The human nervous system reacts very subtly to the surrounding psychogenic environment. Even mechanisms worked out for millennia do not always work. Of course, all this affects the state of health. A huge number of neuropsychiatric diagnoses today do not bother anyone. In a huge list of diseases, depressive neurosis is worth mentioning separately. This disorder is not present in all medical classifications. It, according to ICD-10, refers to affective states.
Brief Description of the Problem
Depressive neurosis should be understood as a type of neurotic disorder that is characterized by constantly sad mood, lethargy, and severe inactivity. It is inherent in vegetative-somatic disorders and sleep problems. On the other hand, there is an optimistic view of the future and the preservation of the ability to professional activity, the absence of profound changes in personality. The described clinical picture fully characterizes depressive neurosis.
The history of the disease goes back to the 19th century. Since 1895, in neurology and psychology, another term has been used to describe the disorder - "neurotic depression." This concept was introduced into medical practice by K. Kraepelin. A little later, scientists made an attempt to isolate the disease as a separate form of neurotic disorder, but colleagues did not support it. Therefore, in the ICD of the 9th revision, it still acts as an independent ailment. However, in the last published American classification there is no mention of neurotic depression.
The development of a neuropsychiatric disorder
To better understand the essence of the disease, it is necessary to present a typical clinical picture for it. A person can be in a psychogenic environment for a long time. For example, he has a constant quarrel at work or in the family. There may be an internal conflict due to dissatisfaction with one’s own life. Not finding the strength in himself to change the current situation, he begins to experience constant stress and psycho-emotional stress.
As a result, chronic fatigue develops. The ability to think effectively decreases, and the ability to think decreases. All these symptoms indicate an impending neurosis. If you add to it a bad mood and an inability to enjoy life, you can talk about depressive neurosis. At the beginning of the development of the disease, general weakness is sometimes supplemented by somatic disorders: changes in blood pressure, poor appetite, dizziness.
Main reasons
Every day a person is forced to face many problems. They can concern both the family and personally him. Depressive neurosis is not a neglected form of a nervous disorder; it does not appear on its own. Also, studies of scientists do not find confirmation in a genetic predisposition.
When conducting a psychotherapist's conversation with a patient, it becomes clear that in the role of a provocateur, most of the problems are serious psychological trauma. Various events that carry an emotionally unfavorable color should be taken into account.
Anything can serve as the cause of the neurosis: death of relatives, conflicts at work or dismissal, alcoholism of parents, impossibility of their own realization. Psychotherapists argue that this disorder is often the result of problems in childhood. It begins to develop actively if traumatic circumstances affect a person for a long time. The situation that appeared to him seemed hopeless. All the time he spends on trying to hide his emotions, and not on finding a way out of the situation.
Clinical picture
Among the main symptoms of neurotic depression, doctors note lethargy, depressed mood and decreased activity. First, the patient complains of a deterioration in overall health and the appearance of weakness. Then the clinical picture is supplemented by vegetative-somatic signs of the disease. These include the following:
- drops in blood pressure;
- dizziness;
- cardiopalmus;
- decreased appetite.
Patients rarely seek timely medical attention because many of them are not even aware of the diagnosis of depressive neurosis. Symptoms of autonomic-somatic disorders make you go to the doctor, at the reception from which they learn about the presence of the disease.
The clinical picture after a course of therapy
After taking a course of symptomatic treatment, not all patients fully recover. Often their health worsens, a feeling of weakness appears, and persistent hypotension develops. The psycho-emotional state of the patient is aggravated. He is constantly sad. Gradually, the clinical picture is supplemented by meager facial expressions and a decrease in motor activity.
Depressive neurosis is almost always accompanied by sleep problems. They are manifested by frequent night awakenings and difficulty in falling asleep. In the morning, patients feel overwhelmed and weak, very tired. Some are worried about anxiety attacks, various phobias.
If we compare this disorder with ordinary depression, then its symptoms are less pronounced. Patients always retain the ability to soberly assess the environment, do not lose self-control. They are never visited by suicidal thoughts. They are quite optimistic about various situations in life.
Features of the disorder in young patients
Depressive neurosis in children is characterized by a fuzzy clinical picture. They most often have the so-called equivalents of depression. They appear in the form of increased excitability, irritability, uncontrollable behavior. Such children show anger towards others, including their own parents. For example, even in the elementary grades, a student with severe physical disabilities is the most arrogant and hooligan. He offends everyone who accidentally looked at him. It seems to him that others are constantly taunting his defects.
In adolescence, depressive neurosis is manifested by isolation and a desire for solitude. These children usually have reduced academic productivity. They are constantly haunted by headaches, insomnia and discomfort in the heart. They are frequent patients with various doctors, willingly take prescribed medications.
Diagnostic and treatment methods
In order to correctly diagnose and select therapy, the doctor must first collect a patient's history. In this case, special attention is paid to information about mental and somatic pathologies among close relatives. The specialist needs to know what changes in the patient's life preceded a change in his well-being.
The diagnosis of depressive neurosis / neurotic depression is confirmed in the following cases:
- the patient is disturbed by mood changes and other symptoms associated with the disorder;
- his ability to evaluate his own condition is not impaired;
- behavior complies with generally accepted standards;
- the disorder is persistent, is not a single reaction to stress.
It is sometimes difficult even for an experienced doctor to make a correct diagnosis, since the manifestations of neurosis are similar to many signs of somatic ailments. In this case, the patient is advised to consult a neuropsychiatrist. To exclude somatic etiology of the disorder, a number of examinations are additionally prescribed: ECG, ultrasound, EEG.
Treatment involves holding sessions of psychotherapy, which is supplemented by the use of pharmacological drugs.
Drug therapy
The basis of this treatment is various antidepressants. The following drugs are especially effective: Moclobemide, Mianserin, Imipramin. Depending on the characteristics of the course of the disorder, therapy is supplemented with antipsychotics, sedative nootropics, tranquilizers. Even well-chosen medical treatment gives only a temporary improvement.
Psychotherapeutic effect on the disorder
Only through drug therapy can not overcome depressive neurosis. Therefore, very often, various methods of psychotherapeutic intervention are prescribed to patients.
The most common treatment is hypnosis. Its use has a beneficial effect on the mental state of the patient, and with regular use gives a positive result. Hypnosis sessions help to remove the patient from a depressive state. The number of specialist visits depends on the stage of the disorder, the individual susceptibility of the body. This method of exposure is recognized as absolutely safe.
Procedural treatment
What else can a doctor prescribe for a diagnosis of depressive neurosis? Sedative drugs or antidepressants are used only at the initial stage of the development of the disorder. Drug therapy is considered an addition to the main treatment. Its basis is the psychotherapeutic effect and various physiotherapy.
As for the latter, exercise therapy, darsonval, reflexology and electric sleep have proved to be effective in practice. Ayurvedic, classical and acupressure types are also considered useful. To improve overall well-being and get rid of bad mood, doctors recommend walking, yoga and meditation.
Prognosis for recovery
Depressive neurosis, the symptoms and treatment of which were described just above, is not considered a serious ailment. Therefore, the prognosis for most patients is favorable. They have every chance of returning to the usual rhythm of life and complete recovery. However, if the violation is started and not treated, it can transform into a more dangerous problem - a neurotic personality disorder.