Reactive depression: what it is, symptoms and frequent causes
We speak of reactive depression when we want to refer to a mood disorder that occurs in response to an external event or several . It is the classic depression, the most frequent. The one in which we think when we imagine a depressed person. What we probably do not imagine and can not understand with the same intensity is how deep the pain of these people reaches.
We will present a little information about its causes, which are the most frequent clinical manifestations and in what ways we can improve the life of people with reactive depression.
- Related article: "Are there several types of depression?"
Causes of reactive depression
The distinction between endogenous and reactive depression was made by Paul Julius Moebius in the 19th century . This differentiation assumes that there is a distinction between depressions that occur due to biological causes and those that occur due to psychosocial causes. The truth is that although the empirical support for this supposed distinction is far from being conclusive, it can be useful to communicate with speed among health professionals and quickly know what they are facing.
In reactive depression, a disorder that women have between 10 and 25% of risk of developing throughout their lives and for men ranges between 5 and 12%, the disorder occurs after the presence of a stressor which causes the development of depression. Imagine a break, the death of a close friend, the loss of work , or any type of vital change that is perceived as very stressful and uncontrollable.
What is important in depression, beyond the objective gravity of the event, is in what way it is perceived as a threat. Each individual has different coping skills, and that is why each person experiences problems with more or less difficulty. What for one can be a traumatic event that can be recovered after 2 weeks, for another can be a blow that leaves him emotionally destroyed. Therefore, in the evaluation of the patient we must be very aware of the coping skills that the patient had before the event.
Symptoms and signs
Reactive depression is always a complex and heterogeneous clinical picture, no two cases are the same. An added problem is that most symptoms are not exclusive of depression, and it is also difficult to differentiate what is an adjustment disorder after a very stressful situation of what has become a well-established reactive depression. As a guide, it is possible to group depressive symptoms under five different categories.
Sadness is present in 9 out of 10 patients with reactive depression and is usually the main complaint of those who gather the courage to come to consultation. In most patients this sadness manifests itself in the form of hopelessness and permanent helplessness. It is the feeling that the future holds nothing good, that everything positive has been finished and nothing remains but misery and misery. In the most serious cases, sadness can be eclipsed by a feeling of emptiness so great that they deny feeling anything. As if they were internally dead.
In children, on the other hand, more than despondency they show irritability or instability . Many of the children whose parents are separated in an undesirable way express depression through explosions, bad responses or tantrums for issues that were never a source of trouble before.
Reactive depression causes the patient to lose interest in activities that he used to like . He does not want to continue doing them, nor are they satisfactory when he does them. You lose your favorite hobbies, your daily routine, and you have stopped enjoying in general. Even the energy is reduced, to the point where the person has so little strength that getting up and showering can be a great victory.
The movements are very slow and expensive, they require a lot of energy. This psychomotor delay is sometimes so severe that patients fall into the so-called depressive stupor, a state similar to catatonia that seems almost total motor paralysis. The heterogeneity in the symptoms allows us to also find patients who, instead of being slow, are very agitated and can not stop biting their nails or smoking in a restless way.
In the same way that happens with movements, thought is slowed down . They have a hard time thinking that those who have a minimally demanding job are unable to perform normally. In children, for example, academic performance drops suddenly, reflecting a lack of concentration due to depression. Not only concentration, memory is also altered.In depressed elderly patients these memory problems can be confused with dementia, but the non-progression of memory deterioration is what indicates whether it is a depression or not.
The depressive person evaluates everything in a negative way. Think that it is worthless, that the world is a terrible place and that the future is black. They have a skewed style of thinking that prevents them from seeing anything in any other way than through pessimistic glasses, perpetuating depression. Sometimes depression occurs with hallucinations congruent with the mood, for example, blaming or accusatory voices.
Although vegetative symptoms are more characteristic of endogenous depressions, we also find problems with sleep as hypersomnia or insomnia in reactive depression . In fact, in many patients, the alteration of sleep is the first symptom that appears and the last one disappears. There are body aches such as headaches, digestion problems, muscle or lumbar pain.
When you stop doing activities, you also stop seeing your friends , it is usual that the social sphere of the patient who falls into a reactive depression deteriorates gradually. These people reject social contacts because they have ceased to be pleasant and have no energy, and others end up giving up trying. The total social isolation can be reached, since social contact ends up generating anxiety, overexertion and feelings of failure.
Reactive depression treatment
The treatment happens first by establishing a link with the patient and that this person has us for improvement . Once you feel really understood, you may agree to start recovering lost activities and behaviorally activating, recovering previously lost social life. In parallel but always little by little, we must try to identify the negative thoughts that cloud the thinking of the depressed patient and apply cognitive restructuring. It is also indicated pharmacological therapy by antidepressants such as SSRIs, ISRN or tricyclic for example.
Due to the reactive nature, The emotional processing of that stressful situation that caused the depression will also be addressed . A poorly managed duel or a life experience that is not emotionally processed can be subject to intervention. The psychologist will help the patient to acquire coping skills and emotions management to be able to turn the page. Memories will remain painful and sad, but should not interfere with the normal functioning of the person.