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Psycology » Psychiatry and psychotherapy » Affective psychosis » Manifestations of affective phases: depression

  1. Affective psychosis
  2. Manifestations of affective phases: depression
  3. Manifestations of affective phases: mania, cyclothymia, dysthymia
  4. Diagnosis and treatment of affective psychosis

Depression, by Kraepelin, characterized by a triad of symptoms of mental activity inhibition: affective, ideational and motor braking. In the modern sense of depression - is depressed, pessimistic, sad mood, which may deepen to the extent expressed dejection vague feeling of hopelessness and some impending disaster, as well as physically painful sensations "heartache."

As I thought I. Glyattsel (1982), a typical characteristic of endogenous depression symptom complex includes three registers existing in this pathology. First - psychopathological including triad braking E. Kraepelin. Second - somatic-vegetative, with a predominance of symptoms sympathicotonia third - biorythmological, which appears to change daily and seasonal rhythm sleep disorders (early awakening, etc.), worsening of depression in the morning and weakening it in the evening, return and worsening depression at certain times of year, such as spring and autumn, while in the summer months can occur excitement phase.

The initial stage of depression characterized by a change in the form of well-being to reduce the overall affective tone, often with a sense of fatigue, weakness, impotence (asthenic component), blurred somatovegetativnymi hyperpathia disorders with symptoms, the appearance of "headaches", "heartbeat". Disturbed sleep (early awakening), appears a special sentimentality, tearfulness. Reduced Biotonus manifested a subjective feeling of boredom, laziness, lethargy, weakness, spleen, discomfort, etc. One of the early signs of developing depression is a loss of the sense of joy, failure to cheer, with the same enthusiasm to engage in favorite things. Tendency to appear pessimistic assessment of their capabilities, these persons lost inherent sense of perspective, confidence. Some patients report the disappearance of old habits, such as quitting smoking abruptly, it can sometimes be one of the first signs of depression. Longing and anxiety there is still not enough differentiated, may still appear "schemlenie in the chest." Depressive status painting begins to emerge and the weakening of motivation to communicate, emotional contact, a penchant for solitude. Dominated by subjective feelings of discomfort unclear, although explicit, objective, visible to others signs of depression yet.

Cyclothymic depression stage accompanied by depression buildup of depression, depressive affect is more clearly expressed, more differentiated. Notably seen all the components of the "depressive triad." This is also reflected in their subjective feelings and experiences of patients, affecting their appearance and behavior. Subjectively perceived diverse manifestations of depression are reduced to a painful state of health (bodily discomfort), dim emotional reactions more obvious reduction motives, restricted movement. Voice of patients becomes less sonorous muted loses full range of overtones, patients say quieter than usual, they do not immediately select the correct expression in the conversation ("rusty" thinking on Kannabihu Yu, 1914), which to some extent makes it difficult to ease and natural communication. Subjectively, many of them say "impoverishment of speech," the people of creative work becomes more difficult to write, musicians have difficulty playing the violin, piano ("hands do not obey, as before", "technology brings," etc.). Become obvious main symptoms of depression: on the foreground, depressed mood, which is perceived as a clear "anguish", appears vague anxiety, further hinders bodily discomfort becomes more noticeable reduction motives. "Tosca" is regarded by many researchers as a phenomenon depressive hypersensitivity, which has a special character protopathic. Despite having a "projection of bodily anguish" (the chest, epigastric, ie "predkardialnaya", "epigastric" longing), such feelings are perceived as painful mental disorder. The phenomenon of "atrial angst» (precordialeangst) was first described and designated terminology K. Fleming (1844) when he described dysthymia. SS Korsakov is a disorder called "psychic hyperalgesia" (1901). Such disorders stage Cyclothymic depression yet still unstable and short-lived. For example, the experience of "boredom" may occur during the day in the form of brief episodes from a few minutes to half an hour, at least - a little bit longer. The majority of patients develop overvalued education that fully complies with the basic gipotimicheskomu the affect - the idea of ​​shame, excessive feelings of moral responsibility for their actions, reduced self-esteem own "I" with thoughts of his inferiority, ugliness, unfit for work, family life, with the disparagement of the the role they play in the eyes of others. At this stage of depression may develop selective fixation on one or more aspects of their patients experience changes insolvency. The complaints of these patients can be noted for their significant manifestations somatopsychic inferiority. Overvalued and concerns the interpretation here is psychologically understandable. At this stage of the depression, as seen from the description already exist all the structural components which allow to predict the nature of deeper and more complex depressive disorders.

Melancholic depression is characterized by a type of simple deepening of all components cyclothymic depression. Thus patients say about the very strong feelings of longing, anxiety, and their combination (which happens much more often), about the experience of losing their abilities. They have "no sense" (psychic doloroznaya anesthesia, "a sense of senseless"), "no desire", "no memory" (sharp braking associative process), they are "completely petrified", "became stupid." Consciousness is filled with painful sensations (vital anguish, unbearable anxiety, a sense of brevity, voltage), is dominated by the idea of ​​the complete and final state of hopelessness, a variety of concerns.

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