According to statistics, about 15% of Americans suffer from one or another form of depression, and it costs the nation 89 billion dollars every year (it includes not only cost for treatment and medicines, but also production loss, work absences and suicidal thoughts). Each year in the U.S. occur about 30 thousand attempted suicides, resulting in the death of a considerable number of people. Depression – is one of the main reasons of employability’s lost among people aged 15-44. Doctors called it «emotional cancer», the same malignant disease disposed to relapses.

Nowadays they used more than two tens of antidepressants with different mechanisms of action. Some of them are not so efficacious as it was expected. Others had tendency to suicidal actions by teenagers, and perhaps by adults.

Today the most popular are medicines which belong to the group of selective serotonin reuptake inhibitor (SSRI). The reason – is simplicity of application (one pill per day).

Some time ago, with a help of government budgeting, there was a wide trial after the medicine called Celexa (citalopram). The studies included 3 thousands of patients suffering from depression, from which this antidepressant has helped only a third people, despite the fact that they were given in higher doses than usual.

The next stage of research were conducted with those people who are not helped Celexa. Among those patients were people who suffered from depression more than one year. These patients were prescribed other antidepressants of different classes – Zoloft (from the same group as Celexa), Wellbutrin (other class than SSRI), or Effexor (which has another point of application in brain). It turned out that such simple medicine change has helped at least a quarter of patients do not experience depression attacks during 3-4 months.

Another group of similar patients have continued to give Celexa, but in addition was appointed a Wellbutrin or sedative BuSpar. Among these patients, one third had a calm period during the same term, however, the combination with Wellbutrin was more effective.

The doctors were very interested in these studies, consider it as a new hope for people suffering from depression. Indeed, such a simple procedure, like substitution one medicine with another or addition of a new therapeutic agent allows you to help more patients, especially with severe and long-term recurrent forms of depression. But it is known that the suicidal inducements often occur with a medicine change, so patients and their surroundings should be especially attentive during these periods, to avoid trouble.

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.

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