We distinguish a minor disorder, dysthymia, that is, the bad mood, occasional, less
serious, more limited in time and in signs, from the major, actual, more serious,
psychiatric depressive disorder.
It's a chronically depressed mood, present for most of the day, almost every day
for 2 years. Individuals with Dysthymic Disorder feel sad and "down". They still
have one or more of the following symptoms:
- lack of appetite or otherwise hyperphagia (eat chocolate, sweets, snacks,
etc.)
- insomnia or hypersomnia
- Low energy or asthenia
- low self-esteem
- difficulty in concentrating or making decisions
- feelings of despair
There is dysthymia in 2% of the elderly who may arise as a loss of self-esteem,
ie the elderly's inability to cope with emerging needs; the dysthymia arises
especially in the autumn or winter season, when the elderly is more at home and
alone; it can be associated with other feelings: sensation of chest pain,
dyspnoea, cardiopalmos, vertigo, abdominal pain, constipation, pollakiuria,
urinary urgency, widespread musculoskeletal pains, headache, memory disorder,
dizziness. It can be associated, again, with true systemic pathologies:
- hypothyroidism
- ischemic cardiopathy (cardiopathic patient, infarcted, hospitalized in UTIC
etc.)
-brain cerebral disease (patient with a cerebral stroke who cries, gets
desperate, is not self-sufficient)
- Parkinson's Disease (disoriented, aggressive, asocial patient, who feels
abandoned and disabled)
It can be mild, moderate or severe. According to American studies, 26% of women
and 12% of men are affected, especially if there is a relative degree in the
family who is affected.
Major depressive episode
It is characterized by:
There are 5 or more of the following symptoms reported; is characterized by a
period of 2 weeks, not caused by particular pathological situations (eg serious
illness and hospitalization) nor associated with delusional cues:
- Mood depressed for most of the day
- weight loss or weight gain or reduced appetite almost every day.
- insomnia or hypersomnia
- agitation and psychomotor retardation almost every day
- fatigue
- feelings of excessive or inappropriate self-evaluation or guilt (which can be delusional), almost every day
- reduced ability to concentrate or think
- thoughts of death (not only with a specific plan or conception of a specific plan to commit suicide.
- Symptoms cause significant distress and impairment in social, occupational, or
other important areas of functioning.
- Symptoms are not dependent on substance use, e.g. drugs
- Symptoms do not depend on mourning, ie loss of person (eg spouse)
There were no other psychiatric manifestations, e.g. schizophrenia, delusional
or psychotic depressive disorder, or hypomaniacal
It is characterized by the presence of two or more major depressive episodes,
interspersed 2 months one from the other there must not be other manifestations
of psychiatric relevance (as above)
It is written with the exclamation point because every disturbance of the mood
should never be underestimated and I tell you by experience and knowledge of the
cause: it is not the first time that we read of suicides in the newspaper of
people at the peak of career, housewives divorced, of students, etc. The first
goal is to go to the psychiatrist, without shame, or hesitation! Well aware that
20% of the population, subjected to the pressure of daily stress, is affected by
psychiatric problems. The psychiatrist will carefully evaluate your problem and
prescribe the antidepressant medication that "sews", or better, on you,
depending on the symptoms you are suffering from. They are:
- old tricyclic antidepressants
- the new SSRIs, ie serotonin reuptake inhibitors; eg: fluoxetine, sertraline,
paroxetine, fluvoxamine and citalopram
- other antidepressants, bupropion, nefazodone, trazodone, venlafaxine,
mirtazapine and reboxetine.
- MAO inhibitors.
The treatment is highly specialized, so you must contact the psychiatrist; the
drugs at the beginning of the treatment can give sedation, but then this is a
beneficial effect that can be used for therapeutic purposes (in fact, if a
person suffers from insomnia because his head makes him run down and sends him
down, better than that! ); sometimes they can give dry mouth, impaired ability
to focus on objects, tachycardia, sexual dysfunction, for anticholinergic action;
finally they can give weight gain, but it's okay if a subject was previously
asthenic. In short, you must take care if you have directions. And we close with
a curiosity: studies conducted in the 80s have shown that exposure to sunlight
seems to 10,000 lux directed towards the patient's face X 30 minutes at least
once a day is able to cure depression and stress. The discovery means that in
our cursed metropolises of the North, without parks, without sun and without
color, we live badly; take account of the political lords in planning with the
architects the metropolis of the future, where parks and life in the sunlight is
important: as you can see the article soma psiche ambiente had already hit the
target, ie an individual lives in a a social and natural context in which his
body plunges into an environment, descending with the psyche, that is, with the
central Nervous System that connects us to everything else; it follows that if I
am sick in my natural environment, because I have no contact with the social,
with the neighbor, with the gardener, with the charcuterie, with the priest and
so on, nor with nature, my mind and mine are affected body.