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There are several reasons why we may experience anxiety and depressed mood. They manifest themselves in different ways, and it can be quite difficult to distinguish between these causes. To do this, you need to have sufficient information, access to which is far from being available to everyone. An educational program on depressive and anxiety disorders was decided by journalists Daria Varlamova and Anton Zainiev¹.

דעפּרעסיע

You are depressed all the time. This feeling arises, as it were, from scratch, regardless of whether it is raining outside the window or the sun, Monday today or Sunday, an ordinary day or your birthday. Sometimes a strong stress or traumatic event can serve as an impetus, but the reaction may be delayed.

It’s been going on for a long time. Really long. In clinical depression, a person can stay for six months or a year. One or two days of bad mood is not a reason to suspect that you have a disorder. But if melancholy and apathy relentlessly haunt you for weeks and even months, this is a reason to turn to a specialist.

Somatic reactions. Sustained mood decline is only one of the symptoms of a biochemical failure in the body. At the same time, other “breakdowns” occur: sleep disturbance, problems with appetite, unreasonable weight loss. Also, patients with depression often have reduced libido and concentration. They feel constant fatigue, it is more difficult for them to take care of themselves, go about their daily activities, work and communicate even with the closest people.

GENERALIZED ANXIETY DISORDER

You are haunted by anxiety, and you cannot understand where it came from.. The patient is not afraid of specific things like black cats or cars, but experiences unreasonable anxiety constantly, in the background.

It’s been going on for a long time. As in the case of depression, for a diagnosis to be made, the anxiety must have been felt for six months or more and not be associated with another disease.

Somatic reactions. Muscle tension, palpitations, insomnia, sweating. Takes your breath away. GAD can be confused with depression. You can distinguish them by the behavior of a person during the day. With depression, a person wakes up broken and powerless, and in the evening becomes more active. With an anxiety disorder, the opposite is true: they wake up relatively calm, but over the course of the day, stress accumulates and their well-being worsens.

PANIC DISORDER

פּאַניק אנפאלן — periods of sudden and intense fear, most often inadequate to the situation. The atmosphere can be completely calm. During an attack, it may seem to the patient that he is about to die.

Seizures last 20-30 minutes, in rare cases about an hour, and the frequency varies from daily attacks to one in several months.

Somatic reactions. Often, patients do not realize that their condition is caused by fear, and they turn to general practitioners — therapists and cardiologists with complaints. In addition, they begin to be afraid of repeated attacks and try to hide them from others. Between attacks, the fear of waiting is formed — and this is both the fear of the attack itself and the fear of falling into a humiliating position when it occurs.

Unlike depression, people with panic disorder don’t want to die.. However, they account for about 90% of all non-suicidal self-harm. This is the result of the body’s reaction to stress: the limbic system, responsible for the manifestation of emotions, ceases to provide a connection with the outside world. The person finds himself detached from his body and often tries to harm himself, only to regain the feeling inside the body.

PHOBIC DISORDER

Attacks of fear and anxiety associated with a frightening object. Even if the phobia has some basis (for example, a person is afraid of rats or snakes because they can bite), the reaction to the feared object is usually disproportionate to its real danger. A person realizes that his fear is irrational, but he cannot help himself.

Anxiety in a phobia is so strong that it is accompanied by psychosomatic reactions. The patient is thrown into heat or cold, his palms sweat, shortness of breath, nausea, or palpitations begin. Moreover, these reactions can occur not only in a collision with him, but also a few hours before.

סאָסיאָפּאַטהי Fear of close attention from others is one of the most common phobias. In one form or another, it occurs in 12% of people. Social phobias are usually associated with low self-esteem, fear of criticism and increased sensitivity to the opinions of others. Social phobia is often confused with sociopathy, but they are two different things. Sociopaths are scornful of social norms and rules, while sociophobes, on the contrary, are so afraid of judgment from other people that they do not even dare to ask for directions on the street.

OBESSIVE-COMPULSIVE DISORDER

You use (and create) rituals to deal with anxiety. OCD sufferers constantly have disturbing and unpleasant thoughts that they cannot get rid of. For example, they are afraid of hurting themselves or another person, they are afraid of catching germs or contracting a terrible disease. Or they are tormented by the thought that, leaving the house, they did not turn off the iron. To cope with these thoughts, a person begins to regularly repeat the same actions in order to calm down. They can often wash their hands, close the doors or turn off the lights 18 times, repeat the same phrases in their heads.

Love for rituals can be in a healthy person, but if disturbing thoughts and obsessive actions interfere with life and take a lot of time (more than an hour a day), this is already a sign of disorder. A patient with obsessive-compulsive disorder realizes that his thoughts can be devoid of logic and divorced from reality, he gets tired of doing the same thing all the time, but for him this is the only way to get rid of anxiety at least for a while.

HOW TO DEAL WITH THIS?

Depressive and anxiety disorders often occur together: up to half of all people with depression also have symptoms of anxiety, and vice versa. Therefore, doctors may prescribe the same medications. But in each case there are nuances, because the effect of drugs is different.

Antidepressants work well in the long run, but they won’t relieve a sudden panic attack. Therefore, patients with anxiety disorders are also prescribed tranquilizers (benzodiazepines are commonly used in the US and other countries, but in Russia since 2013 they have been equated with drugs and withdrawn from circulation). They relieve excitement and have a calming effect on the central nervous system. After such drugs, a person relaxes, becomes sleepy, slow.

Medicines help but have side effects. With depression and anxiety disorders in the body, the exchange of neurotransmitters is disrupted. Medicines artificially restore the balance of the right substances (such as serotonin and gamma-amionobutyric acid), but you should not expect miracles from them. For example, from antidepressants, the mood of patients rises slowly, a tangible effect is achieved only two weeks after the start of administration. At the same time, not only will the will return to the person, his anxiety increases.

Cognitive behavioral therapy: working with thoughts. If medication is indispensable for dealing with severe depression or advanced anxiety disorders, then therapy works well in milder cases. CBT is built on the ideas of psychologist Aaron Beck that mood or anxiety tendencies can be controlled by working with the mind. During the session, the therapist asks the patient (client) to talk about their difficulties, and then systematizes his reaction to these difficulties and identifies thought patterns (patterns) that lead to negative scenarios. Then, at the suggestion of the therapist, the person learns to work with his thoughts and take them under control.

Interpersonal Therapy. In this model, the client’s problems are seen as a reaction to relationship difficulties. The therapist, together with the client, analyzes in detail all the unpleasant sensations and experiences and outlines the contours of the future healthy state. Then they analyze the client’s relationship to understand what he gets from them and what he would like to receive. Finally, the client and therapist set some realistic goals and decide how long it will take to achieve them.

^1. D. Varlamova, A. Zainiev “Go crazy! A Guide to Mental Disorders for a Big City Resident” (Alpina Publisher, 2016).