What Is Endogenous Depression?

The etiology of this disease is not very clear at present, and may be related to psychosocial factors, genetic factors, neuroendocrine and central neurotransmitter dysfunction, see related content. These factors are intricate, intertwined, and vary from person to person. Fortunately, in most cases, they do not prevent doctors from diagnosing the disease and taking effective treatment measures. ^[1]

Endogenous depression

Depression is generally divided into two categories, exogenous and endogenous. The so-called exogenous usually refers to depression caused by external environmental events, which is the result of response to mental stimulation events such as frustration, unfortunate events in life, work and study stress. Such as reactive depression, depressive neurosis and so on. Endogenous is depression caused by "internal" factors in the body, with obvious biological characteristics, such as prominent genetic components, and is a common type of depression. This depression is described below. It is a group of mental disorders with the basic characteristics of persistent depression, which can be accompanied by changes in thinking and behavior, and often has physical symptoms such as sleep disorders, decreased appetite, dry mouth, and constipation.

Causes and pathogenesis of endogenous depression

Clinical manifestations of endogenous depression

Endogenous depression can be divided into bipolar disorder and unipolar disorder according to the characteristics of its course. Bipolar disorder has two episodes of mania and depression. Patients with manic episodes exhibit high emotional, relaxed, happy, self-conscious, energetic, and agile thinking. They often overestimate their talents, status, pretentiousness, and exaggerated ideas. Unipolar depression means that there is only a depressive episode in the history and no history of manic and manic episodes. Most of the endogenous depressions seen in the clinic belong to this category, so the following mainly introduces the clinical manifestations of depression.

1. Emotional symptoms. The main feature is low mood, which can range from mild depression to sadness, depression, depression, and even pessimism and despair. Patients often feel heavy, lose enthusiasm and fun for life and work, be pessimistic and disappointed in their future, cannot find the value and meaning of life, and feel that "it is better to die than to live", accompanied by strong self-blame, guilt and useless Sense, look at your past, present, and future in a negative manner ^[3] .

2. Thinking changes. Obviously slow thinking, I feel that it is difficult to think about problems. I often complain that "the brain has become stupid", "I will not think about problems anymore". He speaks lowly, slowly, and with a small amount of speech. He has distorted cognitions of the past and the future, depreciating himself excessively, and always making himself useless. With the worsening of symptoms, some will gradually develop into a delusion of self-guilt based on the concept of self-blame and guilt, thinking that they have serious sins and will be punished. There can also be poverty, suspicion, and nothingness.

3. Behavior change. Reduced activity, subjective feelings of inadequacy, fatigue, and weakness, although daily activities continue, but mechanically passive. They are far away from the lively scenes in life, and like to be quiet and alone. In severe cases, they can not speak, refuse to eat, and cannot complete daily life.

4. Physical symptoms. Most patients are accompanied by sleep disorders, loss of appetite, poor digestive function, weight loss, dry mouth, constipation, decreased libido, and various physical discomforts such as palpitation, chest tightness, belching, nausea, and so on.

Endogenous depression diagnosis

The patient's state of mind is low and is not commensurate with the situation they are in. It can range from sullen to distressed, and even a state of rigidity. In severe cases, psychotic symptoms such as hallucinations and delusions can occur. Depression lasts for at least 2 weeks, during which time there are at least four of the following symptoms:

1. Lost interest in daily activities and no sense of pleasure.

2. The energy is obviously diminished and the fatigue continues.

3, psychomotor retardation or agitation.

4, self-evaluation is too low, self-blame, guilt.

5. Associative difficulties, decreased thinking ability.

6, repeatedly want to die, suicide.

7, insomnia or early wake up, or too much sleep.

8. Loss of appetite or weight loss.

9. Decreased libido.

10. Low mood, loss of interest and happiness, easy fatigue, if it lasts for more than two weeks without reason, or even no improvement for several months, it is usually regarded as the most typical symptom of mild depression. ^[4]

Differential diagnosis of endogenous depression

1. Neurasthenia. Mild depression often has complaints of dizziness, headache, weakness, or insomnia, and is easily misdiagnosed as neurasthenia. However, there are certain psychological factors before the onset of neurasthenia, such as long-term tension, excessive brain use, anxiety and vulnerability as the main emotions, excitement, fatigue and muscle tension pain. Good self-awareness, fluctuating symptoms, and earnestly seek treatment. Endogenous depression is mainly depression, accompanied by slow thinking, self-blame, self-incrimination, dying and biological symptoms (such as light day and night, loss of appetite and sexual desire), loss of self-knowledge, and more inactive treatment . Depression symptoms of depressive neurosis are more prominent than neurasthenia.

2. Schizophrenia. Schizophrenia's emotions are not depression but indifference or indifference, expressions are dull, and emotional activities are not coordinated with inner experience and surrounding environment. In addition, its delusional content is ridiculous, and has nothing to do with mood. Tension schizophrenia is similar to depressive wood stiffness, but it is still possible to get some response when deeply exposed to depression patients, and patients can show depression.

3. Reactive depression. Although it shows emotional depression, depression, etc., its emotional origins have more specific and precise objects and events. The psychological experience is strong. It often complains to others about its misfortunes. It can reduce the environmental symptoms, shorten the course, and generally does not recur. . In addition to depression, endogenous depression often has delusions of guilt, significant reduction in exercise, lack of psychogenic experience, and the specific origin of depression is often unclear. In addition, there have been similar episodes in the past, with symptoms that vary from day to night and light nights, and the course of the disease can be delayed for several months.

4. Bipolar disorder (mania-depression). Most cases occur before the age of 50. Recurrent attacks tend to be completely normal between attacks, with each attack lasting from 3 months to half a year.

5. Unipolar disorder (only depression). Onset at any age. Recurrent. About half of those with major depression relapse in the second year after the first episode, and some may become chronic after the first episode. It is worth mentioning that about 15% of patients with recurrent major depression eventually died of suicide. ^[5]

Five major dangers of endogenous depression

1. Driving people to extremes: The most serious harm is the emergence of patients' self-harm and suicidal thoughts and behaviors. Depressive mood can cause negative thinking and pessimism in patients with depression, always immersed in self-condemnation and inferiority, pessimistic despair of the future.

2. Physical torture is constant: the harm is not only the damage to mental health, but also it can bring a lot of physical symptoms. Such as loss of appetite, fatigue and so on. These physical discomforts can involve various organs, and symptoms of autonomic dysfunction are more common. Depression patients' physical symptoms are often unfounded, and most of them are non-specific and difficult to locate, but they do not necessarily exclude physical diseases.

3. Persistent bad mood: A common danger of depression is that patients will experience the most painful and bad mood. And this kind of pessimism has no obvious external cause, 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 are always accompanied. Menopausal depression is a typical example. Such patients with depression not only feel depressed, but also have inexplicable anxiety of nervousness and panic.

4. Destroy people's spirit: The second manifestation of the great harm of depression is that it can make a normal person who is full of energy become sluggish all day long, and in severe cases, it will still appear dumb. In addition, depression patients have no interest in everything around them. They have no enthusiasm for work and study. They are slow to reflect their thoughts, and they often become sloppy with neat people.

5. Deprivation of sleep: Depressive patients often have intractable sleep disorders, which are manifested as insomnia, difficulty in falling asleep, early awakening, sleep disorder, and poor sleep quality. ^[6]

Endogenous depression treatment

There are many treatment methods, commonly used are drug therapy, electric shock therapy and psychological therapy. It can be used reasonably according to different depression situations. ^[7]

Endogenous depression medication

Tricyclic antidepressants are still used as first-line drugs for the treatment of depression. Second-generation atypical antidepressants are second-line drugs. The efficacy of various tricyclic antidepressants is comparable, and clinical choices can be made according to the strength of depression and sedation, side effects, and patient tolerance. Imipramine and normipramine have weak sedative effects and are suitable for patients with depression due to psychomotor retardation. Amitriptyline and doxepin have strong sedative effects and can be applied to patients with anxiety, agitation, and insomnia. However, tricyclic drugs have large anticholinergic and cardiovascular side effects, so they should be paid attention to when they are applied. There are many second-generation atypical antidepressants. The selective 5-HT reuptake inhibitors fluoxetine, paroxetine, and sertraline are widely used with small side effects, good safety performance, and long-term maintenance. treatment. ^[8]

The treatment of bipolar depression is the same as that of unipolar depression. However, the application of antidepressants in bipolar patients may turn into hypomania. Therefore, antidepressants and lithium carbonate are often used in combination.

For patients with depression accompanied by hallucinations and delusions, antipsychotic drugs such as perphenazine and sulpiride are often required.

Physical therapy for endogenous depression

By increasing the secretion of 5-HT, promoting the release of norepinephrine, enhancing the excitability of nerve cell activity, and thereby reducing the depression of individuals. By promoting the secretion of endorphin with a sedative effect, patients can maintain a relaxed and comfortable mental state, which is conducive to better alleviate the previous negative and depressed emotional state. In addition, through the improvement of patients' brain waves and the improvement of various physiological indicators, it plays a role in improving various physical symptoms of depressed patients.

At present, the more mature method abroad for physical therapy is transcranial microcurrent stimulation therapy (CES for short). There are alpha-stim, fisherwallace, health pax and so on. At present, only alpha-stim scs is introduced in China (Chinese: Ansidin)

Treatment of endogenous depression with electric shock

. Patients with depression should strictly prevent suicide and suicide. For people with a strong sense of suicide, electric shock can be used to obtain immediate results. Drugs and consolidation should be used after the condition is stable.

Endogenous depression psychotherapy

Psychotherapy is very important in the treatment of this disease, but it is usually combined with drug therapy. For the specific methods and steps, please refer to the relevant content of this book.

Endogenous depression prevention

Depression can seriously affect a person's quality of life, light affect the mood, not interested in things, affect sleep, and at the same time become mentally debilitating, produce worldly feelings, and even tragedy of suicide.

method:

1. Resolve the pressure of thought first: talk to me-it is the most effective early response method in my opinion, because people can't always treat themselves in isolation, let alone suppress themselves in an indifferent way. We must know a lot Chronic diseases, such as the frequent cerebrovascular disease in recent years, cannot exclude the stimulation of these factors. I think that in addition to family members' talk, the way to talk to trusted friends in your life is the best way to detox, because, in this way Not only can increase the communication between friends, but also cultivate and deepen the friendship between each other.

2. Singing therapy: You can go to the karaoke room with your friends and sing loudly and unrestrainedly, release the depression in your chest, and have great benefits in regulating your emotions and releasing stress.

3. Affirm yourself in time: To prevent depression, self-affirmation is an essential link. Before going to bed every night, you must fully affirm your achievements and progress this past day, and do not talk about negative things. The best way to keep a diary is to keep good experiences, progress, and achievements in the diary. I keep my diary like this every day, I think life will become more and more interesting. ^[9]

4. Sports Therapy: Swimming first, swimming regularly and quantitatively 1-2 times a week is the best way to keep my body and mind healthy and relieve stress in recent years. After each swim, I will feel my body and mind Relaxed, refreshed, and quick-minded. Followed by a walk after dinner is also a good way. It is best to choose a quiet garden walk and see the lushness of flowers and trees, people's mood will calm down quickly, rational thinking, eliminate troubles, once walking If you develop a habit, you will deeply appreciate its many benefits.

5. Broaden your horizons: cultivate your interest in reading and enrich your spiritual life. You can also browse the web pages you are interested in and listen to the radio in your spare time to learn about the daily news in the world. Try not to let that negative emotion. Encroach on one's consciousness.

6. Do something meaningful, do something meaningful can keep a healthy and happy mood, try to do three things every day, it does not matter the size, even if it is a smile or learning to cook a dish, as long as you think there is Meaning things, you will feel happy.

7. Reasonable diet, pay attention to your eating habits, ensure comprehensive nutrition, and strengthen your physique. This will have a strong protective effect on your body. ^[10]