We talk about reactive depression when we want to refer to a mood disorder that occurs in response to an external event or to several. It is classic depression, the most common. The one we think of when we imagine a depressed person. What we probably can’t imagine or understand with the same intensity is the depth of pain these people have.
We will present some information about its causes, what are the most common clinical manifestations, and how we can improve the lives of people with reactive 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 due to biological causes and those that occur due to psychosocial causes. The truth is, while the empirical support for this so-called distinction is far from convincing, it can be helpful to communicate between healthcare professionals quickly and quickly know what they are up against.
In reactive depression, a disorder that women have between 10 and 25% risk of developing throughout their life and for men ranges from 5 to 12%, the disorder occurs after the presence of a stressor that causes the development of depression. Imagine a breakup, the death of a loved one, the loss of a job, Or any type of vital change that is perceived to be very stressful and out of control.
What matters in depression, beyond the objective seriousness of the event, is how it is perceived as a threat. Each individual has different coping skills, which is why each person experiences problems with varying degrees of difficulty. What for one can be a traumatic event from which he can recover after 2 weeks, for another can be a blow that leaves him emotionally destroyed. Therefore, in assessing the patient, we must keep in mind what coping skills the patient had before the event.
Symptoms and signs
Reactive depression is always a complex and heterogeneous clinical picture, no two cases are identical. An additional problem is that most of the symptoms are not unique to depression, and it also becomes difficult to differentiate what is adjustment disorder after a very stressful situation from what has become established reactive depression. As a guide, it is possible to group depressive symptoms into five different categories.
Sadness is present in 9 out of 10 patients with reactive depression and is usually the number one complaint of those brave enough to come to the clinic. 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 all the positive is over and that all that remains is misery and misery. In the most serious cases, the sadness can be eclipsed by a feeling of emptiness so great that they deny hearing anything. As if they were dead inside.
In children, on the other hand, they show irritability or unsteadiness rather than depression.. Many young parents are unwantedly separated, expressing depression through outbursts of anger, wrong answers, or scolding about issues that had never been a source of trouble before.
Reactive depression causes the patient to lose interest in activities he previously enjoyed. He doesn’t want to keep doing them, and they aren’t satisfying when he does them either. They lose their favorite hobbies, their daily routine and have stopped enjoying them 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 so-called depressive stupor, a state of catatonia that resembles almost total motor paralysis. The heterogeneity of symptoms also allows us to find patients who, instead of being slow, are very agitated and keep biting their nails or smoking constantly.
As with movements, thinking is slowed down. They find it so hard to believe that those with low-demanding jobs are unable to work normally. In children, for example, school performance drops sharply, reflecting a lack of concentration due to depression. Not only concentration, memory is also impaired. In depressed elderly patients, these memory problems can be mistaken for dementia, but the non-progression of memory impairment is what indicates whether it is depression or not.
The depressed person evaluates everything in a negative way. He thinks it’s worthless, that the world is a terrible place and the future is dark. They have a biased thinking style that prevents them from seeing anything other than pessimistic glasses, perpetuating depression. Sometimes depression is accompanied by mood-conforming hallucinations, such as guilt or accusing voices.
Although vegetative symptoms are more characteristic of endogenous depressions, sleep problems such as hypersomnia or insomnia are also found in reactive depression. Indeed, in many patients, sleep disturbances are the first symptom to appear and the last to disappear. Body aches such as migraines, digestive problems, muscle or lower back pain occur.
When you stop doing activities, you also stop seeing your friendsIt is common for the social sphere of the patient who falls into reactive depression to gradually deteriorate. These people reject social contact because they have stopped being nice and run out of energy, and others end up trying. Total social isolation can be achieved, as social contact ends up generating anxiety, overwork and feelings of failure.
Treatment of reactive depression
Treatment begins with establishing a bond with the patient and having that person rely on us for their improvement.. Once you feel truly understood, you can accept to start recovering from lost activities by activating them already behaviorally, regaining previously lost social life. At the same time, but always little by little, it is necessary to try to identify the negative thoughts that obscure the thinking of the depressed patient and to apply cognitive restructuring. Pharmacological treatment with antidepressants such as SSRIs, SSRIs or tricyclics is also indicated.
Due to the reactive nature, the emotional treatment of this stressful situation which caused the depression will also be addressed. A poorly managed duel or an emotionally untreated life experience can be the subject of intervention. The psychologist will help the patient develop coping and emotional management skills so that they can move on. The memories will remain painful and sad, but they should not interfere with the person’s normal functioning.