( enroll) .
How do antidepressants affect libido?
Some antidepressants can lower libido ( sexual attraction) and blunt emotions in general. This side effect is typical, first of all, for selective serotonin reuptake inhibitors ( SSRIs). Usually it is indicated in the instructions for a particular drug. Also, the doctor warns about the risk of such problems before prescribing the drug. In the case of long-term use of antidepressants, this effect may remain even after stopping the use of the drug itself. Some experts even identify such a disorder called post-SSRI sexual disorder.The side effect of a decrease in libido should not stop doctors and patients if the patient really needs a course of antidepressants. Just the patient should be informed, and in case of such problems, contact a specialist.
What are the consequences of taking antidepressants?
In rare cases, the effects of taking antidepressants can be felt for quite a long time after the end of the course of treatment. This is due to the fact that during the period of taking medications, the central nervous system in a certain way “rebuilt” and “got used” to the regular intake of active substances from the outside.The following are the most tangible effects of taking antidepressants:
- The development of drug dependence. Dependence develops gradually due to artificial stimulation or inhibition of certain parts of the nervous system. Sometimes, special medical care may be required to get rid of this addiction.
- Problems with certain organs and systems. Side effects of some antidepressants may be associated with the work of the heart, liver, kidneys, organs of the gastrointestinal tract. After stopping treatment, some patients may experience heart problems, diarrhea or constipation, abdominal pain, and other symptoms. As a rule, these violations do not last too long ( no more than 2 - 3 weeks), after which the work of the organs returns to normal. With severe symptoms and significant discomfort, it is better to seek medical help, and not wait until the problems go away on their own.
- The return of depression. Sometimes the course of treatment does not give a stable result, and the patient, after stopping antidepressants, soon returns to a depressive state. In this case, you should definitely consult a psychiatrist. The doctor will objectively assess the patient's condition and find out why the treatment was not effective. Sometimes the course of treatment is extended ( with or without drug change), and sometimes just give the nervous system a little time to return to normal. Of course, the patient is observed by a doctor until complete recovery.
For what diseases and problems are antidepressants prescribed?
Currently, the range of use of antidepressants in medical practice is very wide. They are used not only for the treatment of depression itself, but also for a number of other mental illnesses, syndromes and disorders. This is due to complex disorders in the work of the central nervous system that accompany many pathologies. Almost every antidepressant has its own advantages and disadvantages. A qualified specialist can combine these drugs with other drugs to achieve a good therapeutic effect.The most common antidepressants ( alone or as part of complex therapy) is prescribed for the following diseases:
- depression;
- neuroses;
- panic attacks;
- schizophrenia;
- various psychoses.
Depression
Can depression be treated without antidepressants?
Vegetative-vascular dystonia ( VSD)
Vegetative-vascular dystonia is not considered by many specialists as a separate disease, since its manifestations can be very diverse and difficult to classify. The disease usually comes down to a nervous breakdown, in which abrupt changes in blood pressure, periodic pain, urinary disorders, a sudden change in heart rate and breathing, and severe sweating are most often observed. An abrupt attack can provoke a panic attack in a patient. Currently, many neurologists recommend prescribing antidepressants to patients with similar problems as one of the main medicines as part of complex therapy.The following groups of antidepressants are most effective in VVD:
- SSRIs);
- some tricyclic antidepressants;
- tetracyclic antidepressants.
Polyneuropathy
Polyneuropathy is a very serious problem in which patients, for one reason or another, are affected by peripheral nerves. This can be accompanied by very severe pain, sensory disturbances, and in severe cases, motor disorders ( motor function). Treatment of this disease should be comprehensive, aimed at both eliminating the cause of the disease and combating its manifestations.Some antidepressants are widely used as a symptomatic treatment for diabetic polyneuropathy. In particular, amitriptyline and venlafaxine are more effective in relieving pain than many conventional pain medications ( non-steroidal anti-inflammatory drugs).
The effectiveness of antidepressants in polyneuropathy is explained by the following mechanisms:
- dulling of pain occurs at the level of the nervous system;
- the severe condition of patients with advanced diabetes mellitus is often accompanied by depressed mood and depression ( which are also relieved by antidepressants);
- eliminate root cause proper nerve damage) with diabetes is almost impossible, and pain must be fought constantly, and antidepressants are just designed for long-term use.
Neurosis
Panic attacks
Panic attacks are acute nervous disorders that can present in a variety of ways. It is currently believed that cupping ( elimination of acute symptoms a) panic disorder can be successfully managed with antidepressants. As a rule, this initial stage of treatment lasts several weeks. During the period of fixing the result, antidepressants are combined with other drugs and psychotherapy, and the full course of treatment can last more than a year.It should be noted that panic attacks are often combined with other mental disorders. They can occur, for example, against the background of various phobias. For full treatment, the patient must undergo a consultation with a psychiatrist and a neurologist, who will exclude the objective causes of disorders and clarify the diagnosis. In some cases, antidepressants will be prescribed in combination with other drugs.
In the treatment of panic attacks, the following groups of drugs are most often used:
- tricyclic antidepressants ( clomipramine, desipramine, nortriptyline, amitriptyline, etc.);
- selective serotonin reuptake inhibitors ( fluoxetine, escitalopram, etc.);
- MAO inhibitors ( monoamine oxidase) reversible and irreversible action ( pirlindol, phenelzine, etc.).
Do antidepressants help with anxiety and fear ( anti-anxiety effect)?
Many antidepressants have a complex effect on the central nervous system, and they can be used not only for the treatment of depression. Among the drugs of this group, there are those that have a pronounced anxiolytic effect ( relieve anxiety, unreasonable fear, anxiety). They are quite widely used in anxiety neuroses and similar pathological conditions in psychiatry.Most often, patients are prescribed the following antidepressants with anti-anxiety effect:
- maprotiline;
- Azafen;
- mianserin;
- mirtazapine.
Do antidepressants help with insomnia?
Depressive states can be accompanied by a variety of disorders in the work of the central nervous system. Quite often, patients have sleep disorders ( drowsiness or insomnia). In the case of insomnia, the patient's condition is greatly aggravated due to the exhaustion of the nervous system. In such conditions, antidepressants with a sedative effect are used. Their use quickly calms the patient and gives a hypnotic effect. In different drugs of this group, this effect is expressed in different ways.In general, antidepressants with a sedative effect ( amitriptyline, imipramine, nortriptyline) are widely used to treat insomnia. The effect of their use appears within a few weeks after the start of the course of treatment. However, all patients respond to treatment differently, and to achieve the best effect, it is better to select the drug and dose from a qualified specialist.
Do antidepressants help with menopause ( menopause)?
Menopause normally occurs in women between the ages of 40 and 50. It is characterized by hormonal changes in the body, as a result of which not only the menstrual cycle stops, but also a number of concomitant disorders and disorders occur. Many of them are related to the emotional state in general and possible mental disorders ( in some cases). Medical assistance during this period includes a fairly wide range of drugs, among which there are antidepressants.The use of antidepressants is possible throughout the menopause. For some women, this period stretches from 3 to 10-15 years. To maintain a stable emotional background with the help of antidepressants, it is better to consult a specialist ( gynecologist, psychiatrist). They will help you choose the optimal dose of the drug. As a rule, in these cases, mild antidepressants are prescribed, which have fewer side effects and relieve the symptoms that have arisen. The appointment of stronger drugs is necessary only in the case of the development of severe mental disorders.
Antidepressants for menopause help eliminate the following symptoms:
- severe mood swings emotional lability);
- sleep disorders;
- lack of motivation;
- fast fatiguability ;
Are antidepressants prescribed for postpartum psychiatric disorders?
Postpartum mental disorders are a relatively common problem. Changes in hormonal levels and lifestyle can cause severe stress in a woman. This is especially true for women whose pregnancy took place with various complications. As a result, after childbirth, certain psycho-emotional problems may be observed for a long time ( depression, irritability, etc.). Sometimes antidepressants are prescribed to correct these disorders.With postpartum depression, antidepressants usually have a good therapeutic effect. The drug and dose are prescribed by the attending physician ( usually a psychiatrist). The main condition is the safety of the chosen medication during breastfeeding. Longer courses of treatment with stronger drugs may be necessary for patients in whom pregnancy has led to an exacerbation of existing sychic disorders.
Is it possible to take antidepressants for weight loss?
Antidepressants as a group of pharmaceuticals have a wide spectrum of action on various body systems. One of the possible effects of taking these drugs is a decrease in appetite and a kind of "motivation" of a person to a more active lifestyle. In this regard, many people use antidepressants to combat excess weight. Moreover, some anti-obesity clinics include some drugs in this group in their treatment programs.Definitely deciding whether it is possible to take antidepressants for weight loss is very difficult. The fact is that each drug has its own characteristics, and only a qualified specialist can predict its effect on a particular patient.
- Side effects. Antidepressants have a lot of serious side effects that can occur even if the drug is taken correctly according to the scheme prescribed by a specialist. Taking these drugs to combat obesity is dangerous, since their main task is still to affect the central nervous system. It has been noted that healthy people who do not have direct indications for taking antidepressants may experience seizures, diarrhea, heart rhythm problems, sleep problems, and even suicidal tendencies.
- Availability of alternative treatment regimens. In most cases, patients can choose a safer treatment regimen to get rid of excess weight. Dietitians can help with this. In some cases, weight gain can be an endocrinological problem. Accordingly, the patient will need to normalize the hormonal background under the guidance endocrinologist ( enroll) . Antidepressants are needed only for those patients who began to gain weight against the background of emotional or mental disorders.
- The possibility of the opposite effect. As practice shows, the treatment of obesity with antidepressants is not universal. In some patients, such treatment gives a tangible effect only at the beginning of the course. In later stages, the patient may begin to gain weight again. To avoid this, it is better to develop a treatment regimen using several methods that complement each other, and not rely only on antidepressants.
Can antidepressants help with headaches?
Chronic headaches can be associated with a variety of diseases and disorders in the body. Sometimes they accompany depression. In these cases, the pain is partly "mental" and conventional painkillers may not be effective. Thus, for the correct treatment of headaches, it is important to establish the cause of their occurrence.Some antidepressants have been shown to relieve or eliminate headaches not related to specific structural damage. In other words, with injuries, tumors or high blood pressure, they will not give any effect. But if the patient is chronically stressed or has previously identified mental disorders, antidepressants are sometimes the best option.
Of course, you cannot take these drugs on your own for any headache. In some cases, this can only exacerbate the problem. It is better to consult with a specialist therapist, neurologist, etc.), which will prescribe the necessary examinations. He will be able to recommend the drug that will be most effective in this particular case.
Can I take antidepressants after a stroke?
In principle, antidepressants are recommended after a stroke for many patients as part of complex rehabilitation therapy. Quite often, a stroke is accompanied by a patient's disability, as certain parts of the brain die or temporarily fail to cope with their functions. According to modern research, some drugs from the group of antidepressants accelerate the "adaptation" of the brain to new conditions and accelerate the return of lost skills. This group includes mainly selective serotonin reuptake inhibitors ( SSRIs) - escitalopram and cipralex. In addition, many post-stroke patients suffer from depression. To eliminate this problem, they may be prescribed a course of treatment with antidepressants from other groups.It should be noted that antidepressants in these cases are prescribed by the attending physician only some time after the stroke ( at a certain stage of recovery). Their immediate use in the first days or weeks can be dangerous due to possible side effects.
What to do if the prescribed funds do not help?
Almost all drugs that belong to the group of antidepressants have their own characteristics of use. Even qualified specialists are not always able to choose a drug that will help a particular patient the first time. As a rule, the doctor warns the patient about this possibility and agrees in advance with him the time of the second consultation. The patient himself can not always correctly assess the effect of the drug.If the patient does not feel improvement within a few weeks, you should contact the doctor who prescribed the course of treatment. Sometimes the right drug, which has a good effect on a particular patient, can only be selected on the second or third attempt. In severe cases, a combination of several drugs is possible, which will enhance the therapeutic effect.
WHAT IS DEPRESSION?
Depression (from Latin - suppression, oppression) is a mental disorder that can lead a person out of emotional balance for a long time and significantly worsen the quality of his life (labor activity, personal relationships, etc.). Often, depression occurs as a response to psychological trauma or a negative event (death of a loved one, dismissal from work). Depression, or painfully low mood, can be both an independent disease and a manifestation of many others. Low mood can be in perfectly healthy people. Depression is one of the most common mental disorders. You need to know that depression in all its manifestations is a disease that needs to be treated, otherwise it will take a protracted course and lead to disability. Timely treatment in most cases leads to complete recovery.
TYPES OF DEPRESSION
big depression
Major depression is also known as major depressive disorder, unipolar depression, or clinically significant depression. The word monopolar means the presence of one extreme position - the "pole" - in the range of emotions, which is characterized by only one (dreary, depressed) mood. As a rule, major depression is a persistent feeling of sadness or complete joylessness, when even the most beloved activities do not bring pleasure. Other disorders are also noted: insomnia, inability to concentrate, forgetfulness, loss of appetite, pain in different places.
Scientists believe that the cause of major depression is a violation of the processes of biochemical activity of the brain. Another reason may be the incorrect operation of the biological clock - a time reference mechanism that controls the strict periodicity of physical, chemical and physiological processes in the body.
Major depression can affect people of any age and social class, but in most cases it first appears between the ages of 25 and 44. Some people experience depression more often than others, especially those who have had their first bout before age 20. And also for those whose relatives suffer from depression. The likelihood of recurrence of depression becomes greater with each new episode (period of depression) of the disease - the more bouts of depression a person has experienced, the higher the likelihood of recurrence of new episodes.
Groups of symptoms that indicate major depression:
- Mood disorders
- Changes in behavior
- Difficulty thinking or impaired cognition
- physical manifestations
- Treatment for major depression usually consists of taking medications and methods of psychotherapeutic assistance provided by psychotherapists and psychologists. Or combinations of these therapies are used.
Types of major depression:
Psychotic depression.
In addition to the symptoms of depression itself, patients develop delusions and hallucinations against the background of depressed mood. Due to the severity of symptoms in this form of mental disorder, a person may not be able to soberly assess the environment and foresee the consequences of their actions. The risk of suicide increases sharply.
atypical depression.
In atypical depression, there is a mixed picture of symptoms - typical of major depression and atypical (atypical). People feel helpless, engage in self-accusation. But at the same time they sleep and eat more than usual. In addition, this form is still characterized by a protracted character, while in a typical course the disease is divided into episodes, manifesting itself in the form of seizures that occur from time to time. The onset of the disease is usually in adolescence. Treatment consists of medication () or psychotherapy, or both.
postpartum depression.
This is a disorder that occurs due to hormonal fluctuations days, weeks and even months after the birth of a child. The symptoms of the disorder are similar to those of major depression.
postpartum psychosis.
In some rare cases, postpartum depression can turn into a more serious disorder called psychosis. Psychosis is a severe withdrawal from reality, including hallucinations and delusional thoughts. Postpartum psychosis occurs shortly after the birth of a child, in which case delusional thoughts often focus on the newborn child.
Premenstrual dysphoric disorder (syndrome).
Women suffering from true premenstrual dysphoric syndrome, on a monthly basis, usually during the week before the onset of menstruation, experience the following symptoms:
- Anger, irritability
- Anxiety
- Fatigue
- Cravings for unusual foods
- Feelings of guilt and self-blame
- Sadness
- Tearfulness
- Dizziness, weakness, swelling
dysthymic disorder.
Dysthymic disorder or dysthymia is a long-term form of depressive disorder, which is characterized by a persistent feeling of joylessness. Symptoms of dysthymic disorder are fixed for at least two years, and more often even longer.
Symptoms of dysthymic disorder:
- Inability to concentrate
- Decreased or increased appetite
- Low self-esteem
- Insomnia or drowsiness
- Fatigue
- Guilt
- Feeling hopeless
- Thoughts of imminent death and suicide
- Inability to act and make decisions
- Low self-esteem
Dysthymic depression often begins in childhood, adolescence, or adolescence and may continue for many years. In addition, dysthymia increases the risk of developing deep depression at certain, as a rule, crisis moments in life.
People suffering from dysthymia look weakened, deprived of vital energy. They seem to be pessimists, constantly irritated and grouchy. People with dysthymia often look at their difficulties as natural circumstances of life and do not look for a way out.
There is no guaranteed cure for dysthymia. However, treatment can significantly mitigate and weaken its symptoms and prevent the progression of the disease. Previously, dysthymia was treated with the help of psychotherapy, most often psychoanalysis. Other methods of verbal psychotherapy (treatment with a word) are cognitive, behavioral and interpersonal psychotherapy.
Seasonal affective disorder.
Seasonal affective disorder is a form of depression that occurs at certain times of the year. The depression in seasonal affective disorder lasts five months. As a rule, depression occurs in October-November, and ends in March-April.
Symptoms of seasonal depression:
increased appetite
Craving for food rich in carbohydrates
Increased need for sleep and rest
Irritability
Feeling of heaviness in arms and legs
Therapy for seasonal affective disorder usually begins with phototherapy: the patient every day sits for a certain time under the rays of bright light. Sometimes the patient is prescribed antidepressants.
Bipolar disorder.
Bipolar disorder is a disorder in which people periodically experience unusual euphoric mood swings called manic periods.
When the emotional response transitions between its extremes—between severe depression and mania—this variant of the disease is called "bipolar disorder, type I." When mood swings occur in a narrower range between depression and hypomania, this is "bipolar disorder, type II."
People who go through the manic period of bipolar disorder may appear cheerful and happy. At this time, a person needs less sleep, he experiences unusual creative upsurges, is full of energy and enthusiasm. The main danger is that during manic periods, arousal gets out of control. A person loses sobriety of mind, prudence, common sense. People often spend a lot of money, gamble, make hasty and thoughtless decisions, and engage in risky sexual encounters.
In most cases, manic episodes alternate with periods of depression. Sometimes a change in mood to the opposite occurs within one day. Bipolar disorder carries a greater risk of suicide than other forms of depression. During the depressive phase of the disorder, the same symptoms appear as in major depression.
Varieties of bipolar depression:
Accelerated Circulatory Disorder.
In some people, the mood disorder often reverses direction, going back and forth between depression, mania, and hypomania. If there are four or more such cyclical attacks per year, then this is one of the rare forms of bipolar depression - accelerated circular disorder. Patients are usually prescribed lithium, mood stabilizers - anticonvulsants, alone or in combination with lithium.
dysphoric mania.
Most often, dysphoric mania affects young people. Dysphoric mania responds poorly to lithium therapy. Anticonvulsants are usually prescribed, alone or in combination with lithium.
mixed states.
Some people may experience both depression and mania at the same time. Such patients are said to have a mixed condition.
Cyclothymia.
Cyclothymia or cyclothymic disorder is a mild, not pronounced, but more prolonged form of type I bipolar disorder, when the emotional reaction makes transitions between hypomania and mild depression. In cyclothymia, short, irregular bouts of depression and hypomania do not last for weeks, but for only a few days. The diagnosis of cyclothymia is made in adults with short, irregular bouts of depression and hypomania that occur for at least 2 years with no more than 2 months of no symptoms of the disease. Cyclothymia most often develops between the ages of 15 and 25.
MAIN SYMPTOMS OF DEPRESSION
Depression is often difficult to recognize. This is due, on the one hand, to the erroneous opinion that telling others about your problems and the inability to cope with them yourself is a sign of human weakness, and on the other hand, by the fact that patients often hide their depression behind aggressive behavior and / or alcohol abuse. Going headlong into work, active participation in sports or sports that are associated with risk, extreme situations, and gambling can all indicate depression to some extent.
Depression is not a weakness of character. It has been proven that during depression in the structures of the brain that transmit impulses, there is a deficiency of serotonin.
Emotional manifestations:
- Longing, suffering, oppressed, depressed mood, despair
- Anxiety, feeling of inner tension, expectation of trouble
- Irritability
- Feelings of guilt, frequent self-blame
- Dissatisfaction with oneself, decreased self-confidence, decreased self-esteem
- Decreased or loss of ability to experience pleasure from previously pleasurable activities
- Decreased interest in the environment
- Loss of the ability to experience any feelings (in cases of deep depression)
Depression is often combined with anxiety about the health and fate of loved ones, as well as with the fear of appearing incompetent in public places.
Physiological manifestations:
- Sleep disorders (insomnia, drowsiness)
- Appetite changes (loss or overeating)
- Bowel dysfunction (constipation)
- Decreased sexual desires
- Decreased energy, increased fatigue during normal physical and intellectual stress, weakness
- Pain and various discomforts in the body (for example, in the heart, in the stomach, in the muscles)
Behavioral manifestations:
- Passivity, difficulty engaging in purposeful activity
- Avoidance of contact (tendency to solitude, loss of interest in other people)
- Rejection of entertainment
- Alcoholization and substance abuse providing temporary relief
Thought Manifestations:
- Difficulty concentrating, concentrating
- Difficulties in making decisions
- The predominance of gloomy, negative thoughts about yourself, about your life, about the world as a whole
- A gloomy, pessimistic vision of the future with no perspective, thoughts about the meaninglessness of life
- Thoughts of suicide (in severe cases of depression)
- The presence of thoughts about one's own uselessness, insignificance, helplessness
- Slow thinking
To be diagnosed with depression, some of these symptoms must persist for at least two weeks.
IMPACT OF DEPRESSION ON HEALTH
Immunity.
The human body has a well-established system of resistance to many infections and diseases. Depression lowers the body's resistance and makes it susceptible to disease.
Bone system. Depression contributes to the development of osteoporosis (brittle bones).
The cardiovascular system. Depression affects the functioning of the heart and blood vessels. The disorder doubles the risk of diseases of this system.
Nervous system. Depression is similar to dementia in its effect on memory, the concept of attention and other thought processes. It contributes to the development of dementia: the area of the brain that controls memory is reduced in size in people suffering from chronic depression. Chronic, undiagnosed and untreated depression eventually destroys neural connections in the brain, which leads to the death of nerve cells.
Pain perception.
The depressed person experiences unspeakable emotional pain.
Depression affects the function of the entire body. For example, a change in appetite leads to overeating and becoming overweight, or malnutrition and weight loss.
Depression is fraught with malfunctions in the hormonal system and many other physiological changes.
Thus, the insidiousness of depression is that it affects the body, mind and soul at the same time.
DRUGS THAT PROVOKE DEPRESSION.
A drug |
In what cases is it assigned |
Anatabus (teturam) |
Alcoholism |
Anticonvulsants, anticonvulsants |
Epilepsy |
Barbiturates |
Epilepsy and (rarely) anxiety |
Benzodiazepines |
Anxiety and insomnia |
Beta blockers |
|
Calcium channel blockers (calcium antagonists) |
High blood pressure, heart disease |
Corticosteroids |
Inflammatory diseases and chronic lung diseases |
Contraceptives and use during menopause |
|
Interferon |
Hepatitis and cancer |
Levodopa, amantadine |
Parkinson's disease |
high cholesterol |
|
Zovirax |
Herpes and shingles |
DISEASES THAT PROMOTE DEPRESSION.
- Bronchial asthma
- Oncological diseases
- chronic fatigue syndrome
- Heart disease
- Diabetes
- Viral hepatitis
- Systemic lupus erythematosus
- Multiple sclerosis
- Parkinson's disease
- Acute cerebrovascular accident, stroke
- Ulcerative colitis
HOW TO TREAT DEPRESSION?
Depressive disorder is successfully treatable, although there is no single standard regimen for this. Treatment will depend on the type of depressive disorder and the severity of its manifestations. The goal of treatment is to relieve depression, improve mood. Major depression is usually treated in two or three phases. The first is to eliminate the most severe painful manifestations. This stage of treatment of acute disorders takes from 6 to 12 weeks. The next stage is the treatment, which must be continued, despite the satisfactory state of health. This additional treatment is intended to protect you from a possible recurrence of the disease. It takes 4 to 9 months. In the future, the help of a doctor may not be required if the experienced attack of the disease is the first or second in life. Individual patients move on to the third stage - maintenance treatment, which can last a long time, sometimes a lifetime. Supportive care is aimed at preventing recurrence of the disease. Relapse is a separate new attack of the disease against the background of apparent recovery. Maintenance treatment is usually taken by those who have suffered three or more attacks - relapses of the disease.
Independent work or self-help.
These are your own efforts to deal with depression. Many studies support the value of self-help in dealing with emotional, behavioral, and physical difficulties. By answering the following two questions, you can determine if self-help is enough for you:
Are you familiar with suicidal thoughts? If yes, you need specialist help.
Do you feel the effects of depression in most areas of your life: work, relationships, health, ability to rest? If yes, it is possible that you are suffering from generalized depression, which requires more intervention than self-help to get rid of.
If you answered “no” to both questions, you can start with self-help. If you don't notice any improvement after a few months of self-study, seek additional help. Lack of confidence, increasing despondency, suicidal thoughts, or any other deterioration in well-being signal the need to urgently contact a professional. Self Help Resources:
Books.
Books can give you a wealth of information that is not available in psychotherapy sessions. You can read at your own pace, put the book aside for a while, or re-read it. If you combine work with books and psychotherapy, you will achieve better results faster.
Video cassettes, disks.
People who perceive visual information better can watch video cassettes or CDs dedicated to combating depression and improving their own condition.
Self help groups.
Psychological groups provide participants with the support and understanding they need. When people with similar problems meet, they can share information and experience, express feelings without fear of judgment.
Internet.
There are many sites on the World Wide Web dedicated to the fight against depression. You can read the materials or chat in the forum or chat.
Tips and rules:
Spare yourself.
The disease consumes your strength and there is not much left for daily activities. Try not to set yourself difficult tasks, take a lot of responsibility. Break big tasks into several stages and do as much as you can. Avoid major life changes whenever possible.
Avoid stress.
Learning to avoid stressful situations is not easy. Try to identify the range of events and actions that can have the most stressful impact on you, and think about how to avoid them.
Exercise regularly.
Half an hour of gymnastics at least three times a week can improve your mood in a few weeks. Charging relieves nervous and muscular tension, increases vigor, strengthens the spirit. Exercise also stimulates the body's production of endorphins and enkephalins, chemicals that act as natural antidepressants.
Follow the routine in everything.
Build a suitable daily routine for yourself and try to fulfill it as best as possible. Get up at the same time every day, eat at certain hours, and go to bed early to get a good night's sleep and rest. Following a routine will contribute to the normal setting and functioning of the body's biological clock, which can be disrupted in a depressive disorder.
Enlighten yourself.
The more you know about depression, the easier it will be for you to cope with the disease in yourself. Being aware of the disease makes it less mysterious and frightening.
Avoid alcohol and psychoactive substances.
Drugs and alcohol can only temporarily alleviate the condition, which, once the intoxication passes, will become even worse after the use of these substances.
Pay attention to what you are thinking.
When depressed, try to listen to your thoughts, without setting the goal of deciding whether they are right or not. Just be careful what you think about. A conscious approach to the presence of such thoughts will create the basis for one's own objective view of the worldview distorted by depression.
Don't lock yourself in.
In a depressed state, people often avoid communication. But being alone, alone with your difficulties, you will feel very bad, while in the company of other people you will be distracted from your depressive experiences. Do what you love with someone else. Often support groups help, where people gather who understand this condition.
Stock up on patience.
Depression is a serious disease, it does not go away immediately. You need to know that recovery from depression is the rule, not the exception. Be patient and always remember that you are on the road to recovery.
Medical treatment.
Medications are widely used in the treatment of both depressive and manic conditions: this is especially true for severe conditions in major depressive disorder and in bipolar depression. Other types of depressive disorder can be treated without medication.
It is prescribed for patients with mild, moderate and severe manifestations of depression. A necessary condition for the effectiveness of treatment is cooperation with the doctor: strict adherence to the prescribed therapy regimen, regular visits to the doctor, a detailed, frank account of one's condition and life's difficulties.
When prescribing medications for taking, you need to ask the doctor questions that will immediately make a lot of things clear to you:
- What is the name of the medicine?
- What dose is needed?
- What are the side effects of this drug?
- How will this medicine help?
- Are there other drugs with the same effect?
- How much does this drug cost? Is it possible to use its analogue?
- When should this medicine be taken?
- What foods should not be eaten while taking this medication?
- Can I drink alcohol while taking this drug?
- Can I take other medicines while taking this drug?
- If I forget to take my medicine on time, can I take a double dose later?
- How long will I need to take it?
- How realistic is it to help me?
- How will I feel that it helps me?
- How soon will improvement occur after starting treatment?
An antidepressant is usually prescribed to treat major depression. All antidepressants are divided into several groups. There are tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and other antidepressant drugs.
In bipolar depression, doctors most often prescribe drugs that level the mood, the so-called effect stabilizers. Lithium is one of them. Affect stabilizers are intended for the treatment of depression and mania. Delusions and hallucinations are eliminated with the help of antipsychotic drugs or antipsychotics. Some patients suffering from manic states take anxiolytics - drugs that relieve anxiety and fears.
Dysthymia is treated with tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, bupropion, or various combinations of these drugs.
Antidepressants.
Antidepressants act by changing the content of neurotransmitters in the brain - chemical messengers for transmitting signals in brain tissues and regulating emotions. The simplest scheme of this mechanism is as follows. Mediators carry the signal through the area of contact of nerve cells (neurons) - the synapse. Passing through the synapse from one neuron to another, the neurotransmitters complete their journey, becoming attached to the receptor of the recipient neuron. Having completed the task of signal transmission, the neurotransmitters are removed from the joke and again freely swim in the synaptic cleft. Here they will either be recaptured by the sending neuron or destroyed by the enzyme monoamine oxidase. In other words, the brain exposes the synapse to cleansing - flushing from neurotransmitters. Antidepressants improve mood by interfering with this cleansing process. Doctors believe that depression comes from an excess or deficiency of neurotransmitters and other chemical mediators involved in emotional responses, when one type of such mediators cannot provide the normal number of contacts with a neuron. The result is a mental disorder. Antidepressants surround the synapse like a zipper, interfering with the balance of neurotransmitters in the synaptic gap and beneficially changing the biochemistry of the brain, which leads to an improvement in the patient's condition.
Antidepressants do not cause addiction and the development of a withdrawal syndrome, unlike drugs of the class of benzodiazenine tranquilizers (phenazepam, relanium, elenium, tazepam, etc.) and Corvalol, valocordin, which are widely used in our country. In addition, benzodiazepine tranquilizers and phenobarbital, which are part of corvalol and valocordin, with prolonged use, reduce sensitivity to other psychopharmacological agents.
Tricyclic antidepressants.
These antidepressants get their name from the structure of their underlying chemical compound, which consists of three rings (cycles). Tricyclic antidepressants were discovered by accident. In the 1950s, a Swiss doctor began to prescribe imipramine to patients. Those who took it, markedly improved mood. And soon scientists realized that with the help of imipramine, depression can be eliminated. Tricyclic antidepressants block the reuptake of norepinephrine. This leads to an increase in the content of this neurotransmitter in the brain, which affects mood. Some of the tricyclic depressants block the reuptake of another mediator, serotonin. Tricyclic antidepressants affect the action of other mediators involved in the regulation of various processes in the body. This leads to side effects that vary depending on which tricyclic antidepressant you are taking. This can be lethargy, drowsiness, dry mouth, constipation, difficulty urinating, visual disturbances, palpitations, orthostatic hypotension (when you get dizzy and lose consciousness when you stand up abruptly). More rare - skin rashes, increased sweating, tremors, delayed and reduced orgasm, weight gain, dry eyes. Tricyclic antidepressants are not suitable for everyone. Due to the danger of overdose, threatening the death of the patient, these drugs are rarely given to patients with suicidal tendencies. Can not take tricyclic antidepressants and people with certain somatic ailments. Tricyclic antidepressants should not be taken by those who suffer from bipolar depression, since antidepressants can cause the transition of a depressive state into hypomania or mania.
monoamine oxidase inhibitors.
These drugs are more difficult and less reliable to use. While taking them, you need to avoid the use of certain foods, drinks, drugs. Failure to comply with these restrictions can lead to a sharp rise in blood pressure. The most common side effects are: dizziness, fluctuations in blood pressure, weight gain, sleep disturbance, difficulty in achieving sexual orgasm, swelling of the ankles and fingers. Sometimes there may be dry mouth, constipation, blurred vision of objects in the field of view, difficulty urinating. These inhibitors have a positive effect on the patient's condition by suppressing the action of the monoamine oxidase enzyme contained in the nerve endings. Monoamine oxidase destroys mediators - norepinephrine, dopamine and serotonin, and they affect a person's emotions and mood. When taking monoamine oxidase inhibitors, these mediators are destroyed less, their content increases, and, accordingly, the patient's mood improves.
Selective serotonin reuptake inhibitors.
Selective serotonin reuptake inhibitors are more recent drugs that have gained popularity in the fight against depression due to the fact that they have fewer side effects, which they have and are not as severe as those of tricyclic antidepressants and monoamine oxidase inhibitors. The selective serotonin reuptake inhibitors include fluoxetine, paroxetine, fluvoxamine, and sertraline. The action of selective serotonin reuptake inhibitors is aimed at increasing the supply of the brain with the neurotransmitter serotonin, which regulates mood. The mechanism of action is the blockade of reuptake (re-absorption) of serotonin in the synapse. These inhibitors selectively target only serotonin and do not affect other brain chemicals. Therefore, they cause fewer side effects than earlier antidepressants. But like other antidepressants, with selective serotonin reuptake inhibitors, the time to improve the patient's condition can take from 3 to 5 weeks. The most common side effects are: nervousness, agitation, insomnia, headaches, nausea, diarrhea. Less common is lethargy, drowsiness, frequent yawning, increased sweating, skin inflammation. Among the serious side effects: sexual disorders in the form of a faded interest in a partner, reduced sexual arousal and difficulty in achieving orgasm. It is not recommended to take these drugs in patients with bipolar depression - these antidepressants can lead to the appearance of hypomanic and manic states. They should not be taken by patients with an unhealthy liver, since the biochemical transformations of serotonin reuptake inhibitors take place in this organ.
other antidepressants.
There are other antidepressants on the market that differ from the drugs described above, both in their chemical structure and in the features of their action.
- Bupropion is a drug that is less likely than other antidepressants to cause weight gain and sexual dysfunction. Side effects: agitation, anxiety, insomnia, nausea, slight tremor.
– Trazodone works by the serotonin neurotransmitter reuptake mechanism. Side effects: indigestion, bad taste in the mouth, nausea, palpitations, lowering blood pressure. It is not recommended to take with coronary heart disease, as it causes heart rhythm disturbances.
Venlafaxine hydrochloride is a group of antidepressants called selective noradrenergic and serotonin reuptake inhibitors. It blocks the reuptake of mood-regulating mediators, which include serotonin, norepinephrine, dopamine, but does not interfere with the action of other participants in the biochemical processes of the brain. Side effects: headaches, lethargy, drowsiness, low blood pressure, dizziness.
– Nefazodone hydrochloride increases the content of serotonin and norepinephrine in brain tissues. Side effects: lethargy, drowsiness, low blood pressure, accommodation disorder (unclear vision of objects in the field of view).
– Mirtazapine stimulates the release of serotonin and norepinephrine and simultaneously blocks two receptors for serotonin. Side effects: drowsiness, increased appetite, weight gain, dizziness.
Mood stabilizing drugs.
The drugs of this series are used in the treatment of bipolar depression to level the mood, which can fluctuate, periodically rising or falling. First of all, these are lithium preparations. Anticonvulsants are also used.
Lithium.
Lithium is a drug for the treatment of bipolar depression, capable of relieving both depressive and manic disorders in patients. But those suffering from bipolar depression also take it when they feel quite satisfactory - to prevent new attacks of the disease. Lithium alleviates melancholy in depression, restrains manifestations of high mood in mania, and maintains balance during the normal state. In the form of a drug, lithium is a mineral salt - lithium carbonate or lithium citrate. Side effects: stomach pain, nausea, vomiting, diarrhea, slight tremor of the fingers, fatigue, weakness, confusion, acne, bad taste in the mouth, memory loss, hair loss.
Anticonvulsants.
These anticonvulsants, or anticonvulsants, suppress mania and prevent seizures. The group of anticonvulsants includes: carbamazepine, valproic acid, divalprex sodium, clonazepam. Assign these drugs alone or together with lithium.
- Carbamazepine. This drug has a calming effect on the nerves that control muscle movement and thus helps prevent seizures. Side effects: dizziness, drowsiness, confusion, nausea, diarrhea, headaches, double vision, skin rashes. There may be an unsteady gait.
– Valproic acid and divalprex sodium. These drugs help curb mania and either prevent future mood swings altogether or make them less pronounced. Doctors prescribe any of these drugs when lithium and carbamazepine do not help or their side effects are very disruptive to the patient's daily life. Side effects: drowsiness, indigestion, indigestion, diarrhea, hair thinning.
- Clonazepam. The drug does not have a stabilizing, i.e. mood-leveling action, but only weakens some manifestations of a manic state: a jump in ideas, speech pressure, hyperactivity. Side effects: dizziness, lethargy, drowsiness, awkwardness in movements, psychological and physical dependence.
Antipsychotic drugs.
For the treatment of conditions of severe mental disorder - psychosis, when the patient's connection with reality is sharply disrupted, antipsychotic drugs, known as neuroleptics, are used. Antipsychotics are able to eliminate or reduce such symptoms of patients with mental forms of depression as delusions and hallucinations. Side effects: drowsiness, accommodation disorder (blurred vision of objects), dry mouth, constipation, changes in muscle tone and movement disorders. The mechanism of action of antipsychotics lies in their ability to reduce the effect of the mediator dopamine on the biochemical processes of the brain.
Anxiolytics.
In some cases, in the treatment of manic and depressive states, drugs are used that relieve anxiety and fear, which are called anxiolytics or sedatives (calming) drugs.
Lorazepam.
Prescribed for manic states. The drug facilitates the course of mania, eliminating its manifestations such as a jump of ideas, talkativeness, hyperactivity. If taken for more than one week, it can cause psychological and physical dependence.
Alprazolam.
It can cause addiction and addiction, so it should be taken for a short time. Alprazolam is prescribed for those whose depression is not very deep, but due to its painful manifestations, it requires more active medical supervision. And also in cases where, due to associated health problems, antidepressants cannot be taken.
Psychotherapy.
Psychotherapy is a work with a specialist who uses psychological techniques to eliminate or reduce the severity of emotional problems.
Psychotherapy is not an alternative, but an important addition to the medical treatment of depression. Unlike drug treatment, psychotherapy involves a more active role of the patient in the treatment process. Psychotherapy helps patients develop the skills of emotional self-regulation and in the future more effectively cope with crisis situations without sinking into depression.
Types of psychotherapy:
Psychodynamic psychotherapy.
According to psychodynamic therapy, the psychological basis of depression is internal unconscious conflicts. For example, the desire to be independent and at the same time the desire to receive a large amount of support, help and care from other people. Another typical conflict is the presence of intense anger, resentment towards others, combined with the need to always be kind, good and keep the goodwill of loved ones. The sources of these conflicts lie in the patient's life history, which becomes the subject of analysis in psychodynamic therapy. Each individual case may have its own unique content of conflicting experiences, and therefore individual psychotherapeutic work is necessary.
The goal of therapy is to recognize the conflict and help in its constructive resolution: to learn how to find a balance of independence and intimacy, to develop the ability to constructively express one's feelings and at the same time maintain relationships with people.
Psychodynamic therapy is based on the concept that a person's feelings and behavior are strongly influenced by past experiences and subconscious desires and fears. According to this theory, many mental illnesses can be cured by changing the patient's view of himself and the workings of his own mind and emotions. Psychodynamic therapy does not just relieve the symptoms of the disease, it aims to change the personality, character of a person, help him learn to trust others, build close relationships with people, better cope with difficulties, losses and not deprive himself of a wide range of emotions. According to psychodynamic theory, the cause of depression can be a conflict between subconscious and conscious thoughts, beliefs and desires of a person. We try to suppress the conflicts that disturb us and instinctively move them from our consciousness to the subconscious.
The task of psychodynamic therapy is to raise these repressed and unresolved conflicts from the depths of the subconscious and bring them into our consciousness in order to face them and get rid of them.
The disadvantages of psychodynamic therapy are that it is expensive and can take several years. The examination process often involves painful and deeply personal experiences of a person. This makes the patient anxious and upset for a while. To fully benefit from this type of psychotherapy, you need to be able to talk and maintain relationships with other people and constantly, throughout your life, apply the acquired new views in practice.
Interpersonal psychotherapy.
Interpersonal psychotherapy is a method that aims to change human relationships that contribute to the causes of depressive experiences. The interpersonal psychotherapist tries to improve the patient's self-image and communication abilities, which in turn improves his relationships with people. The course of interpersonal psychotherapy takes from 12 to 16 weeks.
behavioral psychotherapy.
Behavioral psychotherapy is aimed at resolving the patient's current problems and removing behavioral symptoms: passivity, refusal of pleasures, monotonous lifestyle, isolation from others, impossibility of planning and involvement in purposeful activity.
The task of behavioral psychotherapy, which is also called psychotherapeutic improvement of behavior, is to help patients modify those actions and actions that exacerbate the severity of depressive experiences. The theoretical basis of the method is the premise that depression is a behavior that can be learned, but also unlearned. According to behavioral therapists, a depressive state occurs when too much is required of us, and the reward for this is disproportionately small.
Cognitive psychotherapy.
Cognitive psychotherapy was developed by Aaron Beck. A. Beck's theory is based on the premise that a person's way of thinking affects his well-being, including emotional one. Cognitive psychotherapy involves the client working with a psychotherapist using psychotherapeutic techniques to get rid of emotional problems. Cognitive therapy techniques rely on the interconnection of feelings and thoughts. Thoughts determine feelings and emotions, and feelings, in turn, change thinking.
According to cognitive psychiatrists, our thoughts are formed under the influence of beliefs that develop from childhood. In a state of depression, we are at the mercy of negative ideas about ourselves and our actions. Such negative beliefs gain strength in our minds because we make one or more mistakes:
- Drawing unreasonable conclusions
- In our conclusions, we are based on any one detail, taken out of the general context of thoughts
– We base our conclusions on one or two separate aspects of the information received
– We pay attention to the bad facts, not seeing the good ones at all
– We perceive facts and events as relating personally to us, even when it is contrary to common sense
– Viewed only in black or only in white light
According to cognitive therapists, mood is shaped by our way of thinking. In a depressed state, thoughts cause mental pain. As you learn to think more objectively, you will feel better. This kind of patient education is seen by most cognitive therapists as a treatment program in which therapist and patient work together. The course of cognitive psychotherapy consists of 12-16 sessions. In the case of long-term forms of depression, treatment can stretch from 6 months to 2 years.
Family psychotherapy.
The task of family therapy is to acquaint family members of the patient with his illness and show them how they can help in treatment. The family is a powerful source of strength for the depressed patient if its members understand the illness of their close relative and participate in his treatment. Family psychotherapy is designed for some short time, during which the patient and his family members meet with a psychotherapist from 5 to 10 times.
couples psychotherapy.
The task of couples therapy is to remove the difficulties created by the disease in the relationship between you and your life partner. Couples therapy specifically aims to build relationships between partners through calm analysis and resolution of emerging problems.
Phototherapy.
Light therapy is used for seasonal affective disorder - depression, which occurs in winter. During the phototherapy procedure, patients are exposed to very bright light every day for a certain period of time. It is assumed that phototherapy procedures should compensate the patient for the lack of sunlight in the winter, which provokes winter depression. It usually takes 3 to 14 days to improve mood with phototherapy. It is believed that phototherapy works best in the morning. Side effects: headaches, eye fatigue, irritability, insomnia.
Electroconvulsive therapy.
When a severely depressed patient is unable to take medication, treatment with electroconvulsive therapy (ECT) may be offered. Electroconvulsive therapy is based on the effect of electric current on the brain.
It is used to treat a special group of patients. First of all, these are patients who really cannot take medication, patients with severe depressive and manic states, patients with psychosis or suicidal tendencies, as well as those patients whose illness does not respond to other types of treatment.
Before starting the ECT procedure, the patient receives an anesthetic. This is an anesthetic, which during the procedure creates a state of oblivion and insensibility in the patient. Then, with the help of electrodes applied to the head, an electric current is passed through one or more hemispheres of the brain. When the current passes through one hemisphere of the brain, ECT is called one-way, through both hemispheres - two-way. A current pulse causes for a short time uncontrolled electrical activity in the brain, which manifests itself outwardly as a seizure with muscle trembling and convulsions: first in the form of a strong tension of the whole body (tonic convulsions), then in the form of a rapid twitching of all its parts (clonic convulsions). To avoid seizures, the patient is given a short-acting muscle relaxant. Thanks to this remedy, the body remains relaxed during an attack. The seizure lasts from 25 seconds to one minute, after which another 10-15 minutes pass and the patient regains consciousness. Typically, electroconvulsive therapy is given three times a week. Patients with states of depression and mania recover in two or three weeks. It is assumed that electrical shocks affect the brain centers responsible for regulating mood. Current discharges stimulate the production of amino acids by the brain, which give rise to the synthesis of molecules of biochemical mediators - mediators involved in mood regulation. Side effects: confusion, memory impairment.
Personal records.
You can improve the quality of treatment with the help of your own medical history, in which you yourself will record your condition. By analyzing your notes, you will delve into the specifics of the course of your illness, which will help you in many ways.
Complementary treatments.
Healing herbs.
A popular and well-known remedy is St. John's wort herb. St. John's wort extract is supposed to have a calming effect, similar to antidepressant medications, while producing fewer side effects. St. John's Wort Disadvantages: Using St. John's wort remedy can interfere with the body's ability to absorb iron and other minerals, and this remedy can make the skin more sensitive to sunlight. St. John's wort treatment may take 4 to 6 weeks before it works. It is suggested that several other plants may be useful in the treatment of depression. Gingo biloba leaf extract improves cerebral circulation and oxygen supply to the brain. For the treatment of anxiety disorders, insomnia and depressive conditions, preparations from the rhizome of quotation marks are used. It is assumed that the supply of the brain with serotonin, a mediator involved in the regulation of mood, can be increased with walnut leaf tea. Melissa officinalis, oat straw and peppermint are sometimes used in the treatment of depressive conditions.
Dietary Supplements.
To alleviate the manifestations of depression, it is sometimes recommended to add certain substances to food. Such therapeutic dietary supplements include B vitamins, magnesium salts, zinc, folic acid and the amino acid tyrosine.
Some experts recommend changing the nature of nutrition in depression. Eating complex carbohydrates leads to an increase in the brain's production of serotonin, a neurotransmitter involved in mood regulation. A diet high in protein can increase brain levels of neurotransmitters like dopamine and norepinephrine, which can also improve mood. These foods include beef, chicken, fish, legumes, nuts, eggs, and tofu. Some experts recommend cutting out sugar, caffeine, and alcohol, and if that's not enough, then convenience foods, canned foods, and avoiding foods high in saturated fatty acids.
Homeopathy.
Homeopathy proceeds from the concept of “like can be cured by like”, that is, a substance that in a high dose causes a disease can, if diluted enough, cure this disease, since in this form it is able to activate the healing capabilities of the body itself - its “ life force." Various substances are used depending on the symptoms, personality type and previous diseases.
Other alternative methods.
Other non-standard types and methods of treating depression are deep breathing, therapeutic massage, meditation.
Breathing exercises increase the amount of oxygen entering the brain and improve mood.
Massage treats depressive states provoked by psychotraumatic circumstances. Therapeutic massage leads to a decrease in the content of hormones in the body, relieves anxiety and improves sleep.
Meditation can also help relieve depression. During such exercises, you relax, focusing all your consciousness on certain specific things - on breathing, on repeating a phrase or word to yourself, on some imaginary picture. Meditation helps to relax and find peace of mind.
HOW TO FIND THE RIGHT SPECIALIST?
Who is who in psychotherapy.
Psychologist- a licensed specialist with a higher education, thoroughly versed in human behavior and mental processes. The task of a psychologist is to understand and understand why a person acts, thinks and feels in this way and not otherwise. Psychologists do not prescribe drugs to their patients. With the help of special techniques (tests), they conduct a psychological examination and engage in psychotherapy with patients.
Clinical (medical) psychologist- additionally received training in the study of the functioning of the human psyche in special circumstances, such as diseases and deep life shocks. In the training of medical psychologists, emphasis is placed on studying the foundations of psychotherapy. A medical psychologist often has a Ph.D. To obtain this degree, after receiving a bachelor's degree, and then a master's degree, you must undergo an additional 2 or 3 years of special training and defend a doctoral dissertation. Medical psychologists must also have spent at least one year in an internship under the guidance of experienced psychotherapists and write a paper on a scientific topic.
Psychotherapist- Physician, mental health specialist. The job of a psychotherapist is to treat emotional disorders with a combination of psychotherapy and medication.
Psychiatrist is a physician who specializes in the detection and treatment of emotional disorders, including depression. The psychiatrist puts emphasis on the search for biological causes and drug treatment of depression. The education of a psychiatrist consists of 4 years of a university course for a bachelor's degree, 4 years of study at the medical faculty and at least 4 years of a special internship in a mental illness clinic.
Social worker- The social worker uses psychotherapy, but his main task is to organize social services, provide services and help people find the resources they need.
Things to think about when choosing a specialist:
Financial aspect.
Think about what amounts will be acceptable for you. Investing in psychotherapy often results in unexpected benefits. Studies have shown that successful psychotherapy reduces doctor visits because physical health improves in addition to emotional health.