AM I DEPRESSIVE?

Frustration and lack are an integral part of our lives. These two feelings are familiar to all of us, and sooner or later we encounter them. Some face the feeling and are able to overcome it, others get depressed more or less easily, entering a stage of mild depression or major depression.

Some will face the loss of their parents and will be sad, even for a long time, but they will not go into depression. Others will score low on an exam and experience severe depressive symptoms. What makes an individual depress is a predisposition, a series of stimuli and behavioral correspondents in the face of these stimuli. In other words, we go through a moment of sadness, we have an answer to that feeling, which will be different for each one, depending on our personal and family history, hereditary, environmental factors (work, routine) and resilience.

DEPRESSION OR DYSTYMIA?

Before any explanation, it is necessary to understand how recurrent, profound, debilitating and present the change of mood is. Depression and Dysthymia are different mood disorders, so they are not always related.

WHAT IS DYSTHYMIA?

Dysthymia, known clinically as Persistent Depressive Disorder, is characterized by an episode of Major or Minor Depression, lasting at least two years, and in that period, the patient had significant symptoms that constitute a mood disorder. Therefore, the patient must have presented symptoms such as changes in mood, motivation, pleasure, thinking, memory, attention and executive functions. As well as loss of facial expression, body movements, personal hygiene and speech (change in timbre, rhythm and vocabulary. In addition, behaviors such as excessive crying, feelings of hopelessness, helplessness, guilt, worthlessness, apathy and adynamia are common.

In this way, Dysthymia is a chronic form of Depression, but with milder, pertinent symptoms that do not always have a causative agent, a clear triggering episode or trauma, thus being able to appear even part of the individual's personality.

Research shows that 6% of the Brazilian population currently has depressive conditions. It is estimated that, at any time in life, 1/5 of the world population presents depressive symptoms to any degree, that is, 20% of the world population.

Depression is more common in women, 3 to 4 times higher than in men, due to hormonal and social factors. However, men seek less professional help than women. In addition, there is heredity, which favors the appearance of depressive symptoms.

Dysthymia is diagnosed by present behavioral changes, such as nervousness, pessimism, severity, difficulty in healthy social interaction, loss of value and skepticism. However, even so, these are not enough features to diagnose a Major Depression. Therefore, any chronic depressive condition that does not have enough intensity to be classified as Major Depression will be classified as Persistent Depressive Disorder, dysthymic subtype, or just Dysthymia.

The symptoms of Dysthymia are:

- Demotivation

- Physical weakness

- Low psychological resilience

- Pessimism

- Lack of Pleasure in Life

- tiredness

- Willingness to sleep all day

- Escape from everyday difficulties

A Dysthymic manages to maintain his social, family and work life, despite the constant sadness, however he will not lock himself up, isolate himself, shut himself off from the world. Although less severe, Dysthymia can trigger a Major Depressive condition, if left untreated. Dysthymic is also usually resistant to treatment, believing that what he feels is natural and that "life is really bad". Such behavior is very harmful, since the individual will only seek help when he is in a more severe condition, making treatment more difficult.

WHAT IS DEPRESSION?

Depression commonly observed, called Major Unipolar Depression, is a very debilitating, constant and profound mood disorder, which can lead to other responses and behaviors, such as self-depreciation, self-harm, social isolation and even suicide. Above all, much more than a constant bad mood and a low coping behavior, Depression presents psychological and physical symptoms, harming a number of aspects of life.

Behaviors such as excessive crying, feelings of hopelessness, helplessness, guilt, worthlessness, apathy, adynamia and others are present. Unipolar Depression harms the individual in several areas, compromising social coexistence, bringing suffering, isolation from family and friends, in addition to disinterest in life, even when there was more affinity.

It is important, from the beginning of the symptoms, psychological monitoring to give emotional attention and, if necessary, that the patient can be medicated by a Psychiatrist. Therefore, the patient who presents depressive symptoms

and not receiving adequate treatment can chronicle your emotional state, evolving from a depressive condition to Major Depression.

Depression symptoms are:

- Daily or recurring depressed mood

- Deep sadness

- Guilt and self-deprecation

- Feeling of emptiness and incompleteness

- Irritability

- Anxiety

- Social isolation

- Feeling of worthlessness, guilt, loss of worth and meaninglessness in any task

- Demotivation and lack of interest in daily activities, especially those with greater affinity

- Impaired sleep quality, sleeping a few hours or staying in bed for a long time, fragmented sleep and nightmares

- Lethargy, fatigue, tiredness and loss of energy

- Excess of Hunger or Lack of Hunger

- Significant weight gain or loss

- Sexual compulsion or total loss of libido

- Feeling of hopelessness (feeling that everything is lost and will never get better)

- Difficulty concentrating and maintaining focus

- Suicidal ideas (thoughts and planning about death)

- Recurring thoughts about death, negativity, suicide, fear and anguish

- Physical pain without medical explanations and diagnoses

- Lack of sensitivity to pain and little reactivity

To put it in a nutshell, Dysthymic has a chronic lowered mood, he has always maintained a deep sadness, since the Depressive needs a depressive episode for the disease to manifest, whether he may have a previous dysthymic condition or not.

INTERMITTENT GREATER DEPRESSION

Characterized by long-standing Depression, two years or more, in which there were Major and Minor Depressive conditions. In other words, a patient who, during the two years necessary to characterize Persistent Depression, had significant improvement and worsening cycles, however, remained in Depression.

SUBSTANCE-INDUCED DEPRESSION

Some legal drugs, such as medication and alcohol, and illicit drugs, such as cocaine, can trigger a Major Depression induced, that is, a Mood Disorder resulting from drug use, even though there is no precedent in the patient's history.

Marijuana is a drug that, after prolonged use in the vast majority of individuals, or moderate use in patients with a tendency to Depression, such as heredity, can trigger a Depressive Mood Disorder, despite being commonly treated as a harmless drug. The use of stimulating substances, such as cocaine, amphetamines and heroin, on the other hand, can trigger a Major Depression in response to the attempt to stop the use of drugs. That is, abstinence can generate a significant imbalance in neurotransmitters, sufficient to depress. In addition to those mentioned, some legal drugs such as immunosuppressants, drugs to stop smoking, antihypertensives, anti-convulsants, anti-acne and sedatives or sedatives, can also interfere in the brain circuitry, unbalancing the patient's mood.

Specific treatment for depressed patients due to drug use must be done by a multidisciplinary team, with a Psychologist and Psychiatrist, but also Social Workers and a support network, such as family and friends, so that the individual is grounded and safe in the treatment. Attention should be paid to the fact that, for patients using various types of drugs, it is not possible to withdraw them immediately. The wise thing is to respect abstinence or use of substances, being withdrawn one by one. Above all, also assess the patient's progress and response to the present or not present difficulty.

WHAT ARE THE CAUSES?

Trauma, frustration, loss, lack, the moment of deep sadness. These are examples of possible agents that trigger Depression. Losing a loved one is a difficult time, one of deep sadness and it can be a depressive episode. In other words, it is normal to become depressed in the face of a loss like this, however, grief can be worked out and life can continue, or it can trigger a Major Depressive picture. Therefore, the psychic response is different for each individual.

What are the risk factors for the development of Dysthymia or Depression?

- Family history (Heredity)

- Dramatic changes in life and traumatic situations

- Hormonal deregulation

- Family and loving conflicts

FOCUS EXCHANGE DOES NOT HELP

One of the most recurring pieces of advice among people close to depressives is the change of focus. Phrases like "start dating someone", "adopt a dog", "stop being sad, rejoice", are all completely useless, irresponsible, inopportune and inattentive with suffering, which needs attention.

Irresponsible attitudes during a Mood Disorder, such as following advice rather than treatment, can remotely remit some symptoms, but it is not a possibility of definitive treatment.

THEN WHICH TREATMENT IS INDICATED?

Depression is one of the most debilitating illnesses that we know of and, even though it is not contagious, it is very common. The most indicated treatments are Psychotherapy and Psychiatric care for cases of minor and major depression.

It is important to note that not all cases of Depression will require drug intervention. For these cases there are many types of medications, which must be evaluated by the Psychiatrist for each patient specifically.

For cases with Minor Depression, it is possible that only Psychotherapy is capable of remitting symptoms and, through a therapeutic plan, the construction of viable means of treatment. All theoretical-practical lines recognized by Psychology are capable of treating Depression, however Cognitive-Behavioral Therapy has shown consistent results in the treatment of patients with Depression and other Mood Disorders.