UTHealth Harris County Psychiatric Center
后期抑郁症
抑郁症类型•Causes•Signs & Symptoms•Treatment•Medication Therapy•Psychotherapy•Living with Depression•家人和朋友如何提供帮助
到达长老时，会带来变化 - 身体，心理，情感和社会 - 可能破坏自己的生活。有些人还没有准备好接受这一变化。因此，这可能是一种创伤经历。悲伤和灰心的感觉可能是对这些困难情况的正常情绪反应，但是长期，激烈的悲伤并不是年龄较大的正常部分。当这些感觉持续超过几周时，这可能是一种称为抑郁症的主要情绪障碍的迹象。
抑郁症在老年人中很常见。实际上，65岁以上的人中有20％以上患有一定程度的抑郁症。另外10％的被诊断患有痴呆症的老年人实际上可能患有抑郁症。这种误诊很普遍，特别是在那些不跟进医生的老年人中。
美国自杀率最高的是65岁以上的自杀率。这是因为老年人不愿寻求精神病治疗，这可以帮助他们恢复以前的健康心理健康状态。在男性中尤其如此，他们以女性的比率两倍。
如果人们尽早识别出症状和模式并寻求治疗，他们可以避免很多不必要的痛苦。
抑郁以几种形式发生，其中一些可能重叠。在抑郁症的情况下，精神科医生可能会提供多个诊断，因为这种疾病通常与其他问题有关，例如滥用药物，饮食失调或焦虑症。
临床抑郁是指足够严重的疾病，需要专业治疗。据说在单个时期遭受严重抑郁症的人患有临床抑郁症。更严重或夸张的症状表明重度抑郁症。精神科医生将这种抑郁症称为重度抑郁症。
When a person exhibits depressive symptoms on a consistent basis, that person likely suffers from a dysthymic disorder. When a major depressive episode strikes someone with dysthymia, it is called double depression.
应对压力大的生活事件所产生的压抑情绪代表着与抑郁症的调整反应。丧亲 - 处于哀悼状态 - 也具有重要的抑郁症特征。
最近确定的抑郁症形式 - 季节性情感障碍（SAD）是由季节性变化触发的，例如天气模式或可用的日光量。
Another severe type of depression is manic-depression, or bipolar disorder, so named because its sufferers experience not only the lows of depression but also the highs of mania.
While research has led to a significant understanding of depression, scientists have not found the exact mechanism that triggers depression. Most likely there is no single cause. However, recent studies have linked depression to genetic changes in body chemistry. These changes usually involve imbalances of neurotransmitters (chemicals that allow brain cells to communicate), particularly serotonin and norepinephrine.
Other factors, such as negative family relationships, serious illness, major loss or change, and substance abuse, can cause or complicate depression. Close relatives of people with depression are sometimes more likely to develop either depression or manic-depression than the general population.
真正的临床抑郁症经常被误认为是偶尔的悲伤，沮丧，失望或“忧郁”。这些感觉通常出现在抑郁症中，但形式更强烈，形式。患有抑郁症的人可能会表现出以下一个或多个行为：
- Feelings of worthlessness, hopelessness, helplessness, total indifference and/or extreme guilt
- Prolonged sadness; unexplained crying spells
- 跳跃或易怒
- Withdrawal from formerly enjoyable activities or relationships
- 无法集中或记住细节；优柔寡断
- 突然减肥或增加的食欲明显变化
- Changes in sleep patterns: constant fatigue, insomnia, early waking, oversleeping
- 无法解释的身体疾病
- 死亡或自杀企图的想法
抑郁症是所有精神疾病中最可治疗的一种。多达90％的抑郁症患者对治疗的反应良好，几乎所有治疗的人都会受益。像许多其他精神疾病一样，抑郁症通常接受药物治疗，心理治疗或两者的结合。病人通常可以在短短几周内看到症状的缓解。
Antidepressant medications are used to correct imbalances of certain neurotransmitters. Five groups of medications are most often prescribed for depression: tricyclic antidepressants; monoamine oxidase inhibitors (MAOIs); selective serotonin reuptake inhibitors (SSRIs); and serotonin and norepinephrine reuptake inhibitors (SNRIs); and other "atypical" antidepressants.
The effectiveness of antidepressant medications depends on a person's overall health, weight and metabolism, and other unique physical traits, and they are usually prescribed to fit the individual. If one medication doesn't work, the physician may try another or a combination of medications to determine the most effective regimen. Generally, antidepressants become fully effective within three to six weeks.
其他形式的治疗是电抽搐治疗（ECT）和光治疗。尽管已经开发出更先进的药物，但其使用量降低，但ECT对于治疗因医疗状况，老年，营养不良或对抗抑郁药反应的患者而无法忍受或服用药物的患者非常有效。光治疗主要用于患有季节性情感障碍的人。使用这种治疗的患者花费了定期的治疗课程，这些治疗会在全光谱光源的光中沐浴。
Psychotherapy involves the verbal interaction between trained professionals and patients. The therapist uses techniques to help the patient gain personal insight that will allow him or her to positively change thoughts, feelings or behaviors.
Several forms of this "talk treatment" have proven to be helpful in the treatment of depression. They include interpersonal psychotherapy, cognitive-behavioral therapy, psychoanalysis and psycho-dynamic psychotherapy.
抑郁会使一个人感到疲倦，毫无价值，无助和绝望。重要的是要意识到这些感觉是抑郁症的结果，并且不能准确反映一个人的真实情况。在治疗生效之前，患有严重抑郁症的人应：
- limit commitments;
- 设定现实的目标和期望；
- 与其他人共度时光；
- 参加愉快的活动；
- 在做出重要决定之前，请寻求亲密朋友或家人的建议；
- realize they will not "snap out" of their depression;
- 积极思考并拒绝消极的想法。
How Family and Friends Can Help
The most important thing family and friends can do for the depressed person is to help him or her get treatment. This may involve encouraging the patient to stay with the treatment, going with the patient to the doctor, or even monitoring whether the patient is taking medication.
Another important way to help is to offer emotional support - understanding, patience, affection and encouragement. Always listen to the depressed person. Do not ignore any remarks about suicide; report them to the doctor immediately.
