Depressive neurosis – what is it and how is it treated?

In medicine, a state of constant sad mood, hypodynamia (diminution of a person's strength or power) and general lethargy is distinguished, and this type of disorder is called depressive neurosis. In the presence of this problem, sleep disturbances and autonomic-somatic disorders are observed, but the problem does not affect optimism about the future of a person, professional activity and does not cause strong personality changes.

To make this diagnosis, you need to get an appointment with a neuropsychiatrist, who, after consultation, will prescribe a certain treatment. Most often these are psychotherapeutic techniques, medications and physiotherapy.

General information about the disorder

In 1895, doctors introduced the term "neurotic depression", which is still used today in neurology, psychiatry, and psychology. Neurotic depression is identical with the definition of "depressive neurosis".

Not all doctors studying this problem and treating people with depressive neurosis consider the disease as an independent ailment. For example, experts from America include neurosis in the concept of situational depression.

Most often, neurosis is encountered by people with a straightforward and purposeful character, as well as those who are categorical in their opinion and constantly restrain the external manifestation of internal experiences. A little less often, the problem is diagnosed in people with low self-esteem, who often cannot make a certain decision for themselves in a given situation, who are experiencing difficult changes in their lives.

Causes of the disease

External traumatic circumstances can be immersed in a state of depressive neurosis. The reasons due to which the disorder is caused are most often significant for the patient and differ in the duration of the course.

There are two groups of traumatic situations that lead to this diagnosis, namely:

- Multiple failures occurring at the same time in several areas of activity. Such circumstances cause the patient to feel that their life has failed, and drives them into a depressive neurosis.
- Circumstances of emotional deprivation. These circumstances are characterized by the forced hiding of the relationship, the inability to establish contact with a loved one, prolonged separation from people dear to the heart, the lack of opportunities to engage in something pleasant to the soul.

If the patients are influenced by traumatic circumstances for a long time, they are often diagnosed with a depressive neurosis. During this state, the patients do not see any opportunities to solve the situation, and instead of looking for a way out of the problem, all forces are directed to hide the negative emotions that arise. This behavior and internal psychological state is reflected in the patient's health. First of all, the central nervous system suffers and a vegetative-somatic disorder appears.

Symptoms of neurotic depression

The classic course of the disease is manifested by three typical symptoms, namely:

- Vital activity decreases, sometimes there is general lethargy;
- Mood is suppressed;
- Thinking and speech slows down.

When the disease is just starting to develop, the patient begins to suffer from chronically bad mood, general weakness, and also complains of vegetative-somatic manifestations, for example, dizziness, surges in blood pressure, palpitations, poor appetite, problems with the gastrointestinal tract.

In such cases, patients are sent to a therapist, and they, in turn, begin to treat the symptoms. But, in this case, therapeutic treatment will not give positive results. The feeling of weakness only intensifies, arterial hypotension appears, and spastic colitis often develops. The mood only worsens, constant sadness and apathy develops, and the person practically does not smile or laugh, even if any joyful events occur in life.

Patients are also characterized by lack of motor activity, poor facial expressions, quiet and slow speech. But it is worth noting that in relation to professional activities, people with this problem show a great craving for work.

Sleep is often disturbed, it is difficult to fall asleep, and in the middle of the night the patient can wake up abruptly with a strong heartbeat and anxiety. In the morning, people with the disease feel very weak and overwhelmed, but such people do not have anxiety and depression in the morning.

The set of symptoms of depressive neurosis differs from the clinical symptoms of classical depression, namely, that they do not reach the degree of psychosis, but have a less deep neurotic severity.

People can control themselves, adequately perceive everything that is happening around. They do not think about suicide and have an optimistic outlook on the future. Patients are able to think about their plans from a positive point of view, without considering the adverse situation that has happened to them. This manifestation is called a symptom of "hope for a bright future."

How is depressive neurosis diagnosed?

One of the complicating factors during the establishment of this diagnosis is that the patients do not associate their condition with psychogenic factors. During consultations with specialists, they do not tell that they have a chronic traumatic situation. Therefore, very often doctors begin to treat accompanying symptoms.

It is important that people with similar complaints visit not only therapists, but also a neuropsychiatrist. It is this doctor who will conduct a detailed questioning of the patient, which will help determine the cause of the disease and find out what experiences torment the person.

To exclude somatic (physical) pathologies, the patient is prescribed additional examinations:

- ECG;
- Ultrasound diagnostics of the abdominal cavity;
- EEG;
- Visiting a cardiologist;
- Visiting a gastroenterologist.

It is important to visit a competent specialist who is able to differentiate depressive neurosis from hypochondriacal neurosis, asthenia, chronic fatigue, neurasthenia, anxiety-phobic neurosis. Also, during the diagnosis, the doctor must take into account the fact that the patient may have a combination of depressive symptoms and neurotic manifestations that form a hypochondriac-depressive syndrome or any other.

It is important to carefully study the patient's history and mental status, and then an accurate diagnosis will be established, and therefore treatment will be prescribed.

Differences between neurotic depression and clinical depression

Treatment methods

To achieve the result, the treatment must be psychotherapeutic, but also include medication, as well as the use of physiotherapy techniques.

Neurotic depression is most commonly treated with persuasion. During therapy, a logical study of the very situation that provoked this condition is carried out and the purpose of the study is to change the patient's attitude to the situation. Sometimes self-hypnosis is also used, which consists in pronouncing certain phrases to the patient that will help them form a new personal view of the situation.
Medical treatment consists in the use of antidepressants, for instance, selective serotonin reuptake inhibitors such as Paroxetine. Also, if the peculiarities of the course of the disease require it, neuroleptics, nootropics, psychostimulants, sedatives and tranquilizers can be prescribed. But it is impossible to achieve complete recovery of patients with the use of only medication, psychotherapy is also highly recommended.

Physiotherapy methods of influence that help patients cope with depressive neurosis are the following procedures:

- Electrosleep;
- Massage: neck and collar zone; general massage (acupressure, phytomassage, classical, aromatherapy, Ayurvedic);
- Reflexology;
- Hydrotherapy.

What the doctor prescribes depends on the individual characteristics of the patient, therefore, it is mandatory to visit a consultation with a physiotherapist. After examination and communication with the patient, they will be assigned all the necessary physiotherapy procedures, which in turn will have a beneficial effect on the psychological and physiological state of the patient, and will help to quickly cope with the problem.

Post is made based on the information provided by: Elizabeth Agrer, clinical pshychiatrist, Copenhagen, Denmark