"Since ancient times, autumn is sad and lonely", "Thousands of miles of sorrow and autumn are often guests"... As we enter autumn, the weather is getting colder and the grass and trees are withering away. Many people are prone to low mood, depression and sadness in the autumn, and autumn and winter are also the high incidence of depression seasons. So, what is going on behind the "tragic autumn"?
Why is it easy to be depressed in autumn?
Everyone's mood may be more or less affected by external environmental factors, such as some people will have different moods in different weather such as sunny and cloudy days.
In the autumn, many people's mood is easy to fall, mainly due to the reduction of light time, the weakening of intensity, and the cold weather after the autumn, which may induce the body's circadian rhythm, or changes in the biological clock, resulting in an increase in the secretion of melatonin levels, and the abnormality of the biological rhythm may affect the body's neuroendocrine, neurotransmitters and other changes, which is a very important physiological basis for depression to occur.
Clinically, it can indeed be seen that the onset of some patients with depression shows seasonal characteristics, especially autumn and winter are the high incidence seasons of depression. But "seasonal depression" is not a technical term, just a subtype of depression, essentially depression, but its episodes have obvious seasonal characteristics.
The study found significant seasonal differences in 5-ht transporter (sert) protein levels in patients with "seasonal depression," which in turn led to fluctuations in 5-ht levels. As the autumn night time gradually increases, sert levels rise with it, leading to a decrease in the level of active 5-ht. In addition, changes in the photoperiod can promote neurotransmitter conversion between dopamine and growth hormone suppressors (ssts), which is also an important pathogenesis for the seasonal onset pattern of depression.
In addition, seasonal depression and typical depression are also different in clinical manifestations, such as common depression is mostly manifested as insomnia, poor appetite, weight loss, etc., but seasonal depression is manifested as drowsiness, binge eating, cravings for carbohydrate-rich foods, weight gain, etc.
It is worth noting that to determine whether you have seasonal depression, you need to meet the following characteristics: the onset and remission of depression has seasonal characteristics, such as starting in autumn and winter, and remission in spring; In the last 2 years, there have been 2 depressive episodes that match the above seasonal characteristics, and there have been no depressive episodes during this period that do not meet the above characteristics; Depressive episodes that match seasonal characteristics are significantly more frequent than those that are non-seasonal throughout the patient's course. Situations that can be explained by seasonally related psychosocial factors, such as seasonal unemployment or school holidays, need to be excluded.
Depression is not simply a "bad mood"
In fact, a bad mood does not equate to depression. However, as the public pays more attention to the topic of depression, many people will even "sit in the right seat". For example, some people who are in a bad mood will self-doubt whether they have depression, in addition, there are many judgments or screenings on the Internet whether they are depression "self-test meters", but in fact, most of them are only symptom scales or screening scales, even if the self-test gets a "positive" result, it is not necessarily depression, so the determination of depression needs to be further evaluated by doctors in professional hospitals.
At present, the World Health Organization has a common set of diagnostic criteria for depression (ICD-10), which includes three core symptoms of low mood, loss of interest and pleasure, loss of energy or easy fatigue, as well as seven additional symptoms of reduced ability to concentrate and pay attention, self-evaluation and self-confidence, self-guilt and sense of worthlessness, pessimism about the future, self-injury or suicidal idea or behavior, sleep disorders, and decreased appetite.
Depression is based on the need to meet at least two core symptoms and at least two additional symptoms that occur most of the day for more than two weeks, and have many negative effects on daily life, study, work, interpersonal interactions, and exclude secondary depression caused by other causes. In addition, the degree of depression is mild to severe, with mild need to meet two core symptoms plus two additional symptoms, moderate two core symptoms plus at least three additional symptoms, and severe three core symptoms plus at least four additional symptoms.
Therefore, depression is not simply a "bad mood", it has strict diagnostic criteria, but also requires professional doctors to follow up, according to the new information may be corrected diagnosis, this is a complex diagnostic process, and can not be based on simple individual symptoms or a simple screening scale to think that you have depression.
The earlier the treatment, the better
Until now, the causes of depression are not well understood, usually as a result of a combination of biological, psychological and social factors. Still, it's a treatable disease, most of which are curable with treatment, and, like other diseases, the sooner it is treated, the better.
At present, there are three main treatment methods for depression in the clinic, namely drug therapy, psychotherapy and physical therapy, and many evidence-based medical evidence and clinical practice have found that comprehensive treatment is more effective than a single treatment method. At the same time, doctors will decide the specific treatment plan according to the severity of depression, for example, mild to moderate depression can be preferred as non-drug treatment, while the degree of depression reaches more than moderate to severe, especially if there is a serious risk of suicide or accompanied by hallucinations, delusions and other psychotic symptoms, it is necessary to receive medication and hospitalization if necessary.
It is worth noting that although the internet is full of information about depression, there are still many misunderstandings about depression. Clinically, the manifestations of depression are very complex, different patients may vary greatly, such as seasonal depression eating and sleeping and other manifestations of the performance of ordinary depression is the opposite, and some patients are mainly somatic symptoms, so it is easy to be considered to have a physical disease, usually repeatedly go to the general hospital to see and check. Therefore, depression is particularly susceptible to misdiagnosis and missed diagnosis. In addition, although some patients perceive that they have depression, they are afraid of being discriminated against by others, so they dare not go or do not take the initiative to go to a specialist hospital for treatment, resulting in missing the best treatment period and delaying the disease, which is not uncommon. At present, the medical treatment rate of depression is still low, and the latest national survey in China found that the consultation rate and treatment rate of depression is only about 10%.
For a disease of unknown etiology, although there is no specific means of prevention at present, there are indeed some effective measures to reduce the risk of its onset, such as shaping a healthy personality with the help of professional psychotherapists, obtaining good family and social support, avoiding stress events, eating a reasonable diet, living regularly, actively exercising outdoors, learning to talk, catharsis and relaxation.
Chen Lin, deputy chief physician of the Department of Psychiatry, Beijing Huilongguan Hospital