A disease state characterized by depression. Its characteristics are: low mood, slow thinking, reduced language movements and sluggishness. Its onset forms: mild depression, depression without psychotic symptoms, depression with psychotic symptoms, recurrent depression. See: Depressive neurosis (F34.1) (depressive neurosis) ICD-10 pointed out that in the past it meant that there was no obvious endogenous depressive symptoms, but a causal connection with stress events, and a personality related to maladjustment. The available evidence shows that there is no homogeneous clinical disease that meets all criteria. CCMD-3 does not use this term. See: endogenous depression; dysthymia. The performance of depressive episodes can be divided into three aspects: core symptoms, psychological symptoms and physical symptoms.
What is the Core symptoms of depression ?
Depressive episodes are disease states characterized by depression. Its characteristics are: low mood, slow thinking, reduced language movements and sluggishness. Its onset forms: mild depression, depression without psychotic symptoms, depression with psychotic symptoms, recurrent depression. The core symptoms of depression include low mood or mood, lack of interest, and loss of pleasure. The diagnosis of depression should include at least one of these three symptoms.
The patient experiences depression and sadness. The mood tone is low and gloomy. Patients often complain that they are in a bad mood and cannot be happy. Patients with depression can often distinguish the pessimism and sadness they experience in a depressed state from the sadness caused by the loss of relatives and friends. This is the “special nature of depression” that is often mentioned in the diagnosis. It is the difference. One of the symptoms of “primitive” and “reactive” depression.
On the basis of a depressive episode, the patient will feel hopeless, helpless and useless.
- Despair: Feeling disappointed with the future and thinking that there is no way out. This symptom is closely related to the concept of suicide, so it should be differentiated in clinical practice.
- Helplessness: It is a symptom closely related to despair, lack of confidence and determination to change one’s current situation. The common narrative is to feel that one’s current situation such as the disease state cannot get better, and lose confidence in treatment.
iii. Useless: I think my life is worthless, full of failures, and useless. Think that what you bring to others is only trouble, and will not be useful to anyone. Think that others will not care about yourself.
Lack of interest
It means that the patient lacks interest in various previously favorite activities, such as entertainment, sports, hobbies and so on. The typical person lacks interest in everything, good or bad, lives alone, and does not want to see people.
Loss of fun
It means that the patient cannot experience pleasure from life, or it is called anhedonia.
The above three main symptoms are interrelated and can appear in the same patient at the same time, acting as cause and effect for each other. But there are also many patients who are only prominent in one or two of them. Some patients do not think that they are in a bad mood, but are not interested in surrounding things. Affected depression patients can sometimes participate in some activities under the boring situation, mainly activities that they participate in alone, such as reading books, watching movies, TV, and engaging in sports activities, etc. On the surface, the patient’s interest still exists, but further inquiries It can be found that patients cannot have fun in these activities. The main purpose of engaging in these activities is to kill time, or hope to get rid of pessimism and disappointment.
What is Psychological symptom cluster ?
Depressive episodes contain many psychological symptoms, which can be divided into psychological accompanying symptoms (anxiety, self-crimination, psychotic symptoms, cognitive symptoms and suicidal ideas and behaviors, insight, etc.) and psychomotor symptoms (psychomotor Sexual excitement and psychomotor agitation etc.).
Anxiety and depression often accompany, and often become one of the main symptoms of depression. Subjective anxiety symptoms can be accompanied by some physical symptoms, such as chest tightness, rapid heartbeat, frequent urination, sweating, etc. Physical symptoms can cover up subjective anxiety experience and become clinical complaints.
The patient has some slight negligence in the past
Or add blame for the mistake, thinking that what you did is disappointed by others. Believe that his illness brings a huge burden to the family and society. In severe cases, the patient will “online on the line” without limitation for his own faults, reaching the level of delusion.
Mainly delusions or hallucinations. The content that is in harmony with the depression is called the delusion that is in harmony with the mood, such as the delusion of sin, worthless delusion, physical illness or disaster delusion, mocking or condemning auditory hallucinations, etc.; and the content is not in harmony with the depression Delusions that are not in harmony with the state of mind, such as being persecuted or self-invoking delusions, auditory hallucinations without emotion, etc. These delusions generally do not have the characteristics of schizophrenia, such as primary, absurdity and so on.
The cognitive symptoms associated with depression are mainly decreased concentration and memory. Such symptoms are reversible. Alleviate with the effective treatment. Cognitive distortion is also one of the important characteristics, such as making pessimistic explanations of various things, and seeing everything around as gray.
Suicidal ideas and behavior
About half of people with depression have suicidal ideas. People who are mild will often think of content related to death, or feel that life is meaningless and boring; in addition, life is worse than death, hoping to die without pain; after that, they will actively seek suicide methods. Depression patients will eventually die by suicide in 10%-15%. Occasionally, patients will have so-called “expanded suicides”. Patients can kill several people before committing suicide, leading to extremely serious consequences. Therefore, it is definitely not a “benign” disease that can be cured or not. Active therapeutic intervention is very necessary.
Psychomotor retardation or agitation
It is more common in so-called “endogenous citation” patients. Psychomotor retardation patients are psychologically manifested by the slowness of thinking activation and the slowness of thinking. The patient described it as “the brain seems to be not lubricated”. At the same time, it will be accompanied by a decrease in concentration and memory. In action, it is manifested as slow movement and decreased work efficiency. In severe cases, it can reach the level of stupor. The agitated patient is the opposite, thinking repeatedly in the mind without purpose, thinking content is unorganized, and the brain is constantly in a state of tension. However, because one cannot concentrate on thinking about a central issue, the efficiency of thinking is reduced and creative thinking cannot be carried out. In terms of behavior, they are irritable, nervous and agitated, sometimes unable to control their movements, but do not know why they are irritable.
A considerable number of patients with depression have complete self-awareness and actively seek treatment. People with obvious suicidal tendencies may be distorted or lack a clear understanding of their current state, or even completely lose their desire to seek treatment. Those with psychotic symptoms have incomplete or even complete loss of insight. Patients with bipolar depressive episodes are not as complete as patients with unipolar depression.
What is Physical symptom group ?
Sleep disturbance, appetite disturbance, sexual dysfunction, non-specific physical symptoms such as pain, general discomfort, autonomic dysfunction, etc.
It is one of the most common accompanying symptoms of depression and the chief complaint of many patients. Manifestations include early insomnia, mid-stage insomnia, end-stage insomnia, lack of sleep and so on. Among them, early insomnia is the most common, and terminal insomnia (early awakening) is the most characteristic. Unlike these typical manifestations, snooze can occur in patients with atypical depression.
Mainly manifested as decreased appetite and weight loss. The incidence of loss of appetite is about 70%. Mild cases show unsatisfactory food, but the amount of food consumed may not be significantly reduced. At this time, the patient’s weight change may not be obvious for a period of time; severe cases completely lose the desire to eat, weight loss significantly, and even malnutrition. Patients with atypical depression have hyperappetite and weight gain.
Decreased sexual function
It can be a decrease in libido or even a complete loss. Some patients barely maintain sexual activity, but cannot experience pleasure from it.
Manifested as listlessness, fatigue, weakness, laziness, and reluctance to meet people. Sometimes accompanied by psychomotor retardation. Lack of energy or fatigue is the core symptom of a depressive episode.
Morning heavy and night light
That is, emotions increase in the morning. When the patient opened his eyes in the morning, he was worried about the new day and couldn’t help himself. In the afternoon and evening, it is alleviated. This symptom is one of the typical manifestations of “endogenous depression”. The symptoms of some psychogenic depression patients may worsen in the afternoon or evening, on the contrary.
Non-specific physical symptoms
Depression patients sometimes complain of such symptoms, so they wander in general hospital clinics for a long time. The difference from hypochondriasis is that these patients only complain about such symptoms and hope to get the corresponding treatment, but they do not have a strong association with hypochondria, thinking that they have an incurable disease. Of course, it is not uncommon for depression to be accompanied by hypochondriasis. Such non-specific symptoms include headache or general pain, general discomfort, gastrointestinal dysfunction, palpitation, shortness of breath and chest pain, frequent urination, urination, etc., and are often diagnosed as various peripheral nerve disorders in general hospitals.
What is Depression harm ?
Push people to desperation
The most serious consequences are the occurrence of self-harm and suicidal thoughts and behaviors. Depressive mood will cause depression patients to think negatively and pessimistically, always immersed in self-condemnation, low self-esteem, and pessimistic and hopeless about the future.
Continuous physical torture
The harm is not only the damage to mental health, but it also brings a lot of physical symptoms. Such as loss of appetite, fatigue, etc. These physical discomforts can involve various organs, and symptoms of autonomic dysfunction are more common. The physical symptoms of depression patients are often unsubstantiated, and are mostly non-specific, difficult to locate, but it is not necessary to exclude physical diseases.
Persistent mood disorders
One of the common dangers of depression is that it makes the patient experience the most painful and bad mood. And this kind of pessimism appears without obvious external causes, so it is very difficult to solve, so that the mood of patients with depression is always pessimistic. On the other hand, depression and anxiety always accompany, represented by menopausal depression. Such patients with depression are not only depressed, but also inexplicably nervous, panic and anxiety.
Destroy the human spirit
The second manifestation of the great harm of depression is that it can turn a normal person who was full of energy into listless all day long, and in severe cases, it will appear dull. In addition, patients with depression have no interest in everything around them, have no enthusiasm for work and study, have slow thoughts, and become unruly with neat people.
Depression patients often have intractable sleep disorders, manifested in the form of insomnia, difficulty falling asleep, waking up early, disordered sleep patterns, and poor sleep quality.