Unfortunately, most people suffering from depression are not aware that they are sick and, therefore, do not consider it necessary to seek medical help. In addition, many patients are convinced that it is impossible to help them. In some cases, the disease recedes, the intensity of the severity of its symptoms weakens and the person believes that in the future he will independently cope with his condition, he will be able to do without treatment. Indeed, with depression, spontaneous recovery is possible, but in this case a sufficiently long period of time is required to stabilize the patient’s condition, most often, the depression returns again, with more pronounced manifestations. Such periods of deterioration of well-being exhaust the patient and, eventually, force him to seek professional help. For successful treatment of depression, it is necessary that it includes biological therapy, psychotherapy (psychological assistance) and a system of social measures aimed at improving the social status of the patient.
It is generally accepted that the treatment of depression is quite long. It should, in terms of intensity and duration, correspond to its clinical manifestations, the main parameters of affective pathology, in particular, its severity and structure.
Spontaneous recovery (spontaneous remission) with a prolonged course of depression is rare and makes up no more than 13% of all cases, and the return of depression occurs over the next 2-4 years (McCullou J., 2000).
The efficacy of treating depression with placebo drugs is relatively low, usually not exceeding 10–15% of the total number of people receiving this therapy (Montgomery S. et al., 1994).
The effectiveness of the treatment of depression depends on its clinical picture and the adequacy of therapeutic interventions. If a short-term depressive episode is relatively well treatable, then protracted and chronic depressions, on the contrary, respond poorly to therapy with pharmacological and psychotherapeutic methods of treatment (Akiskal H., 1973, 1980; Keller M., 1990).
Minor efficacy of therapy was registered among those patients who had repeated episodes of severe depression in the history of (Keller M. et al., 1982). An unfavorable prognosis was noted among those patients who for a long time suffered from depression and did not receive adequate treatment (Keller M. et al., 1992). Despite the fact that the results of treatment of patients with chronic unipolar depressions inspire optimism, the need to improve the quality of remission in this disease is emphasized (McCullou J., 2000). The low effectiveness of the treatment of depression can partly be explained by concomitant diseases of internal organs (Farmer R., Nelson-Gray R., 1990), in particular, cardiovascular diseases, as well as a combination of depression with personality disorders (Pepper C. et al., 1995 ). Resistance to the treatment of depression should be considered not only as a problem for the patients themselves, but, above all, as an incorrect diagnostic and therapeutic tactic of the attending physician (Hell D., 1994).