Depression is a depressed, very depressed emotional state. Often it is accompanied by catatonia, a phenomenon in which a person simply does not respond to events around him. This condition is considered pathological and requires appropriate treatment.
A little information
Involutional depression is a type of depression that is characterized by a numbness of a person over a long period. A patient in this state can constantly be silent, for days on end just lie down and not show any reaction to everything that happens.
A few years ago, catatonia was even attributed to one of the types of schizophrenia. But modern doctors believe that this condition can accompany various psychological problems, including depression, bifurcation, and personality disorder.
Symptoms of Involutional Depression
Treatment of such a pathology can begin only after an accurate diagnosis, which requires the presence of at least three of the 12 signs:
- excessive excitement and anxiety;
- echopraxia - a meaningless repetition of the movements of another person;
- catalepsy - a long stay in a trance state;
- mutism - refusal to communicate;
- echolalia - meaningless repetition of the speech of other people;
- ritual, stereotypical movements, for example, crossing arms and legs, swinging;
- wavy flexibility in which a person does not react to words at all and does not change his original position;
- unusual, abnormal habits, movements or words;
- curvature - facial expression, which creates the feeling that a person is hurt;
- negativism - behavior that is absolutely opposite to the emotions of a person, for example, he wants to eat, but at the same time refuses the offered food;
- prolonged stupor or deterioration of the normal response to stimuli, for example, during a conversation;
- posturing, taking unnatural poses for a long time.
A person in this state can also feel such classic signs as a feeling of hopelessness, hopelessness, sadness and depression.
However, the most common symptoms of involutional depression that can be suspected of having a problem are numbness and excessive silence.
Such a disease, among other things, can affect the person’s appetite, concentration, sleep, and mobility.
Causes
Treatment of involutional depression is almost always carried out according to the standard scheme, regardless of why it occurred. And the thing is that psychotherapists still can’t say for sure what specifically provokes the development of pathology. True, there are many hypotheses on this score. According to doctors, the main cause of involutional depression is the depletion of dopamine - the neurotransmitter responsible for mood, which is located in the brain.
In general, such a pathology can be triggered by a combination of several conditions, among which it is worth highlighting:
- the presence in the family history of psychological defects;
- critical changes in life, for example, a divorce or the death of a relative;
- abnormal changes in the structure of the brain or its activity as a result of which it becomes more susceptible to the produced hormones;
- all sorts of medical indicators including insomnia, chronic pain syndrome, prolonged course of the disease or attention deficit disorder.
In addition, people at high risk include people who are addicted to drugs or alcohol.
Features of the course in old age
According to the dynamics of its development, this pathology most often turns out to be a single protracted depressive period. Usually, women encounter it in the period of menopause, that is, at about 45-55 years old, and men are 5-10 years older.
In old age, involutional depression most often proceeds atypically, while the main symptoms of the disease are fear of the future, excessive anxiety, anxiety. With effective treatment, the acute phase of the pathology is fairly fast, although in some people it can last for a year.
In most elderly patients, the initial symptoms of catatonia remain unchanged for several years. In other words, at different periods of the disease, the clinical picture is monotonous. In general, monotonous anxiety is observed in combination with anxiety expressed in movements, as well as constant depression.
Diagnostics
Usually a person with involutional depression does not respond at all to the questions asked by the doctor. That is why close people should take part in the survey and talk about their own observations. A specialist, among other things, will have to conduct a differential diagnosis with other similar pathologies, for example, malignant antipsychotic syndrome. This disease has similar symptoms and can occur if a person has a negative reaction to antipsychotic drugs.
In addition, the therapist can refer the patient to auxiliary instrumental studies. This is necessary in order to exclude the possibility of a tumor in the brain or other defects conducive to the development of catatonia.
Therapy
To treat involutional depression, doctors usually prescribe benzodiazepines, such as Lorazepam. This drug has a sedative and relaxing effect. Most often, the drug is administered intravenously, but in some cases it can be taken in the form of tablets.
If drug therapy is unsuccessful, a specialist can recommend electroconvulsive therapy to the patient, which is carried out under general anesthesia. Such treatment is effective in approximately 80-95% of cases.
With involutional depression, doctors can resort to other methods aimed at stimulating the brain. For example, magnetic therapy and activation of the deep brain are often used - such measures, as a rule, allow you to get rid of the manifestations of catatonia. After the symptoms of involutional depression subside or completely disappear, the patient is additionally prescribed appropriate antidepressants and psychotherapy sessions.
Probable complications
Without proper treatment, people suffering from involutional depression can face a number of negative consequences. Possible complications include:
- the appearance of pressure sores;
- blood clots;
- the development of contracture or pathological contraction of tendons and muscles.
Patients with this diagnosis may need long-term therapy, even after improving their well-being and eliminating the symptoms of depression.