We each experience depression in different ways. According to World Health Organization, globally, an estimated 264 million people are affected by depression.
The symptoms of depression can considerably affect the quality of life. Neglecting this disorder, even at the earliest signs, can lead to more serious complications. But it is very easy to identify it correctly.
What is depression?
Depression is an affective disorder in which there is a sad mood or loss of interest and pleasure for a significant period of time.
Almost everyone has experienced a depressive mood. But depression is an illness that 15 out of 100 people get in their lifetime (it is a very common illness). Depression doesn’t kill, but it does become chronic and has a major impact on quality of life.
Content:
Affective disorders are medical diagnoses, meaning they will be determined by a psychiatrist, following a consultation.
Mood is defined as the underlying, persistent emotional state that a person feels within him or herself over a period of time and that profoundly influences his or her point of view and the way he or she perceives himself or herself, others and the world or life in general. In other words, there are close correlations between the background emotional state and the way a person thinks, in both directions (they influence each other).
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How common is depression?
Depressive disorder is one of the most important mental illnesses, both in terms of severity and frequency. The lifetime prevalence in the general population is 10-15% in women and 5-12% in men. The onset of the first episode can be any time, with an average age of about 40 years. Report women/men is 2:1, but after the age of 50, the ratio of women to men becomes equal. The two-fold higher frequency of major depression in women is universal regardless of culture or country.
The history of depression begins in the second millennium BC in Mesopotamia and was originally called “melancholia”.
It was not until the early 1900s that significant improvements would be made in the approach to and treatment of depression. Several types of melancholia will be classified, each of which will begin to be addressed as mental health problems. Thus, the focus will start to be on making a treatment that will be much more effective and precise than the relaxation methods, which were all that was used before.
Gradually the term “depression” began to be used together with “melancholy” and was replaced by “melancholy” in the mid-19th century. XX.
Depression is frequently associated with anxiety (90% of cases).
Defined as a feeling of tension, intense emotion or fear, without apparent reason or much more intense. Inadequate or in excess of the cause when it exists.
Symptoms of depression
DEPRESSION = you have at least 5 of the following symptoms within a 2-week period.
Symptoms represent a significant change from the person’s usual mood:
Most of the day, almost every day. Indicated either by subjective reporting (e.g: “I feel sad or empty inside”) or comments made by others (e.g.: “looks tearful”). Note: in children and adolescents the mood may be irritable.
Faţă de toate sau aproape toate activităţile pe aproape toată durata zilei, aproape în fiecare zi (după cum indică pacientul sau după observaţiile altora).
Evident ca in absenţa unui regim de slăbire sau creştere în greutate.
De exemplu: o schimbare de peste 5% din greutatea corporală in 1 lună, scăderea sau creşterea apetitului alimentar înregistrată aproape în fiecare zi.
Notă: la copii, de luat în consideraţie absenţa câştigului în greutate așteptat.
Aproape în fiecare zi. Nu reușește să adoarmă sau se trezește prea devreme deși își dorește să doarmă.
Lipsa somnului se simte, a doua zi fiind obosit, somnoros, nervos, amețit.
Sau din contră, pare că singurul lucru pe care îl face este să stea în pat, să moțăie sau chiar să doarmă și ziua și noaptea. Somnul este neodihnitor, agitat, cu coșmaruri.
Aproape în fiecare zi. Observabile și de către alţii, nu doar senzaţia subiectivă de nelinişte sau lentoare.
De exemplu:
- pare să nu-și găsească locul, este neliniștit, iși frământă mâinile, se „foiește” prin casă.
- devine mai nervos și mai irascibil decât de obicei sau a devenit din ce în ce mai apatic.
- este mai lent în mișcări și în vorbire, mai greoi, îi este greu să se deplaseze chiar și în casă.
- „Zace” la pat, nu mai are energie să se îngrijească de alții sau de el însuși.
Aproape în fiecare zi.
- te poți simți epuizat, permanent obosit, te scoli mai obosit decât te-ai culcat.
- nu mai ai forță, elan pentru activitățile curente, pe care le faci cu dificultate, greoi, parțial sau chiar deloc.
- unele persoane pot suporta cu greu scăderea energiei și devin iritate, nervoase. Altele caută alte boli care să explice această oboseală.
Care poate fi delirantă aproape în fiecare zi (nu doar auto-reproşuri sau vinovăţie în legătură cu starea de boală). Inițial pot fi vagi sentimente de inadecvare: de a nu fi „suficient” de bun soț/soție, de a nu mai fi bun la serviciu/de a nu reuși un proiect, de a fi greșit față de anumite rude/prieteni.
Apoi treptat apar ingrijorări legate de anumite situații din viață, în care ar crede că a ales gresit. Că „nu ar fi trebuit să…”, că e vinovat de dificultățile din viața altora.
Poate crede că este „o povară”, crede că „celorlalți le-ar fi mai bine fără mine”, că existența lui „le face rău celorlalți”.
Uneori se consideră vinovat de problemele întregii lumi. Se consideră „cel mai mare păcătos”, că va fi pedepsit de Dumnezeu, pierzând în cazuri severe legătura cu ceea ce poate fi real (idee delirantă).
Sau indecizie, aproape în fiecare zi.
- nu poate fi atent mult timp la conversații, la serviciu sau la activitățile zilnice.
- Are sentimentul că are „mintea tulbure”, că are gândirea „încețoșată”.
- Îi este greu să se hotărască ce vrea sau să înceapă o acțiune.
- Îi este dificil să se concentreze, apoi să o termine.
- Are tulburări de memorie din cauza faptului că a scăzut capacitatea de a se concentra, ceea ce uneori poate fi singurul motiv pentru care ajunge la medic.
Nu doar frica de a muri, ideaţie suicidară recurentă fără un plan specific, fără o tentativă de suicid sau un plan specific de a comite suicid.
Symptoms of depression in women
Depression in women is twice as common than in men.
The symptoms of depression in women are largely the same as in men. Recent research suggests that there are certain peculiarities of depression in women.
- Rumination: Tendency to think excessively about negative events and rewind problems endlessly in the mind;
- Changes in eating habits: If you eat more or less than usual, you may be suffering from depression;
- Sleep disorders: Sleep deprived people are more likely to develop depression. Women are more prone due to the fact that most of them are the primary caregivers of children;
- Decreased libido: Some mental health experts believe that changes in women’s sex drive are key factors in the diagnosis of major depression;
- Physical symptoms: pain, cramps, migraines, breast tenderness, bloating, chills depression.
Physical symptoms of depression
- Headache
- Tremor of the limbs
- Feeling of weakness in the legs, tension or twitching of the muscles, tingling of the skin;
- Digestive disorders: nausea, “burning” or “knot in the stomach” sensations, diarrhoea or chronic constipation, aerocolia (bloating), vague, diffuse abdominal pain,
- Vertigo, dizziness
- Chest pain
- Sweating, cold or heat waves
- Low back, muscle and joint pain
- Fatigue, despite at least 6-8 hours sleep
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Types of depression
Chronic Depression
It is a less severe form and has fewer symptoms than severe depression. It is also called in specialist terms dysthymia.
O chronic depression is one that has been going on for less than 2 years and does not improve within the expected time intervals despite treatment with antidepressants. So if a depression resists the treatment used, it will become chronic.
From this level you can also have periods of major depression – also called ‘double depression’.
Severe Depression
It is a term usually used to emphasize the severity of depression. When a medical specialist mentions this, he is referring specifically to a major depressive disorder.
Categorization is done according to the number of symptoms present in a person into the following categories:
- mild depression – 5 symptoms, which is the minimum required to receive this diagnosis;
- mild depression – somewhere between mild and severe, around 5-6 symptoms;
- severe depression – more symptoms than the minimum required, going as far as cases where all of the above symptoms are present in a single patient.
Postnatal Depression
It is present in women after giving birth. It makes them feel sad, scared, angry or anxious for the first 4-6 weeks.
These emotions, often without any cause, are the opposite of what the young mother expected to feel and make her think she is a “bad” mother. Symptoms occur due to rapid and sudden changes in hormone levels, the difficulties of childbirth and the stress of adjusting to new responsibilities as a mother.
There is a need for emotional and responsibility-sharing support from other family members and education on the skills of motherhood, as well as the normal physical and psychological changes of this period.
Categories of depression
Depression in women
Depression in women is twice as common than in men. There are even specific forms of depression found only in these. Those related to childbirth, the onset of menopause and menstruation, etc.
Women also have higher rates of seasonal affective disorder and dysthymia (persistent depressive disorder) than men.
Depression in men
The way depression manifests itself can differ in men compared to women. Figures showing the gender discrepancy of this disease are forever being fought. The challenge is based on the refusal of many men to go to the doctor for their mental problems. That’s to avoid looking weak.
Depression may be masked in men by maladaptive behaviors, such as verbal or physical violence, which they resort to in order to “treat” their own distress.
How depression manifests itself in children
Depression in children brings with it an increased risk of suicide as puberty begins.
Up to 20% of US high school students have experienced suicidal ideation and 10% have experienced suicidal behaviors. Suicide often occurs in vulnerable adolescents or those with mental disorders as a reaction to a recent school failure stressor.
My child is depressed. Have we, as parents, done something wrong?…is the most common question parents ask. There is no single answer. In children, as in adults, genetic, biological, social and psychological factors are all involved.
Causes of Depression
Genetic causes
Depression is a disorder in which genetic factors play an important role. Major depression runs in families, meaning that the predisposition to develop the illness during life is inherited. Depressive disorder is much more common in relatives of an ill person than in the rest of the population (1.5-3 times more common). There is no single gene that causes the disorder. There are several loci (gene segments) that are influenced by environmental factors (multifactorial polygenic transmission). Thus, if you have a close relative who suffers from depression, the risk that you, going through stressful life experiences, will have a depressive episode is higher than in other people.
Knowledge of biological factors has revolutioniszd the treatment of depression in the modern era. Knowledge of psychological and social factors, in addition to treatment implications, provides very useful information on the prevention of depressive disorders.
Understanding the psychotraumatic factors, how emotional reactions, thinking, behavior, develop and function to produce the depressive reaction has preoccupied many schools of psychotherapy. They have provided a variety of theoretical models of the psychological aetiology of depression.
Stressful life events, trauma
A long-standing clinical observation is that events considered to be psychotraumatic only precede the first episode of depression, not necessarily the subsequent ones. Thus, after the first trauma and the development of the depressive episode, the person develops biological changes that sensitise him or her to subsequent episodes.
Stressful childhood events often occur in the context of long-term problems. Thus, parental divorce often follows prolonged family tension and cannot be classified as an acute event. This is why depression in young people tends to be recurrent.
Most people cope with stress every day, their bodies readjust quickly to these pressures. When stress is too great, the readjustment or coping mechanism stops responding, and depression can set in.
Personality
The existence of certain temperamental traits, which are formed as personality before the illness, can predispose the person to depressive disorders in contact with stressful life events.
With the help of these instruments, it has been shown that the most common personality traits characteristic of depressive disorder are:
- ✓ low self-esteem
- ✓ low independence
- ✓ little interest in social relations
- ✓ excessive caution
- ✓ excessive meticulousness
- ✓ pessimism
- ✓ inclination towards order
- ✓ rigidity
- ✓ conventional thinking
- ✓ inclination towards routine and habit
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Depression Treatment
EFFECTIVE TREATMENT OF DEPRESSION CONTAINS THE FOLLOWING ELEMENTS
The treatment of depression is usually a mixed approach, with medication and psychotherapy.
Mild to moderate depressive disorders can only be treated with psychotherapy. In severe cases, medication is necessary.
1. Psychiatry – Medication
- The treatment is done with antidepressants
- preferably a single drug is administered
- the average duration of treatment is 1 year
- antidepressants don’t make you dependent on them and don’t sedate
- anxiolytics and sedatives (another class of drugs) should not be taken for more than 1 month
There are up to 30 different drugs for treating depression, suggestively called antidepressants. They are divided into five main classes, the most commonly used now being those in the Selective Serotonin Reuptake Inhibitors (ISRS) class. These medicines differ in the way they work and the side effects they can cause. What they have in common is that they regulate the amount of certain neurotransmitters in the brain.
2. Psychotherapy
Psychological treatment in depression is essential not only for the treatment of the present episode, but also for the prevention of new episodes after discontinuation of medication.
The psychotherapeutic method tries to find and change the cause of the symptoms. It consists of weekly or bi-weekly sessions with a psychotherapist (psychologist or psychiatrist with super-competence in psychotherapy) for a period of at least 6 months (depending on the severity of the problems and the depth of therapy). Psychotherapy alters the deep way of thinking and feeling. It also resolves the unconscious/conscious psychological conflicts that have been underlying the symptoms.
There are several types of psychotherapy in which therapists specialize.
Depending on the severity of your depression and your behavior and personality type, some will suit you better than others. However, depression is curable and with a little help from medication, the process can be easy.
Types of therapy recommended for treating depression:
- Cognitive psychotherapy – For those with moderate major depression, cognitive therapy can help, sometimes even better than medication;
- Cognitive-behavioural psychotherapy – It can help a person not only change the way they think but also the way they behave;
- Interpersonal psychotherapy – aims to improve relationships with others;
- Psychoanalytic psychotherapy – increases self-confidence and frustration tolerance;
- Humanistic psychotherapies – profoundly changes the personality and focuses on resolving childhood trauma.
3. Psychoeducation
Through the process of psychoeducation, special skills are developed to help you successfully overcome depressive episodes and prevent new ones from occurring. Psychoeducation is a psychosocial treatment that has proven effective in treating depression in addition to psychotherapy and specific medications. It helps to improve the clinical course, increases adherence to treatment and psychosocial functioning of depressed people.
Psychoeducation for depression helps you acquire essential knowledge about:
- the nature of the disease;
- treatment methods and how they work;
- effective ways of approaching illness to enhance healing through psychotherapy.
All these steps are the full treatment of depression, according to the World Health Organization. At Hope Clinic they all use and make up a specialised treatment programme called the NACELA PROGRAMME.
Alternative treatments
In addition to medication and psychotherapy, depression can also be overcome by changing habits in your daily routine to improve your well-being:
- a healthy diet: helps your body to be balanced and have more energy;
- rest: otherwise you cope with everyday situations when your batteries are charged;
- sport: regular exercise helps to maintain a positive mood;
- hobby: enjoyable activities help you to;
- herbal remedies for depression: there are several teas or herbal medicines that provide spot relief from depressive states. Beware of side effects;
- practicing relaxation techniques: Yoga, mindfulness, relaxation massages.
Learn more about the right treatment for depression!
Why choose our treatments?
We are with you in the treatment of depression. We offer all the types of interventions you need. Our psychiatrists and psychotherapists work as a team to get you back on your feet as quickly as possible. Our depression programme includes both psychiatry and psychotherapy in all the styles that would suit you, as well as a behavioral change programme to accelerate changes in individual therapy.
“NACELA” – Specialized program for the treatment of depression
NACELA is a 12-week group psychotherapy specifically designed for those experiencing a depressive disorder. It provides support, psychoeducation and specific skills training to successfully overcome the depressive episode. It also helps prevent new ones from appearing.
Group psychotherapy sessions will be weekly. Duration 90 minutes and the group will be limited to 8-10 people.
The programme has a structured pattern for each session. It is built to go in parallel or to be followed by individual psychotherapy.
At the end of 12 weeks, you will be able to:
- recognize and change Negative thoughts
- find out what Actions and behaviors are related to/ exacerbate depression and what to replace them with
- to be able to have human contacts that support and value your life, and to build relationships based on respect and intimacy
- reconnect with the basis of the Vital Energy in each other; you will know the concepts of Free Child and Adapted Child, and how to work with them to increase the level of Energy
- you will become aware of the role of Limits in the origin of depression and feelings of worthlessness, powerlessness and meaninglessness
- you will begin the long journey of finding your Aspirations and hope for a happy life and the Anchors for it
- learn relaxation techniques and effective stress management strategies
- you will receive information about the causes of depression, the role of brain neurotransmitters and how depression can be prevented and treated
We are dedicated to providing the best treatments for your mental and emotional health. How do we know what they are? We apply the knowledge of the latest international treatment guidelines and aim to provide the full range of scientifically proven interventions that are most effective, from medication to types of psychotherapy.
We are a clinic specializing in the treatment of depression
We are among the only ones in Romania that have a complete treatment programme for this disorder, as recommended by the World Health Organization.
In addition to medication and psychotherapy we also use the psychoeducation part, which improves
Doctors work in collaboration with psychotherapists and all treatments are supervised by our best specialist to warrant a high evolution and efficiency.
All the services needed to treat depression you can find with us. You don’t need to call in other specialists.
Our program is built on techniques of cognitive-behavioral therapy, transactional analysis, mindfulness and psychiatry.
About us
Efforts to build comprehensive treatment programs brought the clinic in 2018 an unexpected international appreciation, with Hope Clinic becoming the only clinic in Romania to receive the prestigious award Rose of Paracelsus, awarded by the European Medical Association for “Best Medical Practice”.
The clinic is founded and supervised by Dr. Gabriella Bondoc – one of the leading specialists in the field of mental health in Romania. She takes care to maintain our goal of maintaining our accreditation and offering the best treatment methods available globally to patients in Romania.
We currently have 3 offices in Bucharest, 1 in Cluj Napoca where a team of more than 30 doctors and more than 45 psychotherapists work. They have multiple trainings in order to have a much broader understanding of mental disorders. This way they can provide a more precise and effective treatment to reduce your effort.
It all starts WITH A DOCTOR’S EVALUATION.
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Intrebari frecvente despre depresie
Nu. Nu orice stare de tristeţe este depresie. În majoritatea cazurilor când vom suferi în viaţă o pierdere, vom simţi tristeţe şi chiar şi unele din simptomele de mai sus. Aceasta face parte din procesul firesc şi în mod ironic, sănătos, de reacţie. Dacă însă aceste sentimente de tristeţe, disperare sunt excesive şi prelungite sau dacă sunt ignorate (represate), pot fi o bază de dezvoltare a unui episod depresiv major şi a unei veritabile tulburări psihice.
De multe ori ignorate, dar tocmai de aceea frecvent asociate cu precipitarea unor episoade depresive la persoanele vulnerabile sunt şi aspectele legate de trecerile prin diversele etape ale vieţii. Pierderea copilăriei ca urmare a unor abuzuri sau dificultăţi care duc la o maturizare prea precoce, pierderea tinereţii, a libertăţii cu asumarea responsabilităţilor de mamă la apariţia primului copil sau pierderea statutului de mamă, de angajat, la plecarea copiilor din casă şi respectiv la pensionare.
Toate aceste experienţe pot fi privite, psihologic, ca pierderi şi se poate considera că trebuie parcurse etapele unui mic doliu..
Dacă te-ai regăsit în multe din descrierile de mai sus, mergi la cel mai apropiat psihiatru şi discută cu medicul simptomele tale.
Împreună veţi stabili :
- Diagnosticul
- Ce analize sunt necesare pentru stabilirea acestuia şi a tratamentului
- Felul în care se va institui tratamentul: ambulator/spitalizare, în funcţie de gravitatea bolii
- Tipul de tratament:
- Psihofarmacologic
- Psihofarmacologic şi psihoterapeutic
- Psihoterapeutic
E posibil ca medicul să dorească să stea de vorbă şi cu membri ai familiei tale, bineînțeles cu acordul tău.
Depresia este o suferință adâncă, ce se instalează treptat. Începe prin a te simți trist, nu te mai amuză nimic, ești abătut, posomorât și fără chef. Nu numai ca nu mai ai interes să mergi la serviciu, dar încet-încet nu mai ai chef să te întâlnești cu prietenii sau să ieși din casă. Nu te mai bucură evenimentele plăcute ale vieții, copiii, hobby-urile.
Dispare plăcerea de a trăi și totul ți se pare inutil, fără scop. Te simți și tu la fel de inutil, nefericit, iți vine să plângi cu ușurință. Apare un sentiment de lipsă de speranță care se intensifică (începi să vezi numai „partea goală a paharului”). Nu mai vezi nimic bun în jur, devii cinic.
Totul te dezamăgește, inclusiv tu, nu mai vezi ieșirea din situațiile în care te afli. Te cuprinde un sentiment de neputință, viața începe să pară din ce în ce mai dificilă. Situațiile care altădată ți se păreau ușor de rezolvat acum devin un efort/o sursă de suferință.
Aceste sentimente de lipsă de speranță (hopelessness) si de neputință (helplessness) sunt cele mai importante caracteristici ale tristeții din depresie și sunt și repere ale evoluției sub tratament.
Avantajele:
- Rapiditatea instalării „stării de bine”: 3-4 zile-2 săptămâni;
- Ușurința administrării tratamentului (fără un efort special, 1-2 pastile/zi);
- Acces mai facil la tratament (trebuie găsit un medic psihiatru cu care să aveți o bună colaborare);
- Cost redus – Marea majoritate a medicilor psihiatri au contract cu Casa de Asigurări și de aceea, pe baza unui bilet de trimitere obținut de la medicul de familie, consultul este gratuit. Medicamentele recomandate pe rețeta obținută au prețul compensat între 50-100%.
- Cauzele depresiei sunt și psihologice. Tratamentul medicamentos acoperă efectele, nu și cauzele;
- Fără o modificare substanțială a tiparelor de gândire, comportament, a stilului de viață și a calității relațiilor cu ceilalți, după un interval variabil de la întreruperea tratamentului, simptomele reapar;
- Mai multe schimbări de antidepresive sunt în general necesare până când schema potrivită de tratament este găsită.
Avantaje – Tratamentul depresiei prin psihoterapie:
- Modifica Cauza;
- Reduce semnificativ/complet sansa reaparitiei simptomelor.
Dezavantaje – Tratamentul depresiei prin psihoterapie:
- Primele efecte sunt instalate lent în timp (2-3 luni);
- Efort semnificativ pentru schimbare;
- Accesibilitate redusa (psihoterapia pentru depresie poate sa nu fie accesibila in unele zone).