Introduction
Depression indicates serious violations of a person’s activity and a decrease in his or her interest in the world and own life. Determining the exact cause of this mental health issue may be difficult, since several factors – hereditary, physiological, neurological, and psychosocial – act together to bring about depression. An accurate diagnosis can be made after studying the patient’s anamnesis. The course of treatment involves a combination of conservative and psychotherapeutic methods.
Assessment
A twenty-five-year-old male patient complains of losing interest in life and suicidal thoughts. Visually, there is slowness in mental processes and oppression of basic instincts.
Diagnosis
Depression – F32.1
Pathophysiology
While such factors as hereditary predisposition as well as hormonal disorders may impact the development of depression, stress, and anxiety are considered the main factors conducive to this mental health issue. Stress leads to functional disorders of interactions between mediator systems, which, in its turn, results in the misalignment of physiological functions in the central nervous system and the formation of a durable pathological state (Moncrieff et al., 2022). Disorders in emotional and motivational behavior, circadian activity, and the speed of the motor and thought processes, in their turn, become the immediate pathophysiological causes of depression (Maurer et al., 2018).
Manifestation
The manifestations of depression can be very different. Depressive states can manifest themselves as the appearance of sadness or despair, mental and muscular inhibition, lasting at least 2 weeks (Hyland et al., 2020). This state is often accompanied by a feeling of longing, hopelessness, and uncertainty. At the same time, the patient is completely immersed in his gloomy experiences, and external events, even the most joyful ones, do not affect his or her mood. Anxiety arises at the very thought of the need to make some decision or change one’s plans due to suddenly changed circumstances. Anxiety can also manifest itself at the physical level in the form of belching, intestinal spasms, loose stools, frequent urination, shortness of breath, palpitations, headaches, and increased sweating.
The picture of depression is complemented by the disappearance of desires, interests, a pessimistic assessment of everything around us, and ideas of self-blame. Deficiency of vital impulses is manifested in patients with a variety of symptoms – from lethargy, and physical weakness to a state of exhaustion, loss of energy, and complete impotence. Moreover, a person in depression complains of the slowness in mental processes, notes the oppression of instincts, the loss of the instinct of self-preservation, and the lack of the ability to enjoy life (LeMoult & Gotlib, 2019). Another recognized danger of depression is the possibility of suicidal thoughts, which often lead to suicide attempts.
Interventions
Nowadays, effective treatment of depression consists of a combination of pharmacotherapy, psychotherapy, and, if necessary, other types of treatment. At the same time, the main role in therapy belongs to antidepressants – medications specially developed for the treatment of various types of depression. An important additional role in antidepressant therapy is played by tranquilizers – drugs capable of preventing mood swings in various depressive disorders such as lithium preparations or valproic acid salts (Alexopoulos, 2019). When they are systematically taken the clinical manifestations of depression either disappear completely or become less pronounced.
Conclusion
In the drug therapy of depressive states, an unconventional, strictly individual approach is used, with the obligatory cooperation of the patient with the doctor. The patient’s belief in the possibility of recovery and systematic compliance with doctor’s prescriptions largely contribute to the achievement of therapeutic success. Psychotherapy of patients with depressive states is carried out along with drug treatment and assumes several forms such as individual conversations, family and group therapy (Miller et Campo, 2021). An important element of social rehabilitation is participation in the work of mutual support groups of patients who have suffered from depression. This allows the patients to get help with their problems, to realize that they are not alone in their misfortune, and to see the possibilities of personal participation in rehabilitation activities and public life.
Reference List
Alexopoulos, G. S. (2019). Mechanisms and treatment of late-life depression.Translational psychiatry, 9(1), pp.1-16.
Hyland, P., Shevlin, M., McBride, O., Murphy, J., Karatzias, T., Bentall, R. P.,… & Vallières, F. (2020). Anxiety and depression in the Republic of Ireland during the COVID‐19 pandemic. Acta Psychiatrica Scandinavica, 142(3), 249-256.
LeMoult, J., & Gotlib, I. H. (2019). Depression: A cognitive perspective. Clinical Psychology Review, 69, 51-66.
Maurer, D. M., Raymond, T. J., & Davis, B. N. (2018). Depression: screening and diagnosis. American family physician, 98(8), 508-515.
Miller, L., & Campo, J. V. (2021). Depression in adolescents. New England Journal of Medicine, 385(5), 445-449. DOI: 10.1056/NEJMra2033475
Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2022). The serotonin theory of depression: a systematic umbrella review of the evidence.Molecular psychiatry, 1-14.