Depression syndromes. Astheno-depressive syndrome. Complications and consequences

Astheno-depressive syndrome is a psycho-emotional disorder characterized by constant fatigue, decreased performance, etc.

The absence of symptoms characteristic only of this disease, the similarity with the first manifestations of depression and depression, make some experts doubt the correctness of identifying this syndrome as a separate disease. But, despite the lack of an accurate classification and unambiguous approach to defining the syndrome, all doctors agree on one thing: the number of patients suffering from similar symptoms is constantly increasing, and a significant part of all patients are children: schoolchildren and teenagers.

There are many reasons for the development of astheno-depressive syndrome, but the increase in the number of patients in recent decades is associated, first of all, with an increase in information load, starting from a very early age, deterioration of the general environmental situation and changes in a person’s lifestyle.

Today, most of us experience colossal information overload, chronic stress and overwork. Starting from the 1st grade, and some children even earlier, they spend most of their time studying, while adults spend up to 60% of their time at work, “saving” on rest and sleep.

After just a few years of such a life, for some earlier, for others later, the nervous system ceases to cope with stress, becomes exhausted, and the person finds himself at risk of developing neuropsychiatric diseases.

Some manage to stop in time, switching to a less stressful schedule, resting more and gradually recovering, others develop psychosomatic diseases (stomach ulcers, arterial hypertension, type 2 diabetes), which also force them to take care of their treatment and lifestyle, but still others astheno-depressive syndrome may develop.

Risk factors that increase the likelihood of developing the disease are:

Symptoms

Diagnosing astheno-depressive syndrome is quite difficult; its manifestations are simultaneously similar to the symptoms of asthenia and depression. Most often, at the beginning of the disease, it is not diagnosed at all; its manifestations are attributed to ordinary fatigue, malaise, problems at work, and the like. Then fatigue and decreased performance are accompanied by constant bad mood, lack of interest in the environment, apathy and negative thinking.

The disease can be recognized if several signs are simultaneously present:

Astheno-depressive syndrome in children

Astheno-depressive syndrome has become quite common in school-age children and teenagers.

This is associated with increased workload at school, in extracurricular activities, with the child’s involvement in social networks and computer games, as well as with poor lifestyle and nutrition.

Today, most schoolchildren simultaneously study in a regular, comprehensive school, attend 1-2 additional classes, study with tutors, and spend their free time at the computer.

Often at school age, parents no longer control what and how a teenager eats, how much time he spends in the fresh air and how he rests. Excessive workload can lead to exhaustion of the nervous system and even astheno-depressive syndrome.

In children, it is manifested by frequent colds and viral diseases, decreased performance, constant irritability or tearfulness. A previously sociable child stops leaving the house or becoming interested in anything, preferring to spend most of his time alone or at the computer.

Treatment

Treatment of astheno-depressive syndrome is quite complex; it must be comprehensive and include lifestyle changes, medications and psychotherapy.

Treatment begins with normalizing the patient’s condition and combating the main symptoms of the disease:

• drug therapy;
• maintenance therapy;
• psychotherapy.

Drug therapy

Treatment of astheno-depressive syndrome begins with taking sedatives: tincture of valerian, motherwort, hawthorn and drugs based on them. If they are ineffective, stronger drugs are prescribed: antidepressants: Mianserin, Fluoxetine, Azafen, Amitriptyline and others. For panic attacks, antipsychotics are used: Sonapax, Chloprotexin, and so on.

It is important to understand that drug therapy does not provide recovery, it only reduces the symptoms of the disease and normalizes the patient’s condition, and for a complete recovery he needs to change his lifestyle and attitude towards work and rest.

Psychotherapy

Psychotherapy is one of the most effective methods of combating depression and asthenia. The specialist helps the patient understand what problems caused the development of nervous tension and how to avoid such situations in the future.

The patient learns to evaluate his thoughts and actions, set priorities, and treat his health and condition more carefully.

For the treatment of depressive conditions the following is used:

• cognitive behavioral psychotherapy ();
• rational psychotherapy;
• family psychotherapy;
• body-oriented therapy;
• dance psychotherapy;
• holotropic breathing.

In addition to working with a psychotherapist, the patient must learn relaxation techniques that will allow him to cope with stress on his own.

Without treatment, astheno-depressive syndrome can cause the development of neuroses, depression and other severe mental illnesses. Therefore, it is very important to contact a specialist in a timely manner and be sure to follow all his recommendations.

Causes of depression can be very different - stress (excessive workload, lack of sleep, financial difficulties, problems in personal life, etc.), the onset of a cold season with short daylight hours, cyclical changes in a woman’s body (it is no coincidence that this disease occurs in women at 8 times more often than in men).

Sometimes they occur against the background of diseases such as neurodermatitis, coronary heart disease, oxygen deficiency of the brain (ischemia), incl. and due to atherosclerosis, neurosis, Meniere's disease, neurasthenia, hypertension and other chronic and intractable diseases, as well as intestinal dysbiosis, helminthic infestation such as toxoplasmosis. Therefore, it is often not depression itself that needs to be treated, because... it is a consequence of other problems, but its root cause.

The so-called should be included in a special group. seasonal depression, so-called disaptation neurosis, which are associated with a lack of light.

Symptoms. It seems that nothing hurts, but life loses its meaning, becomes uninteresting and tasteless. There are no visible reasons. But for some reason my soul is so heavy that I have no strength to bear this burden. And all these mental ailments become especially noticeable at the end of winter, when you really want the long-awaited spring sun.

Many of those who see a therapist have depression. Only they complain of other symptoms. It seems like your heart hurts or it's hard to breathe. They complain of a headache. This is the so-called hidden depression.

There are also obvious signs of it. Low mood. Motor sluggishness. Intellectual or mental retardation. It is absolutely not necessary to have all three signs, and they can manifest themselves in different ways. The depth and nature of depression depend on this.

Let's say that there is not always a pronounced bad mood. There is simply no vitality, no courage, as if the light inside you has been turned off. It is you and at the same time not you.

Depressive patients are characterized by a constant feeling of fatigue - everything is difficult. The person understands that he has become different: “I think I can do it, but I don’t want to.”

One of the common signs of a depressive disorder may be waking up early. At 5-6 o'clock in the morning there is no sleep in either eye, and when I have to get up for work, painful drowsiness sets in.

Depression is sometimes accompanied by anxiety, causeless worry, and fear for the future.

An unmotivated feeling of guilt arises. There is a depressive reassessment of the past. A person remembers some action when he really was not up to par. And he begins to analyze his actions, believes that now he is rightly suffering, because he has done something disgusting, shameful. But before the onset of depression there were no such memories and torment about them.

Vulnerability appears in relation to the external environment, to the weather, weather dependence, for example. “Today is a clear day and I feel good. Tomorrow is a bad day, and I feel bad.”

Diurnal rhythm fluctuations associated with hormonal changes are characteristic: life is easier in the evening, lethargy and depression in the morning. I don't want anything. And by the end of the day, the brain works better, and something can be done.

Very often, depression can manifest itself in the form of a wide variety of ailments: headaches, joint pain, back pain, discomfort in the heart, rapid heartbeat, changes in blood pressure, gastrointestinal disorders. Such depressions are called “masked.” And then years may be spent in a fruitless struggle with any chronic disease. And the reason is this: depression.

Complications . Depression in its extreme phase of development is, first of all, dangerous because of its tendency to commit suicide. And this is the main reason why it needs to be treated. Moreover, it can be repeated. The state of depression is painful for patients.

Depression is a prerequisite for many physical illnesses, but the clearest connection exists between depression and heart disease. By its nature, depression is in many ways similar to hidden stress, which means it is destructive to the body.

Some researchers claim that when taking a special group of antidepressant drugs that increase the concentration of serotonin, there are no side effects, incl. and there will be no getting used to them. Serotonin ensures clear interaction between cells responsible for active life. It is also called the hormone of happiness and good mood. We need to help the body restore lost serotonin. Depression is associated with disruption of biochemical processes in the body, in particular, with a decrease in the brain content of the neurotransmitter serotonin, a substance through which nerve cells exchange impulses. At the same time, on the contrary, the level of stress hormones – adrenaline and norepinephrine – increases, as a result of which health and mood may worsen. If it seems to you that you haven’t smiled for a long time because “there’s nothing to smile about,” “life is hard,” stop and think. Stable pessimism may be a sign of biochemical disorders in the body.

The importance of the intestines and dysbiosis in it

Doctors usually prescribe antidepressants for depression. Patients turn to psychiatrists, and they vaguely talk about some kind of “chemical imbalance.” Gradually, the dose of antidepressants has to be increased, which in turn causes other discomfort, including weight gain, weakened libido, impotence...

Antidepressants are used for people with low levels of serotonin; they do not increase its production, but only retain in the body the amount that is already available. These remedies provide some benefit for mild depression, bringing the patient into a more stable state, but often they mask the real problem, which lies in the intestines, where the lion's dose of serotonin is produced.

One of the most important causes of low serotonin production may be decreased thyroid function, which occurs due to stress, allergies and poor diet. Thanks to the transition to a healthy diet, in particular the use of large amounts of living plant foods, the body is cleansed. During our treatment, the weight of patients approaches normal and, most importantly, they can gradually move away from antidepressants.
When the intestines are damaged and inflamed due to poor nutrition and mostly dead food, there is a slow decline in serotonin levels, since most of it is produced in this organ. The intestines are the largest “factory for the production of happiness,” but this factory works fully only under certain conditions and the good mood of this factory. Serotonin is not produced here simply from simply eating food. In this case, the way we receive signals (neurotransmitters) about what to feel (with or without pleasure) and how to respond to influences from the world around us physically changes.

There are many reasons for low serotonin levels in the body. We can optimize serotonin levels if necessary. Practice shows how restoration of intestinal functions will help restore its secretion, as a result of which despondency disappeared and consciousness cleared.

Since most antidepressants only work for a limited time and many people become addicted after 6-12 months, treating depression without restoring the body to its normal state is pointless.

When the production of serotonin in the body increases naturally, it is equivalent to putting a hundred fresh horses into the race rather than finishing off a hunted one.

The intestinal factory for producing happiness . The amount of serotonin produced is highly dependent on diet. It is synthesized from substances obtained from food. The building blocks for its production are certain amino acids, especially tryptophan, which comes from foods containing large amounts of protein. Ancient people consumed much more tryptophan in their diet than we do. Meat from grain-fed animals contains much less of it because it contains less omega-3 fatty acids. In addition, the production of serotonin is slowed down by caffeine, alcohol, aspartame, as well as a lack of sunlight and physical activity in a person, leading to pleasure from fatigue and better sleep at night. The first step on the path to health is restoration of the intestines.

Importance of Vitamin C. So, since depression and disaptation neurosis are associated with stress and an excess of stress hormones - adrenaline and norepinephrine, it is known that their biosynthesis in the body is associated with the presence of vitamin C. In winter, this vitamin is always lacking, which means the synthesis of these substances is limited. All this disrupts the operation of the pendulum mechanisms, when the lack of power in the swing of one wing, the rocker arm of the pendulum, leads to a weakening of the opposite wing, including the serotonin wing. That is, on the one hand, a short-term increase in stress hormones leads to suppression of the synthesis of the hormone of happiness. In small measured doses, stress hormones are even useful; they tone, adapt, adjust the body, and therefore, over time, strengthen their antiphase. In turn, chronic stress also leads to a weakening of the antiphase. The insufficiency of these stress hormones again leads to the same effect - a weakening of the opposite phase - serotonin. Therefore, it is necessary to repeatedly increase the intake of vitamin C.

Which treatment approach is best? In these cases, taking chemical antidepressants prescribed by doctors gives almost nothing, but only requires increasing the dose over time, which will only harm the central nervous system over time. It is necessary to eliminate the true root causes of the disease, which doctors usually do not offer, but try to influence the symptoms and secondary consequences, taking the disease deeper, masking it. In this regard, I suggest that you additionally indicate to me in writing about possible additional problems and diseases listed here, which may be the root causes, so that I can give you additional recommendations.

To eliminate unpleasant symptoms, some resort to self-medication, consult with psychologists, neurologists, psychics, etc. Each of them prescribes certain medications that reduce or lead to the disappearance of the manifestations of the disease. However, taking chemical medications for a long time is not harmless - side effects occur: drowsiness, absent-mindedness, difficulty driving, memory deteriorates, negative effects on the function of the liver, intestines, etc. All this is a consequence of driving the disease deeper, its disguise, when we treat one thing, but provoke new consequences that can manifest themselves remotely, and which are often not associated with long-standing non-targeted competent treatment.

I believe that there is no addiction to antidepressants, as long as they are of plant origin and have a mild, targeted effect. Modern herbal preparations are well tolerated. These include the infusion of St. John's wort.

Natural medicinal plants can also come to the rescue here, for example, hydroalcoholic extracts of motherwort, Echinacea purpurea, lemon balm, hawthorn and rose hips. The originality of this composition is that, according to the outstanding Russian physiologist Academician I.P. Pavlova, it is better to use balanced components that, on the one hand, tone the body (echinacea purpurea, rose hips, hawthorn), and on the other hand, have a calming effect (lemon balm, motherwort).

The extract of these herbs provides vigor throughout the day, and in the evening will help you fall asleep easily. Also, such a complex extract or tincture has a mild cardiotonic effect, increases blood supply to the muscles of the heart and brain, and increases the stability of the cardiovascular system under excessive load. Due to hawthorn bioflavonoids, it stabilizes blood pressure levels. Thanks to the presence of lemon balm and rose hips, it reduces the manifestations of cerebral atherosclerosis, Meniere's disease, and reduces the possibility of developing vascular stroke.

The Importance of Sugar in Depression. In fact, sugar has the same effect on the body as a drug, only weaker and hidden. We get used to it and cannot live without it. The more we drown out depression with sugar, the more dependent we become on it. Cravings for sugar or easily digestible carbohydrate foods are a manifestation of one of the forms of depression. A form of the body's fight against depression. Without sugar we feel bad and sad. But we don’t want to look at healthy food; we’ve simply weaned our body off healthy habits. But by drowning out serotonin depression with sugar, we thereby cause irreparable harm to it. This is a dead chemical product and removes negative charges from us, i.e. charges of life, it discharges our cells from charges, thereby exposing them from their protection from burns by positive charges, acids and radicals. Due to the distortion of charges on the membranes, that is, a decrease in the degree of electropolarization on them, sugar leads cells to a shift in metabolism towards the predominance of a more anabolic lipid metabolism with the formation of excess fats. This is the basis for a huge number of subsequent chronic and incurable diseases, including oncology. This is a disease that secretly wears away our health and we cannot cope with it. This Disease of Civilization which humanity suffers everywhere. This is an artificial feeling of temporary momentary “joy” due to loss vitality and VITAUKT, that is, loss of health forever.

To treat this disease, I suggest ordering the following:

1. NEIRVANA – 2 bottles (350 g). CHRONIC INSOMNIA, LACK OF SLEEP, DROWNESS, FATIGUE, Lethargy, IRRITABILITY, ANXIETY, ANXIETY, DEPRESSION, AGGRESSIVENESS, HORMONAL DISTURBANCES - THIS IS A thing of the past

Yours will be returned sweet Dreams and tender feeling complete rash, freshness, clarity and lightness in head, and even intellectual abilities, and then vigor and health, which means joy and fullness of life.

During peaceful deep sleep in organism work is returning to normal all internal organs And systems, muscles relax, the nervous system rests, the brain has time process the information accumulated during the day. And most importantly, the exhausted daily resource is restored, incl. and transmitters – the signal of antiphase occurs due to the connection of the counterbalance pendulum mechanism of increasing deep rest, the supreme representation of which is located in the pineal gland. Without achieving the normal depth of the resting phase, i.e. deep sleep and, accordingly, the amount of the hormone melatonin required for this, full recovery, normal wakefulness and a full sense of the joy of life are impossible. With chronically disrupted cycles and disturbances in the depth and duration of sleep, the amplitude of oscillation of this pendulum mechanism weakens. The result is lethargy, weakness, irritability, tearfulness, nervousness and numerous other consequences.

Around the world, the number of people suffering from nervous disorders increases every year, the most common cause being stress. Among the variety of mental disorders, the leader is depression- the most common disease, often associated with loss of ability to work.

Every year, chronic depression destroys the health of about 100 millions of people around the globe. Although depression causes severe emotional disturbances that prevent a person from living and working normally, unfortunately, in most cases it is not diagnosed either by the patients themselves or even by certified specialists, especially when its symptoms develop gradually. Highly effective synthetic antidepressant drugs used to treat depression often have to be discontinued or replaced due to dangerous side effects, which, in turn, also require treatment.

If you have: depressed, depressed mood; loss of interest in loved ones, everyday activities, work; insomnia, early awakening in the morning or, on the contrary, excessively long sleep, irritability and anxiety, fatigue and loss of strength; decreased sex drive; lack of appetite and weight loss or sometimes, on the contrary, overeating and weight gain; inability to concentrate and make decisions; feelings of worthlessness and guilt; feeling hopeless and helpless; frequent bouts of sobbing; thoughts of suicide,

If you: you are often sick, work at night, experience great physical and nervous stress in the course of your work; If you suffer from weakened memory or mental illness, then after a few days of regularly taking the NEIRVANA phytocomplex you will feel the first symptoms of its beneficial effects.

The feeling of weakness will disappear; In stressful situations, self-control and composure will appear.

You will feel a comfortable feeling of lightness and calm. Mental and physical performance will increase; Memory function and mood will improve. Sleep will become deep and complete. The craving for alcohol and stimulants such as coffee will calm down.

Many people cannot see or do not want to admit the problem that is gradually eroding their health and immunity, depriving them of joy, that is, chronic depression. Mistakenly, we take this condition as a sign of mental weakness, which can be overcome with the help of willpower. But the roots of this problem are much deeper and not at the psychological level. The latest scientific evidence indicates that one of the reasons for its occurrence is a violation of biochemical processes in the brain: an imbalance of neurotransmitters - chemical substances (such as serotonin and dopamine) - whose activity is responsible for our mood. It will help restore the normal level of these mediators NEIRVANA.

Indications: Sleep disorders (insomnia, nightmares, frequent awakenings). As an adaptogen to normalize biological rhythms. States of anxiety, anxiety, fear. Depressive states of mild to moderate severity. Seasonal affective disorder. Emotional imbalance and tendency to melancholy. Increased irritability, fatigue. Anxiety related to dieting, for example for weight loss, etc. Treatment of addiction to alcohol and nicotine. Psychovegetative, neurotic disorders. Psychoemotional disorders associated with menopause. Increased nervous excitability

Component Properties

They have a moderately expressed sedative, as well as calming and analgesic effect.

Improves the functional state of the central and autonomic nervous system.

They have pronounced antidepressant and anti-anxiety activity.

They adapt the body to rapid changes in time zones, reduce desynchronosis, and reduce stress reactions.

They have a general strengthening effect on the body, especially during intense mental work.

Accelerates falling asleep, reduces the number of night awakenings. They do not cause feelings of lethargy, weakness and fatigue when waking up. Improves well-being after waking up in the morning.

Antispasmodic and anti-inflammatory effect.

Compound:St. John's wort, lemon balm, hops, peach leaf

St. John's wort

St. John's wort extract is indispensable against seasonal emotional disorders, e.g. winter blues.

In winter you lethargic, apathetic, depressed, angry for nothing.

Besides, sleep more than usual, prone to overeating, you has a craving for sweets.

That's what it is seasonal affective disorder.

It seems to you that you need to consume more vitamins, fruits, and juices. But nothing helps.

Women experience the same thing before their period.

The common reason is lack of serotonin.

When consuming St. John's wort extract, the level of serotonin in brain tissue increases. This improves mood, apathy, lethargy, and drowsiness disappear.

Women stop being gloomy and irritable, do not feel unhappy.

Biochemistry of mechanisms of action.

At least 10 biochemically active substances have been identified that act as antidepressants. The effect may develop as a result the combined effect of the active components of St. John's wort preparations on these systems and the manifestation of an antidepressant effect as a result of the total effect.

Efficiency Medicines based on St. John's wort extract in the treatment of mild to moderate depression have been proven by the results of numerous clinical trials, as well as a meta-analysis of more than 20 studies in which more than 1,500 people took part. The effectiveness of St. John's wort has been proven in clinical studies in 6,000 patients with moderate depression! Moreover, a study involving 317 patients compared the effects of St. John's wort and the classical synthetic drugs imipramine, amitriptyline and maprotiline. It turned out that the activity of St. John's wort is 6% higher! Similar results were observed in 149 patients when comparing the antidepressant effects of St. John's wort and the best-selling synthetic drug fluoxetine. When treated with St. John's wort, depressive symptoms decreased from the initial 24 points on the diagnostic scale to 10.2. And when treated with fluoxetine - only up to 12.5.

Practice shows that many patients stop treatment with synthetic antidepressants, unable to withstand the unpleasant side effects. St. John's wort preparations are distinguished by a minimum of side effects and easy tolerability. During trials, patients taking St. John's wort were 3 times less likely to drop out of the study due to side effects. And the side effects themselves were observed 2 times less often.

St. John's wort tea does not cause drug dependence; it is completely safe to take 4-6-week courses, for example, every winter. It will be especially appropriate for northerners who especially suffer from seasonal depression due to insufficient daylight hours

Good clinical effect and safety administration allow the widespread use of drugs based on St. John's wort, especially in cases where the use of synthetic antidepressants is contraindicated. First of all, this applies to elderly patients with concomitant somatic and neurological diseases and taking various medications for this reason. Concomitant depression not only aggravates the course of major neurological diseases, such as stroke, Alzheimer's and Parkinson's diseases, epilepsy, multiple sclerosis, but also the manifestations of somatic pathology (coronary heart disease, diabetes mellitus, obesity, cancer, weakened immunity).

Physiological mechanism of action. All this is mediated through the involvement of deep mechanisms of regulation and balancing of the seratonin-melatonin pendulum, that is, the highest control mechanism in the entire hierarchical pyramid of the body, which eliminates desynchronosis or failure of numerous biorhythms. This determines the clarity and severity of the daily rhythm of the relationship between sleep and wakefulness, which means a good manifestation of daytime freshness and deep night sleep. Increasing the production of melatonin determines the necessary sensitivity (tolerance) of the hypothalamus, and then the optimal mode of operation of the entire endocrine, immune and neuro-vegetative systems, which generally resists the mechanisms of premature aging. Gray hair is a sign of melotannin deficiency.

St. John's wort, like synthetic pharmaceutical antidepressants, increases the concentration of substances that transmit excitation in nerve cells - at the points of contact between brain cells (in synapses) - counteracts depression and improves mood. But St. John's wort is milder than antidepressants and is easier to digest.

Advantages

For mild and moderate depression efficiency comparable to that of tricyclic antidepressants and selective serotonin reuptake inhibitors;

Unlike synthetic antidepressants, the complex biochemical composition and multiple mechanisms of action of the drug determine rapid onset of lasting effect(within 2 weeks);

Unlike synthetic antidepressants, St. John's wort preparations do not impair cognitive function(reaction speed, short-term memory), and also do not affect coordination;

Safety, allowing the drug to be used outside of psychiatric and neurological practice, as well as to be prescribed to certain categories of patients who are contraindicated in taking synthetic antidepressants;

Positive assessment of the effectiveness and tolerability of therapy by the patients themselves, as well as improving their quality of life.

In addition, the following was noted under the influence of St. John's wort preparations:

Rising night products melatonin.

The flow becomes easier chronic fatigue syndrome.

Severity is reduced by 50% premenstrual syndrome.

Decreasing craving for alcohol.

Relieved drug addiction treatment and drug addiction.

Stimulated adaptogenic and anti-stress activity.

Reduced intensity of persistent headaches.

Deep dream regulated by the pineal gland hormone - melatonin. St. John's wort extract increases melatonin levels in the blood. Melatonin is not only regulates deep sleep, he slows down age-related brain changes. With age, the activity of the pineal gland decreases, therefore the amount of melatonin decreases, sleep becomes superficial and restless, possible insomnia or chronic drowsiness. Melatonin promotes eliminating insomnia, prevents disruption of the body’s daily routine and biorhythm. Serotonin helps to cope, obviously, with chronic drowsiness, lethargy, and weakness. Affects adaptation processes when changing time zones, helps the body adapt to various harmful influences of external and internal origin (radiation, stress, etc.). That is, it acts as a strong adaptogen. Prolongs active sexual life, stops the manifestation of menopausal syndrome, increases potency, etc.

- Melissa. Melissa essential oil has a sedative (calming) effect on the central nervous system, exhibits antispasmodic properties, which is important for nervous spasms, dizziness and tinnitus. Medicines from lemon balm are prescribed in conditions of general nervous excitement, hysteria, vegetative-vascular dystonia, migraine, insomnia, increased excitability, painful menstruation, various neuralgia, heart rhythm disturbances and changes in blood pressure under the influence of emotional factors of postpartum weakness, menopausal disorders.

- Hops. The neurotropic properties of herbal preparations from hop cones are associated with the content of lupulin, which has a calming effect on the central nervous system, reduces irritability, and reduces nervous excitement. Cannabidiol contained in hop leaves has sedative, analgesic, antispasmodic And anticonvulsants properties. Hops is mild sedative. It is used for insomnia, nervous fatigue, increased nervous excitability, anxiety, a state of fear, vegetative-vascular dystonia (especially the hypertensive type), hysteria, convulsions, sexual neuroses (frequent emissions, premature ejaculation), climacteric disorders.

PROMISING POTENTIAL OPPORTUNITIES OF St. John's wort

It turns out that St. John's wort's ability to manifest its properties as an antidepressant is only a small part of its hidden potential. After all, it is related to the supreme conducting mechanisms, i.e. located at the top of the entire pyramid of the neuro-hormonal system, which is under the jurisdiction of the pineal gland, which controls the melatonin-serotonin pendulum. The latter is a mechanism that optimizes all life rhythms, cycles and stages of development of the organism as a whole. Through these mechanisms, there is an analysis of the general exo- and endosituation, and then coordination, synchronization and integration of them through mediation through numerous regulatory nuclei centers of the hypothalamus, increasing the threshold of tolerance in them, i.e. sensitivity, responsiveness.

St. John's wort, through these mechanisms, is the key to regulating the melatonin-serotonin pendulum.

Many problems in the body begin with the neuro-hormonal system, with failures in them, disruption of synchronization and optimization of many processes. It is here that the primary mechanisms of various particular desynchronoses arise, manifesting themselves in the form of numerous pathologies, and ultimately merging into a single desynchronosis , including in the form of premature aging.

Insufficient power and activity of the pineal gland, and therefore the pendulum mechanism, leads to the fact that the sensitivity threshold of the hypothalamus rises, and a general elevation process occurs in order to restore the homeostat between the center and the periphery. The amount of hormones in a number of target glands increases many times. In some cases, certain functions of the hypothalamus are lost altogether. Wear of these centers occurs for a number of reasons, including natural age-related elevation, poor blood supply to the brain, chronic overstrain, work in a suboptimal mode, stress, toxicosis, lymph congestion, etc. The pituitary gland is completely subordinate to the hypothalamus . It is the pituitary gland that controls all peripheral hormonal target glands, and they each have their own sphere of influence.

Moreover, if the pineal gland is the conductor, then the hypothalamus represents the neural score, i.e., a certain set of regulatory nuclei, which in turn determine the sound of the orchestra through the pituitary gland and in other directions.

But all the cores do not work on their own, independently, but are completely dependent on each other, balanced. There is a certain range of their sound, in which the entire orchestra plays harmoniously and all the processes they play out are at their optimum. All this ensures the preservation of homeostasis of the entire organism as a whole. A shift in the degree of activity of one of the nuclei leads to a leash reaction in numerous other nuclei. A re-adjustment of their relationship begins. This is permissible only up to certain limits of the area of ​​​​their harmony, subordination; beyond this, the first sounds of dissonance begin, when cacophony begins and there is no connection from each other. All these centers operate in close proximity to each other. On the periphery, this is manifested by numerous symptoms. The pineal gland, which supports this optimum performance of the “orchestra”, essentially works like a gyroscope (a top spinning at a given frequency, relative to which the frequencies of other processes are oriented and adjusted), i.e. a mechanism that does not allow deviations from a given path and brings everything into synchronicity, matching frequencies, setting the rhythm for all rhythms, coordinating all particular rhythms under a single general rhythm - this is the serotonin-melatonin pendulum mechanism.

Obviously, in all these cases, it will be possible to alleviate these symptoms with the help of our drug Nervana, which, by extrapolating its potential, can be recommended for the treatment and prevention of the following symptoms: various acquired hormonal disorders, including disorders of the thyroid gland, and what is especially important are their consequences, i.e. hormone-dependent tumors, cysts, hyperplasia, menstrual irregularities, pathological menopause, as well as weakened and distorted immunity in the form of allergies, neurogenic mechanisms of hypertension, duration and quality of human life etc.

Benefits of using the drug Nervana before other methods of artificially increasing melatonin in the body. Any artificial introduction of melatonin into the body leads to a compensatory decrease in the production of its own hormone by the pineal gland. At the same time, the body goes into a dependent position, does not produce its own hormone, the pineal gland atrophies, hormone dependence begins, and numerous processes associated with it quickly “stall”. Any introduction of hormones is violence. The task is to achieve all this naturally, encouraging the body to do so. The drug Nervana belongs to this group of drugs.

Features of the drug Nervana is that it is needed not only in the presence of this pathology, but also to prevent it. It belongs to a rare group of drugs that are needed by almost all adults when the beginnings of inevitable age-related problems and diseases begin to appear against the background of a significant decrease in the level of melatonin in the body. All this can be significantly maintained, and not by a one-sided load on the exciting lever of the pendulum, for example, constant use of stimulating substances that invigorate the body over the years, such as coffee, tea and other stimulating processes, which ultimately, passing through the phases of adaptation and training, lead to a state similar to stress (general adaptation syndrome), when reserves are exhausted and the body is exhausted. This leads to the pendulum being skewed and destroyed. It would be much more correct to use an alternative to them for years - teas and preparations like Nervan. Balancing the pendulum with the method we propose, and even some tilt in the opposite direction, suggests the possibility of getting rid of a large part of inevitable age-related diseases and, accordingly, significantly prolonging life to natural biological norms.

Everyone needs Nervana! It should be in every home!

2. GINKGOtropil- ginkgo tablets in a jar. For a 3-month full course you need 3 jars.- cardiovascular diseases, cerebrovascular insufficiency, tinnitus, multiple sclerosis, poor blood supply to the extremities, varicose veins, arteritis (inflammation of blood vessels), accompanied by painful symptoms (painful cramps when walking), Raynaud's disease, migraines, toxic shock, reduces the likelihood of heart attacks and strokes, eliminates the consequences of a stroke, improves certain hearing and vision disorders, as well as dizziness, reduces cholesterol, slows down brain aging, increases performance, alleviates depression, stimulates memory, attention disorders

The course is at least 3 months, then a break of 2-3 months and repeat.

It will help get rid of some types of depression, since some types of depression are also associated with impaired blood supply to the brain.

The effectiveness of ginkgo has caused a real scientific explosion, in particular in Germany and France, where tens of millions of people have already achieved success in improving their health with its help. All over the world, many people take drugs from ginkgo to cleanse blood vessels from atherosclerosis, prevent heart attack and stroke, improve efficiency and improve brain function, to stop and eliminate the symptoms of aging, to extend life by 10-15 years.

Lack of Sleep Predisposes to Depression and Causes Increased Abnormal Eating. The body struggles with lack of sleep, i.e. insufficient production of melatonin through a compensatory increase in appetite. This is due to the fact that simultaneously with a decrease in the level of melatonin, the level of the antiphase neurotransmitter serotonin also decreases. To do this, the body is forced to compensatoryly increase appetite in order to increase the production of the missing serotonin, that is, the hormone of pleasure. Regular doses of food do not inhibit appetite, because... the level of tolerance is too high. This is where the primary roots of metabolic failures arise, failures of the regulatory functions of the melatonin-serotonin pendulum regulation mechanism, from which subsequent disruptions in the hormonal system and numerous age-related problems of “unclear etiology” begin. As a result, young people who are sleep-deprived, sleeping less than 8 hours a night, tend to indulge in sweets and fats (snacks, snacks, and often on the go) more voraciously than their peers who get enough sleep. This was discovered by scientists from the University of Sydney (Australia), who studied the lifestyle of young people aged 16-25 years. Behind this lies a subsequent metabolic disorder and possibly excess weight, premature aging, and accelerated onset of atherosclerosis.

3. ENERGOVIT- Succinic acid: - improves oxygen supply and nutrition to the brain and so that harmful metabolic products are more intensively removed from the brain.

– take 2 tablets after meals. 2-3 times a day, course 1 month, break, and repeat, until the end of the year. Taken regardless of other drugs, i.e. in parallel with them.

Improves cerebral and coronary blood flow, activates metabolic processes in the central nervous system, restores consciousness, reflex disorders, sensitivity disorders and intellectual-mnestic functions of the brain, has an awakening effect in post-anesthesia depression.

Stimulates respiration and energy production in cells, improves the processes of oxygen utilization by tissues, restores the activity of antioxidant enzymes. The drug activates intracellular protein synthesis, promotes the utilization of glucose and fatty acids. Application area: conditions with depression of consciousness, multiple organ failure syndrome. Neurology: acute and chronic cerebrovascular accidents, traumatic brain injury, dyscirculatory and posthypoxic encephalopathy, peripheral neuropathies, acute and chronic neuroinfections.

5. Kurunga(probiotic) - 3 b. – the powder is fermented in milk, or crackers with jam, or taken after meals in the form of fermented kefir, 1-2 glasses a day, the course is at least 3-5 months, the break is the same and can be repeated. - For the treatment of the intestines from dysbiosis, which is a prologue for allergies and weakened immunity. Usually when taking black walnut, you skip taking Kurunga. Book Garbuzova G.A.: “ Dysbacteriosis - prevention and treatment without drugs »

6. Green tea with GINKGO(powder for oral administration). - tea acts as an antiphase to St. John's wort.

7. Instructions “Treatment of depression with high doses of salt and water” Salt is a powerful stress reliever. Salt is vital for the kidneys to cleanse excess acidity and eliminate acid in the urine. Without enough salt, the body becomes more and more “acidic.” Salt is an essential element in the treatment of emotional and mood disorders. Lithium is a salt substitute that is used in the treatment of depression. By taking a small amount of salt, you can prevent painful depression. Therapeutic effect only occurs with long-term use over many months.Salt is necessary to maintain serotonin and melatonin levels in the brain. When water and salt perform their natural antioxidant functions and cleanse the body of toxic waste, it does not have to sacrifice important amino acids such as tryptophan and tyrosine. as antioxidants. In a well-hydrated body, tryptophan is saved and enters the brain tissue in sufficient quantities, where it is used to produce serotonin, melatonin and tryptamine - important neurotransmitters with antidepressant effects.

Many people experience depression during the winter, when there is an acute lack of sunlight and warmth. Polyunsaturated fatty acids, which fish are rich in, relieve depression and eliminate brain dysfunction. This explains why Japanese and Finns who eat fish every day are least susceptible to depression.

Diet:meaning of bananas . It has been scientifically proven that bananas increase efficiency, sharpen concentration, cleanse the body of toxins and especially the gastrointestinal tract, and take part in the production of the “happiness hormone” - serotonin. One or two bananas a day - and you have a stress reliever in your hands.

In the diet you need to reduce the fat content and increase the carbohydrate content. Moreover, both “fast” carbohydrates (sugars), which indirectly affect the content of serotonin, and slow ones (fiber) are needed. You also need to take care to get enough B vitamins and folic acid - substances that have a general regulating effect on metabolic processes in the body, in particular, on the vital activity of nerve cells. The main sources of B vitamins are cereals and brown bread.

Worm infestation as a cause of depression. Toxaplasmosis in humans provokes depression, increased anxiety and schizophrenia, and there is evidence of a connection between these diseases and the presence of antibodies to toxoplasma in the blood. In 2008, the Turkish Kocaeli University proved that these antibodies were found in 40% of schizophrenic patients who took part in the study, and only in 14% of healthy people from the control group.

I believe that for preventive treatment and additional elimination of other disease mechanisms, it is necessary to cleanse the body of worms. To do this, order.

- Take 1 teaspoon 2-3 times a day before meals, course 1 month, break 2 months and repeat. There are 3-4 such courses per year.

Black walnut infusion : for the mandatory concomitant cleansing of the intestines and liver from worms (by the way, in all American Health Centers, the mandatory program also includes the use of cleansing the body of worms using Black Walnut).

The introduction of the pathogen occurs in the small intestine; With the lymph flow, Toxoplasma enters the nearest lymph nodes, where inflammatory changes occur. From there, Toxoplasma enters various organs and tissues through the bloodstream, where cysts are formed that remain in the human body for decades and for life. In this case, “silent” allergization of the body and the production of antibodies occurs. The infection often goes unnoticed, but when the body’s defenses are weakened, a sharp and severe exacerbation of the disease can occur, and with significant suppression of the immune system (another serious illness, taking immunosuppressants, AIDS), a generalized infection can develop, affecting the heart muscle and brain (severe encephalitis) .

Additional drugs:

2. Infusion of horse chestnut flowers- 3 bottles

3. Book Garbuzova G.A.: “ Imagination - self-healing programming »

Every a person wants to behappy, to meet and see off a new day with a smile. Butfar not everyone can boast of being persistentgood mood. Oftencause lies ina disease called depression. What is depression? Depression is not at all a synonym for “depression” and not a sign of “weakness of will.”

How can you tell if you have depression? The manifestations of depression are very diverse. Today, unfortunately, only about a third of cases of this disease are recognized. But any form of depression is characterized by persistent (lasting more than two weeks) bad mood. Therefore, a simple test can be used for home diagnostics. See if you or your loved ones exhibit any of the following signs.

Basic: low or sad mood, loss of interests and desire to have fun, increased fatigue.

Additional: decreased ability to concentrate, low self-esteem or self-doubt, feelings of guilt, pessimistic vision of the future, suicidal thoughts or actions, sleep disturbances, appetite disturbances

With severe depression, 3 main and at least 4 additional signs are observed, with moderate depression - 2 main and 3 additional, with mild depression - 2 main and 2 additional.

Do you need to specifically fight depression? A person suffering from depression finds himself in a vicious circle: lacking the strength and desire to improve his life, he thereby worsens it. There is evidence that the cause of depression is a genetic predisposition. Moreover, in people prone to this disease, depression recurs several times in their lives. Special antidepressant measures will help not only cope with the current attack of depression, but also avoid a new one.

How to deal with depression? Depression can only be overcome by comprehensive measures, including changes in diet and lifestyle, as well as taking special medications. Those suffering from depression are advised to change their daily routine, spend more time in the fresh air, and increase physical activity.

Antidepressant medications are as important for those suffering from depression as insulin injections are for those suffering from diabetes. According to some data, 68% of general practice patients require medication correction with antidepressants. Drugs in this group are often needed by those who want to lose weight or reduce the manifestations of premenstrual syndrome. Antidepressants are divided into two large groups: synthetic and natural. Synthetic ones can be different in nature, but with good effectiveness they are distinguished by a large number of side effects.

TO STOMP AGE OR SENIEL CHANGES AS A CAUSE OF DEPRESSION

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THE 21ST CENTURY IS NOT EASY, “OUTPOST” WILL HELP US ALL

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In the last two decades, the importance of oxidative stress in the etiology and pathogenesis of various diseases has been established: atherosclerosis, diabetes, cancer, hypertension, neuroses, and inflammatory processes. The use of natural antioxidants has shown a number of their advantages in the treatment and prevention of free radical pathologies. Most of them are characterized by an effective effect on the leading factors of damage, the absence of side effects and low toxicity. Therefore, the search for highly active natural antioxidants is very relevant.

IT IS IMPORTANT. Oxygen is a vital element. However, it is very active and easily interacts with many substances, including harmful for the human body. Its aggressive forms provoke the formation of free radicals.

Free radicals are highly active substances that can cause harm to our cells. We are exposed to them constantly.

Their sources can be ionizing radiation (solar and industrial radiation, cosmic and X-rays), ozone, nitrogen oxide contained in exhaust gases, heavy metals (mercury, cadmium, lead, etc.), cigarette smoke, alcohol, unsaturated fats and many other substances contained in food, water and air.

CAUSE OF AGING AND CHRONIC DISEASES. Free radicals dangerous in that they destroy the lipid membranes of cells, participating in the processes of lipid peroxidation, and also cause damage DNA molecule, the keeper of all genetic information.

These reactions can lead not only to death cells, but also their degeneration, which sharply increases the risk of developing cancer. At the same time, free radicals are responsible for the development of many diseases, such as:

atherosclerosis, myocardial infarction, stroke etc.

An excess of free radicals leads to disruption of the functions of the cell membranes of our body, to health problems and premature aging.

HOW TO KEEP YOUR HEALTH

Substances can help the body resist these processes - antioxidants, capable of neutralizing the activity of free radicals.

"OUTPOST" – a natural balanced complex that can neutralize the harmful effects of free radicals. It not only has an antioxidant effect, but also activates and supports the body's own antioxidant defense system. A specially selected complex of plants complements and enhances the antioxidant effect of each other.

COMPONENT PROPERTIES

They have antioxidant (protect the body from free radicals) and adaptogenic effects

Strengthen the immune system, increase the body's natural defenses

Increases the body's resistance to infectious diseases

Have a detoxifying effect

They have a vascular and capillary-strengthening effect, increase the strength and elasticity of blood vessels

Reduce blood lipid levels, reduce cholesterol oxidation and its deposition in the walls of blood vessels

Reduce the risk of developing cardiovascular diseases, including myocardial infarction

They have anti-inflammatory and anti-edematous effects, stimulate the processes of restoration of damaged tissues

Inhibits the growth of tumor cells, has an antimutagenic effect

Increases the body's resistance to adverse environmental factors

Prevents premature aging

Diabetes

Atherosclerosis

Chronic stress conditions

Chronic fatigue syndrome

Diseases and conditions occurring against the background of suppressed immune response

Diseases of the gastrointestinal tract, accompanied by inflammation and spasms, disorders of bile secretion, digestion and assimilation of food - biliary dyskinesia, hepatitis, cholecystitis, pancreatitis. Colitis, etc.

Protecting the body from aging processes

Cardiovascular diseases

Cleaning from impurities and toxins

For long-term prevention and complex treatment of benign neoplasms and malignant tumors. Also during courses of antitumor, radiation and antibiotic therapy during the recovery period after surgical interventions, toxic and traumatic injuries.

To increase the resistance of the body of people exposed to adverse environmental, climatic, professional and stress factors (living or working in megacities, in environmentally and climatically unfavorable regions)

In conditions of acute and chronic intoxication (harmful effects of industrial and household waste, radiation, exposure to tobacco and alcohol

Compound:

- Black walnut is a powerful antioxidant. It binds free radicals, preventing their destructive effect on body tissue. Delays the aging process and helps prevent cancer, diabetes and heart disease.

- Common peach . In China, peach symbolizes longevity and is considered one of the main components of the elixir of youth. Peach leaf extract is rich in plant substances with a phenolic structure, in particular flavonoids, which have antitumor, choleretic, capillary-strengthening, antioxidant and immunomodulatory effects. The extract helps improve the detoxification function of the liver, normalizes the composition of bile, and also normalizes the tone of the smooth muscles of the bile ducts and the gastrointestinal tract as a whole. In addition, peach extract improves metabolic processes in the pancreas, and is recommended for use in cases of cholecystitis, pancreatitis, biliary dyskinesia, and dystrophic changes in the liver. Peach leaf extract has a positive effect as a means of preventing stomach cancer in the treatment of chronic atrophic gastritis and gastric ulcer. Removes toxins and waste from the body. It has a positive effect on all levels of the body’s defenses: it increases the effect of macrophages, as well as neutrophils, activates the production of antibodies, and also promotes the production of T-lymphocytes. Peach protects body cells from destruction by free radicals, thereby preventing age-related changes. There is evidence obtained from the Oncological Research Center at the Russian Academy of Sciences that the drug has the ability to prevent the development of cancer.

- Meadowsweet (meadowsweet) promotes regression of atherosclerosis and thrombus formation, relieves headaches of various types, has a powerful antibacterial and antiviral effect in acute respiratory infections, influenza, and herpes. It has been established that flavonoids (quercetin, isoquercitrin, quercetin 4-glucoside, rutin) and phenolcarboxylic acids (gallic acid) of the extract of the aerial part of meadowsweet have a nootropic effect, exhibiting antiamnestic, antihypoxic, antioxidant and adaptogenic activities. Studies of the antioxidant properties of individual compounds have shown the greatest activity of isoquercitrin, 4"-glucoside quercetin and rutin, exceeding similar indicators of dihydroquercetin and ascorbic acid. Thus, meadowsweet, as a plant containing a significant amount of phenolic compounds, is a promising source of antioxidant substances.

- Black grapes . Natural bioflavonoid antioxidant complex. Its active bioflavonoids-proanthocyanidins neutralize a wide range of free radicals, surpassing vitamin E in antioxidant potential by 50 times, and vitamin C by 20 times. Ellagic acid, a phenolic compound from grape seed extract, is another important antioxidant with a proven antitumor effect. Grape seed extract improves recovery, increases the elasticity and firmness of connective tissue and vessel walls. Heals the circulatory and respiratory systems, has an anti-inflammatory and anti-allergic effect. Proanthocyanidins strengthen blood vessels and restore blood circulation, which makes them especially useful for varicose veins, atherosclerosis of the arteries and cerebrovascular accidents.

- Sophora japonica . One of the highly effective components of Sophora is rutin, which is a natural protector of ascorbic acid (vitamin C), due to its antioxidant properties, protects it from excess oxidation. Thanks to the routine, Sophora strengthens the walls of blood vessels, reduces their fragility and permeability.

- Hibiscus(hibiscus). Substances that provide the plant with its red color - anthocyanins - help strengthen the walls of blood vessels. Hibiscus is one of the most natural sources of gamma-linolenic acid, with the help of which it is possible to perfectly cope with cholesterol problems in the human body. Normalizes blood pressure.

Method of administration and dose. Adults and children over 12 years old - 3-6 ml (1-2 teaspoon) 3 times a day. It is permissible to increase the dosage to 3 teaspoons. You can drink it with water. The course of admission is 30 days. The course can be extended to 2-3 months (for chronic diseases). Repeated courses after 2 months (if necessary).

Depressive syndrome in its most typical form (so-called simple depression) is represented by a depressive triad: depressed, melancholy mood (hypotymia), slow thinking and motor retardation. Low mood can have various shades: from feelings of sadness, depression to deep depression or gloomy moodiness. In more severe cases, oppressive, hopeless melancholy predominates, which is often experienced not only as mental pain, but also as an extremely painful physical sensation in the area of ​​the heart, less often the head or limbs (vital melancholy). Ideational inhibition is manifested by slow, quiet speech, difficulty concentrating, impoverished associations, and complaints of a sharp decline in memory. The movements of the patients are slowed down, their facial expressions are mournful, inhibited or frozen, and there is no desire for activity. In severe cases, there is complete immobility, a gloomy stupor (depressive stupor), which can sometimes be suddenly interrupted by a state of melancholic frenzy (raptus melancholicus). Depressive states, especially shallow ones, are characterized by fluctuations in depression throughout the day with an improvement in general condition, a decrease in ideational and motor inhibition in the afternoon and evening. In severe forms of depression, such fluctuations usually do not occur. Depressive syndrome is characterized by pronounced somatovegetative disorders in the form of sleep disturbances, appetite, and gastrointestinal tract functions (constipation); patients lose weight, their endocrine functions are upset, etc.

Types of depressive syndromes

Depression with Blame Ideas- thoughts about one’s worthlessness and inferiority are typical; a depressive reappraisal of the past occurs; in more severe cases, overvalued ideas of self-accusation or delusions of guilt and sinfulness arise; The severity of depression is indicated by suicidal thoughts and tendencies.

Anesthetic depression - accompanied by phenomena of melancholic derealization and depersonalization up to painful mental anesthesia (anaesthesia psychica dolorosa), painful insensibility, experiences of internal devastation, loss of love for loved ones, disappearance of the emotional response to the environment.

Ironic (smiling) depression - the smile is combined with bitter irony over one’s condition with extreme depression of mood and a feeling of complete hopelessness, the meaninglessness of one’s existence.

Tearful depression- depression with a predominance of tearfulness, incontinence of affect, and a feeling of helplessness.

Aching depression - constant complaints about something.

Grouchy (sullen) depression - a feeling of hostility towards everything around you, detachment, irritability, gloominess.

Asthenic depression- with low mood, severe weakness, exhaustion, hyperesthesia.

Adynamic depression- with a predominance of lethargy, apathy, indifference, and a general decrease in vitality.

Anxious depression - in the picture of depression, anxiety, prevailing over the affect of melancholy, and anxious fears occupy a significant place; more or less pronounced motor restlessness.

Agitated depression - sharp arousal with groans, anxious verbalization, self-torture.

Depressive arousal may be accompanied by fear, timidity, hypochondriacal complaints or unstable depressive delusions: individual ideas of condemnation, punishment, death, impoverishment, etc.

Delusional depression- depressive delirium occupies a central place in the structure of the depressive syndrome and is a persistent psychopathological formation; This is a complex, “major” depressive syndrome.

Delusional disorders often take the form of fantastic ideas of enormity and denial (Cotard's syndrome). There are a number of variants of this syndrome: in some cases, the picture of anxious-delusional depression is dominated by nihilistic-hypochondriacal delirium with ideas of decay or complete absence of internal organs, in others there is depressive delirium with ideas of immortality, eternal torment; sometimes fantastic melancholic delirium manifests itself in denial of the outside world.

There are other variants of complex depressive syndromes, for example depression with delusions of accusation and condemnation, depression with delusions of persecution, the content of which, however, always follows from the content of depressive delirium. A complex syndrome with pronounced depressive affect (with feelings of fear and anxiety), ideas of guilt, condemnation and sensory delusions of persecution, meaning, dramatization is called depressive-paranoid syndrome. At its height, oneiric stupefaction is possible.

In the structure of complex syndromes, depression can be combined with catatonic disorders, hallucinations, pseudohallucinations, and phenomena of mental automatism.

Along with the forms of depressive syndromes described above, there are the so-called hidden (masked, larved, erased) depression, which manifests itself primarily as a variety of somatovegetative disorders (for example, persistent headaches or extremely painful sensations in various parts of the body, etc.). Typically, depressive symptoms are erased or even completely covered by vegetative ones. These conditions are classified as depressive syndromes on the basis of their frequency, daily fluctuations in the state, the positive therapeutic effect of antidepressants, as well as more typical affective phases in the history and frequent hereditary burden of affective psychoses.

Motor retardation in depressed patients can be very pronounced, up to depressive stupor- complete immobility. In a stupor, patients retain a characteristic depressive posture and facial expressions; It’s difficult, but you can still establish contact with them. With a slightly noticeable nod of the head, sometimes even a barely noticeable movement of the eyelids, they answer, making it clear that they hear and understand the interlocutor. A depressive state is often accompanied by delusional ideas, mainly self-deprecation, persecution, and nihilistic delusions. In severe depression, a symptom may be observed painful mental: insensitivity(anaesthesia psychica dolorosa), when the patient ceases to still feel, love, react emotionally to the environment and suffers deeply from this: “I haven’t seen my son for several years, I was waiting for him, and when he appeared, I didn’t experience any joy, this is so hard".

A depressive state is often combined with anxiety, and patients can be very restless, rush about, wring their hands, moan loudly (agitated depression; lat. agitatus - scream, excite). The extreme degree of agitated depression is a “melancholy explosion” - raptus melancholicus (Latin rapio - to grab). In severe depression, depersonalization is often observed.

Depressive syndrome occurs in reactive states, involutional psychoses, organic brain diseases, manic-depressive psychosis, and schizophrenia.

TASK.

Patient O., 54 years old, disabled group II. He is being treated in a psychiatric hospital. She is hardly noticeable in the department and is uncommunicative. Most of the time she is not busy with anything, sits on her bed, often sighs heavily. There is an expression of melancholy and anxiety on the face. When talking with a doctor, he gets agitated, trembles slightly, and constantly moves his hands through his clothes. There are tears in my eyes. Complains of depressed mood, insomnia, and an influx of endless anxious thoughts about home. Life seems unnecessary and aimless to the patient; she often thinks that life is not worth living. Here is an excerpt from a conversation between a doctor and a patient.

Doctor: why do you think that no one needs you? At home you run the household and raise your grandchildren. It would be difficult for your children without you.

Patient: The grandchildren are probably no longer alive... They are gone!

Doctor: why do you say that? After all, just yesterday you had your son on a date. He said everything was fine at home.

Patient: I don’t know... Probably everyone died. Doctor, what's wrong with me? Do something, help...

What type of depression are we talking about?

SAMPLE CORRECT ANSWER

The patient's depression is combined with a feeling of extreme anxiety. Anxiety in its manifestations is close to the feeling of fear, but differs from the latter in the absence of a specific object to which it would be directed. Anxiety lies in the constant expectation of some irreparable misfortune or catastrophe. The patient tries to put this or that content into this anxious feeling, suggesting that misfortune can happen to people close to her, to herself. Anxiety is expressed not only in statements, but, above all, in facial expressions and behavior of patients. Anxious patients are rarely inhibited. More often they are constantly on the move, walking back and forth around the room, moving objects with their hands. This behavior is typical for this patient.

This is anxiety depression.

Anxiety-depressive syndrome is a disease of modern society. This disease manifests itself in the form of various types of mental and physical disorders, which are accompanied by unpleasant sensations throughout the human body. As a rule, depression manifests itself in the form of a melancholic state, apathy and depression, and anxiety is characterized by an increased sense of fear and emotional tension. In practice, it has been found that depressed patients experience more anxiety. In total, they give a complex pathology that is difficult, but still possible to cure.

ICD-10 code

F40 Phobic anxiety disorders

F31 Bipolar affective disorder

F32 Depressive episode

Causes of anxiety-depressive syndrome

The most common causes of anxiety-depressive syndrome are the following factors:

• long-term chronic illness;
• hereditary predisposition to the disease;
• severe fatigue;
• the presence of stressful situations, both at work and at home (dismissal from work, death of a loved one);
• deficiency of important essential amino acids in the body (tryptophan, phenylalanine);
• taking certain medications (barbiturates (phenobarbital), anticonvulsants (Celontin, Zarontin), benzodiazepines (Klonopin, Valium), Parlodel, calcium channel blockers (Kalan, Tiazac), estrogen drugs, fluoroquinolone, statins (Lipitol, Zocor).

Pathogenesis

Anxiety-depressive syndrome begins in adolescence. During the transition period, children are especially sensitive and emotional. They react painfully to any remark. Criticism addressed to them gives reason to think about their inconsistency with society’s criteria. This serves as an impetus for the development of anxiety-depressive syndrome. On its basis, various kinds of phobias subsequently appear. With age, the feeling of anxiety and panic only intensifies. A person perceives the reality around him in gloomy tones. He is aggressive, which can cause him to develop persecution mania. When even minor disturbances in the functioning of the body occur, a person develops a feeling of anxiety, and even panic. Even people close to him are treated with distrust. He struggles with problems that don’t really exist, having spent all his strength and energy on it to no avail.

Symptoms of anxiety-depressive syndrome

A number of symptoms indicate that the patient is developing anxiety-depressive syndrome:

• decreased mood;
• fluctuations in emotional state;
• sleep disturbance;
• constant feeling of anxiety;
• expectation of failure;
• phobias appear;
• fast fatiguability;
• general weakness;
• concentration decreases, the speed of thought processes slows down;
• lack of desire to work.

From the side of the vegetative system the following is observed:

• cardiopalmus;
• tremor;
• feeling of suffocation;
• increased sweating;
• pain in the solar plexus area;
• chills;
• constipation;
• abdominal pain;
• muscle spasm;
• frequent urination.

These symptoms may be present in many people who are under stress, but if they appear for a month or more, there is every reason for a diagnosis of “anxiety-depressive syndrome.” But only a psychotherapist will give a final conclusion.

First signs

The main sign that a patient has anxiety-depressive syndrome is anxiety for no apparent reason. He is constantly in a depressed state, which is accompanied by melancholy, apathy, increased irritability, and inexplicable anxiety. There is a noticeable decrease in interest in activities that previously enjoyed. Labor activity decreases, quickly gets tired during physical exertion and actions that require intellectual expenditure. All his thoughts are full of negativity and pessimism. There is stiffness in movements and inhibition of reactions.

Complications and consequences

If you have symptoms of anxiety-depressive syndrome and do not seek help from a specialist (psychotherapist, neurologist, psychologist), this can lead to serious consequences. These are problems in marital relationships, as well as with other family members. Such patients experience difficulties in their professional activities, which can lead to dismissal, which will only worsen the situation. The risk of accidents increases. If anxiety-depressive syndrome is diagnosed in parents, this will affect the emotional state of children. This mental disorder can lead to significant functional impairment and decreased quality of life. The most dangerous consequence is suicidal thoughts and their implementation.

Complications

Anxiety-depressive syndrome aggravates the course of all diseases. Complications from the cardiovascular system are observed in the form of pain in the heart area, heart rhythm disturbances, hypertensive crisis, increased blood pressure, acute coronary syndrome, and heart failure. Pain appears in the gastrointestinal tract, appetite decreases, which can lead to anorexia and cause increased flatulence, constipation, and nausea. Pain symptoms occur in various parts of the body - migrating or local, paresthesia. Anxiety-depressive syndrome can cause genetic risks and also cause cancer.

Diagnosis of anxiety-depressive syndrome

Like any deviation in the functioning of the body, anxiety-depressive syndrome requires detailed study in order to prescribe the correct treatment. To diagnose this disease, various methods are used in order to deeply study the problem. An integrated approach gives a complete picture of the patient’s condition. It is important to distinguish anxiety-depressive syndrome from anxiety, phobia, asthenia, and chronic fatigue.

Analyzes

For any disease, blood and urine tests are mandatory. Based on the results of the first parameter, the doctor can determine the presence of a particular pathology, which will determine the further tactics of treating the patient. In case of anxiety-depressive syndrome, the level of hemoglobin and ESR will also be important, which will help to establish inflammatory processes in the blood, infectious or allergic in nature, anemia and other blood diseases. To exclude the possibility of hormonal factors.

A general urine test will also indicate the presence of pathologies in the patient’s body, which will indicate the possible cause of anxiety-depressive syndrome due to the presence of chronic pathology.

Instrumental diagnostics

When visiting a doctor, a person cannot always describe the problem that caused the disease. Or he deliberately keeps silent about it. To examine a patient with anxiety-depressive syndrome, electroneuromyography is used, which will help determine the functional state of muscles and peripheral nerves, X-ray diagnostics, ultrasound, EEG, which will help exclude toxic and metabolic causes of psychotic symptoms, MRI to determine the organic causes of unusual behavior, and a study of regional blood flow. In order to exclude somatic pathology.

Changes in the ECG with anxiety-depressive syndrome

Anxiety-depressive syndrome is often accompanied by unpleasant sensations in the chest area. The patient may complain of stabbing pain in the heart, disruptions in its functioning, namely “fading,” and lack of air. The doctor necessarily prescribes an ECG procedure, but the described problems are not confirmed on the cardiogram. Tachycardia or high blood pressure is present. It is possible to identify single extrasystoles. But, despite this, patients still monitor their pulse and look for signs that would indicate the presence of a fatal disease.

Differential diagnosis

To determine the severity of anxiety-depressive syndrome, differential diagnostic techniques are used. Based on their results, the course of treatment is determined.

• Montgomery-Asberg scale. It is used to determine the severity of the disease and the change in the patient’s condition after therapy.
• Hamilton scale: designed to determine the dynamics of depressive states.
• Zung Scale: Used to measure self-reported anxiety and depression. Seven parameters are studied: feelings of mental devastation, mood changes, somatic and psychomotor symptoms, suicidal thoughts, irritability, indecisiveness.
• Methodology “Scale for differential diagnosis of depressive states.” Its purpose is to determine the level of depression.
• Methodology for differential diagnosis of depressive states V.A. Zhmurova.

Treatment of anxiety-depressive syndrome

When treating anxiety-depressive syndrome, the main emphasis is on medications. The use of homeopathic remedies, traditional medicine recipes and herbal remedies is not excluded. Only complex therapy will give a positive result. Medicines.

• Imipramine is an antidepressant. It is used to improve well-being, reduce anxiety, stimulate activity, and increase vitality. The initial and maintenance dose is 50/150 mg. per day, with a gradual increase to 150/250 mg. After the effect is achieved, the dosage of the drug is reduced. Side effects: headache, dry mouth, epileptic seizures, dizziness, rapid heartbeat, hallucinations, weakness, tremor, arrhythmia, weakness, decreased libido, orthostatic hypotension, constipation, paresthesia, allergic reactions, impotence. Imipramine is contraindicated in pregnant women, patients with tachycardia, with renal/liver failure, with bladder atony, with post-infarction syndrome, patients with schizophrenia, those who are sensitive to the components of the drug, children under two years of age.
• Fluxovamin - used to treat all types of depressive conditions. The dosage is determined individually for each patient. The initial daily dose is 0.1 g. With a gradual increase to 0.3 g. Take three times a day. Side effects: causes drowsiness, increases anxiety, tremors, dry mouth, nausea, blurred vision, anorexia. Contraindications: pregnancy and lactation, childhood, liver failure.
• Sertraline is intended for the treatment of depressive conditions. Daily dose: 50 mg, followed by an increase to 200 mg. The result will be in a week, full recovery in a month. Maintenance dose – 50 mg. Side effects: tremor, dispersion, nausea, dizziness, gait disturbance, menstrual cycle disruption, allergic reactions, in men - delayed ejaculation. Contraindications: pregnancy and breastfeeding.
• Prozac is used for depression of any nature. The daily dose is 20 mg, increasing to 80 mg. The drug is divided into two or three doses. For maintenance therapy – 20 mg. The duration of treatment is a month. Side effects: headache, asthenia, hand tremors, impaired attention, memory, increased anxiety, suicidal thoughts, decreased appetite, allergic reactions, disturbances in the functioning of the lungs and liver. Contraindications: individual intolerance, renal/liver failure, diabetes mellitus, epilepsy, anorexia, pregnancy and breastfeeding.

Vitamins and minerals

Vitamin deficiency in the human body is also one of the factors in the development of anxiety-depressive syndrome. To restore balance, they need to be taken in the form of medications or increase the amount of foods with the highest amount in your diet.

• Biotin: beef, liver, milk, cheese, crab, squid, tomatoes, mushrooms, onions, wholemeal bread, carrots.
• Folic acid: beans, onions, parsley, asparagus, carrots, turnips, pumpkin, beets, cabbage, nuts, seeds.
• Vitamin B12: caviar, mussels, egg yolks, hard cheeses.
• Thiamine: liver, bran, seeds, potatoes, peas, rice, buckwheat, parsley.
• Riboflavin: peanuts, figs, grapes, beef, cottage cheese, chocolate.
• Vitamin C: lemon, sea buckthorn, cabbage, tomatoes, malinakiwi, spinach.
• Iron: liver, red meat, almonds, buckwheat, apples, prunes, barley, carrots, rose hips.

Physiotherapeutic treatment

Physiotherapeutic procedures are part of the complex treatment of anxiety-depressive syndrome.

• Electroconvulsive therapy. It is based on an electric shock, which, passing through the brain, causes convulsions, which makes it work more intensely.
• Electrosleep - using low-frequency current of low strength. They cause inhibition in the cerebral cortex, after which it comes to a calm state, improving sleep. Darsonvalization of the scalp and face is a rapidly decaying current of high frequency, high voltage, low strength, which relaxes, after which blood flow increases, and the tissues receive improved nutrition.
• Massage - regardless of the type - manual, hardware or self-massage, it helps to relax the muscles and gives a calming effect.
• Oxygen therapy. The patient is placed in a special chamber into which oxygen is supplied under pressure. The cells of the body are saturated with it.

Traditional treatment

Traditional medicine recipes are also used in the treatment of anxiety-depressive syndrome:

• 1.5 tbsp. chopped mint and the same amount of hawthorn pour 400 ml. hot water. Cover the container and let it brew for 25 minutes. Strain and take ½ cup three times a day after meals.
• 3 tbsp. Chop oat straw. Pour into any convenient container and pour two glasses of boiling water. Let it brew for 8 hours. Drink in small portions per day.
• 50gr. grated horseradish pour 0.5 liters. fortified white wine. Place the vessel in a cool, dark place for ten days. Don't forget to shake it from time to time. Take 1 tbsp. three times a day.
• 0.5 tbsp. poppy seeds, the same amount of eryngium seeds, 200 ml. red wine. Mix all ingredients and put on fire. Boil for 10 minutes over low heat, stirring constantly. Cool, take 1 tbsp. three times a day.

Herbal treatment

Some types of herbs have a calming effect, so they are used in the treatment of various types of mental disorders, including anxiety-depressive syndrome. These include:

• ginseng, from the leaves of which a soothing infusion is prepared. Ginseng-based preparations can be found in many pharmacies;
• angelica Used in the treatment of depression and nervous exhaustion in the form of an infusion. To make medicine I use angelica root.
• bird's knotweed. It is used for lethargy and general weakness of the body, which are present in depression.
• Aralia Manchurian. Helps with mental illness. To prepare the infusion, take the root of the plant and pour it with alcohol. In addition to them, valerian, dog nettle, hawthorn, mint, hops and some others have a calming effect.

Homeopathy

Homeopathic medicines are widely used for anxiety-depressive syndrome.

• Bioline Stop Smokin - indicated for anxiety, increased excitability, irritability, nervous tension. Take one tablet every hour, then 4 times a day. Side effect: allergic reaction. Contraindications: children under 12 years of age, pregnancy, breastfeeding, hypersensitivity.
• Valerian compositum – neurosis, insomnia, headache, anxiety, excitability, fear. Take seven granules three to four times a day for one month. Repeat if necessary. Contraindications: Hypersensitivity. Side effects: Allergic reactions.
• Hypnosed - insomnia, neurasthenia, increased excitability. Dosage: 8 granules per day 4-5 times per day. The course of treatment is three months. Contraindications: Hypersensitivity. Side effects: None identified.
• Cute - A sedative used for nervous excitement, sleep disturbance due to fatigue and nervous excitement. One tablet in the morning and afternoon, 2 tablets in the evening. 15 minutes before meals. Contraindications: hypersensitivity to the components. Side effects: causes allergic reactions.
• Neurosed - Neurotic disorders. The daily dose for adults is 24 granules. For children – 15 granules. Half an hour before meals. The course of treatment is 2 months. Contraindications: Hypersensitivity. No side effects were identified.

Prevention

In order not to think about treating anxiety-depressive syndrome in the future, you need to start preventing it today. The amount of positive emotions should be increased. If the weather is bad outside, then it is best to have a weekend at a sunny resort. There is no such opportunity when you decorate the walls of your home and office with bright, cheerful paintings. To reduce stressful situations you need to lead a healthy lifestyle. Balance your diet, increase the amount of healthy foods in it, and give up bad habits. Play sports and choose active recreation. Make time for your favorite activity. Follow a work-rest schedule. The key to good health is sleep. Get enough sleep and you will always be in a great mood. A healthy lifestyle is impossible without harmony of thoughts and actions. Meditation will teach you to control your thoughts. Be kind to others and avoid aggressive behavior.

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Forecast

Anxiety-depressive syndrome, like any other disorder, occurs differently in each person. Achieving results will require a certain amount of time, as well as patience from both the patient himself and the people around him. If the symptoms were identified at the initial stage and have a clear demarcation, so the cause of the disease is obvious, then the prognosis will be favorable. It is facilitated by the behavior of the patient himself, who regularly visits the doctor and follows his recommendations. Receives full support from loved ones. An important factor is a trusting relationship with the doctor, and when the patient himself understands the purpose of treatment and adequately responds to the measures taken.

It is important to know!

In a recent study carried out by the Queen Elizabeth Medical Center in Western Australia on 400 young adolescents aged 10 to 14 years, 10% were considered clinically depressed, and more than half of the children were assessed by doctors as being prone to depression in the future. Depressed teenagers believed that happiness was achieved only through fame, money and beauty.

Depressive syndromes(lat. depressio depression, oppression; synonym: depression, melancholy) - psychopathological conditions characterized by a combination of depressed mood, decreased mental and motor activity (the so-called depressive triad) with somatic, primarily vegetative, disorders. They are common psychopathological disorders, second only to asthenia in frequency (see. Asthenic syndrome ). Approximately 10% of those suffering from D. s. commits suicide.

In some cases, stuporous symptoms occur—distinct movement disorders reaching the intensity of substupor and, occasionally, stupor. The external appearance of such patients is characteristic: they are inactive, silent, inactive, and do not change posture for a long time. The facial expression is mournful. Eyes are dry and inflamed. If patients are asked a question (often repeated several times), they answer in monosyllables, after a pause, in a quiet, barely audible voice.

Symptoms of depression (in mild cases and less often in severe cases) are especially intense in the morning; in the afternoon or evening, the condition of patients, both objectively and subjectively, can improve significantly (recovery by five o'clock in the afternoon, as French psychiatrists put it).

There is a large number of depressions in which there is primarily a lack of motor, and less often, speech inhibition. They are called mixed depression - a depressed or melancholy mood is accompanied by speech and motor excitement (agitation). At the same time, depressive affect also changes; usually it is complicated by anxiety, less often by fear (anxious-agitated or agitated depression with fear). In this state, patients are haunted by painful premonitions of impending misfortune or catastrophe. In some cases, anxiety is pointless, in others it is specific (arrest, trial, death of loved ones, etc.). The patients are extremely tense. They cannot sit or lie down, they are constantly “tempted” to move. Anxious agitation with motor agitation very often manifests itself in the incessant appeals of patients to the staff with the same requests. Speech excitement, as a rule, is manifested by groans, groans, and monotonous repetition of the same words or phrases: “scary, scary; I ruined my husband; destroy me”, etc. (the so-called alarming verbigeration). Anxious agitation can give way to melancholic raptus - a short-term, often “silent” frantic excitement with the desire to kill or mutilate oneself. Anxiety-agitated depression may be accompanied by depressive delusions of various contents. With them, Cotard's syndrome most often occurs - a fantastic delusion of enormity and denial.

Denial can extend to universal human qualities - moral, intellectual, physical (for example, there is no conscience, knowledge, stomach, lungs, heart); to the phenomena of the external world (everything is dead, the planet has cooled down, there are no stars, no Universe, etc.). Nihilistic or hypochondriacal-nihilistic delirium is possible. With delusions of self-blame, patients identify themselves with negative historical or mythical characters (for example, Hitler, Cain, Judas). Incredible forms of retribution for what they have done are listed, including immortality with eternal torment. Cotard's syndrome in its most pronounced form appears in adulthood and old age. Some of its components, for example, the idea of ​​universal destruction, can arise at a young age.

Depression is also complicated by the addition of various psychopathological disorders: obsessions, overvalued ideas, delusions, hallucinations, mental automatisms, catatonic symptoms. Depression can be combined with shallow manifestations of psychoorganic syndrome (so-called organic depression).

A special version of D. s. are hidden depressions (synonym: vegetative, without depression, masked, somatized, etc.). In these cases, subdepression is combined with pronounced, and often dominant, vegetative-somatic disorders in the clinical picture. Hidden depression, which occurs almost exclusively in outpatient practice, exceeds ordinary depression in frequency by 10-20 times (according to T.F. Papadopoulos and I.V. Pavlova). Initially, such patients are treated by doctors of various specialties, and if they go to a psychiatrist, it is usually a year or several years after the onset of the disease. The symptoms of latent depression are varied. Most often, they occur with disorders of the cardiovascular system (short-term, long-term, often in the form of paroxysms, pain in the heart area, radiating, as happens with angina, various disturbances in the rhythm of cardiac activity, up to attacks of atrial fibrillation, fluctuations in blood pressure) and digestive organs (decreased appetite up to anorexia, diarrhea, flatulence, pain along the gastrointestinal tract, attacks of nausea and vomiting). Unpleasant pain in various parts of the body is often observed: paresthesia, migrating or localized pain (for example, characteristic of lumbago, toothache, headache). There are disorders resembling bronchial asthma and diencephalic paroxysms, and very often various sleep disorders. Autonomic-somatic disorders observed in latent depression are called depressive equivalents. Their number is increasing. Comparison of the symptoms of latent depression with the onset of a wide variety of D. s. reveals certain similarities between them. And ordinary D. s. often begin with somatic disorders. When hidden for a long time (3-5 years or more), there is no deepening of affective disorders. Hidden depression, like depressive syndromes, is characterized by periodicity and even seasonality of occurrence. The mental conditionality of somatic pathology in latent diseases is also evidenced by their successful treatment with antidepressants.

Depressive syndromes occur in all mental illnesses. In some cases they are their only manifestation (for example, schizophrenia,

manic-depressive a), in others - one of its manifestations (epilepsy, traumatic and vascular lesions of the brain, brain tumors, etc.).

The diagnosis is made based on the clinical picture. In elderly people, a differential diagnosis is often made with psychoorganic syndrome.

Mild forms of depression are treated on an outpatient basis, severe and severe forms are treated in a psychiatric hospital. Antidepressants and tranquilizers are prescribed. With the complication of D. s. neuroleptics are added to delusional, hallucinatory and other deeper psychopathological disorders. For anxiety-agitated diseases, especially those accompanied by deterioration of the somatic condition, as well as for diseases with a long-term adynamic component, it is indicated electroconvulsive therapy. For the treatment and prevention of some D. s. lithium salts are used (see Affective insanity ). Due to the possibility of treatment, severe D. s., for example, with Cotard's delirium, are extremely rare; Mostly they occur in undeveloped forms. "Shift" D. s. towards subdepression is an indication for mandatory use, especially in outpatient treatment, psychotherapy, the form of which is determined by the structure of the d. and the personality of the sick person.

The prognosis depends on the development of D. s., which can be paroxysmal or phasic, i.e. The disease occurs with remissions and intermissions. The duration of attacks or phases ranges from several days to 1 year or more. An attack or phase can be single throughout life or repeated, for example annually. With multiple attacks or phases of D. s. often occur at the same time of year. Such seasonality, other things being equal, is a favorable factor, because allows you to begin treatment before the onset of painful disorders and thereby smooth out the intensity of the manifestation of depressive syndrome. In old age D. s. often have a chronic course. Therefore, in these patients, the issue of prognosis should be addressed with caution. D. syndromes that can lead to death, such as malignant presenile melancholia, have practically disappeared (see. Presenile s ). The main danger of D. s. lies in the possibility of suicide attempts by patients. More often they tend to commit suicide at the beginning of development and with a pronounced reduction in depressive disorders. Therefore, it is not recommended to discharge such patients prematurely; it is better to “overstay” them in the hospital. In a hospital setting, suicide attempts are typical for patients with agitation, anxiety and fear.

Bibliography: Anufriev A.K. Hidden endogenous depression. Message 2. Clinical systematics, Journal. neuropath. and psychiat., vol. 78, no. 8, p. 1202, 1978, bibliogr.; Vovin R.Ya. and Aksenova I.O. Protracted depressive states, L., 1982, bibliogr.; Depression (psychopathology, pathogenesis), ed. O.P. Vertogradova, s. 9, M., 1980; Nuller Yu.L. Depression and depersonalization, L., 1981, bibliogr.; Nuller Yu.L. and Mikhalenko I.N. Affective s, L., 1988, bibliogr.