الإكتئاب Depression

الإكتئاب Depression

هو هبوط نفسي بالغ الشدة ، يخيل للمرء المصاب به أنه فاشل في كل شيء وغير نافع لأي شيء ، فيداهمه اليأس ويسلبه نشاطه ويفتر همته . وقد يختفي الاكتئاب من تلقاء نفسه ولكنه يتكرر ، والعلاج لدى الطبيب النفسي يخفض من شدته ويقلل من احتمال عودته.
يرى علماء النفس ان للاكتئاب اساسا بيولوجيا ، ويؤكدون حدوث تغيرات فعلية في كيميائية الدماغ متى شعر المكتئب بالحزن والاسى ، فيلاحظ إنخفاضا في الموصلات العصبية الكيميائية الحيوية لتنظيم أمزجةالمريض خلال نوبة خطيرة من الاكتئاب .

يمكن تقسيم السلوك الاكتئابي إلى ثلاثة انواع رئيسية يتفرع منها العديد من حالات الإكتئاب . هذه الانواع هي إكتئاب خفيف ، إكتئاب حاد وإكتئاب ذهولي حاد .

عوارض الإكتئاب الخفيف :

لامبالاة تجاه أي أمر ، حزن وعبوس ، تشاؤم ، بطء ذهني وحركي ، بلادة في نظرات العيون ، شعور المكتئب بأنه انسان فاشل ، فقدان الثقة بالنفس ،مزاج دوري ،تعب .

عوارض الإكتئاب الحاد :

إضافة إلى عوارض الإكتئاب البسيط هناك : اضطراب المزاج ، تبدلات في الوزن والقابلية إلى الطعام ، اضطراب نمط النوم ،إحساس بالذنب ، برود جنسي ، تعاسة واضحة على وجه المريض .

عوارض الإكتئاب الذهولي الحاد :

رفض المريض الإختلاط بالغير ، العزلة الشديدة ، شعور بالأسى والقهر واحتقار الذات. يعنِّف نفسه بقسوة ويتهمها بأبشع الصفات ، ويكون مقتنعا أنه سبب المشاكل والمصائب لمن حوله. يبدو في بعض الاحيان شديد التوتر والانفعال ، وفي احيان اخرى لا ينفعل لشيء .
يفقد الشعور بالواقع ، وتظهر عليه هلوسات سمعية ، لكن قدراته الذهنية وذاكرته تظل كما هي. يتمنى الموت أو اللحاق بعزيز سبقه الى الموت وقد يحاول الإنتحار .

كما ان هناك العديد من أنواع الإكتئاب منها :
إكتئاب المراهقة ويُنسب لأسباب جنسية حادة ،
اكتئاب داخلي المنشأ سببه اضطراب في تكوين الشخصية وبنيتها ،
اكتئاب خارجي المنشأ يعود لظروف خارجية ،
اكتئاب انفصالي ويأتي عقب انفصال والدي المكتئب ،
اكتئاب قهري ،
اكتئاب خلقي
واكتئاب دوري .
وهناك نوع من الاكتئاب خاص بالنساء وهو الاكتئاب الانتكاسي ،
وتصاب به النساءفي سن الياس، ويعود سببه للتغيرات الهرمونية المصاحبة لانقطاع الطمث مما يحدثت اثيرا سيئا على معنويات المرأة ،
إذ قد تشعر أن السنوات الأجمل في حياتها ولَّت وبانها ما عادت مرغوبة وجذابة ، فتداهمها الافكار اليائسة وتسيطر عليها .
وهناك اكتئاب ما بعد الولادة ،
إذ كثيرا ما تصاب المرأة بالاكتئاب بعد الولادة ويعود ذلك لاحساسها أنها تجد نفسها مسؤولة عن كيان وحياة طفل .

تفكير المكتئب بنفسه عادة سلبي جدا يبكي على ماضيه ويتشاءم لمستقبله وكل لحظة تمر عليه تغدو عذابا ومعاناة، حتى تسريح شعره يصبح عنده جهدا جسميا وروحيا ، لذا فإنه ياخد بالظهور بمظهر أشعت غير مهندم .

اي علاج للمكتئب يجب أن يبدا بفحص طبي شامل ، فبعض الادوية تسبب الكآبة كمفعول جانبي ، وبعد إجراء الفحص الطبي الشامل تتقرر طبيعة العلاج فإما ان تكون بيولوجية او سيكولوجية ، وإما الاثنان معا وذلك تبعا لنوع الاكتئاب المصاب به الشخص .
كما ان التعبير عن الاعجاب بموقف ما قام به مريض الإكتئاب أو الاطراء على عمل ما أدّاه أوإظهار الحب له ، كلها محاولات قد تعود عليه بالفائدة متى قدمت بشكل مقنع ومنطقي ،وقد تخفف من حدة كآبته وترفع من مستوى معنوياته .ومتى كانت حالة المريض متقدمة فلابد من مراجعة الطبيب النفسي ، إذ هناك حالات خطيرة وصعبة يكون التداوي فيها بالعقاقير المناسبة والجلسات الكهربائية اساس في علاج المريض إلى جانب تفهم وحسن معاملة المحيطين به .

الإكتئاب عند الاطفال:

يطال الاكتئاب جميع مراحل الطفولة ، ولكنها تختلف قليلا في سن المراهقة .
من اعراضه في مراحل الطفولة : العدائية ، الكسل ، المزاج الحاد ، الحزن ، ويعود سبب معظمها لانفصاله عن احد والديه أو كليهما معا .

من اعراضه في مرحلة المراهقة :

عدم الاحساس بمباهج الحياة ، الضجر والتبرم ، الشكوى الدائمة ، الحزن العصبية

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(Depression (major depressive disorder

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depression, major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness, nor is it something that you can simply "snap out" of. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychological counseling or both. Other treatments also may help.

Symptoms

Although depression may occur only one time during your life, usually people have multiple episodes of depression. During these episodes, symptoms occur most of the day, nearly every day and may include:

Feelings of sadness, emptiness or unhappiness
Angry outbursts, irritability or frustration, even over small matters
Loss of interest or pleasure in normal activities, such as sex
Sleep disturbances, including insomnia or sleeping too much
Tiredness and lack of energy, so that even small tasks take extra effort
Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
Anxiety, agitation or restlessness — for example, excessive worrying, pacing, hand-wringing or an inability to sit still
Slowed thinking, speaking or body movements
Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that are not your responsibility
Trouble thinking, concentrating, making decisions and remembering things
Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide
Unexplained physical problems, such as back pain or headaches
For some people, depression symptoms are so severe that it's obvious something isn't right. Other people feel generally miserable or unhappy without really knowing why.

Types of depression

Depression affects each person in different ways, so symptoms caused by depression vary from person to person. To clarify the type of depression you have, your doctor may add information to your depression diagnosis called a specifier. Specifiers include having depression with specific features, such as:

Anxious distress — unusual restlessness or worry about possible events or loss of control
Mixed features — simultaneous depression and mania, which includes elevated self-esteem, talking too much, and racing thoughts and ideas

Melancholic features — severe depression with a profound lack of response to something that used to bring pleasure, associated with early morning awakening, worsened mood in the morning, significant changes in appetite, and feelings of guilt, agitation or sluggishness

Atypical features — ability to be cheered by happy events, increased appetite, little need for sleep, sensitivity to rejection, and a heavy feeling in arms or legs

Psychotic features — depression accompanied by delusions or hallucinations, which may involve themes of personal inadequacy or negative themes

Catatonia — includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture

(Peripartum onset — occurs during pregnancy or in the weeks or months after delivery (postpartum

Seasonal pattern — related to changes in seasons and diminished exposure to sunlight

Depression symptoms in children and teens

Common symptoms of depression in children and teens are similar to those of adults, but there can be some differences.

In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.
Depression may occur with other mental health conditions, such as anxiety, eating disorders, substance abuse or attention-deficit/hyperactivity disorder (ADHD

Depression symptoms in older adults

Depression is not a normal part of growing older and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, including:

Memory difficulties or personality changes
Fatigue, loss of appetite, sleep problems, aches or loss of interest in sex, which are not caused by a medical condition or medication
Often wanting to stay at home, rather than going out to socialize or doing new things
Suicidal thinking or feelings, especially in older men

When to see a doctor

If you feel depressed, make an appointment to see your doctor as soon as you can. Depression often gets worse if it isn't treated. Untreated depression can lead to other mental and physical health problems or troubles in other areas of your life. Feelings of depression can also lead to suicide.

If you're reluctant to seek treatment, talk to a friend or loved one, a health care professional, a faith leader, or someone else you trust.

If you have suicidal thoughts

If you or someone you know is having suicidal thoughts, get help right away. Here are some steps you can take:
Reach out to a close friend or loved one.
Contact a minister, a spiritual leader or someone in your faith community.
Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.
Make an appointment with your doctor, mental health provider or other health care provider.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

If you have a loved one who is in danger of committing suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

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Causes
By Mayo Clinic Staff

It's not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:

Biological differences : People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes

Brain chemistry : Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. When these chemicals are out of balance, it may be associated with depressive symptoms.

Hormones : Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result from thyroid problems, menopause or a number of other conditions.
Inherited traits : Depression is more common in people whose biological (blood) relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.

Life events. Traumatic events such as the death or loss of a loved one, financial problems, high stress, or childhood trauma can trigger depression in some people.

Risk factors

Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women are diagnosed with depression than men, but this may be due in part because women are more likely to seek treatment.

Researchers have identified certain factors that seem to increase the risk of developing or triggering depression, including:
Depression that started when you were a teen or child
History of anxiety disorder, borderline personality disorder or post-traumatic stress disorder
Abuse of alcohol or illegal drugs
Certain personality traits, such as having low self-esteem and being overly dependent, self-critical or pessimistic
Serious or chronic illness, such as cancer, diabetes or heart disease
Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor
(before stopping any medication
Traumatic or stressful events, such as physical or sexual abuse, the loss of a loved one, a difficult relationship or financial problems
Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide

Complications of Depression

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