What is anxiety-depressive syndrome? Causes of anxiety-depressive syndrome. A look from the outside and from the inside

He is aware of his condition and is critical of it.

Anxiety disorders, according to the international classification of diseases, are divided into 5 groups, one of which is called mixed anxiety-depressive disorder, which will be discussed.

Anxiety versus depression

The name already hints that this type of disorder is based on 2 conditions: depression and anxiety. However, none of them is dominant. Both conditions are pronounced, but it is impossible to make a single diagnosis. Either anxiety or depression.

The only characteristic is that against the background of depression, anxiety increases and takes on enormous proportions. Each of these conditions enhances the effect of the other syndrome. There are reasons for some fears and anxieties, but they are very minor. However, the person is in constant nervous tension and feels threatened and in danger.

The insignificance of the factors that cause an anxious personality disorder is combined with the fact that in the patient’s value system the problem grows to a cosmic scale, and he does not see a way out of it.

And eternal anxiety blocks adequate perception of the situation. Fear generally prevents you from thinking, evaluating, making decisions, analyzing, it is simply paralyzing. And a person in this state of spiritual and volitional paralysis goes crazy from hopelessness.

Sometimes anxiety is accompanied by unmotivated aggressiveness. Enormous internal tension, which is not resolved in any way, provokes the release of stress hormones into the blood: adrenaline, cortisol, they prepare the body for fight, rescue, flight, defense.

But the patient does nothing of this, remaining in a potential state of anxiety and restlessness. Having not found a way out through active actions, stress hormones begin to purposefully poison the nervous system, which causes the level of anxiety to grow even more.

A person is taut like a bowstring: muscles tense, tendon reflexes increase. It’s as if he’s sitting on a keg of gunpowder, terribly afraid that it will explode and still doesn’t move. Maybe depression overshadows anxiety and prevents the unfortunate person from taking measures to save himself. In a specific case - salvation from a condition that is killing him.

• thunderous heartbeats that are clearly felt in the head;
• the head, naturally, is spinning;
• arms and legs are shaking, there is not enough air;
• the feeling of a “drying out” mouth and a lump in the throat, a faint state and the impending horror of death complete this picture.

Panic attack with anxiety disorders

Anxiety-depressive disorder, which is combined with panic attacks, is common.

Anxiety neurosis, simply put, fear, can always develop into its extreme degree - panic. Panic attacks have more than 10 symptoms. Less than 4 signs do not provide grounds for making a diagnosis, but four or more are a direct vegetative crisis.

Symptoms that indicate the development of PA:

• rapid heartbeat, pulse and general pulsation of blood vessels, the condition is felt as if something is pulsating throughout the body;
• heavy sweating (hail sweat);
• shaking chills with trembling of arms and legs;
• feeling of lack of air (it seems that you are about to suffocate);
• choking and gusty breathing;
• sensations of pain in the heart;
• severe nausea with the urge to vomit;
• severe dizziness (everything is “moving” before your eyes) and lightheadedness;
• impaired perception of the environment and self-perception;
• fear of madness, the feeling that you are no longer able to control your actions;
• sensory disturbances (numbness, tingling, cold hands and feet);
• hot flashes, cold waves;
• feeling like you could die at any moment.

Panic attacks in anxiety-depressive syndrome occur in cases where anxiety in this mixed disorder is more pronounced than depression. The presence of panic allows for a more accurate diagnosis.

The peculiarity of these attacks is that they are always associated with a specific phobia. Panic is a state when horror is combined with the feeling of being unable to escape from it. That is, there are insurmountable obstacles to escape.

For example, panic attacks can suddenly occur on the street, in a store, at a market, in a stadium (fear of open spaces). An attack can also occur in an elevator, subway, or train (fear of enclosed spaces).

The attacks can be short (from a minute to 10), or long (about an hour). They can be either single-shot or “cascade”. They appear a couple of times a week, but sometimes the number of attacks can be less, or can be twice the usual rate.

Causes of anxiety and depressive disorders

Anxious depression can be caused for the following reasons and factors:

1. Severe short-term stress, or chronic, taking the form of illness.
2. Physical and mental fatigue, in which a person “burns out” from the inside.
3. A family history of similar disorders.
4. A long-term, serious illness, the grueling struggle with which is equated to the question of “to live or not to live.”
5. Uncontrolled use of drugs from the group of tranquilizers, antipsychotics, antidepressants, or anticonvulsants.
6. “The edge of life” is a state in which a person feels “excluded” from life. This happens with the loss of a job, unbearable debts, the inability to provide oneself with a decent standard of living, and more and more failures when looking for work. The result is a state of hopelessness and fear for your future.
7. Alcoholism and drug addiction, which deplete the nervous system, destroy brain cells and the body as a whole, which leads to severe somatic and psychosocial problems. somatic disorders.
8. Age factor. Pensioners who don’t know what to do with themselves, women during menopause, teenagers in the period of mental development, men who are in a “midlife crisis” when they want to start life anew and change everything in it: family, work, friends, themselves.
9. Low level of intelligence or education (or both). The higher the intelligence and level of education, the easier a person copes with stress, understanding the nature of their occurrence, a transitory state. He has more tools and opportunities to cope with temporary difficulties without triggering them to the point of psychosomatic disorders.

A look from the outside and from the inside

Anxiety-depressive disorder has characteristic outlines and symptoms:

• complete or partial loss of a person’s skills to adapt to the social environment;
• sleep disturbances (waking up at night, getting up early, taking a long time to fall asleep);
• identified provoking factor (losses, losses, fears and phobias);
• loss of appetite (poor appetite with weight loss, or, conversely, “eating” anxiety and fears);
• psychomotor agitation (disorderly motor activity: from fussy movements to “pogroms”) along with speech agitation (“verbal eruptions”);
• panic attacks are short or long, one-time or repeated;
• tendency to thoughts of suicide, suicide attempts, completed suicide.

Establishing diagnosis

When making a diagnosis, standard methods and assessment of the clinical picture are used.

• The Zung Depression Scale and the Beck Depression Inventory are used to determine the severity of depressive state;
• the Luscher color test allows you to quickly and accurately analyze the state of a person and the degree of his neurotic deviations;
• The Hamilton scale and the Montgomery-Åsberg scale give an idea of ​​the degree of depression, and based on the test results, the method of therapy is determined: psychotherapeutic or medication.

Clinical picture assessment:

• presence of alarming depressive symptoms;
• symptoms of the disorder are an inadequate and abnormal reaction to a stress factor;
• duration of symptoms (duration of their manifestation);
• the absence or presence of conditions under which symptoms appear;
• the primacy of the symptoms of anxiety and depressive disorders, it is necessary to determine whether the clinical picture is a manifestation of a somatic disease (angina pectoris, endocrine disorders).

The path to the “right doctor”

An attack that occurs for the first time is usually not regarded by the patient as a symptom of the disease. It is usually written off as an accident, or they independently find a more or less plausible reason to explain its occurrence.

As a rule, they try to determine the internal disease that provoked such symptoms. A person does not immediately get to his destination - to a psychotherapist.

A trip to the doctors begins with a therapist. The therapist transfers the patient to a neurologist. The neurologist, having found psychosomatic and vegetative-vascular disorders, prescribes sedatives. While the patient takes medication, he actually becomes calmer and vegetative symptoms disappear. But after stopping the course of treatment, the attacks begin to recur. The neurologist throws up his hands and sends the sufferer to a psychiatrist.

A psychiatrist provides permanent relief not only from attacks, but also from any emotions in general. Stupefied by heavy psychotic drugs, the patient is in a switched-off state for days, and looks at life in a sweet half-sleep. What fear, what panic!

But the psychiatrist, seeing “improvements,” reduces the lethal doses of antipsychotics or cancels them. After some time, the patient turns on, wakes up, and everything starts all over again: anxiety, panic, fear of death, an anxiety-depressive disorder develops, and its symptoms only worsen.

The best outcome is when the patient immediately sees a psychotherapist. A correct diagnosis and adequate treatment will greatly improve the patient’s quality of life, but if the drugs are discontinued, everything can return to normal.

Usually, cause-and-effect relationships are consolidated in the mind. If a panic attack occurs in a supermarket, the person will avoid this place. If in the subway or on a train, then these types of transport will be forgotten. Accidental appearance in the same places and in similar situations can cause another panic syndrome.

The whole range of therapy methods

Psychotherapeutic assistance consists of the following:

• method of rational persuasion;
• mastering relaxation and meditation techniques;
• conversation sessions with a psychotherapist.

Drug treatment

The following groups of medications are used in the treatment of anxiety-depressive disorder:

1. Antidepressants (Prozac, Imipramine, Amitriptyline) affect the level of biologically active substances in nerve cells(norepinephrine, dopamine, serotonin). The drugs relieve symptoms of depression. Patients' mood improves, melancholy, apathy, anxiety, emotional instability disappear, sleep and appetite normalize, and the level of mental activity increases. The course of treatment is long due to the fact that anti-depression pills do not act immediately, but only after they accumulate in the body. That is, you will have to wait a couple of weeks for the effect. Therefore, tranquilizers are prescribed in combination with antidepressants, the effect of which becomes apparent within 15 minutes. Antidepressants are not addictive. They are selected individually for each patient and must be taken strictly according to the regimen.
2. Tranquilizers (Phenazepam, Elzepam, Seduxen, Elenium) successfully cope with anxiety, panic attacks, emotional stress, and somatic disorders. They have a muscle relaxant, anticonvulsant and vegetative stabilizing effect. They act almost instantly, especially in injections. But the effect will end faster. The tablets act more slowly, but the results achieved last for hours. Treatment courses are short due to the fact that the drugs are persistently addictive.
3. Beta blockers, necessary if anxious depressive syndrome complicated by autonomic dysfunction, they suppress vegetative-vascular symptoms. They eliminate pressure surges, increased heartbeat, arrhythmia, weakness, sweating, tremors, and hot flashes. Examples of drugs: Anaprilin, Atenolone, Metoprolol, Betaxolol.

Physiotherapy methods

Physiotherapy is an important part of the treatment of any psychosomatic conditions. Physiotherapeutic methods include:

• massage, self-massage, electric massage relieves muscle tension, soothes and tones;
• Electrosleep relaxes, calms, and restores normal sleep.
• Electroconvulsive treatment stimulates brain activity and increases the intensity of its work.

Homeopathy and traditional treatment

Herbalism is treatment with medicinal herbs and soothing herbal mixtures:

• ginseng - a stimulating tincture, or tablet forms of the drug, increases performance, activity, and relieves fatigue;
• motherwort, hawthorn, valerian have an excellent calming effect;
• lemongrass tincture – powerful stimulant, which is especially indicated for depression due to its ability to awaken apathetic, lethargic, inhibited citizens to an active life.

• gentian herb - for those who are depressed;
• Arnica Montana is a drug that eliminates both depressive and anxiety symptoms;
• Hypnosed – relieves insomnia, severe excitability;
• Elm leaves and bark – increases endurance, relieves fatigue.

Prevention of the syndrome

In order to always be psychologically stable, the following conditions must be observed:

• do not dwell on negative emotions;
• Organize a “health zone” around yourself, that is: give up nicotine, alcohol, eat right, move actively, engage in feasible sports;
• do not overwork yourself either physically or mentally;
• get enough sleep;
• expand your “comfort zone”: communicate and meet people, travel, visit interest clubs;
• Find something for yourself that will captivate you and leave no room for anxious thoughts and depressive states.

Far-reaching consequences

When ignored pathological symptoms You can purchase a set of physical and mental ailments:

• increase in the number and duration of panic attacks;
• development of hypertension, cardiovascular diseases;
• dysfunction of the digestive system, development of peptic ulcer;
• the occurrence of cancer;
• development of mental illness;
• fainting and convulsive syndromes.

The quality of life of patients, their professional skills, and marital relationships also suffer greatly. Ultimately, all this can lead to a person stopping somehow interacting with society and acquiring a fashionable disease - social phobia.

The saddest and irreversible complication is a situation when a person takes his own life.

This section was created to take care of those who need qualified specialist without disturbing the usual rhythm of your own life.

How does anxiety-depressive syndrome manifest?

Anxiety-depressive syndrome is one of the neuroses that manifests itself in feelings of anxiety, melancholy, melancholy and depression. This disorder is treatable if a person recognizes his problem and consults a doctor. Such an illness can be treated not only by a psychiatrist; now cardiologists, psychotherapists, and neurologists are also involved in this.

The causes of such neurosis are troubles in personal life, in the professional field, unpleasant life events that became a strong trauma for the psyche. But you shouldn’t put off contacting a specialist; it’s better to fix the problem still later. early stages, when it is much easier and faster to cure it.

Symptoms of the disorder

Anxiety-depressive syndrome, symptoms, its treatment is carried out depending on the clinical manifestations and stage of development of the pathology. The signs of this disorder are in many ways similar to those of other neurological disorders, so diagnosing this condition is sometimes quite difficult. The main symptoms of the disorder are:

1. A feeling of inferiority, which is accompanied by guilt and low self-esteem.
2. The emergence of suicidal thoughts and tendencies.
3. Rapid or difficult breathing.
4. Tachycardia, pain in the sternum.
5. Weakness, increased fatigue.
6. Frequent headaches, sometimes quite intense.
7. Sleep disorders.
8. Melancholy, depression, tearfulness.
9. Decreased sexual desire.

Also, in addition to the listed signs, problems with stool, urination, and many other symptoms are sometimes noted that a person does not even associate with psychological problems.

But before real troubles there is no feeling of fear, only vague sensations of danger appear. This is how it is created vicious circle. The feeling of constant anxiety provokes the production of adrenaline, which contributes to the appearance of nervous excitability and anxiety.

All symptoms of neurosis are divided into 2 large categories. These include clinical signs and vegetative manifestations. TO clinical signs can be attributed:

1. Constant sudden changes in emotional state.
2. Increased restlessness and constant feeling of anxiety.
3. Constant problems with sleep.
4. Constant worries about relatives, the expectation that something negative will happen.
5. Regular tension and anxiety that prevent you from falling asleep normally.
6. Fatigue, weakness.
7. Deterioration in concentration, speed of thinking, ability to work, and perception of new information.

TO vegetative signs can be attributed:

1. Frequent heartbeat.
2. Shiver.
3. Feeling of a lump in the throat.
4. Increased sweating, moisture in the palms.
5. Hot flashes or feeling of chills.
6. Frequent urination.
7. Abnormal bowel movements, abdominal pain.
8. Myalgia, muscle tension.

Neurosis is often accompanied by depression. Making such a diagnosis requires a collection of general symptoms that last for several weeks or even months.

Who has an increased tendency to neurosis?

The main risk group is women. This is due to greater emotionality, sensitivity, responsibility for both family and career. If a woman does not know how to relax and relieve emotional stress, she is susceptible to neurosis. Factors that provoke aggravation of the condition include changes in hormonal levels, the period of gestation, menstruation, the postpartum period, climacteric changes. Risk factors for the disorder include the following:

1. Lack of work. During this period, there is an acute feeling of being thrown out of the working world, the inability to provide for oneself, and the constant search for work that is fruitless. Stress provokes the appearance of the first signs of disorder.
2. Drugs and alcoholic drinks. Such addictions destroy a person’s personality, leading him to constant depression. And constant depression provokes a search for a way out, which a person seeks in a new dose. This creates a vicious circle that is often impossible to break without seeking outside help.
3. Bad heredity. It has been proven that in children of mentally ill people this disorder appears more often.
4. Advanced age. During this period, a person acutely feels the loss of his social significance due to retirement. Children have grown up, they have their own families, they feel less need for parents, friends and significant other leave, communication becomes less and less. Such people need constant support, involvement in the lives of their children and grandchildren, they need to feel important.
5. Serious somatic illnesses. A severe form of depression is often triggered by a person developing an incurable disease.

Therapy for the disorder

After production accurate diagnosis the specialist prescribes complex treatment. It consists of taking medications that are combined with psychotherapy. The psychological impact of this neurosis is aimed at raising self-esteem, increasing control over one’s emotions, developing stress resistance, and combating depression.

Drug therapy consists of the use of tranquilizers, anti-anxiety drugs, drugs for plant based. The main thing is to visit a specialist who will provide competent therapy; it is unacceptable to self-medicate and diagnose yourself.

Often the doctor prescribes antidepressants and tranquilizers. They help regulate vegetative processes in the body, normalize and streamline them. Such medications help calm the nervous system, improve sleep quality, and regulate the concentration of stress hormones in the blood. This complex therapy is very effective. Treatment lasts at least a month.

In addition to drug treatment, it is also necessary to visit a psychologist. The likelihood of developing anxiety-depressive syndrome increases if a person constantly experiences any stress very hard, if he is not used to solving problems, but tends to keep everything to himself and silently endure if the state of affairs does not suit him.

In this case, behavioral psychotherapy will be the best addition to drug treatment, will enhance its effectiveness and help get rid of the problem faster.

The main thing is that the person himself understands his problem and strives to resolve it.

If he learns to live fully and deal with frequent emotional stress, he will be able to overcome the disorder.

Anxiety-depressive disorder

It is known that depression is a pressing problem among people of the 21st century. It develops due to high psycho-emotional stress associated with accelerated rhythm life. Depressive disorders significantly reduce the quality human life, so you need to learn how to maintain personal mental hygiene.

Causes of Anxiety Disorder

Anxiety-depressive syndrome belongs to the group of neuroses (ICD-10), and is accompanied by various types of physical and mental disorders. The most common causes of depression are the following:

• hereditary predisposition to depression;
• many stressful situations;
• organic changes in the state of the brain (after bruises, injuries);
• long-term anxiety and depressive symptoms;
• deficiency of serotonin and essential amino acids in the body;
• taking barbiturates, anticonvulsants and estrogen drugs.

Symptoms of nervous system disease

The main symptom of anxiety-depressive disorder is constant groundless anxiety. That is, a person feels an impending catastrophe that threatens him or his loved ones. The danger of an anxious-depressive state lies in a vicious circle: anxiety stimulates the production of adrenaline, which intensifies negative emotional tension. Patients who have this personality disorder complain of lack of mood, systematic sleep disturbances, decreased concentration, accompanied by chills and muscle pain.

Postpartum depression in women

Many women immediately after childbirth experience anxiety and depressive symptoms, which are called childhood sadness. The condition lasts from several hours to a week. But sometimes depression and anxiety in young mothers takes a severe form, which can last for months. The etiology of the anxiety state is still not precisely known, but doctors name the main factors: genetics and hormonal changes.

Types of depressive disorders

Anxiety differs from true fear in that it is a product of internal emotional state, subjective perception. The disorder manifests itself not only at the emotional level, but also by body reactions: increased sweating, rapid heartbeat, and indigestion. There are several types of this disease, differing in symptoms.

Generalized anxiety

With this syndrome, the patient chronically experiences anxiety without knowing the cause of the condition. Anxious depression manifests itself as fatigue, gastrointestinal dysfunction, motor restlessness, and insomnia. Depressive syndrome is often observed in people with panic attacks or alcohol addiction. Generalized anxiety-depressive disorder develops at any age, but women suffer from it more often than men.

Anxious-phobic

It is known that a phobia is medical name exaggerated or unrealistic fear of an object that does not pose a threat. The disorder manifests itself in different ways: fear of spiders, snakes, flying on an airplane, being in a crowd of people, sharp objects, swimming, sexual harassment, etc. With anxiety-phobic syndrome, the patient develops a persistent fear of such a situation.

Mixed

When a person has several symptoms of depression for a month or more, doctors diagnose “mixed anxiety-depressive disorder.” Moreover, the symptoms are not caused by taking any medications, but worsen the quality of the patient’s social, professional or any other area of ​​life. Main features:

• slow thinking;
• tearfulness;
• sleep disturbance;
• low self-esteem;
• irritability;
• difficulty concentrating.

Diagnosis of depressive disorders

The main method for diagnosing depression in a patient remains questioning. Identification of symptoms of depression is facilitated by a trusting atmosphere, a sense of empathy, and the doctor’s ability to listen to the patient. Also in the practice of psychotherapy, a special HADS depression and anxiety scale is used to determine the level of pathology. The test does not cause any difficulties for the patient, does not take much time, but gives the specialist the opportunity to make the correct diagnosis.

Treatment of anxiety-depressive syndrome

The general strategy for the treatment of anxiety and depressive disorders is to prescribe a complex of medications, homeopathic remedies, herbal remedies and folk recipes. Behavioral psychotherapy is also important, as it greatly enhances the effect. drug therapy. The complex treatment of anxiety-depressive syndrome also includes physiotherapy.

Drugs

Helps get rid of depressive anxiety disorder drug treatment. There are many types of drugs with psychotropic effects, each of which affects its own clinical symptoms:

1. Tranquilizers. Powerful psychotropic medications used when other treatments for depression have not worked. Helps get rid of internal tension and panic, reduce aggression, suicidal intentions.
2. Antidepressants. They normalize the emotional state of a person with obsessive-compulsive disorder (obsessive states), and prevent exacerbation.
3. Neuroleptics. Prescribed for inappropriate emotions of the patient. The drugs affect the area of ​​the brain that is responsible for the ability to perceive information and think rationally.
4. Sedatives. Sedative medications that are used to eliminate nervous tension, normalize sleep, and reduce the level of excitability.
5. Nootropics. They affect areas of the brain to increase performance and improve blood circulation.
6. Alpha and beta blockers. Able to turn off receptors that respond to adrenaline. They increase the level of glucose in the blood, sharply narrow the lumen of blood vessels, and regulate vegetative processes.

Psychotherapeutic methods

Not every person with anxiety-depressive disorder needs medication therapy or hospitalization. Many psychiatrists prefer to treat depression in children and adults using psychotherapeutic methods. Experts are developing a variety of techniques, taking into account gender characteristics, adapted to different social groups. Some patients are better suited to one-on-one consultations, while others show excellent results when treated in a group setting.

Cognitive behavioral therapy

Anxiety disorder can be cured with cognitive behavioral therapy. It is used to get rid of wide range depressive symptoms, including addiction, phobias, anxiety. During treatment course people identify and change their destructive thinking patterns that influence their behavior. The goal of therapy is that a person can take control of any concept of the world and interact positively with it.

Hypnosis

Sometimes the effect of hypnosis on a patient with a depressive disorder is the most effective therapeutic method. Thanks to modern trance techniques, a person’s negative attitudes and perception of reality change. With the help of hypnosis, patients quickly get rid of dark obsessive thoughts and chronic depression. A person’s anxious personality disorder goes away, he receives a powerful charge of energy and a lasting feeling of inner satisfaction.

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The information presented on the site is for informational purposes only. The site materials do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on individual characteristics specific patient.

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Depressive and anxiety disorders

Anxiety The issue of increasing doctors' awareness of the diagnosis and treatment of common psychopathological disorders - depression and anxiety - is becoming more and more relevant every day.

IN modern conditions Considering the significant spread of these psychopathological disorders, especially among patients with somatic pathology, and the emergence of new, safer antidepressants, diagnosis and treatment of mild and moderate depression in most countries of Europe and North America is carried out by first-line doctors, as well as therapists, cardiologists, and neurologists , gastroenterologists, etc., 80% of antidepressants in Western Europe, the USA and Canada are not prescribed by psychiatrists.

The International Psychiatric Association and the International Committee for the Prevention and Treatment of Depression have introduced an educational program on the diagnosis and treatment of depressive disorders, which has been implemented in many regions. In 1998, this program was started in Russia, and in 2002, materials were published in Ukraine. On the stretch recent years the number of scientific publications on this problem in Ukraine is increasing, but practical implementation remains insufficient. There is also no national program for training specialists. Most doctors note the significance of this problem, but do not consider themselves competent in diagnosing and treating depression. Therefore, it is especially important for doctors of all specialties to master the skills of diagnosing and treating depressive and anxiety disorders.

Depression is divided into: psychogenic, endogenous and somatogenic. Psychogenic depressive disorders arise as a consequence or under the influence of causes of a psychological and stressful nature. Endogenous depressive disorders mean those depressions that develop in schizophrenia and manic-depressive psychosis. Somatogenic depressive disorders are observed in various somatic diseases (cardiovascular, endocrine, gastrointestinal tract and etc.). Depression can also occur in cases of intoxication of the body, infectious diseases, drug addiction and alcoholism. Quite often in clinical practice so-called latent depression is observed, when the depressive symptoms themselves are masked as a disruption in work different organs and systems, persistent headaches, changes in sleep and is not recognized by the patient as such.

According to the World Health Organization, from 10 to 20% of the world's population report the occurrence of clinically significant depressive conditions throughout their lives. According to the results of epidemiological studies, every eighth inhabitant of our planet needs specific pharmacotherapy in connection with depressive conditions. In 60% of cases, as a rule, in case of insufficiency or inadequate therapy, repeated depressive episodes occur. Almost half of patients with depression do not go to doctors, and approximately 80% are treated by internists and general practitioners.

The development of depressive disorders is associated with a disturbance in the exchange of the main neurotransmitters: serotonin, norepinephrine and dopamine in the central structures of the brain (limbic system), which are involved in assessing the emotional significance of information that enters the central nervous system (CNS) and forms the emotional component of human behavior. The two-way cause-and-effect relationship of depression with the state of internal organs and the somatization of symptoms of depression can be explained by the close relationship of the central structures and cerebral cortex with the centers of the autonomic nervous system and endocrine regulation.

Depression is diagnosed in 20% of patients with coronary heart disease (CHD), in 30-50% of patients after myocardial infarction and in 30-50% after stroke. The importance of influencing psychoemotional factors was confirmed in the INTERHEART studies, where their contribution to the risk of acute myocardial infarction was not inferior to diabetes mellitus and smoking. Over the past few decades, the relationship between depression and prognosis in patients with coronary artery disease has been examined in more than 60 international prospective studies. It was found that severe depression in patients with angiographically confirmed coronary heart disease is the most significant isolated predictor of coronary events over the course of a year. The mortality rate of patients who have a history of myocardial infarction and suffer from depression is 3-6 times higher than in persons without signs of depression. In cases of depression, patients often do not follow doctors' recommendations regarding treatment. Given the important role of depressive disorders in patients with coronary heart disease, the American Heart Association developed and introduced in 2008 the “Depression and IHD: Screening and Treatment Guidelines,” which emphasizes the need for screening to identify individuals with IHD and depression who require additional treatment. However, the results of the ENRICHD study showed that in the group of patients with depression who suffered an acute myocardial infarction and received serotonin reuptake inhibitors, there was a 42% reduction in the incidence of death or recurrence of myocardial infarction compared with the rate in patients with depression who did not Antidepressants were prescribed.

In most patients, the manifestations of depression are closely related to anxiety disorders. Anxiety is a normal reaction of the human body to unfavorable life factors. But if it occurs without a reason or in severity and duration exceeds the real significance of the event and worsens the patient’s quality of life, then this condition is regarded as pathological.

Anxiety disorder is characterized by manifestations of internal tension, inability to relax and concentrate. Characteristic features include constant internal tension and increased sweating. Patients show increased anxiety during daily work and make pessimistic forecasts; in most cases, they have difficulty falling asleep. Phobias, or fears, are also manifestations of anxiety disorders. The results of epidemiological studies show that anxiety disorders occur in 25% of the population throughout life.

Symptoms of anxiety disorders are diagnosed in 10-16% of patients who consult general practitioners. According to the results of modern scientific research There was an increased risk of cardiovascular complications in patients with anxiety disorders. Among the mechanisms being considered are the main role belongs to an increase in the level of serotonin-mediated platelet reactivity in patients with coronary artery disease and comorbid anxiety (the existence of independent correlations between anxiety and platelet function has been proven). At the same time, platelet reactivity was significantly higher in patients with a combination of depression and anxiety than in patients with depression alone or in persons without patho psychological disorders.

A significant prevalence of anxiety and depressive disorders is also typical for patients with pathologies of the digestive tract. Depression is often diagnosed in diseases of the digestive tract such as functional dyspepsia, functional biliary disorders, irritable bowel syndrome, in the case of chronic diffuse liver diseases of various origins (viral hepatitis, alcoholic liver disease, cirrhosis of the liver, hepatic encephalopathy), as well as in patients who administer interferon therapy. Comorbid anxiety and depressive disorders are also characteristic of other gastroenterological diseases. Thus, according to the results of an American national survey, peptic ulcer of the stomach and duodenum is associated with an increase in the frequency of generalized anxiety by 4.5 times, and panic attacks by 2.8 times. It has been found that increased levels of anxiety are associated with increased healing time for peptic ulcers. According to various authors, depression is detected in 35-50% of patients with peptic ulcer. More than 20% of patients with pathologies of the digestive tract require antidepressants. Comorbid anxiety and depressive disorders are also common in other chronic diseases: endocrinological ( diabetes, hyperthyroidism, hypothyroidism, etc.), pulmological (chronic obstructive pulmonary disease), rheumatic (rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis), oncological, neurological (stroke, Parkinson's disease, etc.), especially if they occur together in the elderly age. Depressive disorders also require attention in young patients, as well as in women after childbirth.

Diagnosis of anxiety and depressive disorders

The main method for diagnosing depression and anxiety remains questioning the patient. The identification of psychopathological disorders is accompanied by a trusting atmosphere of communication between the doctor and the patient, mutual understanding and a sense of empathy, as well as effective Feedback(ability to listen, discuss, clearly pose questions). Methodological materials World Psychiatric Association "Training doctors in skills in the field of mental health» determine the main aspects of the communication style of doctors, which are associated with assessing the emotional state of the patient:

1. Establish favorable eye contact
2. Clarify patient complaints
3. Make comments with sympathy
4. Notice verbal and nonverbal cues patient
5. Do not read medical history notes during a conversation
6. Control the patient's excessive talkativeness

In the clinical guideline “Depression: care for depression in primary and secondary care” developed by NICE (National Institute for Health and Clinical Excellence - National Institute for Health and Clinical Excellence, UK) to screen for depression, it is recommended to ask two questions: “Have you often noted decreased mood, sadness or hopelessness over the past month? and “During the past month, have you often noticed a lack of interest or pleasure in things that usually bring you pleasure?” Questions that can be used to screen for anxiety include: “Have you felt restless, tense, and anxious most of the time over the past month?” and “Do you often have feelings of internal tension and irritability, as well as sleep disturbances?”

Main signs of a depressive episode

1. Depressed mood, obvious in comparison with the patient’s usual norm, is observed almost every day and most of the day, especially in the morning, the duration of which was at least 2 weeks regardless of the situation (the mood can be depressed, sad, accompanied by anxiety, concern, irritability, apathy , tearfulness, etc.).
2. Significant decrease (loss) of interest and pleasure in activities that were usually associated with positive emotions.
3. Unmotivated decrease in energy and activity, increased fatigue during physical and intellectual stress.

Additional signs of a depressive episode

1. Decreased ability to concentrate, inattention.
2. Decreased self-esteem and self-confidence.
3. Presence of ideas of guilt and humiliation.
4. A gloomy and pessimistic vision of the future.
5. Suicidal fantasies, thoughts, intentions, preparations.
6. Sleep disorders ( trouble falling asleep, insomnia in the middle of the night, early awakening).
7. Decreased (increased) appetite, decreased (increased) body weight.

To determine a mild depressive episode, it is enough to state at least two main and two additional symptoms. The presence of two main symptoms of depression in combination with three to four additional symptoms indicates moderate depression. All three core symptoms of depression and at least four additional symptoms indicate severe depression. It should be taken into account that due to various depressions possible risk of suicide. If suicidal symptoms are detected in a patient, consultation with a psychiatrist is necessary.

Particular difficulties arise during the diagnosis of “masked depression”, which can manifest itself functional disorders internal organs (pulmonary hyperventilation syndrome, cardioneurosis, irritable bowel syndrome), algia (cephalgia, fibromyalgia, neuralgia, abdominalgia), pathocharacterological disorders (alcoholism, drug addiction, antisocial behavior, hysterical reactions).

IN scientific literature other emotional disorders that clearly arise at the onset of depression have been systematized:

1. Dysphoria is a gloomy, grouchy, irritable, angry mood with hypersensitivity to any external stimuli. Sometimes it is embittered pessimism with caustic pickiness, at times with outbursts of anger, cursing, threats, and constant aggression.
2. Hypotymia is a persistently depressed mood, which is combined with a decrease in the overall activity of mental activity and behavioral motor activity.
3. Subdepression is a persistently low mood, which is combined with a decrease in overall mental activity and behavioral motor activity. The most characteristic components are somatovegetative disorders, decreased self-esteem and identification of one’s condition as painful.

In ICD-10, anxiety disorders are classified under the headings “Panic disorder” (F41.0), “Generalized anxiety disorder” (F41.1) and “Mixed anxiety and depressive disorder” (F41.2).

The main symptom of panic disorder is repeated attacks of severe anxiety (panic), which are not limited to a specific situation or any specific circumstances, and, as a result, become unpredictable. The dominant symptoms are: sudden palpitations, chest pain, choking, dizziness and a feeling of unreality (depersonalization or derealization). Many patients feel the fear of death and lose self-control. Anxiety and fear can be so strong that they literally paralyze the patient’s will. A panic attack usually lasts several minutes; the condition gradually (from 30 minutes to 1 hour) normalizes. But after this, the patient remains afraid of a new attack. A panic attack must be differentiated from paroxysmal tachycardia, atrial fibrillation and an attack of angina.

Generalized anxiety disorder is characterized by symptoms of internal tension and an inability to relax and concentrate. In this case, constant internal trembling, increased sweating, and frequent urination are also characteristic. Patients exhibit increased anxiety during daily activities and make pessimistic forecasts and have difficulty falling asleep. Phobias, or fears, are also manifestations of an anxiety disorder. A diagnosis of mixed anxiety and depressive disorder is made when both anxiety and depression are present.

A large number of rating scales and questionnaires have been developed for the diagnosis of comorbid anxiety and depressive disorders in clinical practice. The Hospital Anxiety and Depression Scale (HADS) is widely used for screening studies. The scale was proposed by A.S. Zigmond and R.P. Snaith in 1983 and includes 14 statements, 7 of which correspond to depressive (D) and 7 to anxiety (T) disorders, which are counted separately.

Full Name _________________________________________________

This questionnaire is designed to help your doctor understand how you are feeling. Read each statement carefully and choose the answer that best matches how you felt last week. Check the circle next to the answer you have chosen. Do not think too long about each statement, since your first reaction will always be the most correct.

I feel tense, I feel uneasy

From time to time, sometimes

I don't feel it at all

Something that brought me great pleasure and now gives me the same feelings

That's probably true

To a very small extent this is true

That's not entirely true

I feel afraid, it seems like something terrible might happen

This is true, fear is very strong.

This is true, but the fear is not very strong

Sometimes, but it doesn't bother me

I don't feel it at all

I am able to laugh and see something funny in this or that event.

That's probably true

To a very small extent this is true

It's not like that at all

Fussy thoughts are spinning in my head

Most part of time

From time to time and not that often

I feel cheerful

I don't feel it at all

Almost all the time

I can easily sit down and relax

That's probably true

It seems to me that I began to do everything very slowly

Almost all the time

I feel inner tension or trembling

I don't feel it at all

I don't take care of my appearance

I don't spend enough time on this

I think I've started devoting less time to this

I take care of myself the same way as before

I feel restless, I constantly need to move

That's probably true

To some extent this is true

I don't feel it at all

I believe that my activities (activities, hobbies) can bring me a sense of satisfaction

Exactly as usual

Yes, but not to the same extent as before

Significantly less than usual

I don't think so at all

I have a sudden feeling of panic

Doesn't happen at all

I can enjoy an interesting book, radio or television program

HADS assessment criteria: 0-7 points – normal; 8-10 points – subclinically expressed anxiety / depression; 11 or more – clinically significant anxiety/depression

For patient questionnaires, rating scales (4th and 5th columns of the table) and evaluation criteria should not be given.

Patients diagnosed with clinically significant anxiety or depression should be referred for consultation with a psychiatrist. Patients with depression and suicidal thoughts also require consultation with a psychiatrist. In case of insufficient effectiveness of antidepressant therapy for 1-1.5 months, as well as in the presence of a history of depression, which required treatment by a psychiatrist. In cases of subclinical anxiety or depression, treatment may be prescribed by a general practitioner (GP).

Treatment of anxiety and depressive disorders in therapeutic practice

In accordance with NICE Clinical Guidelines: Depression: care for depression in primary and secondary care, Treatment of depression in adults (core edition), guidelines American Association hearts "Depression and ischemic disease heart: recommendations for screening and treatment" and scientific developments of Ukrainian specialists, treatment of mild and moderately severe depressive and anxiety disorders can be carried out by first-line doctors.

In accordance with the NICE Clinical Guidelines, patients with mild depression can be treated without the prescription of antidepressants if a self-help program is provided, which consists of the provision of appropriate written materials, a sleep regulation program and computer-assisted cognitive behavioral therapy, followed by assessment of the patient's condition. In our country, such programs have not yet become particularly widespread in clinical practice. In order to increase information content and attract patients to participate in treatment, a leaflet “Anxiety and depressive disorders” was developed.

Treatment of patients with comorbid anxiety and depressive disorders should be structured taking into account the difficult relationship between the somatogenic and psychological components. In most cases, it is advisable to combine drugs for the treatment of somatic diseases with the prescription medicines to eliminate depressive and/or anxiety disorders. It is important to use drugs whose effectiveness and safety have been proven from the standpoint of evidence-based medicine, to explain to the patient at an accessible level that for recovery it is necessary to normalize the biochemical processes in the nervous system, disturbed by illness, chronic stress, psychotraumatic situations, etc. it is necessary to discuss a treatment plan with the patient, point out the importance of adherence to medication regimen, and also warn that the clinical effect develops gradually. Most patients adequately perceive a logical approach to prescribing drugs that affect the psycho-emotional sphere. In some cases, it is useful to involve family members in comprehensive psychotherapeutic rehabilitation.

The main groups of pharmacological drugs that are used in therapeutic practice: second generation antidepressants (serotonin reuptake inhibitors), tranquilizers, drugs of other pharmacological groups.

The main indications for prescribing antidepressants for diseases of the digestive tract are comorbid anxiety and depressive disorders in patients with functional disorders of the digestive tract, chronic diffuse liver diseases, persistent pain syndrome in chronic pancreatitis, obesity and disorder eating behavior. Special attention required by patients who have suffered a myocardial infarction, patients with arterial hypertension, coronary artery disease and neurocirculatory dystonia. It is advisable to prescribe antidepressants if signs of other chronic diseases are detected (stroke, diabetes, osteoarthritis, etc.).

Antidepressants

When choosing an antidepressant for outpatient treatment it is necessary to take into account safety, tolerability, risk of interaction with other drugs, lack of effect on performance, positive effect previous treatment with antidepressants. In accordance with the requirements of evidence-based medicine, serotonin reuptake inhibitors are considered as the drugs of choice for the treatment of patients with symptoms of depression and anxiety. They do not exhibit cardiotoxic effects and do not cause physical or mental dependence. The clinical effect of antidepressant therapy appears 1-3 weeks after the start of treatment. If there is no clinical effect from an antidepressant for 4-6 weeks, it is necessary to consult a psychiatrist and replace it with another drug.

During the initial period of using antidepressants, the patient should visit the doctor at least once every 2 weeks and pay attention to possible side effects of treatment, which in most cases go away on their own. To achieve a positive therapeutic effect, the frequency of visits to the doctor should be once every 6-12 weeks. The duration of treatment with antidepressants is 6-12 months. If treatment is stopped immediately after achieving a clinical effect, the likelihood of relapse increases significantly. For elderly people in cases of repeated depressive episodes, as well as in the presence of chronic depression in the past, long-term (at least 3 years) or lifelong prescription of antidepressants should be recommended.

When prescribing antidepressants from the serotonin reuptake inhibitor group, it is necessary to take into account their features:

Fluoxetine is an antidepressant with a stimulating effect. Enhances the effect of analgesic drugs. Recommended for depression of various origins, panic fears and bulimia nervosa, premenstrual dysphoric disorders. The advantage is the absence of sedation. Possible side effects: increased excitability, dizziness, increased convulsive readiness, allergic reactions. The positive effect most often appears after 5-10 days, the maximum effect occurs every other day, and stable remission occurs after 3 months. In the case of anxiety-depressive disorders, it is advisable to prescribe Fluoxetine simultaneously with benzodiazepine tranquilizers during the first week, which makes it possible to achieve a sedative effect without the complications characteristic of tricyclic antidepressants.

Paroxetine is a balanced antidepressant. Produces both antidepressant and anxiolytic effects. But it must be borne in mind that this is one of the least selective serotonin reuptake inhibitors (partially affects the reuptake of norepinephrine and blocks muscarinic receptors, which causes a sedative effect). Possible side effects: nausea, dry mouth, excitability, drowsiness, excessive sweating, sexual dysfunction.

Sertraline does not have a sedative, stimulant or anticholinergic effect. Possible side effects: diarrhea, dyspepsia, drowsiness, hyperhidrosis, dizziness, headache, allergic reactions.

Citalopram. The advantage of this drug is the speed of the therapeutic effect (5-7 days of treatment). Possible side effects: dry mouth, drowsiness, hyperhidrosis, dizziness, headache, allergic reactions.

Escitalopram is a member of the group of serotonin reuptake inhibitors with maximum selectivity. Escitalopram has been found to be more effective than Citalopram in patients with moderate depression. The drug has little effect on the activity of cytochrome P450, which gives it advantages in the case of combined pathology that requires polypharmacotherapy.

Promising in general medical practice is the use of the melatonergic antidepressant Agomelatine, which has a pronounced antidepressant effect and a unique additional advantage - rapid restoration of the disrupted sleep-activity cycle and an excellent tolerability profile. Agomelatine improves the quality and duration of sleep and does not cause daytime drowsiness, which is important for patients who continue to work. In the case of predominant sleep disturbance, the drug has significant clinical benefit.

Ademetionine – (-) S-adenosyl-L-methionine is an active metabolite of methionine that contains sulfur, a natural antioxidant and antidepressant that is formed in the liver. A decrease in the biosynthesis of Ademethionine in the liver is characteristic of all forms of chronic liver damage. The antidepressant activity of Ademethionine has been known for more than 20 years and it is considered an atypical antidepressant - a stimulant. Used to treat depression, alcoholism and drug addiction. Characteristic is the fairly rapid development and stabilization of the antidepressant effect (during the first and second weeks, respectively), especially when administered parenterally at a dose of 400 mg/day. The combination of antidepressant and hepatoprotective effects is advantageous when the drug is prescribed to patients with diseases of the digestive tract.

Tranquilizers

Tranquilizers (from Latin tranquillo - to calm down), or anxiolytics (from Latin anxietas - anxiety, fear). In addition to the anxiolytic effect itself, the main clinical and pharmacological effects of tranquilizers are sedative, muscle relaxant, anticonvulsant, hypnotic and vegetative stabilizing. Classic representatives of this group are benzodiazepines, which enhance GABAergic inhibition at all levels of the central nervous system and have a pronounced anti-anxiety effect, which makes it possible to achieve significant success in the treatment of anxiety conditions of various etiologies. However, in the process of accumulation clinical experience With the use of classical benzodiazepines (chlordiazepoxide, diazepam, finazepam, etc.), increasing attention has begun to be paid to the side effects of these drugs, which often negates their positive effect and leads to the development of serious complications. Therefore, drugs in this group, including their rapid clinical effect, are advisable to use on an outpatient basis for the treatment of panic attacks. But when prescribing benzodiazepines, it is first necessary to take into account the possibility of drug dependence, so the course of treatment should be limited to two weeks.

Prospects for the treatment of comorbid anxiety disorders are associated with the use of new generation anxiolytics (Etifoxine, Afobazol).

Etifoxine is an anxiolytic that acts as a direct GABA mimetic. It has a number of advantages compared to benzodiazepines, since it does not cause drowsiness and muscle relaxation, does not affect the perception of information, and does not lead to addiction and the development of withdrawal syndrome. In addition to anxiolytic, it has a vegetative-stabilizing effect and improves sleep. The drug can be used in everyday life. Its effectiveness is more pronounced when prescribed in the early stages of anxiety disorders. Etifoxine can be used simultaneously with antidepressants, sleeping pills and cardiac medications.

Afobazole is a 2-mercaptobenzimidazole derivative, a selective anxiolytic that has a unique mechanism of action and belongs to the group of membrane modulators of the GABA-A benzodiazepine receptor complex. The drug has an anxiolytic effect with an activating component, which is not accompanied by hypnosedative effects, has no muscle relaxant properties, or a negative effect on memory and attention. During its use, drug dependence does not form and withdrawal syndrome does not develop. Reducing or eliminating symptoms of anxiety (preoccupation, bad feelings, fearfulness, irritability), tension (tearfulness, anxiety, inability to relax, insomnia, fear), autonomic disorders (dry mouth, sweating, dizziness), cognitive impairment (difficulty concentrating attention) is observed on days 5-7 of treatment. The maximum effect is achieved at 4 weeks and lasts for an average of 1-2 weeks after the end of the course of treatment. Afobazole is especially indicated for persons with predominantly asthenic features in the form of a feeling of increased vulnerability and emotional lability, propensity to emotionally stressful situations. The drug does not affect the narcotic effect of ethanol and enhances the anxiolytic effect of Diazepam.

“Atypical tranquilizers” include Mebicar, Phenibuta trioxazine, etc.

Mebicar is a widely used daytime tranquilizer-adaptogen, which, in addition to nxiolytic, has nootropic, antihypoxic and vegetative stabilizing effects. The effectiveness of the drug in patients with arterial hypertension and coronary artery disease has been proven. Possible side effects: dyspeptic symptoms, allergic reactions, hypothermia, decreased blood pressure.

Phenibut improves GABAergic neurotransmitter transmission, which causes a nootropic, antiasthenic and vegetative stabilizing effect. Possible side effects: nausea and drowsiness. It should be prescribed with caution to patients with erosive and ulcerative lesions of the digestive tract.

Drugs of other pharmacological groups

Glycine belongs to the amino acids that regulate metabolic processes. It is an inhibitory neurotransmitter, increases mental performance, eliminates depressive disorders, increased irritability, normalizes sleep. Can be used by elderly people, children, teenagers with deviant forms of behavior. In case of alcoholism, it not only helps to neutralize the toxic products of ethyl alcohol oxidation, but also reduces the pathological craving for alcohol, prevents the development alcoholic delirium and psychosis.

Magne-B6 is an original drug, which is a combination of the microelement magnesium and peroxin, which potentiate the effect of each other. Used in cases of psycho-emotional stress, anxiety, chronic mental and physical fatigue, sleep disturbances, premenstrual and hyperventilation syndrome. Can be prescribed as monotherapy or in combination with other drugs. Does not interact with alcohol, used to treat alcoholic hangover syndrome.

Herbal remedies

The use of herbal medicines in the treatment of patients with depressive and anxiety disorders is not regulated by Clinical Guidelines, which meet the criteria of evidence-based medicine. Therefore, it is advisable to prescribe appropriate modern antidepressants/anxiolytics to patients with diagnosed depressive and/or anxiety disorders. But herbal medicines can be used to prevent stress-induced psychopathological conditions and autonomic disorders.

In folk medicine, such soothing herbs as valerian, dog nettle, hawthorn, mint, hops and some others, which are called phytotranquilizers, have long been used. Based on them, a large number of herbal medicines have been developed, which are widely represented on the pharmacological market. Traditionally, tinctures of valerian, hawthorn, etc. are used.

Anxiety and depression is a modern disease that has become increasingly diagnosed and rejuvenated. This condition has a negative impact on a person's quality of life. The emergence and spread of this condition raised the acute question of the need for people to master mental hygiene.

If we do not learn to control our emotions, giving them a way out if necessary, do not master relaxation techniques, and do not learn to think positively, then an anxious-depressive state can be called one of the most common problems of modern man.

Feelings of anxiety are very often a symptom of depression. These conditions can be considered separately, determining general features manifestations. Sometimes the symptoms of anxiety and depression are so similar that it is very difficult to differentiate them. But most often, anxiety and depression exist together, complementing each other and aggravating a person’s condition.

Anxiety-depressive disorder belongs to a group of neuroses that are considered psychogenic conditions characterized by a variety of clinical manifestations. Neuroses are distinguished by self-awareness of oneself as an individual and separation of oneself from the disease.

Anxiety and depression occurs in almost 1/5 of people. Each person has a 20% chance of encountering this neurosis. Some people experience this condition several times in their lives.

But absolute number patients do not go to the doctor, but try to cope with their condition on their own. This is fundamentally wrong, since anxiety and depression can be treated sustainably. At the same time, it is not at all necessary to contact a psychiatrist if the very fact of such treatment is frightening. At the present stage, cardiologists, therapists, and neurologists cope with this disease.

The main symptom of anxiety and depression is constant feeling anxiety for no obvious reason. It is difficult to imagine a state in which there is a constant feeling of incomprehensible danger, misfortune, catastrophe, problem. A person has no fear of any specific problem: an exam, a meeting, a meeting, a trip. He experiences a vague sense of danger of something. Like an incomprehensible, frightening premonition.

This condition provokes a constant vicious circle: the feeling of danger produces adrenaline, which itself escalates the situation, causing a feeling of danger. A vicious vicious circle arises from which there is no way out.

Anxiety and depression have two groups of symptoms: clinical manifestations and vegetative-vascular disorders.

Clinical manifestations:

• sleep disturbance, both in the process of falling asleep and sleep itself;
• persistent bad mood, tearfulness, sharp fluctuations in expressions of emotions;
• constant worry, apprehension of danger, anxiety;
• anxiety and tension even in the most ordinary states;
• worries about loved ones without obvious reasons, creating images of failures and troubles of your loved ones;
• exhaustion, fatigue, weakness;
• low concentration of attention, loss of speed of mental reactions;
• negative thoughts.

Autonomic disorders:

• trembling or tremor, usually in the extremities;
• suffocation;
• feeling of a “lump in the throat”;
• frequent and strong heartbeat;
• dampness of palms;
• sweating;
• gastrointestinal disorders;
• high muscle tension;
• frequent urination;
• pain in the abdomen or in the heart area;
• tides;
• chills;
• freezing of the extremities of the hands and feet.

A large number of people experience similar sensations under stress. But at the same time we are talking about some symptoms. For example, in a stressful situation, people often experience chills, which is why police in many countries give blankets to people injured in stressful situations, while providing psychological first aid.

Anxiety and depression are characterized by a number of characteristics that manifest themselves over several weeks or months. The combination of two groups of manifestations is important: vegetative and clinical. Their general presence indicates the possibility of an anxious-depressive state.

For the diagnosis of anxiety and depression, proven methods are most often used:

• Zung scale;
• BDA depression questionnaire;
• Luscher test;
• Montgomery-Asberg scale;
• Hamilton scale.

Some methods are objective, and some are subjective diagnostics. When diagnosing, it is better to combine them, since the reliability of the information may be in question.

People with unfavorable social conditions are at risk. But according to statistics, anxiety-depressive disorder is very common in countries with an above-average standard of living. Even according to data on those who consulted a doctor, the number of people with this problem is constantly growing in Europe and the USA.

Needless to say about those who, for a number of reasons, including domestic immunity, which does not allow a person to seek help in the hospital, did not make their condition public. The percentage of people who do not contact specialists is 2/3 of all sick people.

Most of the people at risk for anxiety and suspiciousness are women. This is explained by the wide variety of problems.

In the spotlight modern woman a whole range of experiences:

• own career and professional growth;
• caring for children, worries about problems with school or relationships of a teenager;
• taking care of the home: comfort, everyday life, cooking;
• concern about one's appearance: worries, worries, comparisons;
• worries about the husband’s reaction to playing the role of mistress or mistress;
• taking care of a personal car;
• experiencing material difficulties.

Each of these points often aggravates the previous one, causing a whole range of emotions and experiences. In addition, women themselves are more emotional than men. At the same time, they do not know how to relax and relieve tension. If we add menstrual cycles, postpartum experiences, and menopause to the problems, the picture becomes even more complicated.

1. Lack of work and employment. The inability to provide for oneself independently, being thrown out of the world of wealthy people, financial instability, looking for a job, “stepping over” oneself, failures lead to a feeling of hopelessness and hopelessness of one’s condition. Constant unrest cause an explosion of stress hormones that cause new experiences.
2. Drugs and alcoholism. Psychoactive substances not only destroy a person’s personality, but also lead to somatic disorders. Depression is constant and causes the need to search for a new portion of happiness in a new dose of psychoactive substances. It is simply impossible to break this vicious circle without outside help.
3. Unfavorable heredity. Most often, people whose parents had these problems suffer from anxiety and depressive disorders.
4. Old age, retirement. Awareness of one’s own uselessness at work, in children’s families. This condition is aggravated by the appearance somatic diseases, death of relatives, loved ones, friends.
5. Low level of education. According to statistics, this category of people suffers to a greater extent from anxiety-depressive disorder.
6. The presence of severe somatic diseases. The emergence of diseases, the fight against which is equated with the fight against death, causes anxiety and depression. Modern psychotherapy considers it necessary to have positive emotions in patients in any condition.

Anxiety and depression are treated with medications. Their choice depends on the causes of this condition. Therefore, it is very important at the first stage to determine the cause-and-effect relationship of such a condition.

Anxious depression is a common type of psychogenic affective syndrome. With this emotional disorder, the intensity of the symptoms shown is associated with a really existing unfavorable situation in the patient’s life. The foundation of anxious depression is pathological reactions of expectation.

Very often such experiences are associated with anticipation of a deterioration in social status or financial situation. Patients, feeling their guilt, may feel a threat to their official position. If illegal actions have taken place, anxious depression may develop as a reaction to anticipation of investigative or judicial actions. This disorder can occur in those people who experience remorse because they have offended, betrayed, or cheated on someone. They think about the impending disaster if their deception is discovered or their betrayal becomes known to their partner.

Causes of Anxious Depression

This affective disorder is caused by a combination of several factors:

• the presence of specific personal characteristics that predispose to the occurrence of pathological anxiety reactions;
• excessively intense and prolonged exposure to stress factors on the human psyche;
• assigning special importance to certain life circumstances;
• a tendency to fixate attention on traumatic factors;
• psychological illiteracy and inability to solve problems in a constructive way.

Almost all patients indicate existing conflicts in personal relationships or in the professional field. Many people suffering from this disorder indicate that cannot satisfy their needs, and they do not see ways to satisfy them in the future. The majority of those caught up in depression are hardworking, disciplined, responsible workers. They tend to carefully plan their actions and are used to doing everything according to the existing plan. Very often, patients with anxious depression work in an intense schedule. There is no room in their life for good rest and relaxation.

Another feature common to many subjects suffering from this affective disorder is a clear underestimation of their existing abilities. They don't think they can achieve anything significant results. They downplay their own talents and believe that they are not worthy of respect. Very often, the subconscious of such people contains ideas about their own guilt and worthlessness. They reproach themselves for the slightest mistakes and suffer greatly because of the mistakes they have made in life. Patients with anxious depression do not forgive their own weaknesses and are painfully worried if they have committed offenses.

Many people have a special ability to empathize. These are very caring and attentive people. They take to heart all the events that happen in the lives of their children, parents, and spouses. From the outside it may seem that such people do not live their own destiny, but live someone else’s life. They are always ready to help, even if they need to sacrifice their time, health, and resources. Many of these people are not at all capable of refusing; they often act to the detriment of their interests. They mistake other people's desires for their own needs. As a result, such ignoring the needs of one’s own personality leads to the emergence of a deep internal conflict.

Anxious depression: symptoms

The main symptom of anxious depression is anticipation of an impending disaster. Patients are completely absorbed in thoughts of imminent misfortune. Anxiety constantly overcomes a person, causing a feeling of unbearable internal tension and discomfort.

Typical symptoms of anxious depression - the appearance of timidity, timidity, and vague anxiety in a person. Patients are in a depressed, depressed state. They indicate that they feel “that something tragic and irreparable is about to happen in their near future.” Patients describe feeling like “an imminent disaster is hanging over them.” They are sure that nothing good awaits them in the future. They describe their prospects in gloomy tones.

A person’s anxiety can be focused on events expected in the future. For example, they may not give up thoughts about the upcoming marriage or divorce. Experiences can also be oriented to a person’s past. The patient doubts the correctness of the choice made and believes that his decision was wrong. He begins to blame and reproach himself. Or his anxiety may be pointless, vague, global. His painful experiences lead to him often crying for no reason. However, he cannot specifically answer the question of what worries him.

Those around him are struck by the changes that have occurred in a patient with depression. Such a subject becomes wary and overly suspicious. Very often, anxiety concerns are accompanied by symptoms of motor restlessness. People are under tremendous stress. They don't find a place for themselves. Patients cannot maintain one body position: they cannot stand, sit, or lie. They often perform chaotic, meaningless actions. Such subjects may run from corner to corner around the room. Or they begin to walk aimlessly along the streets, going long distances from home. However, no matter where they are, they do not feel peace.

Another symptom of anxious depression is speech agitation. The patients moan and wail endlessly. They may repeat the same words or phrases over and over again. Their narrative is devoid of any logic.

Classic symptoms of anxious depression also manifest themselves at the physiological level. The patient complains of debilitating internal trembling, hot flashes and chills. It indicates acceleration heart rate. There is excessive sweating.

A traditional symptom of anxious depression is occurrence of sleep problems. The patient has difficulty falling asleep. He sleeps in shallow, fitful sleep. In the morning he feels broken and exhausted.

A person suffering from depression indicates an overwhelming weakness, loss of energy. A person quickly gets tired of usual activities. His activity and performance are significantly reduced. The patient has difficulty concentrating. He performs any task fussily and poorly.

Anxious depression often accompanied by panic attacks. Various variations of agoraphobia are often associated with the disorder. The patient may have a panicky fear of open spaces or experience fear of confined spaces. He may be afraid of traveling on public transport. The subject may have a panicky fear of being alone. Or the patient will in every possible way avoid being in crowded places. In a broad sense, the fear of people is called anthropophobia.

Anxious depression: treatment

Anxious depression is often chronic in nature, and as the disorder worsens, the symptoms become more massive and expressive. A person’s “forward” anxiety often pushes one to think about the meaninglessness of life, which ultimately threatens the emergence of suicidal behavior. That is why, in order to overcome pathology and prevent tragic consequences, it is necessary to begin treatment at the first signs of the disease.

Treatment of anxious depression is a long and labor-intensive process, the success of which depends on competently conducted therapy and adherence to a strict sequence of treatment measures. The basic principle of treating anxiety depression is taking SSRI antidepressants for six months. At the beginning of treatment, the patient may be prescribed benzodiazepine tranquilizers. Treatment with benzodiazepines is carried out for a duration not exceeding two weeks, since longer use of these drugs can result in the development of drug dependence.

Against the background of drug therapy, they resort to psychotherapeutic effects. Since the causes of this disorder are in most cases psychological factors and social aspects, to get rid of obsessive anxiety it is necessary to establish the original source of suffering. After discovering the true provocateur of the disorder, work is carried out to eliminate the traumatic factor. If circumstances do not allow harmful components to be completely eliminated from the patient’s life, the psychotherapist helps the patient change his attitude towards these circumstances. Reducing the significance of the psychotraumatic factor, a different view of the existing way of life reduces a person’s nervous tension.

• During psychotherapeutic sessions, the participant receives genuine information about the mechanisms of anxiety and learns the true purpose of a natural human emotion - fear. The doctor conveys to the client the idea that, despite the unpleasant and painful vegetative symptoms that accompany anxious depression, they do not pose a mortal threat to a person’s life. The realization that anxiety and the vegetative manifestations accompanying it do not pose a mortal danger forms in a person a more loyal attitude towards his own well-being.
• During psychotherapeutic sessions, the patient becomes familiar with methods of relaxation and relieving nervous tension. Mastery of such techniques makes it possible to prevent a vegetative crisis and allows you to manage your psycho-emotional state. A balanced psycho-emotional state contributes to the formation of an adequate assessment by a person of his past and present.
• Another goal of psychotherapeutic treatment is to motivate the client to reveal and accept the true self. The doctor helps the patient to look at the characteristics of his personality from the outside. A person discovers new facets of his nature, accepts existing advantages, recognizes the presence of interfering and destructive elements in thinking.
• Of particular importance for the complete elimination of anxious depression is the formation of new functional elements in the individual’s worldview. Understanding one’s true goals, needs, and desires stimulates the subject to build a happy future. Psychotherapeutic treatment enables a person to correctly perceive the situation in which he finds himself. Psychotherapy eliminates harmful attitudes, removes from thinking factors that hinder the growth and development of the individual.

However, psychotherapeutic treatment brings the desired results only when the patient has a true desire to transform his life, is ready to make efforts for recovery and follows all medical recommendations. In situations where a person’s thinking is completely engulfed in anxiety, his volitional sphere depressed, it is advisable to carry out treatment using hypnotic techniques. Modern methods hypnosis does not involve the provision of moral violence: the transformation of a person’s inner world occurs comfortably and painlessly. In this case, the patient does not have to spend the remaining psychic energy to eliminate harmful circumstances. The effect of hypnosis is based on a direct impact on the area of ​​the subconscious - the layer of the psyche where the entire “life program” of a person is recorded. Direct replacement of installations at the place where they are stored for life naturally changes a person’s way of thinking and style of behavior.

It should be noted that success in the treatment of anxious depression is impossible if, after all medical manipulations, a person returns to an environment where he experiences tension and discomfort. That is why the patient’s relatives must create a favorable environment, showing that they are ready to provide full assistance and support to a person who is captured by melancholy and anxiety. The absence of inflated demands, malicious reproaches and unfair claims, the demonstration of sincere confidence in the success of one’s sick relative, and, if necessary, feasible unobtrusive help in solving problems will guarantee the complete liberation of the subject from depression.

If in the twentieth century the “disease of the century” was coronary heart disease, then the disease of the 21st century will most likely be mixed anxiety-depressive disorder.

The causes of anxiety and depression are chronic stress, or so-called learned helplessness - a feeling of inability to radically influence the course of one’s life.

Women are especially susceptible to this disease - in addition to the greater lability of the nervous system, the female sex now carries a burden of responsibility that is quite comparable to the male sex, and sometimes even exceeds it.

TDR can occur in people of different ages and different social strata, one thing remains the same - deterioration in the quality of life, problems in the family and at work, dissatisfaction with the situation and lack of strength to change something. Although this disorder belongs to the group of neuroses, that is, self-awareness is not impaired, many patients do not consider themselves sick, citing fatigue and problems.

Anxiety and depression is a medical condition and must be treated by a specialist.

Anxiety-depressive disorder: symptoms of the disease

Mixed anxiety and depressive disorder is characterized by symptoms of anxiety neurosis and depression, namely:

inexplicable anxiety, worry, irrational fear;

persistent decrease in emotional background, bad mood;

emotional lability (fluctuations from irritation to apathy);

poor concentration, decreased performance and memory.

Also, anxious depression is characterized by so-called vegetative manifestations associated with impaired metabolism of hormones that regulate mood (especially adrenaline):

• increased heart rate,
• rapid breathing,
• sweating,
• shiver,
• nausea,
• dizziness,
• sleep and appetite disturbances.

If you or your loved one has the above symptoms, consultation with a specialist is necessary. Our specialists can not only diagnose anxiety-depressive neurosis, but also prescribe effective treatment.

Mixed anxiety and depressive disorder: treatment

Can anxiety-depressive disorder be cured? Of course, yes, but it is important to understand that this is a disease and must be treated by a doctor. If you have an anxiety-depressive disorder, treatment will be comprehensive. The main treatment is complex multimodal psychotherapy; pharmacotherapy is selected as necessary. If you follow all the doctor’s recommendations, you can successfully cope with the disease.

If you are wondering how to cure anxiety-depressive disorder, do not self-medicate, contact us for help and our psychotherapists will help you get started new life without depression and anxiety!

Our specialists are proficient in modern and effective methods treatment of anxiety-depressive disorder. An individual approach to treatment, monitoring the result, working with the root cause of the disease is the key to a new, fulfilling life for our patients.

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Articles about depression

Depressive neurosis occurs when a difficult life situation exists for a long time, which over time begins to seem hopeless and insoluble. Indeed, there are circumstances that cannot be changed. But even then, you can become healthy again and significantly improve your quality of life. This is possible thanks to psychotherapeutic techniques that will help you get out of the influence of a traumatic situation and learn to live in such a way that it does not provoke the development of the disease.

What are the causes of anxious depression, panic, and phobias? Sometimes there is one reason, sometimes there are several. Only a doctor can identify the causes of the disease. And this is important to do because effective treatment is only possible when it is aimed at eliminating the causes, and not at relieving symptoms.

There is no need to endure, search on the Internet for “can anxiety depression be cured,” or drink all kinds of sedatives in a row. The Internet does not see or understand you personally, and the knowledge put into its “head” is very different. And sedatives relieve symptoms (if they relieve them at all), but do not treat the cause.

How to cope with adversity? Everyone experiences a traumatic situation differently. Someone pours out all their emotions and quickly gets into shape. Somebody for a long time cannot calm down, worries, cries, but gradually everything returns to normal. And there are people who keep their emotions inside and do not let them out. Inexplicable anxiety appears, painful anxiety for no reason, sleep and appetite are still disturbed, the mood is depressed, everything is seen in gray colors. What to do?

We refuse cigarettes, alcohol or drugs, carefully handle cutting objects, put on boots with tractor soles in icy conditions... But how often do we refuse an exhausting and humiliating conversation with our parents, boss or significant other? We say, “I won’t do this, eat, drink.” Why don’t we say, “I won’t listen to this, I won’t follow this, I won’t tolerate this”? Tension accumulates and results in various disorders, conditions and neuroses.

Such a serious condition as depression often takes on a chronic form. When combined with constant causeless anxiety, it transforms into an anxiety-depressive disorder. It’s easy to “earn” it, but it can be very difficult to win. It is dangerous not to attach importance to it. But exaggerating its scale is also fraught with unfavorable consequences - this only provokes additional anxiety.

The nature of anxiety and depressive disorders

Based on the name, the conclusion suggests itself that this disorder includes 2 conditions - depression and anxiety. Both are in an equal position, neither of them dominates the other, but each worsens the course of the other. Because of this, it is called mixed. This definition is contained in 10 International classification diseases, which includes the disorder in the list of neuroses. Their clinical picture is varied. It includes 3 types of pathologies:

• bipolar disorder, when your mood constantly changes;
• all kinds of phobias accompanied by anxiety;
• depressive behavior.

Reasons for development

The causes of anxiety and depressive disorders are divided into 3 groups - physical diseases, mental processes, external factors.

Among physical illnesses, leading to similar condition, stand out:

• brain lesions - tumors, vascular diseases;
• traumatic brain injuries;
• epilepsy;
• heart pathologies;
• somatic diseases of a chronic nature - asthma, endocrine disorders;
• lack of certain substances in the body, mainly vitamins and serotonin - the so-called hormone of happiness;
• excess of harmful substances caused by prolonged use of medications, including antidepressants, tranquilizers, and other drugs that have a strong effect on the psyche and nervous system;
• severe intoxication of the body, occurring in various ways;
• diseases leading to disability.

Among mental processes, the first place is occupied by stress factors that provoke the development of constant fear, depression, irritability, and apathy. Conditions can be combined or alternate. Such provoking factors include family quarrels, conflicts at work, and frequent nervous tension.

External factors can constitute the most extensive group; their list can be endless. Among the most common are:

• physical fatigue caused by constant loads on the body;
• hereditary predisposition to anxiety and depression;
• alcohol abuse;
• material problems - lack of work, low income;
• gender and age reasons - adolescence, menopause, midlife crisis, age-related dementia;
• pregnancy;
• a constant situation of uncertainty regarding the present and future.

Anxiety depression, generated by the above reasons, is observed in approximately 1/4 of the world's population.

Symptoms of pathology

Symptoms of mixed anxiety-depressive disorder can vary significantly from person to person. Some signs of pathology may be pronounced. Others are carefully hidden and appear only under specific circumstances.

Symptoms can be divided into 2 large groups - vegetative, which are similar to the manifestations of various diseases, and clinical, caused by a person’s interaction with the outside world. There is no such thing as depression being overshadowed by anxiety or vice versa; they are considered as a whole.

Autonomic symptoms include:

• pain in the heart area;
• heart rhythm disturbances;
• difficulty breathing, shortness of breath;
• problems with the gastrointestinal tract;
• dizziness, headaches;
• trembling of limbs;
• excessive sweating;
• frequent urge to urinate;
• tension throughout the body;
• chills or fever in the body, often accompanied by an increase in temperature and blood pressure;
• dry throat.

Clinical symptoms:

• insomnia or drowsiness;
• lack of appetite or constant hunger;
• chronic fatigue;
• an uneasy feeling of what is happening;
• debilitating fear for oneself and for loved ones;
• worry over trifles;
• bad mood, tearfulness;
• decreased performance;
• violations of social adaptation;
• absent-minded attention, decreased concentration;
• increased arousal for no reason;
• predisposition to suicidal thoughts;
• feeling of complete hopelessness;
• a sharp decrease in self-esteem.

The destructive role of anxious depression on health is obvious. It significantly worsens his condition and aggravates existing chronic diseases. Often a person loses the opportunity to live fully in society, work, and communicate with other people. The sooner treatment is started, the easier it is to get rid of the pathology.

Forms of anxiety and depressive disorders

There are 2 main forms of disorders:

• depression with anxiety, which becomes constant, the person is under stress, this manifests itself physical signs and mental anguish, a person does not find a place for himself, anxiety prevents him from thinking about solving the problem;
• with an admixture of obsessive states, the individual’s own thoughts prevent them from getting rid of; they are caused by self-focus and reluctance to do anything.

The relationship between anxiety depression and panic attacks

Often this disorder goes hand in hand with panic attacks. This dangerous situation which requires urgent action. First of all, it is necessary to establish the presence of signs of panic:

• pulsation throughout the body;
• fainting state;
• inability to breathe fully;
• pain in the heart area;
• profuse sweating;
• alternating fever and chills;
• nausea turning into vomiting;
• loss of sensation in the limbs;
• acute fear of death;
• impaired coordination of movements;
• difficulties in perceiving what is happening around.

At panic attacks anxiety is more pronounced than depression. If there are more than half of the signs, then we can confidently talk about anxiety-depressive disorder.

A phobia associated with certain objects or phenomena comes to the fore; it gradually grows, paralyzing a person’s will. Such phobias often overtake him suddenly under certain circumstances that the individual cannot overcome on his own. This often happens when panic grips a person in closed spaces. It can be short-term or last quite a long time.

Establishing diagnosis

Treatment of such disorders should begin with an accurate diagnosis. If it is incorrect, treating the patient will be difficult and long. It is necessary to undergo an examination, including visits to a number of doctors, among whom the main focus is on a therapist, a neurologist and a psychiatrist. Start of treatment - comprehensive examination body, allowing to exclude concomitant diseases with similar symptoms.

As part of the research, doctors should check:

• the patient's blood through a series of tests;
• blood pressure level;
• lung volume;
• reaction to nerve stimuli;
• heart condition.

The most famous psychological techniques making a diagnosis:

• Luscher color test helps to understand psychological condition personality, identify deviations;
• The Hamilton scale not only reveals the level of depression and anxiety, but also helps to choose the right treatment;
• The Dung scale is used to establish the severity of the condition.

You should also make a complete clinical picture patient's health:

• presence of symptoms of anxious depression;
• nature and duration of symptoms;
• the presence of additional provoking factors;
• the predominance of signs of anxiety-depressive disorder over the symptoms of other diseases.

Treatment of anxiety-depressive disorder

The disorder is curable if you choose the right treatment tactics. Many patients visit doctors for at least a month because of their unsuccessful attempts make the correct diagnosis. The ideal option is when the patient comes to a psychotherapist. If you access it in a timely manner, the prognosis is extremely favorable, and the likelihood of relapse is significantly reduced.

The main methods of treatment are psychotherapeutic and medication; pathology can be completely overcome with the integrated use of methods, as well as by resorting to additional procedures.

Psychotherapeutic methods

The success of this method largely depends on the personality of the psychotherapist. Will he be able to convince the patient that his anxiety and worry are meaningless and unproductive? Influence through rational arguments is the main method of therapy. It should change the patient’s thinking, bring him to harmony with himself and the world around him.

Are important trusting relationship between specialist and patient. Their presence makes it possible to conduct conversations during which possible causes of disorders and ways to overcome problems are clarified. Cognitive behavioral therapy has a good effect, in which the patient changes his thinking in a constructive direction and learns to use his emotions wisely.

Group classes and hypnosis are also used, during which patients are taught techniques of relaxation, self-control, and self-improvement. We must not forget about preventive measures which the patient must master during treatment.

Medication methods

Medication methods can provide significant benefits. But the use of drugs alone is not enough. With their help, you can remove the symptoms of the disorder, but it is difficult to completely cure a person.

Several groups of medications are used - tranquilizers, antidepressants, antipsychotics, sedatives, beta blockers.

Tranquilizers are the most powerful drugs that relieve acute manifestations depression, take a person out of the acute phase, and often return the patient to normal life. Tranquilizers are used short-term due to persistent addiction, probable side effects, often after taking them you want to lie down all the time. Popular ones are “Phenazepam”, “Elenium”, “Elzepam”.

Antidepressants relieve signs of depression, improve mood and well-being, and form a normal reaction to current events. The doctor prescribes antidepressants for a long course so that the body accumulates a sufficient amount of substances that can resist negative factors. Although antidepressants are relatively harmless, it is necessary to select them taking into account the individual characteristics of a person. The most famous are Prozac and Amitriptyline.

Neuroleptics restore normal brain activity, and the person regains the ability to think adequately and make decisions.

Sedative medications have a relaxing effect, relieve nervous tension, allow the nervous system to function normally, and relieve insomnia. Among sedatives Novo-Passit stands out.

Beta blockers are designed to eliminate most autonomic symptoms. They inhibit the receptors responsible for adrenaline, equalize blood pressure, relieve tremors, and eliminate sweating. Anaprilin, Betaxolol, and Atenolone are often used.

Physiotherapeutic treatment

Physical therapy is important integral part treatment of anxious depression. When choosing a specific method, it is necessary to take into account the patient’s health status and any contraindications. The most popular types of physiotherapy:

• massage has a relaxing effect on the muscular system;
• electrosleep immerses the patient in a state artificial sleep, normalizes natural sleep;
• electrical procedures that stimulate the brain and increase blood flow to it;
• acupuncture affects sensitive points of the body, awakening reflex reactions.

Other treatments

It would be more correct to call them methods not of treatment, but of correction, since they only relieve some symptoms and act for a short time. One of the most effective methods- use of folk remedies.

First of all, we are talking about herbs, among which motherwort and valerine have a calming effect. Ginseng and lemongrass improve mood and increase the body's endurance. The herb gentian is an effective remedy for overcoming depression. The leaves of the elm tree increase performance.

When fighting anxiety-depressive disorder, it is extremely important to follow a daily routine, eat properly and balanced, walk in the fresh air, and do physical exercise.

Conclusion

Among psychological disorders, anxiety and depression occupies one of the leading places. Often its danger is underestimated even by experts. It can significantly worsen life, lead to serious health problems, and lead to suicide. Guarantees of recovery - treatment under the supervision of a specialist, strict adherence to recommendations, acquisition of self-control skills.