6 myths about depression: how to distinguish the disease from spleen and how to escape from it

depri.jpgThe book of Anton Zayniev and former journalist of “Komsomolskaya Pravda” Darya Varlamova “crazy!” became a bestseller and has just been awarded the “Educator” in the nomination “Natural and exact Sciences”. Despite the fact that it is not about physics and not on mathematics, but of psychology and psychiatry. About those mental illnesses that make people suffer from the point of view of others – out of the blue.

Darya and Anton have had clinical depression; recovered and together they wrote this book. Let us now try to understand that common beliefs about depression and its treatment – the truth and what is lies.

Depression is just a very bad mood. And patients just need to pull myself together!

FALSE, AND DANGEROUS. Depression is a serious illness that makes a huge number of people unable to work. Among the main symptoms stifling apathy. Varlamov and Zayniev compare it with the kiss of a Dementor from the “Harry Potter”: the Dementors were able to suck out a person’s soul, and he, devastated, lost the taste for life. The researcher illness, Andrew Solomon said that the opposite of depression is not joy, and vitality. He went through it and recalled: “it was devastatingly difficult for me. For example, the desire to take the handset took effort, comparable to the need to overcome dvohsotkilohramovi rod lying”.

Unfortunately, many people think that the person suffering from depression needs to be written unbelievable grief and suffering. Without noticing them, the patient starts to say something like “cheer up!”, “You really all right – you would look at disabled people and starving children in Africa!”, “Remember that life is beautiful!” and similar phrases, in this case completely useless. In addition, the word “depression” is used left and right as a symbol of a normal spleen, and bad mood (e.g., after parting with the girl or young man, and not because the window is bad weather) – and many end up not treat the disease seriously, not realizing how painful it is.

To distinguish depression from sadness is not so difficult. In depression, apathy and bad mood typically last more than two weeks and (very important) is not directly dependent on external circumstances. That is, the mood falls without any noticeable reasons. Someone sharply reduced self-esteem, someone who sees the future in a gloomy light, and some start without an end to torture yourself over past mistakes… Depression does not extend to any one area of life, and all at once (for example, if a person is bad at work, and in the evenings he dances at parties and is having an affair, depression, he does not – probably just need to change jobs). Finally, depression is commonly associated with psychosomatic disorders, and they can be very different. Often unexplained headaches, shortness of breath, feeling of heaviness in the whole body… Or the person increased appetite, he “jammed” his discomfort – and sometimes, on the contrary, generally do not eat. He may have chronic insomnia, or, conversely, he can sleep all day, trying to get away from the world and its problems.

The suffering of man, which from life removed all the joy, there are intolerable and cause suicide. Although at the peak of depression the patient usually is no will: he just anything no strength to commit suicide including. Paradoxically, suicidal tendencies may occur during treatment, at the very beginning. Sometimes when taking modern drugs will energy back to the patient earlier than a good mood. And this period is considered the most dangerous man is still very bad, and to commit suicide he can.

Antidepressants didn’t help

HELP, ALTHOUGH NOT SO EASY TO FIND THE RIGHT. Like it or not, and they – the main method of struggle with depression. The mechanism of their effects on neurons and neurotransmitters in the book Varlamova and Zayniev devoted many pages. They hot their supporters.

Although opponents of the tablets immediately say that the brain is the most complex and worst of all the studied organ in the human body. And psychiatry as a science was born just a century ago. And tablets that allow you to achieve healing, began to produce and did in the 1950s – 80s. And in this case, each patient suffering from depression, bipolar or obsessive-compulsive disorder, needs its own combination of drugs that cures one will not cure another. And while proper treatment would be to pick up the patient may have time to give up on the pills…

Actually there is quite a movement “antipsychiatric”, which is strictly against modern psychiatry as such. They compare it in its current state with medieval astronomy, who knew neither Copernicus nor Galileo. And I love the experiment posed in 1973 by psychologist David Rosenhan. He and seven of his colleagues decided to become patients of psychiatric hospital, complaining of hallucinations (every told the doctor that he hears the voice repeating the words “empty”, “hollow” and “plop”, but otherwise acted completely normal). Although all the experimenters were malingerers, they immediately put serious diagnoses (mainly schizophrenia) and a few weeks being dosed with drugs – they barely got out of the hospital!

Then the leadership of one of the clinic, learning about the experiment, said that they have exactly none of the simulator does not slip. Then Rosenhan said that within three months especially will send them some “fake patients.” As a result, the hospital management has caught more than forty patients imaginary… and was shocked when Rosenhan admitted that he had cheated doctors and sent to hospital none of the pretender!

Nevertheless, there is the stubborn fact: antidepressants work, they have a very high cure rate. There are thousands of living people, which they pulled out of hell, and they’re wildly grateful to them for it.

Anton Zayniev says: “the Fall mood, fall of appetite, the appearance of apathy is all nephrolithiasis processes, specific disruptions in the brain, in nerve cells. Yes, we don’t know what leads to those or other failures, and I can’t do x-rays, as in the case with a broken hand. But we understand what the failure is. On the one hand, neural connections in humans are less extensive, on the other hand, the brain lacks a specific neurotransmitter, serotonin presumably. And all this with pills can be repaired. Proven: if you take the depressed patients, split into two groups, and the first to give a dummy medication, a placebo, and the second is the real drug, the people from the second group will recover much more likely”.

If depression is the result of biochemical processes in the brain, why man falls into her after the tragic event and can’t come out for months?

EVERYTHING IS INTERCONNECTED. Depression is conventionally divided into endogenous (due to internal factors) and exogenous (caused by external – constant failures at work, death of a spouse, etc.). But one thing can smoothly into the other. On the one hand, the lack of magnesium can cause very real existential crisis. On the other hand, Intrusive unpleasant thoughts can change the biochemistry in the head. Let’s say a person died someone close to her: first, I was depressed due to psychological stress, then it constantly thinks about it, “wind” themselves – and changes the neurochemistry of the brain.

And psychotherapy, so do not need. It’s talking about anything, just a way for the doctor to earn a lot of money on the chatter!

NO. Daria Varlamov: “it so Happens that a person with a terrible spiritual crisis – in fact, in the body just lacks a certain substance. Medicine in General, aligns the affective condition removes the failures in the mood, gives energy and reduces anxiety. But I, having lived through the depression, began to believe in psychotherapy. In my case it was cognitive-behavioral, although there are other methods. With depression, there is a lot of mental garbage: lowered self-esteem, or “toxic” perfectionism: or I have to do everything perfect or I’m worthless… that’s all well sawed psychotherapy, and medication can and should with it to combine”.

If I go to the doctor, I’ll be considered crazy. Even in the hospital stuff. And in General – it’s a brand! Then still at work know about it…

Not TRUE. Since Soviet times there is a fear of “registration in the mental hospital”, but there is no such wording. With anxiety disorders or with depression you have no one in the hospital will be sent if we are not talking about very severe cases in hospitals without you patients enough. Of course, if you show up to the psychiatrist with an axe and saying that you’re being hunted, reptilians, the place’ll be found, but most likely you will be prescribed medications and treated you as an outpatient: according to statistics, hospitalization ends less than 1 percent of visits to a psychiatrist.

Further problems may arise with obtaining a driver’s license. But when applying for a job trouble should not be – officially, the medical institution has no right to keep private information about you.

Daria Varlamova says: “Personally, I think that it is better to go to a good private psychiatrist because the state mental hospital is a lottery. You can get to the appropriate specialist, and may, on very inadequate, which does not help you, and even the wrong diagnoses. Especially if you are morbidly afraid that you will bring in some “lists”, “archives” etc. – it is better to go to the owner: there is no “list crazy” is definitely not. But in any case, if you had bad symptoms, thumbing through a book such as this – faster is better to consult a specialist, and not torment yourself. Unfortunately, in Russia many people think that I don’t see hallucinations and not talking to Martians, too early to go to a psychiatrist, you just have to rest and “pull myself together”. And the result is suffering.”

Electroconvulsive therapy (ECT) – hell method of punitive psychiatry, after the people become vegetables.

Not TRUE. The West has a very poor reputation (thanks to movies like “one Flew over the cuckoo’s nest” or “Francis”). It is now rarely used – largely due to the reputation created by the filmmakers. Consider it a barbaric method, appropriate only in cases of severe, resistant depression tablets.

But among Western psychiatrists found another position. Some of them are themselves prone to depression, strictly punish colleagues: “If I have a head start, do not treat it with pills, just take it to EST!” In fact it is painless and effective procedure that restarts the brain – as a hanged computer which you opened too many programs. Common complication: amnesia: it is possible to forget what happened in the last year (“Dr. house” after ECT, the patient lost all memory forever, but it’s also fantasy writers, in reality, the memory usually returns).

Really barbaric and hellish method of direct effects on the brain, lobotomy, method of excision of certain shares for the purpose of healing from mental illness. But it now does not apply nobody. In this Portuguese scientist EGAS Moniz invented the lobotomy in 1949 received the Nobel prize in medicine. In the 90s, when Mones already died, he retroactively tried to deprive of the Nobel prize – but to no avail, the Nobel Committee has defended it. In his difficult times, when there were no anti-depressants or haloperidol or normotonikov, a lobotomy seemed like a panacea.

Now in the UK patients with extremely severe obsessive-compulsive disorder, which is due to a disease on the verge of suicide, sometimes carried out neurosurgical operations, make accurate cuts in the so-called “striped body”, the part of the brain that is believed to be responsible for the disease. And sometimes then she really is. However, this is an extremely risky procedure.


Howard Hughes (character Leonardo DiCaprio in “the Aviator”): obsessive-compulsive disorder (OCD)

The characters sometimes several times wash hands, step over cracks in the pavement (and if I come back and still step over), put objects in a strictly defined perfect order, close and open the front door, trying to carry out this action “right”. What is “right” or “perfect” – only understand them.

All these are symptoms of OCD, very various and painful diseases. The symptoms can vary – from a pathological desire for purity (around it is full of dangerous microbes!) to come to mind painful thoughts (the believer in the Church’s thinking about what might in some horrible way to desecrate icons, loving children man suddenly thinks that children can be cause severe pain, etc – though, of course, none of this they are not going to do). And someone out on the street, afraid that I forgot to turn off the iron, and now your house catches on fire. Comes back, checks out and thinks: “And suddenly bad check?..” And so – 15 times. And he is well aware of the absurdity of their behavior. Just irrational anxiety is stronger than logic.

All this obsessions, or, to put it simply, obsession, the same obsession, they are the same spell. As the hero of the same DiCaprio in Inception, the most resilient parasite is an idea: if it is located in the head, it will not get rid. People with OCD Intrusive thoughts come endlessly swirling in my head like a catchy melody, causing terrible discomfort. To “shake” them, it is necessary to take actions that in the eyes of others look stupid. For example, to go to the bathroom and as if to metaphorically wash away all the bad hands. Or wash hands to literally remove the germs. Or to say certain phrases in a particular sequence. Or for the sixteenth time to go home and check the iron. It is compulsive, obsessive rituals.

Perhaps it is the pieces of a magical consciousness, trying to find the link between completely different phenomena. “As a child, Turner repeatedly tried to convince myself that it is foolish to try to prevent sudden death of the mother only, not to step into crevices in the pavement of the sidewalk near the school Playground. And yet it never came — and mother remain alive.” This is from the novel by Ian McEwan “Atonement”, and this is a description of OCD that the character with age, however, has not developed – and many developing accidents.

There is another theory. How to write Anton and Daria in his book, “the origins of OCD are in the same place and from other diseases of the disturbing spectrum, but the peculiarity of this disorder that its development involved the striatum (the striatum) and the amygdala is not involved (and therefore the emotion of fear itself is not recognized). Dysfunction in the striatum create a disturbing background, the prefrontal cortex “converts” it into specific fears, the thalamus creates protects them from the rituals. And jump on every new stage in the cycle like the previous clips. This creates a vicious circle that the patient is very difficult to break”.

Carrie Mathison (heroine Claire Danes on “homeland”): bipolar affective disorder (BAR).

In Soviet times it was known as manic-depressive psychosis. The stage of euphoria, of ecstasy and delight in this disease are replaced by the stages of deep depression. You flew on wings and felt like a king, but then suddenly everything became very bad, I want to lie down and look at one spot. People in the manic stage are able to gain credits in the Bank and give all the money to the poor (“Well, I’m making the world better and brighter!”) or buy a sailboat with the goal to go around the world. They invented the saying “keep me seven”. Well, when this stage is replaced by depression, the person is just hell.

There is a soft and simple stage BAR, the so-called cyclothymia, when inexplicable elation (hypomania) is replaced by a slight sadness and melancholy. Many believe that the seasonal cyclothymia was Pushkin, not fond of summer, but very fond of autumn. In particular, this splash explain the number of brilliant texts that he once, not looking up from the paper, wrote in Boldino. Pushkin, of course, not diagnosed, but this version looks quite plausible.

Hypomania for creative people – desirable and blissful state. You are full of inspiration and energy never understand how come the good thoughts, and you do not get tired. Everything seems to be fine, but alas, it can go into BAR 2, where hypomania is replaced by a full-fledged depression. But not in BAR 1, the more severe disease where it’s not about hypomania and mania in its purest form. There may already begin psychosis like delusions of grandeur. For example, a person in a euphoric start to think that maybe jumping from balcony to balcony like a superhero from the movies and all this will end sadly.

Daria Varlamova says: “Easy hypomania is dreamed any man would, I think. Perhaps this sounds unprofessional, but nonetheless… But there is a group of drugs normotimiki, which is the manic state is removed. They can be combined with antidepressants that is a little bit of “pull up” on the top and bottom that the person did not leave neither ecstatic nor in agony, but remained somewhere in between. The most famous normotimiki – Li. It is now considered obsolete, but, nevertheless, it is one of the most effective ways to pronounced “bipolar”. Complain to him, that he creates several “gray”, “no” mood, but the peaks and valleys it cleans quite effectively”.

Rambo (character of Sylvester Stallone in several films): post-traumatic stress disorder

As we know, Rambo is a Vietnam war veteran, who had to deal with torture and other horrors. He has classic PTSD. Characterized by Intrusive memories of the trauma experienced (they may be in the form of nightmares), trying not to think and not to talk about it (for example, a flight attendant, became a witness of the crash, quits his job in the Navy), dark thoughts, negative attitude towards themselves and/or to others and unwillingness to communicate with them. This main symptom – and sometimes even partial amnesia, when a person just erased the memory of a terrible event (and then it may suddenly return).

In Hollywood love to make films about PTSD – is a convenient engine of the plot in thrillers, and all the characters with him are grim, harsh, and effective. Batman, for example, also suffer from trauma (his eyes in his childhood killed both my parents – since he became “the dark knight”, morose and unsociable, which is difficult even to have a relationship with women). But the disease is, unfortunately, not only movie – it is found, for example, many soldiers returning from “hot spots”, women survivors of rape and so on.

But in fact many and not found. Why some people are extremely sensitive to trauma, and others – is relatively easy? How to write Varlamov and Zayniev, “according to one theory, a breakdown caused by a malfunction of the hippocampus (for example, patients with PTSD discovered it increased blood flow). This part of the brain responsible for working memory. It is assumed that the stress memory is not “archived”, so the body over and over again, experiencing it as if it is happening in reality”.