Blog

Schizophrenia is a very common mental illness. Schizophrenia is characterized by disturbances in perception and thinking. Accompanied by emotional and volitional disorders, as well as behavior that deviates significantly from the norm. The term “schizophrenia” was coined by Bleuler , a Swiss psychopathologist.

Schizophrenia-like symptoms were recorded as early as 2000 BC. Physicians from different eras have periodically described symptoms reminiscent of schizophrenic disorder. Even Avicenna, in his Medical Canon, described a mental disorder that resembled schizophrenia.

Schizophrenia began to be analyzed in more detail only at the end of the 19th century. Kraepelin , a German psychologist, observed adolescents who suffered from various psychoses. Later, it was he who established that in all patients, at a certain stage, a state of special dementia occurs. Then it was called “dementia praecox”. Other psychiatrists gradually expanded information about the emerging symptoms, outcomes of this disease. Bleuler suggested and later proved that the disorder can occur not only in adolescence, but also in more mature years. Later, it was also proved that the characteristic feature of schizophrenia is not dementia, but a violation of the unity of the psyche. The concept was supported by many psychiatrists.

Reasons for the development of schizophrenia

Until now, it has not been possible to establish the main cause of the development of schizophrenia, despite the high level of development of medicine. Most psychiatrists agree that genetic predisposition is one of the main reasons. For example, if someone in the family had schizophrenia, then all blood relatives have an increased risk of developing this mental pathology. That’s just the type of inheritance remains unknown.

Also affected:

– Low social status.
– Poor living conditions. – Poverty. – Dysfunctional family. – Drug addiction.
– Alcohol addiction.
– Traumatic brain injury. – Prolonged traumatic situations.

In some cases, schizophrenia can develop after prolonged stressful situations, but in the vast majority of patients, the disorder occurs spontaneously.

Forms of schizophrenia

Today, there are several forms of schizophrenia.

The paranoid form is the most common form of schizophrenia today. It is characterized by autism, thought disorders, inadequacy of emotions and a decrease in their intensity. The disorder is accompanied by delirium. Delusions can be manifested by ideas of persecution that are not accompanied by hallucinations. Ideas of greatness or ideas of influence may also arise. For example, the patient may claim that someone is working on them, they are being manipulated.

– The hebephrenic form is the most malignant. It is characterized by manifestations of foolishness, childishness, inappropriate excitement. Patients suffering from this form of schizophrenia may laugh, act childish, and then act aggressively, destroying everything in their path. The speech of patients is inconsistent, it can be saturated with invented words, repetitions. In some cases, it may be accompanied by cynical abuse. As a rule, the disorder is detected during adolescence.

– The catatonic form is characterized by significant impairment of motor function. Patients may be in an unnatural and very uncomfortable position for a long time. There is no fatigue. They understand words, commands and requests, but they refuse to respond to them. Complete immobility can be replaced by bouts of excitement, thoughtless and very abrupt actions, movements. In some cases, patients copy the speech, movements and facial expressions of the interlocutor.

– Simple form . For a simple form of schizophrenia, negative symptoms are characteristic. Characteristic is complete indifference to the world around, indifference to oneself, inactivity. Gradually, the patient is protected from the outside world. At first, a person may refuse to work, study, after which he breaks off relations with relatives, friends, and relatives. Often people with this form of schizophrenia wander. Over time, the baggage of knowledge, memories and skills is lost. Now we can talk about schizophrenic dementia.

There are also atypical forms of schizophrenia. Atypical forms include:

Schizoaffective psychosis is a condition in which paroxysmal affective and schizophrenic symptoms occur: hallucinations, delusions, manic, mixed and depressive symptoms. The above symptoms develop during one attack. That’s just the general picture of behavior does not correspond one hundred percent to either schizophrenia or manic-depressive psychosis.

schizotypal disorder. It is characterized by hysteria, obsessive phenomena that resemble neurosis. That’s just a neurosis means a certain reaction to a certain traumatic situation. While it is generally accepted that schizophrenia occurs spontaneously. Simply put, the development of schizophrenia is not a response to a stressful situation.

Febrile schizophrenia, which is an acute form of the disorder. Accompanied by pronounced signs of toxicosis. Patients have a fever, as well as somatic disorders: hemorrhages (both subcutaneous and intraorgan), tachycardia, severe dehydration. There is also a catatonic syndrome, a delusion that has fantastic content. Patients in this state are extremely confused, they can make completely meaningless movements. The patient will not be able to tell who he is and where he is. Febrile schizophrenia is different from neuroleptic syndrome, although we are talking about a similar set of symptoms. The latter may occur after taking psychotropic drugs.

What are rare forms of delusional psychosis

Rare forms of delusional psychosis have several varieties, including:

– Paranoia.
– Late paraphrenia .
– Acute transient psychoses. – Chronic delusional disorders are a separate group of mental disorders, the main (sometimes the only) sign of which is the brand. At the same time, delusional visions cannot be considered a manifestation of schizophrenia, organic or affective disorders.

The main factors that provoke the onset of the disorder are: genetic predisposition, some personality traits, as well as living conditions, environment.

Paranoia is manifested in increased resentment, suspicion, jealousy. Such patients are able to see the catch in every act of another person. They remember grievances for a long time, absolutely do not perceive criticism. Almost everyone with paranoia is treated with caution. Sometimes such patients have ideas of persecution or greatness, as a result of which there are whole conspiracy theories directed against them. A person with such a psychosis can write numerous complaints against an imaginary offender, start lawsuits against him.

After a period of confusion, which is accompanied by insomnia and a constant feeling of anxiety, acute transient psychosis occurs. The main manifestation of psychosis is acute delirium, which has a sensual origin. The structure of delirium is changing quite quickly. The most common are the ideas of persecution, influence, staging. There may also be delusions of a double, as well as false recognitions. Auditory distortions and hallucinations are also common. As a rule, they quickly replace each other.

Features of the course of schizophrenia

Today, there are three main types of schizophrenia:

– Continuous.
– Periodic. – Paroxysmal.

Continuous schizophrenia is characterized by steadily progressive dynamics. This species is divided into several subspecies: malignant, moderately progressive , sluggish.

Symptoms in continuous schizophrenia may fade or worsen. But there is no high-quality fixed remission. Both the social and clinical prognosis for such schizophrenia is unfavorable. The vast majority of patients are forced to undergo inpatient treatment or stay in neuropsychiatric boarding schools. As a rule, as a result, patients receive the first group of disability. It is only after many years that patients experience some relief of symptoms, so that they can stay at home, while remaining disabled.

If we are talking about periodic schizophrenia, there are productive mental disorders that occur only occasionally. They do not entail significant personality changes. The number of periods of exacerbation may be different. For example, one patient may have only one seizure in a lifetime, while another may have more than ten. One attack of schizophrenia can last several days or even months. They can be either identical or completely different from each other. The social and medical prognosis for this type of schizophrenia is very favorable. This can be explained by an insignificant number of personality changes or their complete absence (as a result of persistent intermission ). The prognosis may worsen due to worsening, intensification, or an increase in the frequency of schizophrenia attacks.

The most common is paroxysmal schizophrenia. This type of disorder is characterized by the presence of seizures, which are accompanied by poor-quality remission. Each new attack leads to distortions of the personality, as well as to the fact that delusions become more serious, prolonged and destructive. Social and clinical prognosis depends on the frequency of attacks and their severity. The most unfavorable prognosis is in fur-like schizophrenia, which leads to the rapid formation of a personality defect. But in sluggish fur-like schizophrenia, the prognosis is relatively favorable. Other types of schizophrenia are at intermediate levels.

How to Diagnose Schizophrenia

The diagnosis can be made only after the disease lasts longer than six months. A prerequisite is a violation of the ability to work, as well as violations of social adaptation.

In order to establish schizophrenia in a patient, it is first necessary to exclude the possibility of developing affective disorders, drug addiction, alcoholism, which could also cause psychopathological symptoms. It is very problematic to distinguish catatonic and paranoid schizophrenia from infectious, somatogenic, toxic and traumatic psychoses that occur for a long time.

Schizophrenia is defined by its specific clinical manifestations:

– Emotional dullness.
– Volitional disorders. – Violations of harmonious thinking. – Suicidal behavior in schizophrenics

Suicidal behavior should be understood as actions aimed at the voluntary deprivation of one’s own life. In the context of schizophrenia, one can speak of suicidal behavior only if a person commits them quite consciously. The patient should not be in a psychotic state, and should not have pronounced personality defects. Otherwise, such behavior may be classified as auto-aggressive .

According to statistics, about half of people with schizophrenia have tried to commit suicide over a twenty-year period of the course of the disease. But only ten percent ended in death. Suicidal behavior is a significant reason for contacting a psychologist. The best option would be hospitalization of the patient.

Can schizophrenia be cured?

The vast majority of people with schizophrenia need ongoing skilled care. To provide the necessary care, patients are placed in a psychiatric hospital. Hospitalization will help provide the necessary level of supervision, as well as the ability to record minimal changes in the condition. In addition, psychological tests, research are carried out, as well as the details of the disease are established empirically.

Despite the high level of development of schizophrenia, to date, it has not been possible to find methods that can completely cure schizophrenia. But the methods of therapy that are applied to patients make it possible to almost completely restore the daily and social functioning of the patient, as well as significantly alleviate the condition, minimize the number of relapses. A significant place in the treatment is given to psychopharmacotherapy .

Three groups of drugs are used for treatment:

– Antidepressants.
– Antipsychotics.
– Tranquilizers.

Drugs can be prescribed for various periods: a week, a month, several years, or even for life. It is only important to understand that a positive result will come faster if treatment is started earlier.

Is it necessary to treat schizophrenia with psychotropic drugs?

Antipsychotics are necessary for patients who are in an acute condition. Drugs are selected depending on the symptoms of exacerbations. If a hostile, aggressive mood dominates, neuroleptics are used. They have a sedative effect on the body.

With hallucinatory-paranoid symptoms, it is necessary to prescribe typical antipsychotics. The polymorphism of symptoms also requires the use of typical neuroleptics, which have a broad antipsychotic effect on the body. But sluggish schizophrenia should be treated with small doses of antipsychotics and antidepressants. If we are talking about sluggish schizophrenia, which is accompanied by obsessions and phobias, sedative tranquilizers are used .

Side effects of neuroleptics

For quite a long time, the use of neuroleptics led to their intolerance. Intolerance can be manifested by side effects of the nervous system, as well as the development of complications ( neurolepsy , tardive dyskinesia). To avoid side effects, prescribe those drugs that do not cause or practically do not cause such neurological symptoms. If dyskinesias still appear, the patient is prescribed antiparkinsonian drugs. If there are manifestations of depression, the patient is prescribed antidepressants. It is important to consider that only a doctor can prescribe drugs. It is the doctor who adjusts the dosage and duration of use. It is forbidden to change the dosage or stop taking the drug on your own – this can lead to an increased risk of relapse.

Can schizophrenia be treated without medication?

Other treatments for schizophrenia are also used today:

– Electroconvulsive therapy.
– Insulinocomatous . – Atropinocomatous .

Methods are not considered as priority. But they can be used when other treatments have failed. Art therapy, family therapy and psychotherapy are used for professional and social rehabilitation.

Social rehabilitation is necessary for all patients. Exception: people with schizophrenia who have preserved their ability to work and social adaptation. Even in severe cases of schizophrenia, some patients retain self-care skills. If the patient is undergoing social adaptation, he can be involved in simple labor activities.

Schizophrenia is a serious illness both for the person himself and for those close to him. If the patient is not able to recognize the presence of the disease, his relatives are simply obliged to do this in order to contact a psychiatrist.

Many believe that it is simply impossible to help a patient with schizophrenia. That’s just practice shows that with properly selected and conducted therapy, it is possible to achieve prolonged high-quality remissions, when working capacity is fully restored. The main thing to achieve positive results is to recognize the disease in time and start its treatment.

If treatment is not started on time, a person will usually be hospitalized while in a state of acute psychosis. Relatives and loved ones are the only people who can help bring a person with schizophrenia back to normal life. A positive outcome of treatment directly depends on their participation in the treatment process, as well as support and involvement. If you identify schizophrenia in a friend or family member, immediately contact a psychiatrist.

neurotic depression

Depression is a mental health disorder in which there is a prolonged low mood, combined with feelings of hopelessness, meaninglessness of life, lethargy and irritability. This state arises as a response to a number of biological, psychological and social factors, too difficult, complex events and experiences.

There are 2 types of depression – neurotic and psychotic. According to psychiatrists, neurotic depression is characterized by apathy, insomnia, and anxiety. The disease is most often found in straightforward and rigid personalities, with a sense of duty, uncompromising.

Predisposing factors for the development of neurotic depression are:

• severe stressful situations;
• mental trauma in childhood;
• educational mistakes of parents;
• use of alcohol or drugs;
• functional diseases of the nervous system;
• unfavorable genetic predisposition.

At risk are people with the above factors of depression. Most often, a depressive disorder begins due to the influence of external factors, and not hormonal disorders. The most important role is given to traumatic incidents (for example, sudden stress or prolonged residence in adverse conditions).

What are mental disorders

Depressive neurosis is accompanied by such disorders:

• astheno -neurotic type – manifested by exhaustion of the nervous system, prolonged fatigue;
• anxiety – phobic type – manifested by inexplicable attacks of panic, anxiety, fear;
• anxiety-depressive type – characterized by a combination of anxiety attacks with emotional oppression;
• hypochondriacal type – manifested by the predominance of uncomfortable sensations, because of which the patient is constantly looking for non-existent diseases in himself.

Unlike psychotic, in the course of a neurotic disorder, there is no damage to the mental functions of a person. Therefore, patients retain a normal perception of the world. However, disturbances in the train of thought are noticeable, there may be some somatic symptoms. The patient is able to critically perceive his own condition.

What are the forms of depression

Every healthy person has some level of anxiety. It is necessary in order to effectively adapt to reality and to the challenges in society. The development of neurotic depression leads to the emergence of various pathological conditions in a person:

1. The reactive form of neurotic depression occurs as a result of external factors.
2. The personal form of depression is formed from childhood, depends on personal characteristics, the presence of conflict situations.
3. endogenous depression is formed gradually, against the background of certain events.
4. psychotic depression is not combined with disturbances in the processes of perception of the surrounding world. It usually remains sober and reasonable.

Depressive states are also distinguished by the degree of their severity. With masked or latent depression, the symptoms are mild. The condition of the patients is described as mental suffering. The mood is usually depressed. Patients are concerned about pain in the chest.

In the dysthymic-dysbulic form, the symptoms of obsessive-compulsive disorder increase. Previously existing character traits are sharpened; pessimism prevails in thinking.

At the cyclothymic stage, bouts of melancholy and unmotivated sadness appear. Feelings change throughout the day. Exacerbated somatic disorders.

Signs of depression and nervous exhaustion

Exhaustion of the body on a nervous basis has a characteristic triad. It includes:

• oppression of the emotional sphere;
• suppression of cognitive abilities;
• weakening of psychomotor.

Main mental and physical symptoms:

• persistent headache;
• heart rhythm disturbances;
• feeling of discomfort in the chest area;
• respiratory disorders, the appearance of shortness of breath or a feeling of suffocation;
• indigestion, diarrhea or constipation;
• appetite disorders;
• insomnia or sleepiness at night;
• anxiety;
• a feeling of impending danger that appears at any time of the day;
• irritability;
• thoughts of suicide;
• the emergence of auto- aggressive behavior;
• decrease or complete absence of sexual desire;
• tunnel thinking (monotonous; a person sees only what is under his eyes, does not recognize mistakes);
• negative assessment of what is happening in the world;
• social exclusion.

Be careful: there is no definition for neurotic depression in the ICD-10. Depending on the prevailing symptoms, the pathology under consideration is mainly referred to as recurrent depression or dysthymia.

Consequences of a neurotic disorder

Depression at first does not disrupt a person’s performance and social ties. At first, he still works hard. Such performance is associated with the inclusion of a mechanism of escape from a stressful or traumatic situation.

However, the symptoms of depression gradually increase, and after a few years the patient’s quality of life deteriorates markedly. Personal, educational, social spheres suffer, a person becomes more and more isolated in himself.

The disease can be traumatized into a neurotic personality disorder. The patient is at risk of developing drug addiction. Individuals with depression are more likely to commit suicide in 70 to 80 percent of cases. The statistics are staggering: more than 90% of people who died as a result of suicide suffered from depression.

One of the proven symptoms of depression is suicidal ideation . This concept means a person’s awareness in planning and committing suicide.

Treatment and prevention of depression

There has been some progress in the diagnosis and treatment of depression in recent years. Timely seeking medical help speeds up recovery and prevents the aggravation of the pathology. Unfortunately, the patient does not always start treatment on time. In some cases, he begins treatment when he sees that he cannot cope with the problem on his own . To start therapy, the patient must be active himself, which is problematic, since his strength is depleted. In this situation, the help of relatives and friends is important.

Diagnosis and treatment of this disease is carried out by a psychiatrist, psychotherapist or neurologist. Treatment involves a combination of psychotherapy and medication. Medicines are needed to relieve acute symptoms. Psychotherapy, on the other hand, is prescribed so that the patient realizes the causes and mechanisms of the formation of his illness. In addition, consultations with a psychologist teach a person how to properly respond to stress. This helps prevent the development of depression.

As a rule, depression does not have one cause, so there can be many ways to treat this disease. In the treatment of depression, preference is given to non-drug methods. A psychotherapist may recommend breathing and relaxation training. In some cases, it is recommended to attend group classes.

If neurotic depressive disorder has mild symptoms, the doctor may prescribe tonics and multivitamin preparations for the patient. They stimulate the central nervous system. However, it must be remembered that all medicines cannot be prescribed by oneself: this may worsen the condition of the body even more. In addition, an excessive amount of vitamins is unsafe for humans. Antidepressants that are taken without the permission of a doctor can lead to severe poisoning.

The main way to prevent depressive disorder is the ability to achieve physical relaxation, relieve emotional stress. A person needs to adhere to a normal sleep, work and rest schedule. Meals should be regular. At the first symptoms of depression, you should immediately consult a doctor: delaying treatment is fraught with the development of dangerous symptoms.

Early treatment of depression is the key to a speedy recovery.

Psychologist answers to common questions

How is neurosis different from depression?

These are 2 different mental disorders that have a similar formation mechanism. In some cases, the symptoms of these diseases may be similar. However, there are also differences. With depression, a person does not have any positive emotions, he is dominated by a feeling of hopelessness and gloom.

At the same time, during a neurosis, a certain uncertainty, anxiety, and tension prevail. With neurosis, a person’s thinking is fast, which cannot be said about depression. Moreover, with depression, a certain lethargy is noticeable.

How to overcome fears

To combat the feeling of fear, it is recommended to do the exercise. First, a person should think about the situation that causes anxiety or fear. Next, you need to answer the following questions:

• what thoughts arise when I am overcome by a feeling of fear;
• what is the worst thing that could happen in this situation;
• how else can you explain the reasons for this situation;
• How could I have dealt with situations like this before?

Psychologists have a rich set of training techniques to combat fear and anxiety. At the first pronounced signs of neurotic depression, you should immediately contact a psychiatrist.

Article author

Mikhail Ivanovich Skvira

He graduated from the GomGMU with a degree in General Medicine. Clinical psychologist, Master of Psychology, from 2016 to 2018, a leading specialist in the GOKPB for working with alcohol addiction using the Edelweiss method, author of articles and publications. Marked with gratitude for many years of fruitful work in the healthcare system.
Work experience: 16 years

Treatment of obsessions

Psychiatry is often “mystified”, as a result of which the treatment of mental illness seems to most to be something extremely extraordinary, unknown and complex. And very often this is exactly what happens: the process of treating psychiatric patients, indeed, causes a lot of problems and difficulties.

A psychiatrist is the same doctor as a therapist, cardiologist, ENT, etc.

A very specific attitude towards psychiatry has developed in society, and it is groundless and even ridiculous. Treatment by a psychiatrist, unfortunately, is condemned by people, considered shameful and often hidden from relatives and friends.

It is important to understand that mental illness therapy is the usual treatment for an unusual illness. Now there are not so many differences between the principles of treatment in psychiatry and, say, in therapy (although some “unusual” procedures are still used).

A person should not be more afraid of a visit to a psychiatrist than a visit to a general practitioner, cardiologist or ENT . This, in many ways, is the key to the mental health of the population. Let’s look at what a consultation with a psychiatrist can be like using the example of obsessive-compulsive disorder, the treatment of which is very important due to its wide distribution.

What is obsessional neurosis and should it be treated?

The main goal of treatment is to maximize the quality of life of the patient. If the disease interferes with life, then it is definitely necessary to treat it. Does obsessional neurosis interfere with normal life? To understand this, you need to find out what is commonly understood by this term.

Obsession is the appearance in a person of thoughts or actions that are perceived by him as something alien. A person cannot get rid of them: obsessions make him perform certain actions, while becoming the cause of debilitating mental discomfort.

Manifestations of obsessional neurosis

The most common manifestation of obsessional neurosis is fear, which is very difficult, and sometimes almost impossible, to overcome. Phobias greatly complicate social contacts, work and all other aspects of life.

Another variant of neurosis is, in fact, obsessive thoughts that a person cannot “drive” out of his head. These thoughts interfere with learning, concentration of attention and greatly tire the patient. An important criterion: a person with an obsessional neurosis never realizes his thoughts. The last kind is compulsive . It is manifested by obsessive movements, excessive ritualism.

Examples of obsessional neurosis

It is very easy to explain the essence of this phenomenon with examples. Let’s say you believe that you shouldn’t look in the mirror before you leave the house. However, if you accidentally look in the mirror, you will still leave the house without attaching much importance to it.

Or, for example, a black cat on the road will not make you reschedule your business: you may be a little worried, but soon forget about it. A person with compulsive obsessions, after looking in the mirror, will bolt the door and stay at home all day, and, having met a black cat, will go to the pharmacy for sedatives.

As you can see, obsessional neurosis greatly complicates the patient’s life. So, we can say confidently and definitely: this disease definitely needs treatment, and the treatment must be professional and complete.

Treatment of obsessional neurosis

We found out what this disorder is, what is its danger. Let’s return to the main question: how to treat obsessive-compulsive disorder? There are several options here. It is best to combine them, if possible, because this is how you can achieve the best result.

Here is what is in the “arsenal” of a psychiatrist for patients with obsessive neurosis:

– antidepressants of various types and generations;
– funds that normalize mood ( normotimics );
– psychotherapy.

Now let’s look at each of these points in more detail.

Antidepressants

Antidepressants are a group of drugs that affect certain active substances in the brain. By changing the balance of these active substances, and acting differently on the same substance, antidepressants change the speed and orientation of many mental processes, mood and general condition.

In the treatment of obsessive-compulsive disorder, antidepressants occupy a central place, because only they can restore the possibility of normal communication and full socialization to a person. Proper use of antidepressants guarantees long-term remission without relapse. Sometimes a course of treatment (of course, combined) is enough for a person to get rid of neurosis for life.

In recent years, there have been quite a lot of antidepressants: fundamentally new substances have been synthesized that have fewer side effects, are safer and more effective. Old drugs are gradually leaving the practice of psychiatrists (although they remain in the practice of doctors of other specialties). It is unlikely that a psychiatrist will prescribe you amitriptyline or a similar drug: much more effective substances are now available, the use of which gives a stable, good result without the risk of relapses or treatment failure.

The most popular are antidepressants that affect serotonin receptors. These drugs do not cause drug dependence and have relatively few contraindications. One significant disadvantage of this group of drugs: in the first week of treatment, almost all patients complain of severe, exhausting nausea.

Normotimics

Normotimics are drugs used to correct mood: they ensure its stability, stability and constancy. Interestingly, there is not a single drug that would belong to this group and was created only to normalize mood. All such drugs (even the ancient preparation from lithium salts) originally had a different purpose, and the normothymic effect is a kind of pleasant bonus.

If a person suffers from an obsessive neurosis, his treatment will necessarily include drugs that normalize mood. Like antidepressants, normothymic drugs affect the main links in the pathogenesis of obsessional neurosis, and their combination is considered the most effective method of treatment.

The most commonly used carbamazepine and its derivatives. This drug is still used to treat epilepsy (moreover, its various types), but in addition to the anticonvulsant effect, carbamazepine also has a pronounced normothymic effect. By the way, carbamazepine is a substance that was synthesized from a strong antidepressant. To some extent, this explains such an action and high efficiency in the treatment of obsessive thoughts and, in particular, obsessive movements ( compulsions ).

Psychotherapy

One of the most important aspects of the treatment of obsessions is psychotherapy. Perhaps you notice fear or obsessive thoughts behind you, or maybe you observe obsessive movements in your child, contact a psychiatrist. In this situation, individual psychotherapy is indicated.

The most common direction is behavioral psychotherapy based on neuro-linguistic programming or “body” orientation. After all, in a sense, obsessions are behavioral disorders, so treatment should be directed at him. Behavioral psychotherapy can be combined with suggestive psychotherapy (rarely used as a single treatment).

Suggestion is what is called “suggestion”. This technique is carried out, as a rule, after preliminary preparation: a person is immersed in a state of medical or natural sleep, hypnosis, etc. Sometimes suggestion is practiced with an awake person, who, of course, should be calm and relaxed. This state is most easily achieved with sedatives, although experienced psychotherapists can do without them.

Treating obsessive-compulsive disorder with a psychiatrist – safely and effectively

Here is an approximate scheme for the treatment of obsessive-compulsive disorder. There are no insulin lumps, electroconvulsive therapy or CSF cooling. Only fairly soft drugs and strictly individual, accurate psychotherapy. Neuroses, as a rule, can be cured. To do this, you just need to see a doctor in time, discarding all the usual social prejudices.

MEDICINES FOR DEPRESSION

Depression is one of the most common diseases. In terms of prevalence, it is second only to cardiovascular diseases. And of all those suffering from depression, no more than 20% seek qualified help.

In this article, we will tell you about all the drugs used to treat depression.

All drugs with antidepressant action can be divided into several groups:

Antidepressants

Initially, the drugs in this group were developed for the treatment of depression. Currently, indications for taking antidepressants have expanded. They are also used for other mental disorders: neurosis, personality disorders, aggressiveness, psychosis, schizophrenia. And also for many diseases: chronic pain, irritable bowel syndrome, enuresis, insomnia. Used in practice since 1957. The basis of the action of antidepressants is the restoration of impaired serotonin metabolism. Altered metabolism of neurotransmitters is one of the main mechanisms for the development of depression, so its normalization provides an antidepressant effect. Antidepressants remove the symptoms of depression, they will not have any effect on a person with a normal mood.

List of the most common and effective antidepressants

Tricyclic antidepressants.

Amitriptyline is one of the most powerful and effective antidepressants. In severe depression is the drug of first choice. When administered intravenously and intramuscularly, it acts quickly, therefore it is used in emergency psychiatric care. Among the disadvantages are side effects: drowsiness, dry mouth, blurred vision, mild coordination disorders.

Clomipramine ( anafranil ) – also has a strong antidepressant effect and common side effects. In addition to the antidepressant effect, it reduces obsessions and anxiety.

Imipramine ( melipramine ) – has a pronounced stimulating effect. Effective in depression, flowing with apathy and lethargy. Like all tricyclic antidepressants, it has a large number of side effects (dry mouth, a tendency to constipation, etc.)

Azaphen . Of all tricyclic antidepressants, it is well tolerated, therefore it is often recommended for the elderly and those with concomitant diseases of the internal organs.

Monooamine oxidase (MAO) inhibitors

Nialamide . The drug of the first generation of this group, went out of practice many years ago.

Pyrazidol . Highly effective broad-spectrum antidepressant with minimal side effects. It also applies today.

Moclobemide ( Aurorix ). It has an anti-anxiety effect, which makes it effective in depression accompanied by social phobia and anxiety.

Selective norepinephrine reuptake inhibitors

Maprotilin ( Lyudiomil ). He showed himself well in depression with fatigue, loss of feelings, lethargy. A big plus of this drug is the presence of forms in the form of ampoules that allow it to be administered intravenously, which makes it possible to quickly onset of a therapeutic effect.

Doxepin ( sinequan ). Rarely used drug.

Selective (selective) serotonin reuptake inhibitors SSRIs

These antidepressants are currently the most commonly prescribed. They achieved such “popularity” due to a number of advantages: they are effective, easy to dose, well tolerated, and widely advertised by pharmaceutical companies . There are only seven of them, in terms of their effectiveness they are approximately the same:

Selective norepinephrine and serotonin reuptake inhibitors

This group is effective in resistant (not amenable to traditional treatment) depression.

Antidepressants receptor blockers

Medicines of this group are distinguished by the presence of a sedative effect and restoring sleep action.

A new class of antidepressants

It is characterized by a weak antidepressant effect, but excellent tolerance: side effects are extremely rare. Used for mild depression.

Agomelatine ( Valdoxan ). Normalizes sleep.

Vortioxetine ( brintellix ). Improves cognitive functions.

Normothymic drugs

Medicines in this group have an antidepressant effect only in cases where the depressive state is caused by chronic affective diseases, such as bipolar affective disorder (BAD, manic-depressive psychosis), cyclothymia, dysthymia, schizoaffective disorder. Most commonly used medicines:

Carbamazepine ( Finlepsin )

Depakine chrono

Lamotrigine ( lamiktal )

lithium carbonate

Antipsychotics

Despite the fact that most antipsychotic drugs depress the nervous system, among them there are drugs with antidepressant action:

Flupentixol ( Fluanxol ). It gives an antidepressant effect only when prescribed in small doses (less than 2 mg per day).

Aripiprazole . Effective in depression as part of bipolar affective disorder and schizitypal disorders.

Levomepromazine ( tisercin ). Assign with endogenous depression, accompanied by insomnia.

tranquilizers

Bromodihydrochlorophenylbenzodiazepine (Phenazepam). The drug of choice for neurotic conditions with depression, post- stress conditions. That is, in cases where short-term treatment is required.

Clonazepam. Strong anti-anxiety and sedative effect. Long-term use causes addiction.

Alprazolam . Prescribed for anxiety and depression. Recommended for short courses (no more than 10 days) due to the risk of addiction and dependence.

Nootropics and metabolic agents

The funds of this group help to get out of a depressive state that has developed against the background of stress, overwork, encephalopathy, the effects of injuries and poisoning. By improving the blood supply to neurons and energy metabolism within cells, they contribute to the activation of cognitive functions and memory. The most effective drugs in this group:

Aminalon (GABA)

Piracetam ( nootropil )

Pyriditol ( encephabol )

B group vitamins.

herbal remedies

Among a large number of herbal remedies, the most effective and trustworthy doctors were preparations based on St. John’s wort:

Amino acids

Glycine. The most effective drug of this group. In addition to an independent antidepressant effect, it has the ability to enhance the antidepressant effect of drugs from other groups (antidepressants, mood stabilizers ).

Glutamic acid. It is used when depression is combined with neurological diseases and mental retardation.

Psychostimulants

Caffeine. Caffetamine (drug containing caffeine)

Phenamine. In our country it is forbidden to use. In some Western countries, it is used by doctors to achieve a rapid antidepressant effect.

Sidnocarb ( Mesocarb ). Domestic effective stimulant, unfortunately, is currently not available due to low demand and stoppage of production.

What drugs for depression can be obtained at the pharmacy without a prescription

Only preparations from the group Herbal remedies and Amino acids. All other funds are purchased only with a prescription from the doctor of the clinic. Alprazolam , phenazepam, clonazepam and tizercin are prescribed on special accounting forms 148 forms.

What medications for depression can cause addiction

Most antidepressants are non-addictive and non-addictive. Exception: drugs from the group of tranquilizers: phenazepam, alprazolam , clonazepam.

Are there non-drug treatments for depression?

In addition to medications, there are many non-drug treatments for depression. These are psychotherapy, biofeedback therapy, diet therapy, physiotherapy, exercise therapy, reflexology, light and color treatment, sleep deprivation, etc. Most often, a combination of several methods is used to treat depression. For example: psychotherapy + drug treatment, biofeedback therapy + psychotherapy, medication + diet therapy, etc.

It is impossible to prescribe and apply medicines on your own. If you or your loved one is faced with the problem of depression, you need to see a psychiatrist or psychotherapist! Only according to his recommendations can drugs be used. Self-medication is life-threatening!