The World Health Organization (WHO) has predicted that depression will become the main killer of human health in the 21st century. In recent years, as the pressure of competition in modern society has further increased, the number of people suffering from depression and depressive disorders has increased day by day.
According to new statistics from the World Health Organization (WHO) (zui), there are 340 million people suffering from depression worldwide, which has become the world’s fourth most common disease. It is estimated that by 2020, it may become the second largest human disease after cardiovascular disease. Currently in my country, it is estimated that more than 30 million people suffer from depression. Due to failure to receive timely and professional treatment, 85% of depression patients will relapse, and 10%~15% of patients (zui) may eventually die. Yu suicide. Elderly depression is one of the common mental disorders in old age (zui), the incidence of which accounts for 7% to 10% of the elderly population. Generally, the course of the disease is long, although it can be relieved, but there is a tendency to relapse, and some patients have a poor prognosis. According to statistics, among the elderly with physical diseases, as many as 20%-40% are accompanied by depression. Therefore, from the law of illness, depression is a common disease. Like other diseases, it must be good at detecting and treating in time. The earlier the treatment, the better the effect.
What is the manifestation of depression?
The reason why many depressions are not treated early is because they have not been detected, and they always feel that they are normal. Therefore, we must be good at discovering, we must be good at detecting wrong emotions, and more importantly, we must realize that bad emotions are not a problem of thinking, but may be a problem of illness. The common symptoms of depression are as follows:
- Depressive mood
More than 90% have a depressed mood, which is the basis for other manifestations of depression. The inner experience is a bad mood, a sad expression, drooping mouths, frequent crying that causes red and swollen eyes, and a lack of humor. They often complain of feeling down, depressed, or unhappy. A small number of patients do not appear to be depressed at the beginning, but only have other symptoms, such as insomnia and anxiety.
- Lack of emotion
Many depressed patients feel anhedonic or unhappy. Nothing can make them happy, including eating, going out, seeing friends, and engaging in sports. In short, few things can cause pleasure, and many patients feel very distressed about it.
Depressed patients often appear very tired and often complain of lack of energy, weakness, exhaustion, headaches and physical pain. Even when there is nothing to do at leisure, I feel tired and weak. Difficulty starting work, often unable to complete tasks; rest often does not relieve symptoms. This fatigue may also be caused by another common symptom of depression-sleep disturbance.
- Delays in speaking, thinking, and movement
Depressed patients often speak very slowly. It takes a long time to answer a question, and it is often answered in a single vocabulary, so it is very difficult to talk to it, and it gives people a feeling of less words. Family members or medical staff often find it exhausting to get along with such patients. I feel that my brain turns slowly, just like “the brain is rusty.”
- Appetite changes
Many depressed patients eat very little food, eat only a little or no even very delicious meals, claiming to have no appetite, or even the energy to eat. Therefore, patients tend to lose weight. Appetite loss and weight loss occur in 70% to 80% of cases. But there are also a few patients who eat a lot of food for dinner, so they gain weight, but such cases are relatively rare.
- Sleep disorders
Insomnia is a particularly distressing symptom for depressed patients. 70% to 80% of patients have some form of insomnia. The common type is that the patient is usually very tired and has no difficulty falling asleep, but wakes up after a few hours of sleep, and cannot fall asleep again after waking up. This sleep disorder is called morning insomnia, midway awakening, or end-stage insomnia. Another common type of sleep disorder is difficulty falling asleep, and patients are often accompanied by symptoms of anxiety. Since insomnia caused by depression is very common, it is necessary to take antidepressant medicine as the main treatment, and sleep medicine as a supplement. When depression and anxiety are cured, sleep will naturally be better.
A small number of depressed patients sleep too much, which is called “hypersomnia depression.” This may be the patient’s avoidance of physical pain or distress during awakening, or it may be a symptom of seasonal affective disorder.
- Physical discomfort
Depressed patients generally have complaints of physical discomfort, such as pain. In order to relieve pain and other uncomfortable symptoms, they often visit various clinical departments and emergency departments of general hospitals before going to the psychiatric department. Common physical symptoms of patients include: headache, neck pain, back pain, muscle cramps, nausea, vomiting, throat Swelling, sore mouth, dry mouth, constipation, burning sensation in the stomach, indigestion, flatulence, blurred vision and painful urination, etc. There are often no meaningful abnormal findings in various examinations of various departments.
- Hidden depression
Occult depression is depression with physical symptoms and functional symptoms as the main manifestations. The physical complaints are diverse, the emotional symptoms are not prominent, and they usually go to a general hospital for treatment first. Because of excessive examinations, medical resources are wasted, and early antidepressant treatment is rare. Therefore, we must be good at discovering, timely treatment or referral to the psychiatric department.
Depressed patients sometimes show extreme restlessness or nervousness, constantly walking around, walking back and forth, rubbing hands and feet, and aimless movements, etc. These all indicate anxiety. This type of activity for patients is often a last resort, but it does not make the patient comfortable, and ultimately cannot relieve the patient’s tension.
- Low libido
The typical symptom of depression is a loss of sexual interest that often parallels a total loss of energy and pleasure. Note: Sexual function problems can be caused by the disease itself, or it may be caused by the side effects of drug treatment or other physical or psychological problems.
- Decreased interest in daily work and recreational activities
Depressed patients often complain that even if they are engaged in daily activities, they feel that it is very difficult to do housework, let alone complete complex tasks. . Because patients cannot get pleasure and comfort from daily activities and entertainment, patients often give up engaging in such activities. In the early days, I often felt “powerless”. Therefore, patients often feel that they are inferior, are inferior to others everywhere, and their self-evaluation is lowered. I feel like a “waste man”.
- Decreased thinking and attention skills
The thinking process of depressed patients is often very slow, sometimes accompanied by poor memory. Some of the thinking of depressed patients can also be stagnant to a compulsive state, reading or writing can not be carried out; patients often feel that it is also difficult to make decisions about daily trivial matters.
- Feelings of uselessness, self-blame, guilt and shame
Moderate to severe depression will have thoughts such as uselessness, guilt, guilt, shame, feeling that you are inferior to others, and that you are not worthy to live. So especially pessimistic and desperate will lead to suicidal thoughts. These are the core symptoms of depression. Suicide is a way of self-punishment. Depressed patients punish themselves through this way.
Anxiety is a feeling of inner tension and anxiety. Most patients have this symptom. It is often said that anxiety and depression are sisters, and these two symptoms are particularly common complications. 60% to 70% of depressed patients complain of anxiety and episodic extreme anxiety, which can cause many problems. Psychiatrists often give diazepam and other anti-anxiety drugs to patients with anxiety symptoms. Such drugs that are ineffective in treating depression can often mask depression. Therefore, the relationship between anxiety and depression is quite complicated, and it should be distinguished clinically.
- Low self-evaluation
Low self-evaluation includes self-declaration of inadequate function, self-recognition as a failure or will be a failure. Accompanying feelings of frustration, self-deprecation is common.
- Feelings of helplessness, disgust and despair
The patient often feels that no one can help him, so it is meaningless to live. These symptoms are often mixed together. Depressed patients with such symptoms feel that their lives are gloomy and have no future. This kind of experience is more obvious when the patient has unrealistic high standards for himself and cannot achieve it. It is precisely because the patient feels that there is no hope in everything, and he has no power to change everything, so he becomes desperate and helpless, which in turn aggravates his feelings of disgust and sadness.
Some patients resort to suicidal behaviors to relieve feelings of helplessness and despair. For patients, suicide at this time has become a logical behavior, even to get rid of pain and other discomfort.
- Concepts of death and suicide
Suicidal thoughts indicate that the patient has been depressed to a very serious degree, and the mood at this time has also fallen to a certain trough. At this time, treatment should be strengthened, and family care should also be strengthened to prevent accidents such as suicide.
Many depressed patients have suicidal ideation or suicidal behavior. People with suicidal thoughts will say: “I am willing to get rid of everything”, “There is nothing worth living on,” and “I wish I never lived in the world.” Therefore, patients who have mentioned suicide should be highly vigilant to prevent accidents.
- Other symptoms of depression
Some depressed patients are characterized by bad morning mood. The mood will be better at night. The patient was very depressed early in the morning, and his mood improved with the passage of the day. This kind of mood swings in the morning and evening is a typical symptom of endogenous depression.
Other symptoms of depression include constipation, amenorrhea, and dry mouth (dry mouth can also be caused by antidepressant treatment). Urinary retention may also occur in particularly severe patients.
Summarizing the characteristics of depression, it can be called the three-low symptoms, that is, low mood, slow thinking, and reduced willive activities.
What to do with depression?
The goals of treatment at all stages of depression are: strive for complete relief of clinical symptoms, restore social function, and prevent recurrence or recurrence.