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.

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.

Depression is a disease state which has characteristic symptoms.

By no means is depression a manifestation of the lack of character. This is a serious disease which is accompanied by violations of all psychological and even physical (sleep, appetite, body weight, etc.) functions of a person. Loss or reduction of strong-willed character – is one of the symptoms of the depression. Therefore, you should not advise the person suffering from depression, «to pull yourself together» – he will not be able to overcome the disease without medical care. Depression significantly affects the efficiency, education, social life, relationships with other people, including next of kin.

Is there a connection between depression and female sex?

It is common knowledge that women suffer from depression more often than men. This fact is confirmed by numerous epidemiological researches from different countries. The frequency of depression by women is 2-3 times higher than by men. In modern medicine female sex belongs to factors, which are predisposed to development of depression.

What is a reason of depression?

In many respects depression is connected with changes in endocrine profile, which take place in the woman organism during childbearing age. So-called genesial (genital) cycle passes a number of stages, starting with a menstruation and finishing with its completion. It includes menstrual cycle, pregnancy, childbirth, premenopausal and climacterical periods. At each of these stages there are a lot of changes in the composition and number of hormones, which are accompanied by physiological changes of all functions of the female body, including the psychological realm. Therefore, such changes of endocrine profile are connected with the increased risk of depression.

How does depression become apparent by women?

How it was stated above, the risk of depression increases at each stage of the reproductive cycle. There are different variants (syndromes) of depression in the clinical medicine, which are typical for every stage of the reproductive cycle, – premenstrual syndrome, pregnant depressive syndrome, postnatal depression during premenopausal and climacterical periods.

Manifestation of depression may be different. Depressed mood can manifest itself both by oppression and apathy, and by hyperirritability, maudlin, anxiety, a sense of internal tension. The change in mood is usually accompanied by a decreased activity, a loss of energy, an easy fatiguability and a distracted attention. Depression in women is often accompanied by a variety of somatic disorders: disturbance of sleep (insomnia or excessive sleepiness), appetite disturbance (decreased or increased appetite). There may appear unpleasant feelings of stress and pain in the mammary glands, headaches, pains in joints and muscles, pains in heart and occasional heartbeats, weakness in the body, fluctuations of blood pressure, etc.

The duration of depressions which associated with the reproductive cycle may be different. Premenstrual depressive syndrome is usually brief, about 2 weeks (1 week before and 1 week after menstruation), but it has recrudescent character with the monthly worsening. Post-natal depressions and menopause depressions may be more protracted and continue several weeks and even months.

How can you treat depression?

Depression – is a curable disease. In case of the correct choice of an appropriate remedy and its dose, the completely eliminate from the depression symptoms is quite possible.

The treatment of depression occurs only with the help of special medicines, which called antidepressants.

The treatment of depression should be ordered only by a doctor. We must remember that every person has its own characteristics of depression, which are connected both with the gravity of the disease and it clinical manifestations. The correct choice of treatment in each case requires the appreciation of multiple characteristics of the patient. Only doctor can correctly identify, evaluate and classify such features. In no case one should not resort to the help of relatives or friends or choose a means of treating independently, on the grounds that some medication helped someone who you know.

This rule must be observed, especially if change of mood is accompanied by a changes of overall health, violations of bodily functions and pains that is most characteristic for depressions which are associated with the reproductive cycle. In such cases, only doctor can properly assess the nature of symptoms, determine the actual state of internal organs and choose medicines that will be not only effective but also safe. It is strongly encouraged to take antidepressants during pregnancy and lactation.

Nowadays there are a lot of antidepressants. All modern medications of this class are effective and safe. However each of them has its own differential characteristics, which connected both with therapeutic action and its dosage.

The treatment of depression takes time. You should not wait for the recovery in the first days of taking the medication. Remember that all modern antidepressants effect the depression no earlier than in 1-2 weeks after beginning the treatment. During this period a doctor also identifies the necessary dosage.

The abolition from the antidepressant, as well as its prescription, should only be ordered by a doctor. Even after the complete disappearance of all symptoms of depression you should continue to take antidepressants for some period of time. It is connected with a risk of worsening depression, which in case of premature abolition of therapy is very high – up to 60-80%. Moreover, the worsening of depression, associated with the premature termination of treatment, usually more difficult responds to treatment. The duration of such additional period of treatment, which aim is preventive measures, determines only doctor on the basis of individual characteristics of each patient.

Remember, even if you decide to stop treatment before the period determined by a doctor, it is necessarily to consult with a specialist.