I had to treat people who are now gone and who can be called ascetics of the 20th century. And they also had depression!
According to the forecasts of the World Health Organization, by 2020, depression will become the most common disease in the world. Many call it the epidemic of the 21st century, although Hippocrates described a condition called melancholy.
To treat this ailment in his time, tincture of opium, cleansing enemas, prolonged warm baths and the use of mineral water, as well as primitive psychological support were prescribed : the patient was recommended to “cheer up” and “amuse”. From the time of Hippocrates, it’s been 26 centuries, but the word “depression” in the minds of many Russians to this day is a mythological character and is associated with laziness and excess resources.
The same on is actually depression, why it occurs and how to fight it? On these and other questions are answered MD Basil Glebovich Khaled, a psychiatrist, deputy chief physician of the Scientific Center of Mental Health of the Russian Academy of Medical Sciences, Professor PSTGU.
– Vasily Glebovich, what are the signs of depression and how to recognize it?
Depression (from the Latin deprimo, which means “oppression”, “suppression”) is a painful condition that is characterized by three main symptoms, the so-called depressive triad. Firstly, this is a sad, sad, dreary mood (the so-called thymic component of depression), secondly, motor, or motor, inhibition, and finally, ideational inhibition, that is, a slowdown in the rate of thinking and speech.
When we talk about depression, in the first place we remember the bad mood. But this is not enough! The most important sign of the disease – a person loses strength. Outwardly, his movements are smooth, slow, inhibited, and mental activity is also disturbed . Patients often complain about the loss of the meaning of life, the feeling of some kind of dullness, internal slowdown, it becomes difficult for them to formulate thoughts, a feeling appears that the head is completely empty.
Characterized by a decrease in self-esteem, the emergence of the belief that a person is a complete loser in life, that nobody needs him, is a burden to his loved ones. At the same time, patients have sleep disturbance, difficulty falling asleep, often there are early awakenings or the inability to get up in the morning, decreased appetite, weakened sex drive.
The clinical manifestations of depression are very diverse, therefore, there are quite a lot of its varieties, which can be very different from one another. But one of the main characteristics of depression is its severity: it is relatively mild – subdepression, moderate depression and severe depression.
If, with a mild degree of the disease, a person remains functional and this mood does not greatly affect his daily life and sphere of communication, then moderate depression already leads to a loss of strength and affects the ability to communicate. In severe depression, a person practically loses both working capacity and social activity. With this form of depression , suicidal thoughts are often observed in a person – both in a passive form, and in the form of suicidal intentions and even suicidal readiness. Patients with this form of depression often commit suicide.
According to a WHO study, about 90% of all suicides on the planet are committed by patients with various mental disorders, of which about 60% suffered from depression.
With severe depression, a person suffers unbearable mental suffering; in fact, the soul itself suffers, the perception of the real world narrows, it is difficult — or even impossible — for a person to communicate with his relatives and loved ones, in this state he may not hear the priest’s words addressed to him, he often loses the life values that he had before. They, as a rule, already lose their ability to work, because the suffering is very severe.
If we talk about people of believers, then they make suicidal attempts much less often, because they have a life-affirming worldview, they have a sense of responsibility before God for their life. But it happens that even believers are unable to bear this suffering and commit irreparable.
From sadness to depression
– How to understand when a person is already starting to have depression, and when is “just sad”? Especially when it comes to loved ones, whose condition is objectively extremely difficult to assess?
Speaking of depression, we mean a specific disease that has a number of formalized criteria, and one of the most important is its duration. We can talk about depression when this condition lasts at least two weeks.
Each person is characterized by states of sadness, sadness, despondency – these are normal manifestations of human emotions. If some unpleasant, traumatic event occurs , then the normal emotional reaction to it also appears . But if a person has a misfortune, but he is not upset , this is precisely a pathology.
However, if a person has a reaction to a traumatic event, in the norm it should be adequate to the level of a past event. In our practice, we often encounter the fact that a person has a traumatic situation, but his reaction to this situation is inadequate. For example, dismissal from work is an unpleasant thing, but it is not normal to react to it by suicide. In such cases, we are talking about psychogenic-provoked depression, and this condition needs medical, medical and psychotherapeutic support.
In any case, when a person has this prolonged condition with a sad, sad, depressed mood, loss of strength, problems in understanding, loss of meaning in life, lack of prospects in it , these are the symptoms when you need to see a doctor.
Depression “for no reason”
It is important to understand that in addition to reactive depression, which occurs as a reaction to some kind of traumatic situation, there are so-called endogenous depression, the reasons for which are purely biological, associated with certain metabolic disorders. I had to treat people who are now gone and who can be called ascetics of the 20th century. And among them there were too depressed!
Some of them had endogenous depression, which occurred without any apparent, understandable reason. This depression was characterized by some kind of sad, sad, depressed mood, loss of strength. And this condition went very well on drug therapy.
– That is, believers are also not immune from depression?
By Unfortunately, no. They are not immune from endogenous depression or psychologically-induced depression. It must be borne in mind that each person has his own special level of stress tolerance, depending on his character, personality traits and, of course, worldview. One of the greatest psychiatrists of the 20th century, Victor Frankl, said: “Religion gives a person a spiritual anchor of salvation with such a sense of self-confidence that he can not find anywhere else.”
“Christian” depression. Signs of Depression
When we talk about people of believers, in addition to the above symptoms associated with mood and lethargy, there is a feeling of God-giving. Such people will say that it is difficult for them to concentrate on prayer, have lost a sense of grace, feel at the edge of spiritual destruction, that they have a cold heart, petrified insensibility. They can even talk about their particular sinfulness and loss of faith. And then that feeling of repentance, the degree of their repentance in their sinfulness will not correspond to the real spiritual life, that is, the real misconduct that such people have.
Repentance, the sacraments of Confession and Communion are those things that strengthen a person, inspire new strength, new hope. A person who is depressed comes to the priest, repents of his sins, takes communion, but he does not feel this joy of the beginning of a new life, the joy of meeting with the Lord . And among believers, this is one of the main criteria for the presence of a depressive disorder.
They are not lazy. Depression: Symptoms
Another important complaint of a person suffering from depression is that he does not want to do anything. This is the so-called apathy, loss of desire to do something, loss of meaning to do something. At the same time, people often complain about a lack of strength, about fast fatigue – both during physical and mental work. And often others perceive it as if a person was lazy. They say to him: “Pull yourself together, force yourself to do something.”
When such symptoms appear in adolescence, then the relatives surrounding them , severe fathers sometimes try to physically influence them and force them to do something, not realizing that the child, the young man, is simply in a painful state.
It is worth emphasizing one important point here: when we talk about depression, we say that it is a painful condition that arose at a certain moment and caused certain changes in human behavior. We all have character traits, and they usually accompany us all our lives.
It is clear that with age a person changes, some character traits change. But here is the situation: before, the person was doing fine, he was cheerful and sociable, he was engaged in active work, he studied successfully, and suddenly something happened to him, something happened, and now he looks somehow sad, sad and melancholy, and there seems to be no reason for sadness – here there is reason to suspect depression.
Still not so long ago, the peak of disease depression accounted for the age between 30 and 40 years, but to date, the depression rapidly “younger”, and she is often sick people under 25 years old.
Among the varieties of depressions, the so-called depression with “youthful asthenic failure” is distinguished , when it is precisely the manifestations of a decline in intellectual, mental strength that come to the fore when a person loses the ability to think.
Especially brightly it is noticeable among students, especially when a person is successfully studying at the institute, he took one course, second, third, and then there comes a moment when he looks in the book and not can not understand anything. He reads material, but he can not assimilate it . She tries to re-read it again , but again she ca n’t understand anything . Then at some stage he throws all the textbooks, begins to walk.
Relatives can not figure out what is happening. They are trying to somehow influence it, and this condition is painful. There are interesting cases, for example, “depression without depression”, when the mood is normal, but the person is motorly inhibited, he can not do anything, he has neither physical strength nor the desire to do anything, he’s gone where some kind of intellectual ability.
Depression from fasting – a reality?
– If one of the signs of depression is the loss of physical ability to work, think, how safe is it for people to fast mental work? Can a man, while working in a responsible leadership position, feel good eating porridge or carrots? Or, for example, a woman accountant, who during the Great Lent just had a reporting period, but no one canceled household duties ? How can such situations cause stress, lead the body weakened after winter to depression?
Firstly, fasting is not a time of fasting. How would it not have been, lean food contains a sufficient amount of essential body substances. One can cite as an example a large number of people who strictly abided by fasting and at the same time carried out the serious duties assigned to them.
I recall the Metropolitan of Yaroslavl and Rostov John (Wendland), who, of course, led the whole diocese, the metropolis, which during the fast had a unique dish – semolina on a potato broth. Not everyone who tried this lean food was ready to eat it. My dad, father Gleb (Kaleda – ed.), Always, as far as I remember, strictly fasted and combined the post with serious scientific and administrative work, and at one time he had to travel one and a half to two hours one way. There was quite a serious physical load, but he coped with it.