What is the reverse of the coin? There isn’t any! The abundant evidence of research activities have shown that exercises, which improve oxygen exchange (dancing, basketball, jogging, cycling, swimming, walking, etc.), as well as exercises which do not belong to this category (such as weightlifting), can relieve depression, if it is determined as mild or middle. They also can reinforce treatment rates by heavy depression. Even such inoffensive activity like walking does its part. The observance of stable regime in case of melancholy may be a powerful restorative remedy. It is not inconceivable that it is all that need a person.

The exercises are so efficacious, that if person will do them in combination with psychotherapy or/and with medication taking, he rather approaches his recovery, than if he restricts himself with only course of treatment.

Exercise’s effects may be long-term. One research, that included among 5 000 college students in course of mental health, has shown that students who regularly did morning exercises (even during seven years after course ending), had weak depression and anxiety. The exercises, along with others methods, may be a powerful weapon in arms of your beloved.

Why are these exercises so efficient?

There are some theories which can explain this phenomenon. On the psychological level these exercises divert person from pains and bereavement. Winning round in tennis he may become sensation of reached mastery, which can help to conquer a feeling of hopelessness and despair. Exercises which are realized in the form of playing kinds of sports, like dancing or aerobics, may also slacken the feeling of solitude. Moreover, we should remember, that with the purpose of exercises like walking, skiing or jogging, we go to the open air, that is important for our soul.

Positive effects may also come from biological sources. The scientists have discovered that strenuous activity releases in brain chemical agents called endorphins. They act like morphine – they relieve sensations of pain and
revive our spirits. Besides, physical activity improves effect and metabolism of mediators, such as noradrenaline and serotonin. They are very important to regulate our spirits.

How many exercises should be enough?

Do a complex of aerobic exercises just 2-5 times a week by 30-40 minutes. Provide 5-10 minutes at the beginning for warming-up and at the end for relaxation. These exercises should demand efforts, but they must not be too difficult. The person should be able to perform them and be sure that they are not doomed to failure. No one set of exercises will not work if person believes that they are too difficult for him. In this case it is better to start with simple exercises and while its development to increase the load.

The failures may be a reason of psychological stresses and may intensify the feeling of inferiority. That is why he must see his goals. A friendly game in tennis, which does not contain competition, may be more useful than game on points. If person likes it, he will probably want to play more.

It stands to reason that no one combined movements will not be effective if person does not want to do it. The person suffering from depression may be of sluggish disposition. That is why it will be better to start with joint short walks. As they say, half a loaf is better than no bread. Concentrate on little steps which approach you to the aim. In addition, the person will be disposed to exercises, if they are convenient for him and do not disturb the daily routine.

There is only one insignificant risk by physical exercises: some people may be too accustomed to the changes of their state. The sign of such adaptation is a necessity to increase the «dose» of exercises in order to achieve positive effect. The training becomes the main thing. The family relations pale into insignificance. Furthermore, the person is disposed to put such well-doing before all else. That is a bit too thick. Sometimes excessive keenness on exercises may be a sign of impulsive obsession. Such circumstances must be discussed with a doctor. In old time, a Greek philosopher Aristotle advised us be moderate in everything. It includes exercises which help us to cope with depression.

Very often depression is accompanied by chronic diseases. It is considered, that one third of all patients with serious medical problems suffers from a depression. Thus after infarction it is observed by 40 – 65% of the patients, by ischemic disease – 20%, after the stroke – from 10 to 27%, by diabetes and rheumatoid arthritis – from 20 to 30 %.

It is natural, that chronic diseases cause the disturbance of daily routine, especially if there is no possibility to continue the work. In this case symptoms` appearance may be imperceptible for others and patient itself, that’s why it is necessary to know such symptoms in order to take appropriate measures. There are some of them.

• The constant state of depression, sadness, anxiety, nervousness or indifference.
• The inability to enjoy life or its positive moments.
• Loss of weight and appetite
• Insomnia, early awakening or on the contrary, drowse in the morning
• Impatience
• Reduction of vital power and chronic tiredness
• Feeling of helplessness and pessimism
• Feeling of own otioseness and unjustified guilt
• Difficulties with concentration, memory and with taking decisions
• Recurrent suicidal thoughts

If you notice some of these symptoms by your relatives, discuss with a doctor what measures can be taken. The specialist in fundamental illness (for example in diabetes or arthritis) can not often to diagnose the depression himself, but he should connect the patient with a psychiatrist. In many cases qualified treatment of depression can relieve clinical the course of arthritis or recover health after infarction.

In case of unimportant depression doctors recommend psychotherapy like a first stage of the treatment. Among them the most efficient is Cognitive Behavioral Therapy, CBT. It helps the patient to recognize negative ideas and some behavioral reactions and replace them with positive. Usually the course of treatment is not very long – about 10-20 weeks, and is defrayed by medical insurance. Quite often psychotherapy goes with drug therapy, which yields tangible results, especially by acute form of a depression.

The most commonly are used the class of selective serotonin reuptake inhibitors (SSRI). This group includes:

• citalopram (Celexa)
• escitalopram (Lexapro)
• fluvoxamine (Luvox)
• fluoxetine (Prozac)
• paroxetine (Paxil)
• sertraline (Zoloft)

An other class of antidepressants (SNRI) is also connected with a heightened content of serotonin and norepinephrine in the brain – venlafaxine (Effexor) and duloxetine (Cymbalta). So-called tricyclic antidepressant, previously widely used for depression treatment, now are not recommended for people elder 65 because of their side effects, particularly their abilities to cause cardiac arrhythmias.

There are two main proven ways to treat depression: medical therapy and psychotherapy. The most effect gives the combination of 2 these methods. The application only of pharmaceutical substances, according to controlled studies in the field of pharmacotherapy of depressions, leads to expressed improvement only in 60-65% of cases. It means that by 35-40% of depressed patients should be used various methods of psychotherapy.

But for achievement of that expressed improvement is required the long-term taking of antidepressants in quite high doses. Despite the relative safety of modern drugs it would be better to reduce the duration of their intake and dose as low as practicable, thereby minimizing side effects (sleepiness, lethargy, liver and stomach failure, etc.)

The optimum alternative for treating depression is a combination of antidepressants with a course of cognitive psychotherapy. In this case the improvement would be faster and perceptible, and most importantly – it will be received persistent effect of the treatment. Thanks to psychotherapy, the patient gets “powerful weapons” – with a help of psychotherapy he learns how to control his own negative emotions, to perceive the approaching of depression, to take necessary measures and even to prevent the return of the disease. In this case, the percentage of resistant cure is achieved in 98-99% of cases (according to reliable sources).

Cognitive therapy has proved itself in depression treatment, anxiety, phobias and panic attacks. At the heart of cognitive approach is the assertion: “Emotions and human behavior are determined by his world-view”. It means if a person in his subconsciousness has the conviction of “unfriendly world”, then his behavior and emotions will be the same: how can you feel good and comfortable in the place where you are beforehand treated badly?

But there are not a lot of people who can admit the existence of such conviction, and meanwhile just this opinion leads to development of anxiety and depression. The revelation of these basic facilities, its correction and developing of a new mode of thought is an aim which can achieve both psychotherapist and patient.

At the beginning of the treatment the patient is talked about the correlation of thoughts, emotions, behavior, by the example of his own experience. Next, he is learned to identify, track and fix his negative thoughts in a special “Diary of automatic thoughts.” After that, together with the therapist, the thoughts are analyzed and identified, irrational (incorrect and illogical). The special techniques with automatic thoughts are revealed as basic views: in our example it was conviction of «unfriendly world». The next stage – is a correction of irrational basic conviction and formulation of a new one, adequate and realistic.

During this work, the responsibility for own condition is gradually passed into patient’s hands. And by the end of the therapy the patient begins to play the role of the psychotherapist in relation to himself, calling in question own prognosis or conclusions, and skilfully propose an amendments.

As a rule, the course of cognitive psychotherapy consists of 15-25 sessions in the range from 1-2 times per week in an infant state, once a week in following stages, and around the bend it is possible to have meetings once in every week. After completion of the course is required a “booster therapy” – a psychotherapy appointment necessarily 3-4 times per year, in order to observe the situation and get further precise definitions and homework.

• I feel oppression, depression.
• Recently my appetite and weight have been changed.
• I feel anxiety and I have the heebie-jeebies.
• I cry a lot.
• I feel tired for no apparent reason.
• I do not get pleasure from my hobby.
• My thoughts are not as clear as before.
• My future seems joyless to me.
• I do not feel that my life is useful to other people.
• I believe that others would be better if I died.

If you have more than 5 statements, perhaps you’ve got a depression. The depression can become apparent in different ways. Different types vary from weak initiative, insignificant depression, tiredness and sleep disturbance, to oppressions, headaches, eating disorders, constipations, distemper and at last the apathy. Concrete depression’s displays are so different and individual that it is quite difficult to diagnose it correctly. The medicine distinguishes three types of depression:

• Depressions which caused by organic diseases, such as myocardial infarction, heart failure, hormonal disorders, injuries.
• Endogenous depressions. This form of depression occurs from the inside, as a consequence of mental person’s predisposition. « Endogenous» – defined by deep, internal processes (including biochemical). Such depression brings peculiar tortures, because the patient is not able not only to feel joy, love and interest, but also grief, anger and compassion. Accordingly, this depression should be especially recognized in time, as it is well stopped with a help of modern antidepressants.
• Psychogenic depression. It arises from the subjective intolerable feelings because of difficult mental disorders, at that, emotions are so strong that they must be restrain. For different people, with a different personality type, such mental disorder can be differ in strength, content or duration.

Common for everyone is change in yourself, a change in the perception of your past and future, as well as around the world, where everything is seen in the pessimistic tones.

In particular, older people are disposed to depression, suffering from loneliness after the death of a spouse, loss of coevals, changes in habits or restrictions.

Depression deprives a person of the future, or orientations for it. Psychological trauma deprives people of hope and strength to see tomorrow, when the prospects offered only disadvantage, the expected sufferings, pain and despair. Everyone has his own trauma – divorces, separations, difficulties at work, financial difficulties, the suffering of homeless dog. You better know it how it is happens with you. In cases of depression caused by the traumatic events the effectiveness of drugs is minimal. The psychotherapy is here especially medically necessary, directing to comprehension of unsuccessful strategies, seeking of resources, comprehension of the real problems and causes of depression. Depression shows that there is something that oppresses the person, and he should remove it.

The man under the pressure of depression is not self-satisfied, he does not trust himself, does not want to see the reality and he loses his intensity.

Depression can often be linked to the disease, traditionally called psychosomatic.

What is more important, that «mild» depressions are quite normal, if they come after high stresses, so they allow the body to have a rest. But if they are delayed, it is a sign trouble. It is unreasonable to persuade the patient to relax in the cheerful society, to go to remote countries or to argue that everything is not so bad and it will be over.

There is no sense to tell that you also have experienced such situations or to require a patient that he take himself in hand and do not sink.

There is also no point to ignore the possibility of suicide and signs of preparation for it.

It makes sense to show the patient that he is loved, that people are considerate towards him and want to help him. Be ready to mood swings. Help him carefully to be oneself, to explore the history of his life, and together with him find true causes of mental disorders.

It is perfect when such assistance is rendered by a qualified psychotherapist.

Paradoxically, that in some cases, if you want to recover, you should not struggle against the depression, on the contrary, to fall into it, because only in the depths of your being you can find something that has been depressing you for a long time. In the East, depression is sometimes considered as gift of gods, because it allows and even forced to think about the meaning of the life, to seek answers to the question «Who Am I», «Why» and to be updated and re-open the joys and sorrows of this world. And if you go through depression with a guide, will be absorbed in it, so this trip will allow you to understand and to analyze all bereavements and teach you to cope with them.

The word «depression» means dispirited mood. If more exactly – it is a triad of events in the person’s state: the deceleration of physical, mental and psychical activity. Here we give some common symptoms which have most of patients. There isn’t any power to do something; nothing please you; very usual duties become beyond your strength; you have frequent fits of anger and aggression to entourage; you get into a bad mood even in the mornings; you want to lie in the dark room the whole day, and so on, and so forth. All that includes also a physiology with its symptoms – insomnia, light sleep with anxiety dreams, headaches, pressure changes, pains in stomach and heart.

Do you recognize your state? Do not be frightened. Let’s take a closer look at this «depression», the enemy should be known by sight. For one thing, the physicians do not use the diagnosis «depression». With a word «depressed» we can describe different effects: congruent behavior after bereavement, conflict reactions and neurosis, personalities and of course the disease.

In fact, the disease happens rarer than you think, about by four patients from 100. In this case we are really speaking about mental disease, but not about temporal state. The disease is lasting for years and is treated only with a help of medicaments and under the care of a physician. Other 96 patients who complain about the same symptoms, in all probability have neurotic reaction of varying severity to some life’s circumstances. In this case our mind and physiology are able to cope with some difficulties independently. You should only help. The main thing is to notice signals, which our wise organism is sending long before «avalanche» of stated above symptoms.

We got accustomed to another course of events. We do not pay attention to bad spirits, hoping that everything is going to be alright. You have not let it run itself. The fact is that protracted depression has a good chance to turn into serious disease called «Major depressive disorder». You can not cope with this state alone. And there are some words how does depression originate.

How do we react in such a way? The question is in stress. At that, it isn’t referred to one-time shock, but to so-called “accumulative” stress, which has a lot of small “blows” on our psychology. It may be burned omelet, quarrels with neighbor or with beloved person, or even dissatisfaction with oneself. All our life is a complete stream of these stresses. It affects everybody in spite of the age and social status.

A human – is a cat with nine lives and one of the survivable species, so at the very least it can cope with a number of stresses. But a state of chronic stress is accumulated and from time to time our mind (and after that a whole organism) is failed. It is called neurotic reaction. I can safe say that every person has got under its control just once in his life.

As a matter of fact, all stressful situations may be relatively divided into two types. The first of them is social conditions. In this case we can hardly change something. These conditions are simply thrust. Whether you like it or not, you have to learn how to survive. A research worker of one of the universities in the U.S. has made an investigation where we can see a quite definite connection between ups and downs in the American economy and sickness rate of mental diseases. According to his data, during business depression a number of mentally diseased has been increased up to 150 – 200%. The result of economic recessions leads to inevitable ending – a nervous breakdown. You can observe it by people who are absorbed with a crisis situation. The author writes that these people blame themselves. They believe that they have weak points and they are not able to make progress in this financial race, but in most cases they are only innocent victims of society.

These studies show that the more the American has succeed in this race for subsidiary earnings, the greater are his chances to go mad in case of ill effects. According to statistics, the mental diseases happen during economic dislocations by men of substance, who really have something to lose. All these circumstances cause a constant emotional overload and make neurosis as a norm by a definite number of the population.

There is one more important reason of neurotic depression – it is a morbid tendency to move up the career ladder. Theoretically, a conception about career or careerism is not at variance with morality. Why is it bad that person is trying to be successful or he wants to make his family be independent of financial instability? It is bad when this aim becomes the only important thing for him. Such people have so-called «career disease».It is painful both for careerist and for his relatives, as well as it leads to nervous disorders. They are especially discernible by the overthrow of career plans.

The discrepancy between our production commitments, our interests, personalities and even sportsmanship also causes the development of neurotic reaction. For a long time accumulated negative emotions can lead to neurotic disorders. They also provoke a necessity to be engaged in several things simultaneously (at that, all of them are pressing business) – not having time to concentrate at one thing, a person has to switch over another. In this case you get a broken search order and information analysis, you do not have a satisfaction, because you fail to finish the thing which you have started before. You have quickly to redirect and adapt yourself to new conditions.

The second group of reasons of neurotic disorders is personal relations. Here the first place take emotional experiences concerning loss of near relations, love-affairs, adulteries, intrafamilial disputes, as well as alcohol abuse of one family members. Our lives are full of private reasons of one or another varying severity.

One more cause which has an influence on the development and acuity of neurotic reaction – is peculiarity of our nervous system. These peculiarities are innate, that is why they are not liable to variation. According to reaction type to inductive stimulus we are divided into people with type of strong nervous system and weak nervous system.

The people with strong nervous system have high working capacity, especially if it requires staying-power and purposefulness. They do not lose presence of mind in difficult situations. They are enterprising, persistent and independent. They do not like to complain about the shoals of life, as well as they do not seek support by inner circle. These people have rare nervous breakdowns.

The people with weak type of nervous system, on the contrary, have low working capacity. They are lack decision and always try to avoid responsibility and difficult situations. Usually they tend to inadequacy. They can not defend believes and are easily surrender themselves over to somebody’s influence.

Since the beginning of the twentieth century, researchers have experimented with different substances in order to synthesize the drug which relieves depression symptoms. However all experiments were failed. The first antidepressant was «discovered» in 1957 by a chance, when doctors payed attention to iproniazid, that was used by multimodality therapy of tuberculosis. Except of the main medication’s effect, it was observed and a side effect, which was showed in unusual high spirits by tuberculosis patients. A short time later this medication was used for relief of depression symptoms, especially as the tuberculosis remedy it did not justify itself.

According to the other version, the action of the medication was discovered by Nathan Kline. Moreover his disclosure was also more than accidental – with a help of drug he tried to prove the theory about the location of «ego». During psychoanalytical session Kline has mentioned that some patients have not got former problems any more. Iproniazid was offered for sale, but soon it was turned that it increases the risk of jaundice, so the sale of medications was discontinued.

At the same time in Germany Ronald Kun discovered imipramine. Kun gave his patients different medications in order to build the global classification of mental diseases. The German psychiatrists of that time were completely obsessed with this classification. As in previous cases, medication was «discovered» when patients were elated. In contrast to iproniazid, imipramine still is in the list of official medications of WHO and up to Prozac it was the best selling antidepressant.

When the first antidepressants were discovered, no one could have imagined that just in a few decades, treatment with antidepressants would almost force out other types of depression treatment. According to poll, that took place at the end of the XXth century in the USA, the biggest discovery of the last century will be not the theory of relativity, and not the Internet, but a small capsule of Prozac.

Seasonal affective disorder can have the same symptoms as a depression, which are not connected with the certain season. It may be depressed mood, melancholy, anxious feeling, apathy, joylessness or hopelessness. Rarely these symptoms are more pronounced in the first half of the day, whereas to the evening the state becomes better.

More typical for seasonal affective disorder are considered other symptoms. Patients, suffering from seasonal depressions, parallel with depressed mood, anxious feeling and decreased activity, experience drowse and keen appetite during the whole day. During depression they consume more food which is rich in carbohydrates. They can also put on weight. As a rule, reduces the overall tone, but appears weakness and variety of unpleasant sensations in the body.

Asthenic symptomatology of seasonal affective disorder is following: feeling of weakness, flabbiness, souse and all-overishness. It may be different pains and unpleasant feelings in the body. The mental work decreases, the memory and attention worsen. It is significant that intensity of these symptoms practically do not depend on outside force and quite often they are more pronounced in the morning hours after awakening.

In development of seasonal affective disorder the important role plays metabolic serotonin – biologically active substance, which regulate mood.
Experimental researches have shown that in winter the content of serotonin lower than in summer. The significant regulator of serotonin is melatonin – an active material, which production depends on light quantity.

The classical approach of seasonal affective disorder treatment is light therapy. Besides, it has been proved high efficiency of antidepressants with a specific action on the exchange of serotonin in the brain. Prolonged use of these medicines allows not only cure developed depressive state, but also to prevent their future development. As by other depressions, the essential element of effective treatment is psychotherapy

Antidepressants are used for depression treatment, some anxious disorders and other diseases.

Beneficial action

Antidepressants may relief anxiety and depression. Because of sedative effect, they can be taken by many people with panic disorders and anxiety.

Application

In many cases these medications should be taken one-two times per day. Perhaps, you will take them for some weeks, before you feel better. Do not change either dose no scheme. Do not stop take medicines without doctor’s advice. Many antidepressants should be taken over a long period of time – till 8 months. It is very important to carry the treatment with antidepressants through (even if you feel better before the end of the treatment). Your doctor will choose the most suitable medicine and its dose. For best results, it important to keep all doctor’s instructions.

How do antidepressants act?

The action of most antidepressants is based on the slow process of removal from brain chemical agents called neurotransmitters. Neurotransmitters are necessary for the cerebration. Antidepressants keep these substances in the brain for a longer time.

Precautions

• Many antidepressants may have a sedative effect, so that you may feel drowse or less than usual vivacity. Therefore, before driving or working with technology, you should know how you react to these drugs.
• Because these drugs can strengthen the effect of alcohol or other depressants of central nervous system, then by taking some certain antidepressants, adjust with your doctor alcohol use or its combination with other drugs. If you are pregnant, plan to become pregnant or you are breastfeeding, notify your doctor about it before taking medications.
• Tell your doctor about allergic reaction to any drugs, as well as about prescribed or not prescribed medicines.
• Tell your doctor about glaucoma, urinary retention or heart diseases.

Possible side effects of antidepressants

During taking antidepressants many patients experience side effects. These effects usually appear in the beginning of the treatment and disappear in some weeks. More common side effects of antidepressants include drowse, dry mouth, giddiness, headache, tremor, sweating, urinary retention or constipation. These signs point that medicine is working. Tell your doctor if you have some of just listed disturbances. For its abatement doctor can change the dose or prescribe another antidepressant. Immediately apply to a doctor if you have acute or feebly marked symptoms. In spite of side effects it is worth to continue taking medicines, for the sake of close relief.

Types of Antidepressants

Besides widespread tricyclic antidepressants, which have the most acute side effects, they mark out tetracyclic antidepressants, distinguishing with more mild side effects. There is also atypical tricyclic antidepressant Coaxil (Stablon), which is more effective by mild depressions, and latest class of antidepressants – so-called selective serotonin reuptake inhibitor (SSRi) – which side effects are appreciably lower than by tricyclic antidepressants (though concerning power they are not weaker). Also, for depression treatment, phobia and some anxious state are usually used so-called МAO Inhibitors.

This information is for general examination. If you have some of these disorders, consult with a specialist.

Many patients experience false alarm regarding constant dependence on antidepressants. Considerable part of patients, suffering from depression, belong to placebo-reactor, i.e. people who are easily susceptible even for pills, which do not contain some active pharmaceutical substances. All just-listed determine heighten interest of such patients in psychotherapy.

The telling argument, testifying the role of psychotherapy in depression treatment, are those experimental data, which show the importance of psychological factors in the formation of therapeutic resistance to medical products. The effective course of psychotherapy in the long term is possibly more useful than pharmacotherapy, because it teaches the patient. The last one acquires the skills to overcome the depression, learns to recognize its approximation and prevents its recurrence. According to the results of many studies, the normalization of endocrine indicators in the therapy of depression is achieved not only in the process of treatment with antidepressants, but also in psychotherapy. The influence of the psychotherapy on endocrine indicators are observed both in the case of its combination with pharmacological therapy, and in the case of using it as the only method of treatment.

In a number of cases, psychotherapy allows patients to adjust to reality with the continuing violations of affection, thinking and attitudes. With an independent therapeutic effect, psychotherapy promotes the optimal collaboration of the patient and physician, raises the efficiency of medical treatment, improves family relationships and professional status of the patient.

Frequent start of depression after acute trauma or prolonged stress leads to a persistent search of psychological reasons of its occurrence. This situation increases the desire of patients to psychological care. However, excessive revaluation of its capacity, unfortunately, can lead to a complete denial of psychotropic substances, formation of resistant and prolonged depression variants, cause her early exacerbations.

In respect to a doctor, the psychotherapy of depression first of all should be aimed at elimination of its symptoms. Some of them are more sensitive to psychotherapy, and other are relatively difficult to its impact. It is generally believed that by severe depressions psychotherapy’s possibilities are more limited than in cases of slight disease.

As psychotherapeutic targets are chosen mood disorders, paralogia, behavioral disorders, motivation and physiological symptoms. Among affective symptoms – are sadness, sense of guilt and shame and especially anxiety.

There are a number of general principles of operation which have a psychotherapist with a patient suffering from depression. Here the doctor’s control over his own feelings regarding to patient is very important, because of the possible sense of futility, anger, excessive fatigue and sympathy. Psychotherapist not only sympathizes with the patient, but he also carefully observes him, keeping some distance. During the therapy doctor should strictly regulates communicating time with patient and maintains the structure of the momentum to recovery. Active statements of the purposeful questions, confidence in the diagnosis, the real hope are basic rules of depression treatment. The studies have shown that hope, which was received from a doctor, is retrospective by patients and taken as an important help in overcoming a depression.

The peculiarity of work with a patient depression is not so much empathy, as understanding the condition, and in particular, the possibility of change of mood. Often patient aspire to «petrify» the psychotherapist by means of his endless waiting for assistance, and the latter makes an error, starting with theoretical explanations and searches of psychological reasons of depression. In fact, the psychotherapist must ensure that the patient drew attention to himself and seek adequate perception of his situation. A particularly undesirable conversation with the patient is about the symptoms of his condition. More important is to emphasize the dependence of the expression of different situations, to talk about the features and relationships with other people. Psychotherapist’s compassion is usually increases by patient the waiting for assistance, an attempt to ease the symptoms lead to its strengthening, consolation – to inconsolable. It is important to bring the patient to the need for self-help, but not comfort him, show him the importance to understand himself as he is.

For depression treatment it were proposed different methods of psychotherapy:

• Psychoanalysis
• Person-centered psychotherapy
• Existential therapy
• Interpersonal therapy
• Cognitive therapy
• Reminiscence therapy
• Projection variations with time
• Relaxation training
• The therapy of social problems and other methods of psychotherapy.
• Including its mixed and eclectic variants.

According to the most researches the most effective method by depression treatment is cognitive therapy, focusing on correct mindset characteristics of patients suffering from depression.

Typical (main) symptoms of depression:

• The mood is bad, depressed, nasty, dismal, “there’s a gnawing in your heart”
• “You are browned off everything”: you put off some plans or for a long time you make yourself for their performance. There is no desire going into the heart of the matter, – you know that you must do it, but you take any measures. The production decisions and business acquaintances you also leave over until tomorrow. You are not interested in something, you do not want to do anything, but you know that you should do it. There is no pleasure like before – “You are past caring.” You couldn’t remember when you were happy.
• You are tired even after unimportant physical exercises, or in the evening you are completely unable. It may be the feeling of constant tiredness. It seems that you have never had a rest. You want to refuse from routine, rather to take a break and muster your strength. However, brief rest does not improve the condition, and amusements fast lose their attraction.

Other symptoms of depression:

1. It is difficult to concentrate in the presence of an irritant (for example, by television, radio, conversation in the next room); because of «parallel» thoughts – «while reading I am thoughtful of others». It becomes difficult to pick words or to catch the meaning of the conversation. While reading books, magazines or commercial papers it is also hardly to find their meaning, you have to reread it once again.
2. After taking a decision, it appears unusual for you indecision, constant doubts in ordinary domestic or well-known professional duties. The self-reliance has disappeared, – «What if I say too much or do something wrong».
3. The critical appraisal of all past life is quite possible. «Everything that I have had in the past is useless. I had to do other things». You experience painful feeling of the «black sheep» in the family and «white crow» in the work. You reproach yourself in filial irresponsible duties or in insufficient care concerning other next of kin.
4. Your mind is filled with sad thoughts, that you are «loser» and you are not able to solve the problems. There is an ascertaining of full professional failure. The dismal and pessimistic vision of the future may be filled with quite concrete life conditions.
5. Sometimes it occurs to you – «Perhaps it would be better to pass away, because everything is bad, nonsensical, the life has lost its meaning since».
6. The sleep disorder is quite varied. This includes difficult falling asleep; reduction of night sleep because of frequent awakenings; the awaking at 3-4 o’clock at night or at 5 in the morning with following sleeplessness. At all kinds of sleep disorders there is no sense of rest in the morning.
7. You have jaded appetite («I can do with one cup of tea during the day»), or you can even have aversion to food’s sort or its smell.

Depression self-testing

In event that you do not get some of three symptoms (main and extra list), so you do not have depressed mood according to ICD-10.

Mild depressive disorder

The presence of 2 typical symptoms of depression and at least 2 symptoms from the list of “a-g”. You are worried about your state. You feel certain difficulties by work performance or by social activity.

Moderate depressive disorder

The presence of 2 typical symptoms of depression and at least 3 symptoms (preferably 4) from the list of “a-g”. There are formidable difficulties in performance of social duties, housekeeping or by continuation of professional activity.

Major depressive disorder

The presence of all 3 typical depressed symptoms or more than 4 from the list of “a-g”. The social and home activities can be very limited or improbable.

If you have a depressed mood in accordance with the criteria, your state may be exacerbated with a number of additional painful displays:

• You want to be alone, shut yourself off from everybody;
• The next of kin notice that you become silent and you stop smiling;
• The relations with relatives and colleagues become complicated with unusual for you irritability and aggression;
• The feeling of weight in the chest, («A weight sits heavy on my heart»), or an ache in the left part of the chest or burning pain behind breastbone.
• It appears unnatural for you slowness in movements, or on the contrary, moving excitement and anxiety, (« I have the heebie-jeebies»).
• During depression the sexual drive may decrease, («I do not even think about it»).
• You feel bad especially in the morning or in the afternoon. By the evening you feel better (typical diurnal rhythm of disturbance mood)
• The attempt to improve your state with a help of alcohol brings only temporary and unstable effect.

In case if you find by yourself or by some member of your family the foundation for depression self-testing, you should seek a psychological help.