Депресията – най-разпространената болест на Душата

Депресията е състояние, което не преминава само и е необходима консултация с психолог.

ТЪГАТА

Тъгата е усещане, което всички изпитват, и е нормална реакция в трудни времена от живота, която преминава след известен период от време. Когато човек има депресия обаче, тя засяга нормалното му функциониране. Депресивното разстройство не е знак, че човекът е слаб или безхарактерен, тя просто е състояние, което се нуждае от лечение. От него в определен момент от живота страда една четвърт от населението на земята.

Болестта на тъгата

Според класификацията на Националния институт за ментално здраве на САЩ тъгата е само малка част от депресията, а някои хора с депресия може изобщо да не изпитват тъга. Депресията има много други симптоми, в това число и физически. Човек страда от депресия, ако някой от следните симптоми продължава повече от 2 седмици – постоянна тъга, тревога или усещане за празнота, чувство на безнадеждност, песимизъм, чувство за вина, безпомощност, чувство за липса на собствена значимост, загуба на интерес към удоволствията от живота, към практикуване на любимите хобита, спад на енергията, лесна уморяемост, усещане за липса на бързина, трудна концентрация, намалена памет, трудност при вземане на решения. Към симптомите могат да се прибавят трудното заспиване, ранното сутрешно събуждане и свръхсънливостта, повишеният апетит и промените в теглото, раздразнителността, припряността и мислите за самоубийство.

Какво отключва депресията

 

Много фактори могат да отключат депресия, но сред най-разпространените са загубата на любим човек или приятел, трудни връзки, преживени в детството тежки събития или някаква стресова ситуация.

 

Депресията може да се отключи във всяка възраст, но обикновено започва в тийнейджърските години или ранните 20 или 30 години. Повечето хронични разстройства, които влияят върху възрастните, започват с повишена тревожност в детството.

 

Депресията може да се появи отново, съпровождаща сериозни болести като диабет, рак, сърдечна болест или болест на Паркинсон, като тя може да влоши тези заболявания, както и те нея. Понякога лекарствата за тези болести могат да предизвикат странични ефекти, които да подсилят депресията.

Всяка депресия е различна

 

Не всеки, страдащ от депресия, проявява всеки неин симптом. Тежестта и честотата на симптомите, както и тяхната продължителност, зависят от индивида и неговите специфични заболявания, като симптомите могат да варират и в зависимост от стадия на заболяването.

 

Депресията се среща по-често при жените, отколкото при мъжете, заради биологични, житейски, хормонални и психосоциални фактори.

 

Жените с депресия не проявяват всички симптоми на заболяването, но жените с депресия като цяло изразяват симптоми като тъга, чувство на вина и чувство на липса на собствена значимост.

 

Например жените са изключително уязвими и податливи на депресия след раждане, когато хормоналните и физическите промени и новите задължения за отговорности и грижите за новороденото могат да се окажат прекомерни.

 

Мъжете изпитват депресия по различен начин в сравнение с жените. При тях обикновено депресията се свързва с умора, раздразнителност, загуба на интерес към любими занимания и нарушения на съня. Мъжете могат да се насочат към злоупотреба с алкохол и наркотични вещества, когато са депресирани. Те могат да бъдат фрустрирани, обезкуражени, раздразнителни, гневни и понякога да са склонни към насилие. Някои мъже могат да се посветят изцяло на работата си, за да не говорят за депресията, която изпитват, със семейството и приятелите си или да се държат припряно.

Кой се преструва на болен

 

Преди навлизането в пубертета при момичетата и момчетата поравно се повишава рискът да изпаднат в депресивно състояние. Детето с депресия може да се преструва на болно, да отказва да ходи на училище, да лъже родителите си или пък да изпитва тревога от това, че родителите му ще умрат. Тъй като поведението в норма варира в зависимост от възрастта, може да се окаже трудно да се прецени дали детето преминава през временна фаза, или страда от депресия. Понякога родителите започват да се тревожат от поведението на детето си или учителите съобщават, че детето не е на себе си или има странно поведение. В такъв случай детето трябва да бъде консултирано с педиатър за физическите симптоми, които проявява, педиатърът може да прецени и да го насочи към психотерапевт за най-точна диагностика на състоянието му. При децата хронични разстройства като депресията възникват с повишени нива на тревожност.

 

Тийнейджърските години обикновено са тежки, тъй като в пубертета децата формират своята идентичност и самостоятелност от родителите си, справят се с появяващите се полови белези и възникваща сексуалност и се стремят да вземат самостоятелни решения за пръв път в живота си.

 

В тази възраст могат да се очакват странни настроения, но депресията е нещо различно. Децата и тийнейджърите с депресивно разстройство могат да се забъркат в редица проблеми, да не се справят в училище, да бъдат негативни и раздразнителни и да се чувстват неразбрани. Ако родителите не са сигурни дали просто е от възрастта, трябва да преценят колко дълго продължават симптомите, колко тежки са те и как се представя в своите постижения детето спрямо себе си в друг период. Тийнейджърите с депресия могат да бъдат тревожни, да имат хранителни разстройства и да злоупотребяват със забранени вещества. При тях рискът от самоубийство е по-висок.

Децата обикновено разчитат на родители, учители и роднини, които се грижат за тях, да разпознаят техните страдания и да им окажат помощ. Много тийнейджъри не знаят къде да потърсят психологическа помощ, други не искат помощ, защото смятат, че симптомите на депресията са резултат от натоварването в училище или са присъщи на пубертета. Други юноши се тревожат какво ще си помислят хората за тях, ако ходят на психолог. Депресията често продължава и се появява отново в зрялата възраст, ако се остави нелекувана. Ако родителите преценят, че детето им страда от депресия, трябва веднага да започнат да говорят за това, да предложат емоционална подкрепа, разбиране, да проявят търпение и да окуражават детето. Те задължително трябва да говорят с детето, не непременно за депресията, но да го изслушват внимателно. Никога не бива да се подценяват чувствата, които детето изразява, особено споменаването на самоубийство. В този момент е важно да се припомня на детето, че с времето и благодарение на лечението депресията ще изчезне.

Душевното страдание на възрастните

 

Да имаш депресия за дълъг период от време не е част от нормалното остаряване. Повечето възрастни се чувстват удовлетворени от живота си, въпреки че броят на физическите им проблеми и заболявания нараства. Депресията при възрастните е трудна за откриване, защото нейните симптоми са по-трудни за установяване. Понякога възрастните в депресия се чувстват уморени, имат нарушения на съня или пък са гневни и раздразнителни. Объркването или нарушеното внимание, предизвикани от депресията, могат да изглеждат като болест на Алцхаймер или други нарушения на централната нервна система. Възрастните хора могат да имат установени сърдечни нарушения, да са преживели инсулт или инфаркт, да страдат от злокачествени заболявания, които също да предизвикват симптоми на депресия, или пък да приемат лекарства със странични ефекти, които допринасят за депресията.

 

Някои възрастни пациенти могат да изпитват това, което лекарите наричат васкуларна депресия или атеросклеротична депресия. Тя може да се дължи на нарушена гъвкавост и стесняване на кръвоносните съдове. Това пречи на нормалното кръвообращение към органите на тялото, в това число и мозъка.

 

Понякога е трудно да се различи тъгата след загуба на любим човек, което е нормална реакция и обикновено не изисква професионалната намеса на психотерапевт, от депресията, която продължава дълго време и изисква лечение.

 

Дори най-тежката депресия може да бъде лекувана и колко по-рано започне лечението, толкова по-ефективно е то. Повечето възрастни усещат подобрение след терапия с антидепресанти, консултация с психотерапевт или и двете.

Видове депресия

Тежка депресия: Тежки симптоми, които пречат на способността на хората да работят, да спят, да учат, да се хранят и да се наслаждават на живота. Такъв епизод може да възникне само веднъж в живота на човека, но по-често се преживяват няколко епизода.

Персистиращо депресивно разстройство: Депресивно настроение, което продължава поне 2 години. Лице, диагностицирано с персистиращо депресивно разстройство, може да има епизоди на тежка депресия заедно с периоди на по-малко тежки симптоми, но симптомите обичайно продължават около 2 години.


Психотична депресия, която се проявява, когато човек има тежка депресия плюс някаква форма на психоза, като например фалшиви вярвания или скъсване с реалността (заблуди), или чуване на гласове или виждане на неща, които другите не могат да чуят или да видят (халюцинации).

Следродилна депресия, която е много по-сериозна от „умората след раждане“, която много жени изпитват когато хормоналните и физическите промени и новата отговорност за грижа за новородено могат да бъдат претоварващи. Смята се, че 10 до 15% от жените преживяват следродилна депресия.

Сезонно афективно разстройство (САР), което се характеризира с появата на депресия през зимните месеци, когато има по-малко естествена слънчева светлина. Депресията обикновено започва през пролетта и лятото. САР може ефективно да бъде лекувана със светлинна терапия, но почти половината от пациентите със САР не се чувстват по-добре само с нея. Антидепресантите и психотерапията могат да намалят симптомите на САР самостоятелно или в комбинация с лека терапия.

Биполярното разстройство е различно от депресията. Причината, поради която е включено в този списък, е, че някои пациенти с биполярно разстройство изпитват епизоди на екстремно ниски настроения (депресия). Човек с биполярно разстройство също изпитва екстремни високи настроения (наречени мания).

Полина Василева, психолог и писател

В статията е приложена информация от личната ми практика,  допълнени с  материали от „Капитал“ на тема „Здраве“.

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