Mental health

Depression is an illness that affects emotions, thoughts, behaviors and physical reactions in the body. A bad mood, when a person does not want anything, nothing makes him/her happy and he/she has no energy, at some point and to some extent may appear to everyone. If these symptoms are temporary and do not affect the daily life, there is no reason to worry. However, if a bad mood persists and other complaints are added, it becomes difficult to work, learn, communicate with loved ones, it is worth consulting with a specialist. The statistics show, that nearly one in eight people suffer from depression, which requires treatment. Depression is a treatable disease nowadays. It is possible to feel good and enjoy life, if one receives appropriate treatment and assistance to cure depression.

The most common symptoms of depression are:

• Constantly depressed mood (mood is low most of the day for more than two weeks without apparent reason. A person may feel sad, lonely or hopeless. It seems to him or her that in the future there is nothing good and positive to expect. Sometimes low mood combines with annoyance and irritability);
• Lack of interest (everything becomes indifferent, person gets discouraged from things and events, that have raised good emotions in the past);
• Fatigue, exhaustion (person quickly gets tired, feels the need to lie down and rest, nothing else gives the expected refreshment. Often people with depression have no strength and motivation to start doing anything, wake up already feeling tired);
• Sleep disorders (difficulty to fall asleep, a night's sleep becomes brittle, the person begins to wake up in the mornings too early);
• Unfounded guilt (a person starts to blame himself/herself for not being able to work productively, does not feel the joy, cannot "pull oneself together". Person may start to blame himself/herself in idleness, believing that he/she has become selfish and does not justify expectations of others);
• Difficulty to concentrate (a person becomes distracted, inattentive, can begin to admit mistakes in work, can get into accidents. Often it becomes impossible to read or watch television due to concentration difficulties. Ambient sounds, other conversations, music starts to feel uncomfortable);
• Altered appetite (lost appetite, food seems tasteless, a person has no desire, body weight decreases. Inadequate food intake increases fatigue. For others, conversely, in case of depression appetite becomes too great, appears eagerness to sweets and pastries. Weigh increases. Overweight reinforces the sense of guilt and hostility against person itself even more. Increased appetite is characteristic to seasonal, or "winter depression" case);
• Slowed movements and thinking (both, the person and surrounding people begin to notice that the person becomes slower in movements and thinking, begins to answer questions after a longer moment of reflection. In certain cases a person has completely opposite symptoms during depression – he/she becomes agitated, restless, and unable to find peace);
• Suicidal thoughts (in more serious cases a person may have thoughts that life is not worth living. The desire rises to fall asleep and not wake up or even to get an incurable disease. Self-defeating, dangerous behavior such as increased alcohol or drug use, reckless car management, deliberate no treatment of physical disease may be a sign of suicidal risk. Suicidal thoughts is the most important symptom of depression).

Depression can be also combined with other psychiatric disorders – anxiety, intrusive thoughts and compulsive actions, panic, emotional instability, vegetative symptoms: palpitations, sweating, changes in blood pressure, shortness of breath, abnormal stools.

Every manifestation of depression can differ. A specialist can help to assess the severity of symptoms, its' depth, possible cause and the best way of treatment. If necessary, a specialist can send a person for additional tests (clinical tests, encephalogram, magnetic resonance and others) to make sure that depressive symptoms are not caused by any physical abnormalities such as thyroid dysfunction, anemia or any other disease. 

Persons with close relatives suffered from repeated episodes of depression, who have experienced some serious psychological trauma in their lifetime, particularly in childhood, who have particular personality traits such as perfectionism and low self-esteem have a greater risk of depression development. Prolonged stress, low income and long-term unemployment, alcohol and drug abuse also are associated with a higher risk of depression development. Women are diagnosed with depression twice as often, perhaps because women are more willing to look for help. Depressive symptoms may also be caused by physical illness and/or some medications.

Depression does not disappear by itself. Depending on the severity and type of depression, there are different types of assistance.

Psychotherapy (also known as talk therapy) is an effective treatment, which is considered to be equivalent to drug therapy. Psychotherapy is used in different ways – cognitive behavioral therapy, psychodynamic therapy, support psychotherapy, group support therapy. A specialist can help you to choose appropriate types of psychotherapy.
In some cases, drug therapy is also required. In cases of mild depression herbal preparations can be used such as St. John's Wort. If using herbal medicines, it is important to consult a doctor to assess the risk of interactions in case a person is using any other medications for the treatment of disease. In more serious cases of depression specialist may recommend to take antidepressants. Antidepressants are an effective tool for the treatment of depression.

Nowadays, antidepressants are able to reduce the symptoms of depression relatively quickly, have no significant side effects or risk for developing addiction and they are not toxic. Doctor can help you choose the most appropriate antidepressant. 

In addition to psychotherapeutic and/or pharmacological treatment, alternative methods may also use for assistance, for example, to practice meditation or relaxation techniques. It is also important to have a balanced daily regime to relieve stress, a healthy diet, regular physical exercises. It is important not to remain alone with the torment of depression symptoms. But most importantly - take the first step to get help!

Vegetative dystonia or somatic vegetative dysfunction (SVD) is a disorder of functions and senses of the body, while organic and medically explanation of reasons for this disorder is not yet found. Person has symptoms like a physical illness (such as wheezing, chest pain, sweating, dizziness), but during clinical investigations it is impossible to determine the physical cause of the symptoms.

Functions of the body and internal organs are regulated by the autonomic nervous system, which operates independently of deliberate human control.

Autonomic nervous system can be divided into two parts:

• Sympathetic nervous system prepares the body for active work. Metaphorically, it could be described as the body's preparation for the fight, attack or escape. Sympathetic nervous system by activation, accelerates the heart rate, strains the muscles and increases their power, expands the eye pupil, accelerates the metabolic processes, reduces the secretion of digestive juices, extends the airways or bronchi. Sympathetic nervous system increasingly operates if a person is suffering from anxiety and tension.
• Parasympathetic nervous system prepares the body for peace and relaxation. Activation of the parasympathetic nervous system slows the heart rate, breathing, narrows the airways, reduces muscle tension and strength, the eye pupil constricts, increases the secretion of digestive juices.

Emotions affect the autonomic nervous system and adapt it for human needs. For example, in the face of fear the sympathetic nervous system activates, but in the face of well-being, the parasympathetic nervous system dominates. Different emotions are normal and healthy phenomenon. However, if a person is constantly experiencing burnout or prolonged stress, the body spends all its strength to withstand the load and stress.

Emotions are unable to be recycled and adapted. The body starts "survival mode" and it starts a whole series of chemical reactions - heart rate speed up, a greater amount of stress hormones is secreted in the blood, chemical glycogen is released in liver, which later turns into glucose and provides the body with energy, breathing becomes more rapid, so the lungs are supplied with more oxygen, muscles become more tense, ready to the physical activity, if there is such need, sweating is reinforced to cool the body in case if physical activity is actually realized. In case of stress and overload, sympathetic nervous system is overloaded. Autonomic nervous system balance is disturbed, causing a variety of unpleasant symptoms.

The most common symptoms are palpitations, sweating, and shortness of breath, wheezing, tremor, hiccups, cough, abdominal distension, diarrhea or frequent urination. In some cases, it may be pain of various body parts and organs and the severity or tightness in the body. SVD is accompanied by clear symptoms of anxiety, helplessness, fear, often even panic attacks. A person is concerned about his health; think he might have become ill with a physical illness. Usually, people themselves actively and repeatedly look for doctors help and perform a variety of tests. However, the test results do not confirm the suspicion of physical illness.

If a person has a complaint about his physical health, first, the tests must be carried out to ascertain whether health disorders are associated with any physical illness. If tests show the physical pathology and the doctor confirms that the patient does not have any organic change by which the current symptoms could be explained, possibly problems are associated with autonomic nervous system dysfunction. This diagnosis can be confirmed best and more information given by a doctor who specializes in the diagnosis and treatment of such conditions - a psychiatrist or psychotherapist.

Psychotherapy is an effective method in reducing symptoms of somatoform vegetative dysfunction. Sometimes, medication (antidepressants, sedatives or hypnotics) has to be taken in addition. Your doctor may also recommend practicing some relaxation exercises to help balance the daily treatment to reduce the emotional load.

When on your daily run difficulties to distinct work and leisure only increase, overload arises – long-term stress begins to appear, which increases the risk of burnout syndrome. Often responsible and intense work, high sense of responsibility in the areas of work, perfectionism, emotional exhaustion and high working standards create a situation where, contrary to preferred – concentration is reduced and body signals against such manifestations of stress with mentally suppressive disorders, and physical discomfort.

Burnout syndrome is explained as human psycho-emotional and physical condition, which results in a complete exhaustion of mental and physical abilities. Often the trigger is too high requirements to the person itself, low self-control and high standards of work, which can no longer be with reached over time, thus causing not only mental fatigue, but also threaten the physical health, increasing cardiovascular and other disease risks.

Unfortunately, in reality is the desire to make more and better overburdening oneself creates the opposite effect - the loss of quality of work and creativity and daily operations are accompanied by an inefficient use of time.
In parallel to career, also the quality of private life deteriorates and personality changes – worsening relations with colleagues, relatives, friends and loved ones, which leads to social decline and pose a serious risk of depression. A person suffering from burnout syndrome may experience a sense of anxiety, aggression occurs, intolerance, lack of interest, have thoughts of suicide.

In order to restore the health and wellness, it is important to find the reason of burnout syndrome. To protect oneself from disease, it is necessary to ensure a good rest, find hobbies or interests that are not related to work. To feel good about yourself and your body also need physical exercises, a balanced diet and wholesome sleep on a daily basis, as well as the balance between work and rest.

Quite often burnout syndrome risk group includes persons who suffer from inferiority, a feeling of insecurity and low self-esteem, resulting in a desire to compensate these feelings with work, as well as taking more and more responsibilities.

Also people of creative professions are not protected from burnout syndrome, "assistive" professions - doctors, social workers, service sector employees, as well as the professions, which are characterized by increased job stress conditions.

Signs of burnout syndrome:

• Long-term fatigue
• Lack of motivation
• Dissatisfaction
• Perception problems
• Loss of work capability
• Loss of communication capability
• Lost desire to take care of oneself
• Overload of work - constant thoughts about work
• Lack of interest
• Fickle, often listless mood
• Difficulty to concentrate
• Sleep disorders.

Burnout syndrome somatic symptoms:

• Frequent headaches, dizziness, neck and shoulder muscle tension
• Back pain, weight fluctuations, development of stomach ulcers, heart palpitations
• Increase in blood pressure, itchy skin
• There is an increased risk for oncological diseases to develop.

If attempts to restore the well-being by yourself fail, VIVENDI experts are ready to provide a help; working together in teams, they apply the necessary treatment to prevent burnout syndrome caused by health problems.

Sleep is an integral part of human existence – physiologically it is just as necessary to sustain life as air, food and water, because one third of human life is spent in a sleep. Different conditions of sleep disorders can cause changes in human wellness, which again may significantly affect emotional and physical health.

Insomnia is defined as a symptom, which is attributed to the inability to fall asleep, stay calm, to feel refreshment after sleep, as well as the awakening too early in the morning.

Time required for a sleep for adult is individual; it can be from 4 to 10 hours a day. The person, who needs at least 10 hours of sleep daily may suffer from insomnia, if the time devoted to sleep every day is 8 hours. Required sleep time depends on various factors - genetics, age, the presence and depth of mental disorders.

VIVENDI center psychiatrist Inga Albrekte compares long-term lack of good sleep with the bank loan, because sooner or later, just as the indebtedness to the bank, has to compensate and the missing hours of sleep have to be returned the body. After a long period of insomnia, a person may have increased fatigue, loss of concentration, decreased attention span, mood swings, worsened irritability, aggression, deterioration of memory, movement coordination, even perceptual disorders may occur in the form of hallucinations.

Most commonly sleep disorders are associated with psychiatric or somatic diseases - depression, neurotic disorders, dependence of substances, heart or respiratory failure, restless leg syndrome, medication side effects, as well as psychosocial factors and sleep hygiene compliance, 50% of cases of sleep disorders are caused by internal and neurological diseases.

Approximately 90% of patients, who suffer from depression, have also complaints about sleep disorders. While long-term insomnia is a risk factor for depression. Depression is characterized by prolonged sleep latency period, frequent waking during the night or waking up too early.

Sleep disorders are also typical to other mental illness – anxiety, post-traumatic stress disorder, obsessive-compulsive disorders, schizophrenia and other psychotic disorders.

To determine the clinical diagnosis of sleep disorders, the following is found out by interviewing the patient:

• Sleep disorders start, duration, pace, character
• Bedtime routine
• Possible side effects of the disease (arthritis, Parkinson's disease, stroke, dementia, heart failure, etc.), which could be the cause of insomnia.

In cases when there is suspicion of sleep apnea, narcolepsy or periodic limb movement disorder, more specific tests of sleep are needed - polysomnography, which allows to evaluate how the body functions during the sleep.
During the treatment of sleep disorders factors that have caused or exacerbated the insomnia for a patient have to be prevented and the disease has to be treated.

Advices of VIVENDI doctors for healthier sleep:

• Avoid caffeine-containing beverages, alcohol and tobacco use before sleep
• Avoid active exercise 3-6 hours before sleep, but regular physical activity in the morning or early afternoon is required
• Avoid overeating and not starving before going to sleep
• Go to bed and wake up at the same time every day, including weekends,
• Avoid worrying, “brain activating” activities before bedtime,
• Provide a cool, dark, quiet bedroom and a comfortable mattress and pillow
• Not to use the bed as an "office", "dining room" or "cinema"
• Avoid sleeping during the day

Somatic or psychiatric disorders, which are characterized by changes in sleep:

Anxiety and fear are normal reactions in everyday life to a dangerous or stressful situation. However, they are not adequate in situations, where anxiety manifests by high intensity and regularity, as evidence of mental disorder or physical illness.

Anxiety is classified:

• Paroxysmal anxiety (agoraphobia, social phobia, isolated phobias, panic)
• Chronic anxiety (generalized anxiety disorder, anxiety, depression),
• Anxiety as adjustment disorders, manifestation of obsessive-compulsive disorder, post-traumatic stress disorder, somatoform disorder,
• Anxiety as manifestation of other mental illnesses (psychotic disorder),
• Secondary anxiety as one of manifestations of a somatic disease (hyperthyroidism, hyperparathyroidism pheochromocytoma, cardiac arrhythmia, supraventricular cardiac disorders, etc.)
• Psychoactive substance-induced anxiety (amphetamine, cocaine, caffeine withdrawal syndrome after cannabinoid, alcohol, barbiturates use).

In contrast, panic attacks often tend to be short term, spontaneous and intense disturbance, which over time can grow into unpredictable, recurrent and severe anxiety attacks without any precipitating causes and develop rapidly from several minutes up to half an hour.

Panic attacks origin may be based not only on spontaneous impressions; it can also be attributed to the impact of specific life situations on emotional stability. The experience of others and appeasement does not help during panic attacks; therefore, it is essential to get a psychiatrist or psychotherapist counseling to deal with the situation, which influence the appearance of a panic attack outbreaks.

The most common symptoms of panic attacks are:

• Palpitations
• Chest pain
• Wheezing
• Heaviness in the stomach
• Dizziness
• Feeling of unreality, or fear of personal disaster (loss of control, loss of mind, a heart attack or sudden death).

VIVENDI expert advice for relaxation in cases of anxiety and panic attacks:

Nowadays, it is considered that each disease is based on some psycho-emotional aspect. Psychosomatic medicine is suitable for patients and interested parties who wish to improve their physical well-being and solve the emotional factors which cause diseases – raised and remained internal conflicts caused by the disease.

Psychosomatic medicine deals with the interaction role study of body, psychological and social factors of the origin of psycho – somatic diseases and disorders of the human, as well as their course, treatment and prevention.

Psychosomatic medicine pays extra attention to the patient's psyche in parallel with the patient's body during the treatment, as well as to its state and the ongoing process of exploration.

By using psychosomatic treatment approach, it is possible to find answers to the questions why the patient has the particular disease and what to do to heal it and feel better. With a help of psychosomatic medicine, it is also possible to solve the pressing conflicts and situations affecting diseases.

General belief of the psychosomatic medicine is that a person is a single organism, which has to be treated as a whole. Biopsychosocial model of disease origin serves as main postulate, which proves that the following three factors participate in various psychosomatic disorders and the onset of disease:

1. Biological (heredity, physical - chemical irritants, microorganisms, etc.)
2. Psychic (human personality, mood, emotion, etc.)
3. Social (relationships at work, at home, life changes, etc.)

Regardless of the patient's diagnosis and severity of illness, the person who has arranged his own internal (and later also outer) world, is able to reduce the negative effects of somatization or unconscious and / or unresolved internal contradictions on physical health and mood.

Alongside medical treatment, psychosomatic medicine can help in limiting and reducing disease exacerbations and disease severity, as well as the appropriateness of medication treatment dose. Following diseases are considered as classical psychosomatic diseases - diabetes, hypertension, ulcer disease, ulcerative colitis, neurodermatitis, rheumatoid arthritis and coronary heart disease.