Symptoms of a Mild Depressive Episode
The clinical picture includes: reduced ability to concentrate and attention, reduced self-esteem and self-confidence, ideas of guilt and self-deprecation, a gloomy and pessimistic attitude to the future, suicidal ideas and self-harm, sleep disturbances, loss of appetite. These common symptoms of a depressive episode should be combined with a level of depressive mood that is perceived by the patient as abnormal, and the mood is not episodic, but covers most of the day and does not depend on reactive moments. The patient experiences a distinct reduction in energy and increased fatigue, although he can control his condition and often continues to work. Behavioral (mimic, communicative, postural and gestural) signs of a bad mood may be present, but are controlled by the patient. In particular, you can see a sad smile, motor inhibition, which is perceived as “thoughtfulness.”
Sometimes the first complaints are the loss of the meaning of existence, “existential depression”. It is usually noted in the diagnosis whether the depression is without somatic symptoms or with somatic symptoms.
Diagnosis of a Mild Depressive Episode
- In the diagnosis should be at least two of the following three symptoms:
– depressed mood;
– decrease in interest or pleasure from activity which was pleasant to the patient earlier;
– decrease in energy and increased fatigue. - Two of the additional symptoms:
– reduced confidence and self-esteem;
– unreasonable sense of self-judgment and guilt;
– recurring thoughts of death or suicide;
– complaints of decreased concentration, indecision;
– sleep disturbance;
– change in appetite.
Differential diagnostics
Most often, a mild depressive episode has to be differentiated from an asthenic condition as a result of overwork, organic asthenia, decompensation of asthenic personality traits. When asthenia is not characterized by suicidal thoughts, and decreased mood and fatigue are enhanced in the evening. When organic asthenia is often marked dizziness, muscle weakness, fatigue during exercise. History of craniocerebral injury. With the decompensation of personality traits, the psychasthenic rod is noticeable in history, subdepression is perceived by the personality as a natural and characteristic trait for the personality.
Treatment of a Mild Depressive Episode
In the treatment using benzodiazepines, antidepressants of the type: fluoxetine, pyrazidol, petilil, gerfonal, with the anxious component – zoloft, lerivon, mianserin. Showing courses of phototherapy, psychotherapy and nootropics. Sometimes 2-3 sessions of nitrous oxide, amytal-caffeine disinhibition and intravenous administration of novocaine give the effect.