One of the most common diseases on Earth is depression. So according to WHO depression affects more than 150 million people worldwide. According to American psychologists researches, women suffer from depression twice as much as men. For adolescent boys and young men, depression is often accompanied by breakdowns, for girls and women – by eating disorders (anorexia and bulimia).
Depression is an effective state, characterized by negative emotional background, with changes in the motivational sphere, cognitive representations and general behavior passivity. Most psychoanalysts agree that most important components of depression are the loss of self-esteem, self-confidence and self-respect.
Depression course includes the following basic emotions: sadness (key emotion), disgust, contempt, anger, fear, guilt and embarrassment. Anger, disgust, contempt are manifested both towards oneself and other people.
Basic emotions are considered to be primary and most important depression elements, but depression is also characterized by such symptoms as decreased sexual desire, deconditioning and fatigue. The depressed person experiences negative feelings: frustration, sadness, despair. Will activity is greatly reduced, self-esteem is low. A person may feel guilty for past events, those unpleasant events that happened through his fault.
During depression such symptoms are observed as slowness, lack of initiative, rapid fatigability, which leads to suddenly diminished performance in some activities. At prolonged depression, there may be suicide attempts. Healthy people may suffer from depression because of severe circumstances, including loss of loved ones, divorce, infidelity, infertility (inability to have children), unfulfilled hopes and other conditions. In addition, there is a pathological depression – as one of the major psychiatric syndromes.
Biological factors (organic and endogenous, i. e. inborn origin). In case of biological factors most common drugs are used for treatment.
Psychosocial factors (psychological origin). With psychosocial factors prevalence, different methods of psychotherapy are used.
There are two types of depression:
- reactive depression;
- endogenous depression.
Reactive depression is caused by irreversible loss. It could be a loss of loved one, connected with death, separation, divorce, or imprisonment, loss of certain status, financial loss or loss of other important values. Reactive depression manifests in anguish, anxiety, apathy, associative and motor retardation, discomfort, low self-esteem, negative perception of past, present, future, autonomic disturbances.
At reactive depression suicide risk is much more prominent. For many people, interpersonal conflicts with other people are observed. According to its coarse there are acute and delayed reactive depression. Delayed reactive depression may turn into chronic. According to its form reactive depression is divided into anxiety-anguish and hysterical.
Physiological depression symptoms:
- sleep disorders (insomnia, night and early awakening);
- loss or gain of appetite;
- problems with intestinal tract (intestinal obstruction);
- decreased sexual desire;
- easy fatiguability under normal loads, gone feeling and exhaustion;
- aches in the back, neck, heart and others.
Emotional depression symptoms:
- grief, misery, dismal mood, despair;
- anxiety, internal stress, trouble expectancy;
- the sense of guilt, frequent self-reproach;
- dissatisfaction with oneself, decreased self-confidence, low self-esteem;
- decrease or loss of ability to enjoy one’s favorite activities;
- decreased interest in surrounding reality.
Mental depression symptoms:
- concentration difficulties;
- difficulties with making decisions;
- thinking slowness;
- prevalence of downward negative thoughts about oneself, one’s life, the world in general;
- a pessimistic vision of the future with no perspective, the meaninglessness of life;
- thoughts about own uselessness, insignificance, helplessness;
- thoughts about suicide (in severe cases of depression).
Behavioral depression symptoms:
- passivity, difficulties with purposeful activity;
- avoidance behavior (propensity for isolation, loss of interest to other people);
- refusal from entertainment;
- alcohol and psychoactive substances abuse.
- decrease of working activity;
- alcohol and drug abuse;
- frequent divorces;
- death of suicide.
Classification of depression:
- according to severity – mild, moderately severe, severe;
- according to pathology degree – neurotic, cyclothymic, psychotic;
- according to affect structure – melancholy, anxiety, apathetic and mixed;
- according to typology – simple and complex, typical and atypical.
- anxious (agitated) depression;
- depressive-delirium syndrome;
- apathetic depression.
Depression Treatment with Zoloft
Type of treatment that doctor prescribes depends on depression type and severity. Usually, it involves antidepressants application or psychotherapeutic treatment, but more often it’s a combination of both.
Sertraline is an antidepressant with selective serotonin reuptake inhibitor (SSRIs) group. It has stimulatory and sedative action and is used to treat patients with depression accompanied by loginess, hypersomnia, apathy and anguish, and with anxious depression, anxiety, sleep disorders, irritability. It quickly relieves anxiety-phobic component and anguish, although at the beginning of therapy can enhance anxiety symptoms that sometimes requires tranquillizers. In combination with cognitive behavioral therapy, sertraline gives excellent results in obsessive compulsory disorder (OCD) treatment.
Antidepressant, selective serotonin reuptake inhibitor, strengthens its effects, has little effect on noradrenaline and dopamine reuptake; in therapeutic doses blocks thrombotonin reuptake in human platelets.Serotonin reuptake activity inhibition increases serotonergic transmission that leads to subsequent adrenergic activity inhibition in the blue nucleus (locus ceruleus).Sertraline also inhibits serotonin neurons stimulation in the site of suture (middle line of the medulla oblongata) that leads to initial blue nucleus activity increase with subsequent postsynaptic beta-adrenergic and presynaptic alpha2-adrenergic receptors activity decrease.
It does not build up a tolerance, does not have the psychologic, sedative, antimuscarinic and cardiotoxic effect, does not inhibit psychomotor activity. Due to selective serotonin reuptake inhibition, it doesn’t increase sympathetic nervous system activity. Unlike tricyclic antidepressants, during depression or obsessive compulsory disorders (obsessional neurosis) treatment Zoloft (sertraline) does not increase body weight. Unlike other SSRIs, it produces less phase reversal caused by depression – into hypomania and mania. The initial effect is observed at the end of the first week, to a greater extent – after 2-4 weeks, and maximum therapeutic effect – after 3 months from the beginning of regular use.
- hepatic disorders;
- alcohol, psychotropic medication and other drugs intoxication;
- lactation period;
- co-administration of MAO inhibitors.
- neurological disorders (including mental retardation);
- hepatism and/or nephatony;
- weight loss;
- children age.
- allergic reactions;
- hemorrhage (including nasal);
- dry mouth;
- decreased appetite.
* It may lead to emotional and behavioral changes, including increased suicide risk.
During treatmen,t it is necessary to strictly monitor patients behavior (risk of suicide attempts) until significant improvement achieved by treatment. Sertraline administered not earlier than 14 days after MAO inhibitors withdrawal. Women of childbearing age during treatment should use adequate contraception methods. During treatment period patients must be careful when driving and doing other hazardous activities that require high concentration and psychomotor speed actions.