What are the asthenic depression symptoms and how is it treated?

Asthenic depression is one of the most common depressions, the name of which translates as "mental exhaustion". This disease appears at any age, people of any gender and profession can get it. Asthenic depression is a psychopathological condition manifested by general weakness, severe fatigue, disturbances in normal sleep patterns, hyperesthesia, and emotional instability.

Asthenic depression responds well to drug and psychotherapeutic treatment if started on time.

Causes of asthenic depression:

1. All moderate and severe diseases and infections. Asthenia, i.e. severe weakness and fatigue, it is the most common syndrome in medicine, an indispensable component of many diseases. For example, in flu or ARVI, increased fatigue is present: a) in the prodromal period (weakness and fatigue are the main components of this period); b) at the elevation of the fever (weakness up to the maximum severity - "asthenic prostration"); c) during the period of recovery (increased fatigue is again the leading characteristic of the condition).
2. Chronic overwork (physical and/or mental). Overwork may be due to objective reasons (for example, a child's illness, difficult material conditions, including among migrants and forced migrants, etc.), but in the modern world it is more often of a "psychogenic" nature (before such cases were considered as one of the types of neuroses - neurasthenia). In these cases, overstrain is due to the peculiarities of a person's subjective assessment of their situation. For instance, when they make excessive demands on themselves, set unrealistic deadlines, want more than can realistically achieve, thereby driving themselves into a state of chronic overwork. Currently, this type of overwork formation is referred not to mental disorders, but to psychological, non-medical problems).
3. Pathologies that also deplete the central nervous system (tumors, angina pectoris, anemia, arthritis and even bronchitis).
4. Strong intoxication with various substances.
5. Depressed mood and lack of positive, life-affirming emotions.
6. Chronic physical fatigue, especially in physically untrained children and adolescents.
7. Improper nutrition. Lack of proteins and fats, essential vitamins and minerals very quickly affects the health and state of the central nervous system.
8. Suspicious, unstable, receptive character.

A feature of asthenic depression is that it is difficult to differentiate it from other similar depressive conditions in terms of symptoms.

Asthenia should be distinguished from fatigue as a physiological (normal) condition:

Clinical manifestations of asthenic depression

1. Increased fatigue:
- Physical - weakness (including in muscles, limbs), fatigue, desire to rest, interrupt work, reduced productivity.
- Mental - primarily difficulties with maintaining attention. Because of this, complaints of deterioration in intelligence and memory, mistakes due to inattention, unfinished tasks, wasted time (work takes much longer than is normally required).
For example, a student, preparing for a test or an exam, reads a chapter of a textbook, but is unable to keep attention on the material being studied, highlight and memorize the most important points, is distracted by extraneous thoughts, as a result, after reading the chapter, an impression is created (often justified), that they did not understand and did not remember anything.
 

2. Hypersensitivity, pickiness, grumpiness, irritability, mood swings for minor reasons (emotional lability).
It can be simplified to say that people in this state do not have enough strength to "restrain themselves" (to control themselves), to keep their dissatisfaction or irritation with them.

Typical situations we can observe in public transport or in queues, when a foot that has been stepped on, a small accidental push or other inconvenience causes a violent reaction of irritability up to verbal abuse or even assault. Of course, in such situations, one cannot ignore both personal characteristics and the factor of a person's general culture, their upbringing, as well as the cultural norms of society as a whole. In addition, we must not forget about the effect of a chain reaction, when we “infect” each other with such negative emotions in everyday situations.

Quite often, emotional reactions of irritability are also observed in medical institutions, and not only in patients whose irritability and poor self-control can be explained by a physical illness, but also, unfortunately, in medical personnel who have asthenia, which is one of the pathogenetic links in the development of emotional burnout caused by overwork due to improper work organization.

3. Sleep disorders. Sleep disorders in asthenia are present not only during the night, but in fact throughout the day.
- Evening: Difficulty falling asleep. It is characterized by the phenomenon of hyperesthesia, i.e. hypersensitive sensory system, when the slightest inconvenience, noise from neighbors, the beating of one's own heart, an uncomfortable bed, etc. attracts attention. Sometimes an abundance of thoughts interfere with falling asleep (while they are usually emotionally neutral in content; disturbing, exciting thoughts in the same way prevent falling asleep with anxious states).
- Night: shallow, restless sleep, frequent awakenings, nightmares.
- Morning: Difficulty waking up, no feeling of rest after sleep. Often, drowsiness occurs just in time when the alarm goes off. After getting out of bed, a person already suffers from severe fatigue even before the start of any activity.
- Day: daytime sleepiness, difficulty concentrating, additional efforts are needed to overcome drowsiness and focus on work. In the afternoon, a person becomes more active, collected, efficient, but because of this they cannot fall asleep or postpones going to bed later than the required time.

Not all people with asthenia complain of difficulty falling asleep, they often do have trouble falling asleep once in the bed. But because of their condition (lack of inhibition processes), they go to sleep later than the required time (distracted by minor things that could have been done at other times, for example, watching TV, communicating on social networks, etc.). A sign in this case will be a general reduction in the duration of sleep (for example, a student regularly goes to bed at 1–2 in the morning, despite the fact that he has to get up at 7 in the morning).

4. Various vegetative disorders:

- Headaches. They are one of the most common complaints. There are two main types of headache: migraine (unilateral, usually affecting the temporal region, orbit, forehead; pulsating, intense, impeding functioning, accompanied by severe hyperesthesia), and tension headache (pressing, compressing like a "helmet", bilateral, usually extending from the back of the head, associated with tension in the muscles of the scalp and neck). It is the second type of pain that is one of the most frequent autonomic disorders with overwork and asthenia, while with migraine the symptoms of asthenia are also quite pronounced, but it appears secondarily in relation to the migraine itself.
- Hyperhidrosis, sweating, hot flashes or, conversely, chilliness, including in the limbs.
- Palpitations. Due to a violation of the tone of the autonomic nervous system, heart rhythm disturbances, including an increase in the number of extrasystoles, are quite real in asthenia (complaints about them cannot be reduced to autonomic hyperesthesia). It should be borne in mind that substances with a stimulating effect (coffee, energy drinks, etc.), which many people use to try to overcome lack of attention and daytime sleepiness in asthenia, in this regard, may carry additional health risks, potentiating existing rhythm disturbances.
- Dizziness.
- Dyspeptic disorders (indigestion, heartburn, nausea, etc.).

In case of manifestation of vegetative disorders without significant somatic causes, physicians often tell patients that they are healthy and simply need to rest more. While the psychological causes of these conditions are often completely ignored (and besides asthenia, similar symptoms can occur with masked depression, panic attacks and other mental disorders), and therefore patients do not receive adequate therapy.

Other symptoms include:

- Apathy (lack of interest in anything), which is progressing more and more every day: the patient loses interest in what he was previously interested in;
- Flu-like muscle, joint, and bone aches in the whole body, the origin of which is difficult to explain;
- Drowsiness that does not disappear even during the day;
- Low productivity and ability to work;
- Irritability and aggressiveness;
- Disorders of urination;
- Back pain;
- Unexplained tearfulness;
- Intense thirst;
- Lack of appetite;
- Increase or decrease in body weight, which was not there before;
- Forgetfulness;
- Pressure surges;
- Impotence in men.

If asthenic depression is mild, patients remain normally active, but even simple daily activities such as washing, brushing their teeth and dressing tire them and take longer than they used to. If depression is severe, a person with depression feels an absolute loss of energy and has no desire to do anything. The fact that even daily routine becomes so difficult makes the patient spend not only physical, but also mental energy, and this only aggravates the disease.

A feature of this depression is that its symptoms acquire the greatest severity in the morning hours, and gradually decrease in the evening and the patient's condition slightly improves.

Treatment of asthenic depression with medications

Treatment requires, first of all, the correct diagnosis made by a specialist such as psychiatrist or psychotherapist. The therapy can take from 1 to 6 months, depending on the patient's condition.

During the treatment of depression, the patient is prescribed sedatives, tranquilizers, vitamin and mineral complexes, physiotherapy, massage - procedures that are necessary to relieve symptoms and the better recovery of the body after asthenic depression.

Medication for depression consists of taking psychotropic drugs that improve the patient's condition:

- Stimulating antidepressants (for instance, Bupropion) that reduce and relieve apathy, anxiety, melancholy, lethargy, improve mood, restore appetite, normalize sleep;
- Sedative antidepressants (for instance, Imipramine) that remove irritability, excessive excitement and anxiety, improve mood, eliminate anxiety, help restore restful sleep;
- SSRI (for instance, Citalopram) to relieve anxiety, excessive anxiety, feelings of fear, improve mood;
- Sedatives based on St. John's wort and other natural ingredients.
If you start treating depression as early as possible, the disease can be defeated very quickly: with timely therapy, asthenic depression has a favorable prognosis.

Non-drug treatment for depression

It should be noted that medication alone is not enough to cure depression. Psychotherapy has a tremendous healing effect: conversations with a doctor should bring positive results: relieve the symptoms of the disease and gradually restore the patient's lost health.

Besides, one of the most important conditions for the success of the treatment of asthenic depression and depression, in general, is the desire of the person to recover, as well as to contact a psychotherapist to achieve this goal and unquestioningly follow all doctor’s prescriptions. Only then the treatment of depression can be successful.

Maintaining the health of one's own body at the proper level is also of great importance for the treatment of this depression. To do this, patients need to eat right, quit bad habits, normalize their sleep routine, walk in the fresh air, and incorporate mild physical exercise in their daily life.

Post is made based on the information provided by:Christopher Ames, MD, pshychiatrist, Medibank, Sydney, New South Wales, Australia