"Depression patients are reluctant to take medicine, which is a common problem in the treatment process, and patients are unwilling to take medicine and do not cooperate with treatment, resulting in repeated diseases, prolonged conditions, and increased difficulty in treatment. How to help the depressed patients around me overcome their psychological obstacles and persist in treatment?

If you are depressed and you don't want to take medicine, what are you worried about? People with depression are usually reluctant to take medicine because of fear of the side effects of the drug, fear of drug addiction, and stigma. Solving the above problems can greatly increase the patient's compliance with taking medication.

1. The side effects of the drug are controllable

Drug side effects are not as great as patients think, and they don't always occur. Even if it does, it doesn't have to be serious. In addition, doctors can alleviate the side effects of the patient's medication through certain methods, so that the person can gradually tolerate it.

2. Antidepressants do not cause addiction

Manifestations of addiction include the desire to eat when you don't eat, and the inability to control yourself, which is not the case when taking medicine, and the patient does not want to take medicine when the disease is not treated. As the number of depressive episodes increases, the disease becomes more and more difficult to treat, so it is difficult to stop the drug, but taking the drug is maintenance treatment, and it is the disease that makes the patient temporarily unable to stop the drug, not the addiction.

3. Stigma is not advisable

In the popular misconception, mental illness = neurosis. Psychopaths are a derogatory identity. But is the pain in you, is it the other person's idea that matters, or is it important to solve your own problems?

I thought that Yang Lele would read according to the content on the PPT, but I slapped my face, and the questions I just said about the psychology of patients with depression are all from the back, Yang Lele continued.

"Why are depressed patients reluctant to see a doctor? Many depressed patients have a fluke mentality, thinking that they can carry it on their own, and they don't need to receive treatment, so they don't need to see a doctor. Although all kinds of medical knowledge are popularized today, there are still many people who have misconceptions about mental illness, such as casually saying that he is neurotic, be careful. It is precisely this prejudice that leads many people to suffer from diseases such as depression and choose to save face and hide their condition. But in fact, face is the catalyst for depression, and the best way to maintain face is to treat it in time.

Misconceptions about the disease, in addition, can make patients resist seeking medical care. Many patients are reluctant to see a doctor because they believe that once they start taking medication for depression, they may have to take it for the rest of their lives. In their opinion, if they are mentally ill, they will have to deal with drugs for the rest of their lives, and even in their opinion, these drugs will make them "brain bad", and they will really become mentally ill. In fact, this perception is wrong, antidepressant drugs, not only will not eat bad brain, on the contrary, they will protect your brain from being damaged by depression. As for side effects, for most patients, taking the drug under the guidance of a doctor is fine, while stopping the drug without permission will cause the disease to recur. If there is any discomfort after starting treatment, patients can communicate with the doctor and give feedback on the use of treatment, after all, everyone's situation is different, rather than simply refusing treatment. ”

Someone asked a question below, and a pure little beauty asked, "Teacher Yang, what kind of people are prone to depression?"

"This question is a good question, people who are prone to this disease are often very fair, whether they are rich, rich people, white-collar workers in the company, or low-level sanitation workers, business CEOs, rich and troubled more, the quality of life is not necessarily high, people with this disease are often inseparable from the two words "loneliness". Anyone can get depression, regardless of gender, young and old, age, treatment is often very tricky, it needs to be reminded that from one to three o'clock in the morning at night, the suicide rate is quite high, in order to avoid risks, when you practice in the future, you must sign an agreement, otherwise there will be medical disputes, when the time comes, the defendant will lose more than you gain, and it will also make others trust you and the level of treatment greatly reduced, rest for ten minutes, see you or leave. ”

This Yang Lele, I doubt that she has personally experienced it, how can she know so detailed, data is not obtained out of thin air, it will only have to be tested and analyzed by a lot of practice, I want to know Yang Lele's experience very much. Yang Lele walked over and looked into my eyes.

"Your eyes tell me that you want to understand my past very thoroughly?" asked Yang Lele.

"Do you know how to read minds?"

"It's not that powerful, it's normal to think like this, I really won't tell you, I'm also an ordinary person, I've had depression before, but fortunately I've survived, what I have personally experienced and thought is the most real, I am also a psychologist myself, and I am also a mentor, taking out the experience I have experienced as teaching materials, rescuing more patients, and life is worthwhile. ”

Zuo Mi said: "Teacher Yang's experience is extraordinary, I have a lot of interest, we will have a good chat later." ”

"Definitely, definitely, it just so happens that I have some questions to consult Sister Zuo. ”

Ten minutes will soon arrive, and Yang Lele will continue to explain the use of drugs for depression.

"First of all, I will introduce you to several drugs for depression, three bad categories: doxepin and amitriptyline. Monoamine oxidase inhibitors: moclobemide, selegiline, melatonin receptor agonists: agomelatine, selective 5-HT reuptake inhibitors: fluoxetine, paroxetine, sertraline. At present, because the selective serotonin reuptake inhibitor (SSRI) is highly selective for 5-HT, has little effect on NE, dopamine (DA), histamine and cholinergic nerves, has good oral absorption, high bioavailability, good tolerability, and good sequentiality, it is suitable for various types of depression. It is used as the first choice of antidepressants in countries around the world. Among them, the five products of SSRI are vividly called the five golden flowers of SSRI by the psychiatric community in China, they are: fluoxetine, paroxetine, sertraline, fluvoxa, and citalopram. And escitalopram, which was launched in 2015, is known as the "sixth golden flower".

1. Fluoxetine

Fluoxetine is the first selective serotonin uptake inhibitor approved for clinical use, mainly for depression and obsessive-compulsive disorder, and can be used as a treatment for anorexia nervosa. Fluoxetine has a slower onset of action, and some patients take even 6 weeks to take action. Fluoxetine is basically metabolized by the liver, and patients with liver impairment should reduce the dose, which can be changed to the next day.

Studies have shown that fluoxetine is easy to cause headaches, nausea and insomnia, and has a greater impact on sexual function, so fluoxetine is not suitable for patients with insomnia. Discontinuation of fluoxetine usually produces withdrawal symptoms such as dizziness, sensory disturbances, sleep disturbances, fatigue, etc., so it is recommended to gradually reduce the dose when fluoxetine treatment needs to be stopped. Fluoxetine should be taken in the morning.

2. Paroxetine

Paroxetine can treat all kinds of depression, and has a good effect on anxiety disorders and reactive depression. It usually takes 1 to 3 weeks to see results. The dose of paroxetine is usually 20 mg/day, and the dose can be adjusted according to the patient's response, and can be increased by 10 mg per week. According to foreign experience, the maximum dose per day can reach 60 mg.

Similarly, when the drug is stopped, the dose is gradually reduced weekly. Patients should be treated long enough to consolidate the effect, and treatment should be maintained for at least a few months after depression has resolved. Paroxetine has a mild anticholinergic effect and is only the only antidepressant in SSRIs that has an anticholinergic effect. Paroxetine is not easy to produce excitability and is a better choice for insomnia. In addition, paroxetine should be taken in the morning. Students, that's all for today, and I'll talk about the other three drugs in three days, memory is divided into long-term memory and short-term memory. I hope that what I have said, everyone will use it, instead of sitting here and wasting time, after three days I will draw my back, and if I can't answer, the graduation credits will be deducted. ”

Zuo Mi and I were invited to Yang Lele's office, this office is her alone, VIP user, I have to say that it is really domineering, I felt that she was a good girl when I was fishing yesterday, and today I feel different, is a woman really good.

"There are not many people who can make me Zuo Mi admire, I have to say, your professional knowledge is very solid, you have a high level of research in psychology, as the principal's daughter, you are not high because of your identity, you can see that your students listen to you very much, this is a kind of respect for you from the heart, no one deserted in the whole process, including me, how did you do it, you can gently hypnotize dozens of people at the same time?" Zuo Mi analyzed.

"Sister Zuo, I have been teaching my students for so long and I haven't found out that I hypnotized them, you found out the first time, let me be impressed by you, you are worthy of the old rivers and lakes, please take a seat." ”

I was hypnotized? I didn't react at all, yes, those students didn't react, it's easy for a psychiatrist like Yang Lele to hypnotize a person, but why did she hypnotize us, was it to test us or was there another reason.

"Wind Chime, it was not by chance that we met yesterday, that driver is my cousin, I am very interested in you, you have an ulterior secret, this is the reason why I am interested in you. ”

"What's the secret?" I asked curiously.

Zuo Mi hurriedly said: "It's nothing, Yang Lele coaxed you, yes Yang Lele." ”

Yang Lele just covered his mouth and smiled, the two of them acted very well, there should be something to hide from me, I didn't continue to ask, there are some things that can't be asked, go and discover them yourself, they don't want to tell me, this secret is very important.

"Are there any special treatments for depression other than conventional hypnosis, communication or medication?" I asked.

Yang Lele turned the tip of his pen and looked at me and said: "Of course there is, like the more advanced cognitive therapy abroad, this is a kind of rapid therapy for emotional regulation, you can directly apply it to yourself through learning, how about it, are you interested in learning?"

"Of course, I will worship you as a teacher, master one more skill, and have one more chance of surviving in society. ”

"Worship me as a teacher, I haven't confiscated my apprentice, but it's not impossible, but ......" Yang Lele smiled evilly, not knowing what the hell she was thinking.

"Teacher Yang, I really don't have much money except for this person who is mine, can I charge less for tuition. ”

Zuo Mi looked contemptuous of me.

"I don't need money with my apprentices, but I have to do one thing for me, I haven't thought about it yet, anyway, it's not murder and arson, you can rest assured. ”

"That's good, that's good, I'm very timid, these things are not for me. ”

"You come with me, I will take you to visit the culture of our school, and finally come to Hangzhou, just as a tourist. ”