Psychogenic depression

Reactive (psychogenic) depression is a wide range of disorders, the occurrence of which is associated with the adverse effects of psychosocial stress.

The properties of mental injury most often acquire events (“blows of fate”), which, even outside the framework of mental diseases, cause depressive reactions. Despite the fact that these may be short-term situations, they seriously affect the person, especially because of the individual significance of the experiences. First of all, we are talking about irreversible losses – the death of relatives, divorce, separation or separation from your loved one.

The cause of reactive depression can be a major conflict at work, material losses (financial collapse, bankruptcy, etc.). Short-term situations that can cause reactive depression also include situations that suddenly break the main goals of a person (career collapse, abrupt lifestyle change, arrest and etc.).

Psychogenic depression may occur in a person who is ready to heightened response to a certain situation, due to the fact that in the past a similar situation was hard to survive.

Reactive depression is especially often formed in a situation of long-lasting traumatic effects (conflicts of social relations, frequent family quarrels, sexual conflicts). Situations with weak but long-lasting traumatic effects, characterized by prolonged mental stress, the need to constantly restrain oneself (in the family or at work), increased responsibility, can provoke the development of reactive depression.

The most major stressors, most often preceding the occurrence of psychogenic depression, are usually attributed to: adultery, mental disorders of a spouse, divorce from him, his death. In men, more often than in women, after the death of a marriage partner, depression occurs. The latter circumstance is probably due to the fact that women are more able than men to share personal experiences with other people. Depression can occur after the death of the child, leaving the children from home. A protracted forensic investigation can also contribute to the formation of depression.

An important feature of reactive depression is the concentration of consciousness on psycho-traumatic perceptions that become dominant. For the formation of psychogenic depressions, along with psycho-traumatic and situational influences, several other factors are also important – constitutional predisposition, hereditary burden of depression, age, cultural characteristics, associated mental diseases and diseases of internal organs.

On the basis of the duration criterion, short-term (not more than 1 month) and prolonged (from 1-2 months to 2 years) depressive reactions are distinguished.

Acute depressive reactions are most often directly related to the misfortune that occurred, the sudden impact of an individually significant psychological trauma. Acute depression can make its debut following transient manifestations of an affective shock reaction (anxiety, aimless throwing, or motor retardation, psychogenic amnesia) and be combined with hysterical symptoms. At the height of affective disorders dominated by deep despair, fear, thoughts of death, sleep disturbances and appetite. Such conditions are, as a rule, short-lived and come to the attention of the doctor only when they are associated with self-harm or attempted suicide.

Prolonged depressive reactions are more likely to occur due to a prolonged stressful situation. With continued stress, the recovery process from depression is delayed. Occasionally depression can break off a strong mental experience, in its severity much more intense than a prolonged state of chronic depression.

The clinical picture of prolonged reactive depressions is characterized by depression, a sense of hopelessness, frustration, tearfulness, and sleep disorders. In this case, the spectrum of manifestations of the disease becomes wider than in acute depressive reactions. Along with depression, tearfulness, a dark, pessimistic vision of the future, asthenic, asthenovegetative and hypochondriac manifestations are more common.

For depressive reactions characterized by the concentration of consciousness on the events of the unhappiness. The theme of the experience acquires the properties of the dominant representations. Patients are absorbed by the memories. They constantly, in addition to their own will, reproach themselves for not taking measures to prevent misfortune, providing them with qualified help from a loved one, not doing everything possible to alleviate their sufferings, and badly courting him.

The substantial complex of depression does not completely disappear even when the depression becomes protracted and more erased. A casual reminder is enough to make the depression worse for a while, even distant associations can provoke an outbreak of despair. If the day after the affairs of the patients manage to escape, then at night the experienced drama still long surfaced in nightmarish dreams.

With the disappearance of stress, the symptoms of depression are usually completely reduced, leaving no changes, but in some cases there is a tendency to include internal factors in the pathological process. Manifestations of the psychogenic reaction in this case gradually acquire the properties of endogenous depression.

In the process of differential diagnosis of psychogenic and recurrent depression, attention is paid to hereditary burden; experiences reflecting the traumatic situation; development of depression after trauma, especially against the background of current chronic somatic diseases. The severity of psychogenic depression, as a rule, depends on the nature of the mental trauma and susceptibility of the patient, and the dominant depressive ideas are associated with the events of the unhappiness. These ideas often do not disappear even when the depression becomes protracted and erased. Previously, it was believed that with reactive depression, the depressed mood is more often worse in the evening (daily fluctuations of affect, typical of endogenous depression, with psychogenic, as a rule, less pronounced). It should be noted that during psychogenic depression, despite the lower self-esteem, the consciousness of the disease in most cases saved. Psychomotor reactions are not impaired, however, as a result of asthenia and depleted by the end of the conversation with the patient, the slowness of his speech increases. Vital manifestations of depressive affect are not characteristic of psychogenic depression, feelings of guilt are more often directed not towards others, but towards others, suicidal intentions are not typical, and if they do occur, they are often motivated from the standpoint of painful depressive logic. With purposeful questioning, the patient does not hide his thoughts about suicide and tells in detail about them. Psychogenic depression is often accompanied by tears, there is a special sensitivity of its symptoms to psychotherapy.

local_offerevent_note February 28, 2019

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