Depression as part of disorders

The depressive symptom was the most diverse, severe and durational. The fact that depression is not as prevalent, as the patients think, draws attention. Often they use the word “depression” to explain all somatic and psychological problems and request immediate prescription of specific medications (sedatives). Depression in the course of withdrawal is common for stimulants users. We observed dreary depression with adynamia, flabbiness, loss of appetite and body weight. The patient is almost all the time in bed, drowsiness with prolonged sleep was marked. During this period, the most significant limitation for patients is the limitation of ability to enjoy the surroundings. Patients tend to speak about the inferiority of their own existence, hopelessness, feeling of inner emptiness and bleak. At the same time they constantly arise memories of happiness during taking psychoactive substances, which may ultimately lead to its search. Early detection of depression and mandatory prescription of antidepressants (mainly selective inhibitors of serotonin reuptake) is complementary to psychotherapeutic work. Another kind of depression diagnosed during withdrawal period, mainly in opiate addiction, is asthenic depressive state, that is sometimes accompanied by ideas of self-blame, and even suicide attempts, dysphoric depression with predominance of irritability, nastiness, hysterical reactions with inclination to auto-aggression.

In some cases the hypochondriacal disorders and anxiety were included into the depressive syndrome. The patients suddenly became overprotective about their physical health, demanded additional examination and regarded with suspicion to satisfactory results of the tests. The switching of the patient’s complaints only to the physical sphere delayed the psychotherapeutic work and the effectiveness of complex techniques. Firm anxiety-like progressive hypochondriacal disorders have determined the development of pathological personality and poor prognosis of the disease. This was particularly evident at the level of delusional experiences, although delirium was not systematized, not resistant, and the ideas themselves were on the verge of overvalued anddominant formations.

The rarest among emotional disorders are manifarma symptoms, which resemble hypomania by their appearance. This similarity concerns only the mood enhance and light motor disinhibition. The patients are careless, cheerful and flexible. After careful observation it is obvious that their gaiety is not mediated by external causes and does not amuse others. In regard to physical disinhibition, rapid exhaustion (signs of fatigue) without any critical attitude of patients to this fact is obvious. Easy-lost control of a situation, slowness, primitive thinking is observed in thinking disorders. Patients easy give promises, but don’t follow them – mostly they forget about them. Drastic impoverishment of speech is noteworthy, adjectives, adverbs and participles disappear from their speech. These symptoms decreased significantly after the abstinence termination, they demanded the inclusion of mood stabilizers in the treatment complex.