The concept of depression includes clinical conditions whose main disorder concerns mood or affect. Traditionally, this group includes depressive disorders, mania and submaniacal states, and anxiety disorders. A light form of depression is often unrecognized. The person feels chronic fatigue, weariness and discouragement to life. Depression caused by reactive factors is manifested by a smaller number of psychosomatic symptoms. According to the WHO (World Health Organization) report, by 2020 depression may become the second largest health risk after cardiovascular disease. The clinical picture of depression is dominated primarily by the depressed mood, which is felt by the patient as a state of gloom, resignation, and sadness. The patient is unable to experience joy, happiness and satisfaction. Anhedonia appears, or inability to feel any pleasures. A separate problem is the recognition of depression in the elderly age, when symptoms characteristic to depression are very often considered a normal manifestation of the body aging or as an inherent element of the somatic disease. Currently, it is estimated that as many as 40% of cases of depression in people over 65 remain undiagnosed.
The key symptom of depression is lowering the mood, but this is not the only sign of depression. Depression is a disease in which the symptoms reach various intensities and occur in many configurations. We distinguish the following types of depression: reactive, endogenous, neurotic, anankastic, agitated, large and small, morning (subclinical and subliminal), seasonal, masked, psychotic, postpartum, drug resistant, in children and adolescents, in the elderly, involutional, organic , in bipolar disorder, dysthymia, depression and anxiety, and in somatic diseases. Psychotherapy is now a popular and effective method of treating depression. The effects of treatment after the use of antidepressants appear only after a few weeks from the beginning of therapy. Old-generation medicines: these are tricyclic antidepressants (TLPDs), inhibitors of neuromediator reuptake and monoamine oxidase enzyme (IMAO) inhibitors. The new generation of drugs is distinguished by selective serotonin reuptake inhibitors (SSRIs), selective serotonin and noradrenaline reuptake inhibitors (SNRIs), four-ring drugs, noradrenaline reuptake inhibitors, selective reversible MAO inhibitors, and drugs with other mechanisms of action. Phototherapy (treatment of light) is currently a widely accepted method of winter depression therapy. Other treatments for depression include electroconvulsive therapy and transcranial magnetic stimulation.
It is important to run a family therapy alongside treatment of a patient with depression. The patient's family commits quite a frequent mistake of treating depression complaints as a manifestation of laziness, fatigue and ill will. There are two stages in education. In the first one, the essence of depression to the patient and his family is explained. The second stage of education is to draw attention to the mental and social sphere of the patient. This stage consists of two phases: psychological and social. Therapeutic communication is a specific form of communication. Help is directed to people who cannot make order in their own emotions, thoughts and perceive correctly the surrounding reality. The purpose of communication is also to facilitate the patient's expression of emotions. Therefore, therapeutic communication of a healing nature is the basis for helping mentally ill patients. Suicide is usually committed on impulse in the first, acute phase of depression or after entering the latent phase. Suicide is now considered a multidimensional phenomenon, resulting from the complex interaction of biological, psychological, sociological and environmental factors. The psychological state of people with suicidal tendencies is characterized by three characteristics: ambivalence, impulsiveness, stiffness. Suicide in children and adolescents is of the utmost importance
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