Termdepressionmay refer to an emotion or to a diagnosis. In relation to emotion, the term means depressed mood, despondency. When talking about the diagnosis, it means a syndrome in which depression is one of the symptoms. In psychiatry, the diagnosis of depression is used to refer to a condition in which the patient suffers from low mood, retardation of thought and action, and delusional self-blame. This is one of the affective disorders, so named because the mood is disturbed. In psychiatry, endogenous and exogenous depression are distinguished. Endogenous depression is the result of some (non-specific) constitutional disturbance, while exogenous depression is an over-response to some stressful event (loss of security, separation, death of a loved one, isolation, increased responsibility).
Depression affects almost all spheres – emotional, intellectual, volitional and motivational, which manifests itself both subjectively in the patient’s complaints, and objectively – in a change in behavior. A persistent decrease in mood during depression is combined with a loss of interest in what was previously perceived by him as attractive, satisfying or joyful – all kinds of leisure activities, communication, reading books, hobbies, professional activities, sex life, etc. Not only does the feeling of satisfaction disappear as a result of such activity, but there is also no motivation and desire for activity, and interest in activity is replaced by indifference and irritation. With all types of depression, primary biological motivations also suffer – sleep, appetite, and sexual functions are disturbed. The degree of these disorders depends on the severity of the depressive state.
Depressive syndrome manifests itself in various functional areas.
1. Mental symptoms: depression, inability to make decisions, slow thinking, apathy or inner restlessness, fear, dreary thoughts, loss of feelings, inner emptiness.
2. Psychomotor symptoms: stiffness, decreased expressiveness of emotions, or vice versa, external anxiety, restlessness, compulsive unproductive activity.
3. Psychosomatic symptoms: violations of the vital senses (physical weakness, lack of vigor).
4. Autonomic disorders in the narrow sense: dizziness, heart rhythm disturbances, dry mouth, constipation, respiratory disorders.
5. Vegetative disorders in a broad sense: sleep disturbances, sensations of pain, contraction, cold, loss of appetite and weight, menstrual disorders, impotence.
Somatic complaints and functional symptoms as accompanying manifestations or equivalents of depressive disorders can come to the fore so strongly that they dominate the entire clinical picture. Accordingly, an emotional disturbance may recede into the background and go unnoticed. Then we can talk about a psychosomatic illness.
The methods used for psychosomatic illness can be divided into two groups:
- deep psychological methods (psychotest and psychoanalytic psychotherapy, gestalt therapy, psychodrama, etc.);
- symptom-oriented and behavior modification methods (cognitive-behavioral therapy, hypnotherapy). In practice, they can be combined. Deep psychological methods aim to reveal the psychological conflict that is behind psychosomatic symptoms, the restructuring of the personality as a whole and its relationship with the outside world.
The elimination of symptoms is not the primary goal of depth psychological methods of therapy – the symptoms weaken and disappear as the above goals are achieved. A necessary condition for the application of a deep psychological approach is the patient’s ability to self-reflection and the presence of sufficient time for a course of psychotherapy.
Psychosomatic diseases as manifestations of depression
Freud, together with Breir, proved that “repressed emotion and “psychic trauma” can manifest themselves by “conversions” of a somatic symptom.
An emotional reaction, expressed in the form of longing and constant anxiety, neurovegetative-endocrine changes and a characteristic feeling of fear, is a link between the psychological and somatic spheres. The full development of the feeling of fear is prevented by protective physiological mechanisms, but traditionally they only reduce, and do not completely eliminate these physiological phenomena and their pathogenic effect. This process can be considered as inhibition, that is, a state when psychomotor and verbal expressions of anxiety or hostile feelings are blocked in such a way that stimuli coming from the central nervous system are diverted to somatic structures through the autonomic system and, thus, lead to pathological changes in various systems. organs. In the presence of an emotional experience that is not blocked by psychological protection, but, being somatized, it affects the corresponding organ system, the functional stage of the lesion develops into destructive-morphological changes in the somatic system, generalization of the psychosomatic disease occurs. Thus, the mental factor acts as damaging.
The center of gravity of psychosomatic suffering is always the organ that is the most vulnerable and important for the life of the organism in the mind of the individual. The “choice of an organ” indicates the predominant orientation of protective and adaptive mechanisms, causing a damaging effect as disintegration increases in stressful situations.
Respiratory diseases (bronchial asthma, hyperventilation syndrome)
The emotional state of a person is determined both by visible indicators of breathing (its frequency and depth), and by the physiological functions of the lungs (blood oxygen saturation and maintenance of acid-base balance). Simple excitement leads to rapid breathing. A balanced, pleasant state leads to a calm and harmonious rhythm of inhalation and exhalation. In a state of horror and sudden shock, short-term respiratory arrest may occur. Thus, breathing is not only a physiological function that is carried out and regulated by human needs. Breathing is a fundamental property of the state of one’s own Self, it is a way of exchanging and establishing a balance between the individual and the environment. When separating a newborn from the mother’s body, he must first of all breathe. The first cry is the first manifestation of independent life.
Breathing is also a means of self-expression, it reflects emotional processes.
Cardiovascular diseases (essential hypertension, coronary heart disease, cardiophobic neurosis, cardiac arrhythmias)
The heart and blood vessels are involved in all forms of life, although normally a person is not aware of this, because. the activity of the heart and blood vessels is excluded from direct human perception. And only under certain borderline conditions and disorders the heart is perceived consciously. The mental sphere also determines the functions of the heart and blood vessels, as well as the somatic one. The connection between the activity of the heart and emotions is reflected in many sayings. Despite the fact that changes in the work of the heart are manifested both with positive and negative feelings, pathological disorders in the cardiovascular system are associated with fear, anger, rage, longing and other negative emotions, which lead to the fact that, for example, when fear of loneliness, with fear of attack, there is a feeling that the heart begins to beat in the throat and in the head. The release of adrenaline that occurs with all this causes vasoconstriction, increased heart rate and increased myocardium, which, in turn, leads to a state of anxiety and fear. The heart is traditionally associated with love. The question arises: why the breakup of a relationship, the loss of a loved one does not often lead to heart disease. Sometimes the heart turns into a symbol of a loved one and all those feelings are transferred to it, which for some reason cannot be expressed openly. A person is afraid to show his displeasure to others. A woman does not dare to object to her beloved, and in order to reduce longing and avoid depression, she tyrannizes her own heart, taking out her irritation on it. The heart is traditionally associated with love. The question arises: why the breakup of a relationship, the loss of a loved one does not often lead to heart disease. Sometimes the heart turns into a symbol of a loved one and all those feelings are transferred to it, which for some reason cannot be expressed openly. A person is afraid to show his displeasure to others. A woman does not dare to object to her beloved, and in order to reduce longing and avoid depression, she tyrannizes her own heart, taking out her irritation on it. The heart is traditionally associated with love. The question arises: why the breakup of a relationship, the loss of a loved one does not often lead to heart disease. Sometimes the heart turns into a symbol of a loved one and all those feelings are transferred to it, which for some reason cannot be expressed openly. A person is afraid to show his displeasure to others. A woman does not dare to object to her beloved, and in order to reduce longing and avoid depression, she tyrannizes her own heart, taking out her irritation on it. A person is afraid to show his displeasure to others. A woman does not dare to object to her beloved, and in order to reduce longing and avoid depression, she tyrannizes her own heart, taking out her irritation on it. A person is afraid to show his displeasure to others. A woman does not dare to object to her beloved, and in order to reduce longing and avoid depression, she tyrannizes her own heart, taking out her irritation on it.
Gastrointestinal diseases (gastric and duodenal ulcers, constipation, emotional diarrhea, ulcerative colitis)
Absorption and excretion are the main functions of the gastrointestinal tract. But in their manifestations they are in certain relations with the world around a person, with other people and with the external living space. Therefore, such actions as eating, chewing, swallowing, digesting and excreting residues are firmly included in the more subtle levels of human interaction with others. This is reflected in everyday speech – “you are too tough”, “it is difficult to figure it out”, “already drooling”.
A newborn child in functional and psychological terms is a solid mouth. This is the main tool for the interaction of the newborn with the environment. Feeding and a feeling of satiety in the future, with the development of the baby and the formation of an already mature personality, serve not only to achieve satiety, but also mediate care, a sense of security, the experience of being loved. Eating and satiating for life remain a substitute probability of satisfaction, which can always be resorted to in case of any disappointment.
This internal connection between the mental state of a person and the process of absorption-excretion leads to the fact that the emotional state of a person when eating food affects the further process of its digestion. Experiences such as aggression, fear, fear, depression inhibit the functions of the stomach and intestines, disrupt motor skills and, as a result, lead first to functional, and then to organic changes in the structure of the gastrointestinal tract.