recurrent episodes of depression
Introduction
Introduction Depression can cause the patient's emotions, interests, sleep, appetite to be obviously disordered, and the psychological function as a whole is impaired, seriously interfering with learning and life. Early onset of depression usually recurs and prolongs into adulthood, and can easily lead to other serious illnesses.
Cause
Cause
The cause of depression is complicated
So far, the medical community is not very clear about the cause of depression, but the general view is that it has a lot to do with genetic factors, social environmental factors, personality traits, autoendocrine function, brain function.
1. Genetics: Depression has a close relationship with family history. Studies have shown that one of the parents has depression and the child has a 25% chance of getting sick. If both parents are depressed, the child's prevalence increases to 50%-75%. Genetic factors only mean that there is a tendency to develop depression. It is not that parents have depressive illness and their children will definitely get depression. This genetic factor will only work if stimulated by the external environment.
2, social and environmental factors: people feel stressed life events and sense of loss can induce depression, such as widowed, especially elderly widowed, divorced, lost work, financial crisis, loss of health and so on. Intense social competition, excessive psychological stress, family structure and changes in marriage are the psychosocial factors that contribute to the increase in the number of depression.
3. Physical factors. The basis of depression is the disorder of some chemical substances in the brain. One type of person has poor regulation ability and is prone to metabolic disorders. Now study the relatively thorough biological factors, namely the function and metabolic abnormalities of central neurotransmitters.
4. Physical illness. Among the medical patients in general hospitals, one-third are accompanied by depression, and many of the surgical patients are accompanied by depression. Data show that the incidence of depressive symptoms is 5.8% in the general population, 9.4% in patients with chronic physical illness, 33% in general hospitalization, 36% in elderly inpatients, 33% in outpatient cancer patients, 42% in hospitalized cancer patients, and stroke. 47% of patients, 45% of patients with myocardial infarction, and 39% of patients with Parkinson's disease.
5, personality traits: depression and human personality are closely related. Some people are very embarrassed, and there is no such thing in their hearts. These people generally do not get depression. Usually two types of people are more prone to depression. First, people who are inferior, self-blame, and sentimental, such as Lin Daiyu itself, are depressive personality figures. They are sad and eager all day, and everything is going to be bad. They are often trapped in extreme inferiority, self-blame, and pessimism. The other type is people who are too pursuing perfection. These people are serious about everything, pursue perfection, have strong self-respect, and are demanding themselves to be harsh. They are not allowed to make mistakes. Too much pursuit of perfection is actually a defect of personality. Once such people are defeated and frustrated, it is difficult to get rid of it. This is why many people with excellent quality and great achievements finally choose to commit suicide.
6. Brain degeneration changes caused by age. This is a new cause of depression found in recent years. In the absence of obvious external stimuli, the elderly have degeneration with brain function, the body's ability to regulate is reduced, and the incidence of depression is obvious. rise.
7, endocrine changes. The prevalence of female depression is twice that of men. There are three peaks in female depression: First, adolescence, many women have symptoms of depression and anxiety before menstruation, which indicates that endocrine changes are important factors in changing people's mood; It is postpartum depression. According to foreign surveys, about 30% of postpartum women suffer from different degrees of depression. This is because the hormone levels in the body have changed dramatically. Another is that menopausal depression is relatively high, also with Endocrine instability is related.
Examine
an examination
Related inspection
Cerebrospinal fluid magnesium electroencephalography
Depression is a functional disease, usually with a reduction in urine (serotonin) delivery and a decrease in cerebrospinal fluid serotonin levels. However, it is necessary to eliminate the depression caused by encephalitis, brain tumor, cerebrovascular disease and Parkinson's disease in clinical practice. At the same time, it is necessary to exclude depression caused by physical diseases such as hypothyroidism, chronic hepatitis and systemic lupus erythematosus. Wait.
Diagnosis
Differential diagnosis
Differential diagnosis of recurrent depression:
1. Affective mental disorder depressive episodes, also known as endogenous depression, have no obvious psychosocial factors and start the disease, the condition is severe, often mental retardation; depressive symptoms can be accompanied by psychotic symptoms, such as delusions, hallucinations, Self-blame and self-blame; there are still biological changes, such as depression, often with heavy rhythm changes, early onset of insomnia, significant weight loss due to non-physical factors; serious suicide attempts or attempted suicide history and family History, a history of bipolar seizures, or three episodes of unipolar depressive episodes, are easily differentiated from depressive neurosis.
2. neurasthenia sometimes has depressive symptoms, but the clinical manifestations of neurasthenia are mainly characterized by excitement and fatigue. Depressive symptoms are not the first symptoms, but secondary symptoms, few interest reduction, suicidal concept, low self-evaluation Etc. Depression is not a persistent depression and is easy to identify.
3. Schizophrenia often has special thinking disorders and common symptoms such as hallucinations and delusions. Although accompanied by depressive symptoms, it is not difficult to distinguish from depressive neurological symptoms.
4. Anxiety disorders are often accompanied by depressive symptoms, which are difficult to identify. Some people even call it anxiety and depression syndrome. But it is important to first distinguish who is the primary symptom. Anxiety disorders are mainly characterized by anxiety. If you have an acute anxiety attack, or refer to the test results of the anxiety and depression scale, it is easier to identify with depressive neurosis.
5. Single episode of depression In general, single episodes of depression, also known as single episodes of major depressive disorder, refers to only one episode, no manic symptoms, mixed depression symptoms, and mild mania symptoms. The first time suffering from depression and compounding the above symptoms is also called single-episode depression, because it is unknown whether the patient will develop the disease in the future, and if it is re-occurring, it is called recurrent depression.
