Psychotherapy of the depression

Depression cannot be treated without psychotherapy and patients themselves strive for this form of medical and psychological aid. They for a long time are not decided to resort to the method of preparations and, after beginning the method of antidepressants, they sufficiently frequently rapidly cease drug treatment. In view of helplessness and constant doubts, the patients are usually suggested and, reading annotation to these or other medicines, they easily reveal in itself side effects already during the first days of treatment. Furthermore, patients, who suffer depression, have the functional disorders of internal organs and in view of this are actually sensitive to the side effects of preparations. Many patients experience false alarm with respect to a constant dependence on the antidepressants. The substantial part of the patients, who suffer depression, relates to the placebo - reactors, i.e., to people, which easily react to the method even the "empty tablets", which not at all contain what - or active medicinal substance. Entire above-enumerated determines the increased interest of such patients in psychotherapy. Those experimental data are the serious argument, which testifies about the role of psychotherapy in the treatment of depression, which speak about the value of psychological factors in the formation of the therapeutic stability of depression to the medicines. The effective course of psychotherapy in the long-term outlook is useful possible, than pharmacotherapy, since it trains patient. The latter acquires the habits of overcoming depression, it learns to recognize its approximation, to prevent the development of its relapse. As the results of many studies showed, the normalization of endocrine indices in the process of the therapy of depression is achieved not only in the process of treatment with antidepressants, but also with psychotherapy. Moreover the influence of psychotherapy on the endocrine indices is observed both in the case of its combination from the psycho-pharmacological therapy and in the case of use it as the only method of treatment. In a number of cases psychotherapy gives the possibility to patients to be adapted to the real life with the preservable disturbances of affective sphere, thinking and installations. Possessing independent therapeutic effect, psychotherapy contributes to the optimum collaboration of patient and doctor, increases the effectiveness of drug treatment, improves family relations and professional status of patient. The frequent beginning of depression after sharp mental injury or protracted state of stress they lead to the persistent searches for the psychological reasons for its appearance. This circumstance, strengthens the tendency of patients toward the psychological aid. However, the superfluous overestimation of its possibilities, unfortunately, can lead to the complete refusal of the psychotropic means, the formation of the resistance and protracted versions of the flow of depression, the appearance of its early aggravations. From the point of view of doctor psychotherapy of depression must be first of all directed toward the elimination of its symptoms. Some of them prove to be more sensitive to psychotherapy, others comparatively with difficulty be subject to its effect. It is customary to assume that with the heavy depressions of the possibility of psychotherapy it is more than ogranichenny, than in the mild cases of disease. The disorders of mood, thinking, behavior, motivational and physiological symptoms are separated as the targets of psychotherapeutic action with the depression. Among the affective symptoms - grief, the feeling of guilt and shame and especially anxiety it is especially sensitive to the psychotherapeutic action. It is possible to isolate the number of the general principles of the work of psychotherapist with the patient, who suffer depression. The control of doctor on its own feelings with respect to the patient is here important, since is possible the appearance a feeling of void, irritation, superfluous sympathy and fatigue. Psychotherapist not only sympathizes to patient, but also attentively he controls it, preserving the specific distance. In the process of therapy it is necessary to strictly regulate the time of contact with the patient, to support the structure of forward motion to the recovery. The active setting of the goal-directed questions, confidence in the diagnosis, assignment of real hope relate to the fundamental rules of the treatment of depression. Studies showed that the hope obtained from the doctor is retrospectively evaluated by patients as important aid in the process of overcoming the depression. By the special feature of the work of psychotherapist with the patient with depression appears not so much mutual anxiety, as understanding state and, in particular, possibility of the appearance of the episodes of negative changes in the mood. Frequently the patient attempts "it to be sultry" psychotherapist with his infinite expectation of aid, and the latter commits error, being released into the theoretical explanations and the searches for the psychological reasons for depression. In reality the psychotherapist must approach that so that the patient would focus attention on himself and would search for the ways of the adequate perception of his situation. Conversation with the patient about the symptoms of his state is especially undesirable, to it is much more important emphasize the dependence of their manifestation on different situations, to conduct conversation about the special features of nature and interrelations with the surrounding people. The compassion of psychotherapist usually strengthens in patient the expectation of aid, the attempt to weaken the manifestation of symptoms leads to their strengthening, comfort - to the depression. It is important to lead patient to the need for self-help, but not to comfort him, to show it importance to accept itself as such, such as it there is. For treating the depression different methods of psychotherapy were proposed: Psychoanalysis. Client- centered therapy. Existential therapy. Interpersonal therapy. Cognitive therapy. Therapy by recollections. Change of the projection with time. Relaxation training. Therapy of the solution of social problems and other methods of psychotherapy. Including its mixed or eclectic versions. In the opinion of the majority of researchers the cognitive therapy, which is focused on the correction of the special features of thinking patients, who suffer depression, is most effective with the treatment of depression.