Wednesday, July 22, 2009

HELP WITH Depression

Modern approach to treatment of depression involves a combination of different methods - a biological therapy (medication and non medication) and psychotherapy.

Medication.
Appointed patients with mild, moderate and severe forms of depression. A prerequisite for effective treatment is the cooperation with your doctor: strict adherence to the prescribed regime of treatment, frequency of visits to the doctor, a detailed, frank account of his condition and life difficulties.

Antidepressants.
Proper treatment makes it possible in most cases, completely eliminate the symptoms of depression. Depression requires treatment by specialists. The major class of drugs for the treatment of depression is antidepressant medication. Currently, there are various medications of the group, including tricyclic aptidepressanty (amitriptyline, melipramin) and used since the late 50's. In recent years, the number of antidepressant drugs has increased significantly.

The main advantages of new generation antidepressants are to improve portability, reduction of side effects, reduction of toxicity and high safety in overdose. New fluoxetin include antidepressants (Prozac, profluzak) sertralin (zoloft), tsitalopram (tsipramil), paroxetine (Paksi) fluvoksamin (fevarin) tianeptin (koaksil), mianserin (lerivon) moklobemid (auroriks) milnatsipran (iksel) , mirtazapin (remeron) and other antidepressants are a safe class of psychotropic drugs, when properly applied according to recommendations of a doctor. Dose is determined individually for each patient. You must know that the therapeutic effects of antidepressants may occur slowly and gradually, so it is important to positively set up and wait for his appearance.

Antidepressants are not addictive and the development of the syndrome, as opposed to the abolition of the class of drugs benzodiazeninovyh tranquilizers (fenazepam, relanium, elenium, tazepam and others) and is widely used in our country korvalola, valokordina. In addition, benzodiazepinovye tranquilizers and phenobarbital, are part of korvalola and valokordina with long-term use reduces the sensitivity to other psihofarmakologicheskim means.

The main stages of therapy.

* Definition of treatment: the choice of antidepressant in the light of the major symptoms of depression for each patient, the selection of adequate doses of medication and individual treatment
* Implementation of the basic course of therapy aimed at reducing symptoms of depression up to their disappearance, the restoration of the former characteristic of patient activity
* Carrying out maintenance treatment for 4-6 months or more after the normalization of the state. This phase is aimed at preventing the worsening of the disease

What usually prevents the holding of medical treatment:

* Misconceptions about the nature of depression and the role of medication
* A common misconception about the harm of all unconditional psychotropic drugs: the emergence of dependence, a negative effect on internal organs. Many patients believe that it is better to suffer from depression than taking antidepressants
* Many patients interrupt reception in the absence of a rapid effect, or occasionally taking drugs

It is important to remember that numerous studies confirm the high efficacy and safety of modern antidepressants. Damage caused by depression and emotional well-being, according to the severity nesopostavim small and easily removable side effects that sometimes occur when using antidepressants. It should be remembered that the therapeutic effects of antidepressants is often only 2-4 weeks after the start of the reception.

Psychotherapy.
Psychotherapy is not an option, but an important addition to the medical treatment of depression. In contrast to the pharmacological treatment of psychotherapy involves a more active role in patient care. Psychotherapy helps patients develop skills for emotional self-regulation in the future to better cope with the crisis, not plunging into depression.

In the treatment of depression as the most effective and science-based approach proved to three: psychodynamic psychotherapy, cognitive behavioral psychotherapy, and psychotherapy.

According to psychodynamic therapy, psychological basis of depression is the internal unconscious conflicts. For example, the desire to be independent and simultaneous desire to receive a large amount of support, assistance and care from other people. Another characteristic is the presence of intense conflict of anger, resentment on others, combined with the need to always be kind and good and to keep the location of loved ones. The sources of these conflicts lie in the history of the patient's life, which becomes the subject of analysis in psychodynamic therapy. In each individual case may be its unique content of conflicting emotions, and therefore require individual psychotherapeutic work. The aim of therapy - awareness of the conflict and in its constructive resolution: to learn how to balance independence and closeness, to develop the ability to constructively express their feelings and to keep that relationship with people. Behavioral Psychotherapy is aimed at resolving the current problems of the patient withdrawal, and behavioral symptoms: passivity, denial of pleasure, monotonous way of life, isolation from the others, the inability to plan and engage in purposeful activity.

Cognitive psychotherapy is a synthesis of both the above approaches, and combines their advantages. It combines work with the current life difficulties and behavioral symptoms of depression and work with their internal psychological sources (depth and beliefs). The main psychological mechanism of depression in cognitive psychotherapy is considered the so-called negative thinking, which is reflected in the tendency of depressed patients to consider all that happens to them in a negative light. Changes of this kind of thinking requires a careful individual work, which aims at developing a more realistic and optimistic look at ourselves in the world and in the future.

Additional forms of psychotherapy of depression are marital counseling and group therapy (but not all, but specially designed to help depressive patients). Their involvement can be of great assistance in treatment and rehabilitation.

What usually prevents the treatment of psychological help?

* Low awareness of people about what psychotherapy
* Fear of initiation of foreign rights in the personal, intimate experience
* Skepticism that «talk» can provide significant therapeutic effect
* The notion that psychological problems have to handle yourself in a reference to another person is a sign of weakness

In modern society, psychotherapy is a recognized, effective way to help with various mental disorders. Thus, the rate of cognitive psychotherapy significantly reduces the risk of recurrence of depression. Modern methods of psychotherapy focus on short-term (10-30 sessions, depending on the severity of condition) effectively. All information received by a psychotherapist in session is strictly confidential and remains confidential. A professional psychologist trained to work with heavy feelings and difficult life situations of others, he knows how to respect and assist in coping with them. Every person in life there are situations (such as illness), with whom he could not cope alone. The ability to ask for help and accept it is a sign of maturity and rationality, rather than weakness.

Assistance to relatives of people in overcoming depression
Support for relatives of people, even when the patient does not express interest in it is very important to overcome depression.
In this regard, you can give the following advice to relatives of patients:

* Remember, depression - a disease in which you want sympathy, but neither koem if you can not dive into the disease along with patients, sharing his pessimism and despair. You need to be able to maintain a certain emotional distance, all the time reminding themselves and the patient that depression - this is a transient emotional state
* Studies have shown that depression has adversely especially in those families where they do a lot of criticism of the patient. Try to understand the patient that his condition - it is not his fault, and the trouble that he needs the help and treatment
* Try not to focus on the illness of a person and bring positive emotions in their life and family life. If possible, try to involve the patient in some useful activity, but not remove it from the cases