"Complaints of physical discomfort can involve various organs, such as nausea, vomiting, palpitation, chest tightness, sweating, etc."

"Symptoms of autonomic dysfunction are also common."

"Complaints of pre-morbid physical illness are usually aggravated."

"Sleep disorders are mainly manifested as early awakening, generally waking up 2~3 hours earlier than usual, and not being able to fall asleep again after waking up, which is characteristic of depressive episodes."

"Some manifest as difficulty falling asleep and not sleeping deeply; A small number of patients present with excessive sleepiness. ”

"Weight loss is not necessarily proportional to loss of appetite, and a small number of patients may experience increased appetite and weight gain."

"For patients suspected of depression, in addition to a comprehensive physical examination and neurological examination, attention should also be paid to auxiliary examinations and laboratory tests."

"To date, there is no specific test for depressive disorders."

"Therefore, the current laboratory tests are mainly aimed at ruling out depression caused by substance and medical diseases."

"There are 2 laboratory tests that have some significance, including the dexamethasone suppression test (DST) and the thyrotropin-releasing hormone suppression test (TRHST)."

"The diagnosis of depression should be based mainly on the medical history, clinical symptoms, course of the disease, physical examination and laboratory tests, and the diagnosis of typical cases is generally not difficult."

"At present, the internationally accepted diagnostic criteria are ICD-10 and DSM-IV."

"ICD-10 is mainly used in China, which refers to first-episode depression and recurrent depression, excluding bipolar depression."

"Patients often have typical symptoms of depressed mood, loss of interest and pleasure, loss of energy, or fatigue."

"Other common symptoms are (1) reduced ability to concentrate and pay attention; (2) decreased self-evaluation; (3) self-guilt and feelings of worthlessness (even in mild episodes); (4) believe that the future is bleak and pessimistic; (5) self-injurious or suicidal thoughts or behaviors; (6) sleep disorders; (7) Decreased appetite. The course of the disease lasts at least 2 weeks. ”

"About the treatment

1. Treatment goals

"The treatment of depressive episodes should achieve three goals: (1) improve the clinical cure rate, minimize the disability rate and suicide rate, and the key is to completely eliminate the clinical symptoms; (2) improve the quality of life and restore social function; (3) Prevention of recurrence. ”

2. Principles of treatment

(1) individualized treatment;

(2) The dose should be gradually increased, and the minimum effective dose should be used as far as possible to minimize adverse reactions to improve medication compliance;

(3) sufficient amount and course of treatment;

(4) Monotherapy as much as possible, if the efficacy is not good, switch therapy, synergistic therapy or combination therapy can be considered, but attention needs to be paid to drug interactions;

(5) Informed notification before treatment;

(6) During the treatment period, closely observe the changes in the condition and adverse reactions and deal with them in a timely manner;

(7) It can be combined with psychotherapy to increase the efficacy;

(8) Actively treat other physical diseases, substance dependence, anxiety disorders, etc., which are comorbid with depression. ”

"3. Medication

Medication is the mainstay of treatment for depressive episodes above moderate. At present, the first-line antidepressants in clinical practice mainly include selective serotonin reuptake inhibitors (SSRIs, representing the drugs fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram and escitalopram), serotonin and norepinephrine reuptake inhibitors (SNRI, representing venlafaxine and duloxetine), norepinephrine and specific serotonergic antidepressants (NaSSA, representing the drug mirtazapine), etc. ”

"The use of traditional tricyclic and tetracyclic antidepressants and monoamine oxidase inhibitors has been significantly reduced due to the large adverse reactions."

4. Psychotherapy

"For patients with depressive episodes who have significant psychosocial factors, pharmacotherapy is often required at the same time as psychotherapy."

"Commonly used psychotherapy methods include supportive psychotherapy, cognitive behavioral therapy, interpersonal therapy, marriage and family therapy, psychodynamic therapy, etc., among which the efficacy of cognitive behavioral therapy for depressive episodes has been recognized."

5. Physical therapy

"In recent years, a new form of physiotherapy has emerged – repetitive transcranial magnetic stimulation." Let's read a book

"A study that has been tracking patients with depression for 10 years has found that 75%~80% of patients have multiple relapses, so patients with depression need preventive treatment."

"More than 3 seizures should be treated for a long time, or even lifelong medication."

"The dose of maintenance therapy drugs is considered by most scholars to be the same as the therapeutic dose, and regular outpatient follow-up observations should also be made."

"Psychotherapy and social support systems also play a very important role in preventing recurrence."

"Excessive psychological burden and pressure should be relieved or reduced as much as possible, and patients should be helped to solve practical difficulties and problems in life and work."

"Improve the ability of patients to cope and actively create a good environment for them to prevent recurrence."

"Depression can cause sinus arrhythmias".

"When depression occurs, it can manifest as autonomic dysfunction, mainly manifested as palpitation, arrhythmia, insomnia, numbness in the hands and feet, memory loss, attention disorders, loss of appetite, weight loss, etc."

"There are no organic lesions on the examination, but the patient is unable to control his emotions on his own, and medication and psychotherapy are needed to relieve his symptoms." 

"Depression is the fourth most common disease in the world, and it should be treated in a timely manner."

"Depression, also known as depressive disorder, is characterized by significant and persistent depressed mood."

In recent years, the incidence of depression has skyrocketed around the world, and it is still on the rise, and China is no exception. ”

"At the same time, the onset of depression and suicide events are closely related, and patients with depression need to actively take preventive treatment."

"Depression can come back. Depression is a disease that is prone to recurrence, and the recurrence rate of depression in the first episode is 50%~75%; ”

"After two or three recurrent episodes, the recurrence rate is higher."

"Therefore, the key to successful treatment of depression is to completely eliminate clinical symptoms, adhere to medication, improve personality, and reduce the risk of recurrence."

"The recurrence is mainly related to the patient's failure to adhere to medication and negative behaviors, such as maintaining adequate sleep in daily life and relaxing when encountering problems."

Nuan'er, many of her symptoms are in line with her now, she has poor sleep, decreased appetite, poor attention and memory, severe pessimism about the future, and even can't rush to happiness. The most terrifying thing is that she has self-harm, suicide. ”

"Nuan'er, she's so serious, what an optimistic person she is." Ye Qiao covered his mouth and cried.

"Jojo, it's okay." Gu Yixuan hugged Ye Qiao.

"There will always be a way, if you are like this, I can't let you go to see Nuan'er, we must first adjust our emotions." Ye Xuan looked at Ye Qiao and Gu Yixuan in the rearview mirror. "You should persuade well, or we will go back."

"Qiaoqiao, Ah Xuan is right, if we are not in a good mood at this time, it will definitely affect Xia Nuan." Gu Yixuan gently patted Ye Qiao's back.

"I'm fine, I'm just too distressed." Ye Qiao sorted out his emotions.

"No matter what happens, you have to control your own emotions, and you have to think about what is in your stomach regardless of yourself." Ye Xuan told Ye Qiao.

"Well, I know, brother, I'll be fine, I still have help with Nuan'er." Ye Qiao barely managed to squeeze out a smile.

"It's good to know." Ye Xuan didn't go to see Ye Qiao, "It's almost there." ”

"Hmm." Gu Yixuan responded softly.

"Brother, depression doesn't turn into mental illness." Ye Qiao looked at Ye Xuan worriedly.

"Depression and schizophrenia are two different types of disorders."

"In schizophrenia, some cases also have symptoms of depressed mood."

"People with severe depression also have psychiatric symptoms such as hallucinations and delusions, but the two are not the same disease, and the treatment options are different."

"Psychosis is called schizophrenia from a medical point of view, and the answer to whether depression will turn into schizophrenia is uncertain, and some people with severe depression will also experience psychotic symptoms such as hallucinations and delusions."

"Nuan'er, she won't." Ye Xuan replied.

"I'm sorry, brother, I hurt Nuan'er." Ye Qiao really felt that these hardships should be his own

"Jojo, have you forgotten what I just said?" Ye Xuan stopped the car.