Psychosomatics: Depression

Depression as an emotion is a state of suppression and despondency. It has a situational character, but prolonged stay in such a state leads to depression as a diagnosis.

Depression as a medical diagnosis is an affective disorder characterized by poor mood, sluggishness of thoughts and actions, and self-blame.

Depression is diagnosed by three main symptoms:

  • akinesia (reduced motor activity),
  • abulia (indifference to everything),
  • apathy (reduced mood).

Dr. Alexander Lowen (creator of bioenergetics – a revolutionary method of psychotherapy) asserts that the state of depression differs from other emotional states in its inability to interact with the environment.

Psychiatry distinguishes between endogenous and exogenous depression. The first type of depression is associated with constitutional disorder.

Exogenous (psychogenic) depression arises as an excessive response to a certain stressful event (separation or death of a loved one, etc.)

The classification of the second type of depression proposed by psychotherapist A. Lobazova includes the following types:

  1. Melancholic depression, characterized by complaints of loss of joy and interest in events that were once pleasurable. Patients are irritable, grumpy, touchy, and tearful. Their thought processes slow down, self-esteem decreases, and the future seems pointless. They feel longing not only in their soul but also in their body (e.g., “longing weighs down,” “the soul hurts”).
  2. Anesthetic depression, with complaints of emotional emptiness, indifference, loss of feelings (even towards loved ones). People with this diagnosis are silent, inactive, feeling “petrified.”
  3. Apatho-adynamic depression, distinguished by the person remaining indifferent to lost feelings. Such a person sees and hears everything but is indifferent to everything (“living dead”), with decreased muscle tone, impaired gait, drooping shoulders, curved spine, and empty eyes.
  4. Postpartum depression, appearing against the background of hormonal changes on the 3rd-5th day after childbirth as a loss of feelings, tearfulness, or hostility towards the child. Over time, a sense of abandonment and meaninglessness can arise, as well as aversion to sexual life.
  5. Winter (photo-dependent) depression or “autumn blues,” caused by short daylight hours, where the brain fails to produce enough melatonin (which regulates bodily rhythms and emotions).
  6. Chronic fatigue syndrome, characterized by a sense of loss of vital energy from the morning. It may include dizziness, nausea, decreased attention or memory. The psychological state in this depression is similar to other types of apathetic depressions.
  7. Asthenic depression, characterized by increased fatigue, weakness, and exhaustion. There is decreased endurance to usual loads. People with such depression, feeling discomfort in the body, tend to think they are seriously ill.
  8. Dysphoric depression, characterized by a combination of poor mood with sullenness and irritability, which can turn into malice with swearing and aggressive actions.
  9. Agitated depression, a severe state of melancholic depression, characterized by a combination of sorrowful-irritable mood with verbal and motor excitement.
  10. Hypochondriacal depression, distinguished by a generally healthy person (experiencing irritability, tearfulness, appetite and sleep disturbances) being convinced of having a serious illness.
  11. Hypothymia and subdepression, experienced as a feeling of disappointment and sadness, sometimes with feelings of guilt and fear.
  12. Depression with anxiety disorders, characterized by a depressed mood with elements of hypochondria, phobias, panic attacks, etc.
  13. Masked depression, or psychosomatic disorders.
  14. Somatized depression, or psychosomatic diseases.
  15. Secondary depression in somatic disorders, arising as a result of long chronic illness or when one has to be treated for life (in cases of disability).

It has been found that in depression, almost all spheres of human life are affected:

  • Emotional (persistent mood reduction, loss of interest in what was previously perceived as joyful and satisfying);
  • Volitional (unable to make decisions, does not want to do anything);
  • Motivational (loss of interest and desire);
  • Intellectual (confused thoughts, decreased thinking activity).

Hence, we can more specifically outline the symptoms of depressive syndrome:

  1. Psychological symptoms: depression, apathy or anxiety, fear, loss of feelings, emptiness inside, sluggish thinking, sorrowful thoughts, inability to make decisions;
  2. Psychosomatic symptoms: physical weakness, discomfort in certain body parts or organs, etc.
  3. Psychomotor symptoms: stiffness and reduced emotionality or restlessness and fidgetiness, unproductive activity;
  4. Minor vegetative disturbances: dizziness, dry mouth, breathing disorders, heart rhythm disorders, constipation;
  5. Significant vegetative disturbances: sleep disorders, decreased appetite and weight, pain sensations, cold sensations, menstrual cycle disorders in women, and impotence in men.

Causes of Depression

Most psychotherapists and psychologists believe that depression is caused by socio-psychological factors overlapping with certain psychological characteristics of the personality. For example, a person who loves stability may become depressed with changes in social and economic conditions. And those who love risk can fall into melancholy due to a monotonous life.

Psychotherapist A. Lobazova asserts that somatics in depression arises not because of a bad mood, but due to impaired cerebral blood flow and metabolism. This happens when some parts of the brain do not receive oxygen and other nutrients. As a result, the brain starts to function incorrectly, and some of its parts starve to death.

Another cause of depression as a disease, according to A. Lobazova, is that depending on what a person eats and how they react to stress, the chemical composition of the brain is constantly changing. This often leads to an imbalance in the hormonal system (lack of some and predominance of others), which directly affects not only a person’s mood but also the state of the organs.

According to another theory, the emergence of depression is associated with the activation of the protective mechanism of the human psyche. This is a signal that a stage has come in a person’s life when serious changes are necessary. If this signal is noticed in time, then depression can fulfill its useful function (help make these changes, bringing a new positive outlook on the world and one’s life).

But if a person does not want to do anything for their own development, then their condition will begin to deteriorate.

The nature and main cause of depression are revealed in the book by psychotherapist Alexander Lowen “Depression and the Body.” Here he writes that many years of practice allowed him to identify a connection between this disease and the loss of faith, and a depressive person is a person without faith.

Faith in a person begins to develop in early childhood. Thus, Lowen writes that it is in the relationships between parents and children that children acquire faith: first, children acquire faith in parents, then faith in themselves, and only then – faith in the world.

But if a parent mistakenly builds a relationship with a child, starts “playing” with them, and undermines trust in themselves, then faith in the parent begins to be destroyed in the child. From there, problems begin with faith in oneself and in the world.

Psychosomatics of Depression

The human body is so structured that it has a physiological mechanism that protects the psyche of a person from its complete “capture” by fear or other negative feelings. Thanks to it, psychomotor expressions of fear, anxiety, and other feelings threatening mental health are blocked. And signals coming from the central nervous system are diverted through the autonomic nervous system to somatic (bodily) structures. Hence, disorders and diseases of the body appear.

According to psychotherapists, the center of gravity of the disease becomes the most vulnerable organ, which, in the patient’s perception, is the most important.

Psychological Causes of Depression

According to Liz Burbo, depression is a means of protection against pressure, especially emotional pressure. The psychologist, based on her many years of practice, asserts that people in poor relationships with a parent of the opposite sex are more prone to depression. This is the reason why a person in depression tends to blame the spouse (due to poor relations with the father) or the wife (due to poor relations with the mother).

At the same time, the more serious the psychological trauma experienced in childhood (adolescence), the more severe the depression. Remember that such traumas can be: the trauma of rejection, the trauma of abandonment, the trauma of humiliation, the trauma of betrayal, and the trauma of injustice (see the article on the five traumas).

Liz Burbo believes that if a person suffering from depression has thoughts of suicide, it means that something has died to make room for something new. But he perceives this dead part of himself as his entire personality as a whole.

According to Louise Hay, the causes of depression are the person’s feeling of complete hopelessness and the groundlessness of bouts of rage.

Paths to Healing

In treating such a psychosomatic illness as depression, psychotherapy includes depth-psychological methods (psychoanalysis, gestalt therapy, psychodrama, etc.) and symptom-focused and behavior modification methods (hypnotherapy, cognitive-behavioral therapy).

The first group of methods helps to uncover the conflict underlying the psychosomatic manifestations of depression, as well as to reconstruct the individual’s personality and their relationship with the world.

Psychotherapist-psychologist A. Lobazova asserts that the problem of depression cannot be resolved unilaterally or with universal methods. Treatment depends on the constitutional type of the individual, dictating a personal diet, healthy lifestyle, medication adjustments, etc.

According to A. Lobazova, the key in treating this illness is learning skills for constructively resolving conflicts and dealing with the consequences of psychological stress. This aspect of treatment should also match the psychological type of the patient.

It should be noted that most psychologists recommend not ignoring the depressive state of loved ones (saying “calm down, it will pass,” etc.) or advising such remedies as rest, nature, valerian, parties, etc.

Psychologist Liz Burbo states that because a person in depression does not want to help themselves or have others help them, only those close to them (those who live with them) can assist in their healing.

In this regard, they should behave firmly and decisively. According to the psychologist, such a person should be told that no one can help them if they do not help themselves.

Liz Burbo believes the most important thing for such a person is to realize that their depression is caused by emotional sufferings endured in childhood (adolescence), hence their refusal to be who they are.

According to the psychologist, the first stage of healing involves the person feeling compassion for the parent linked to the psychological trauma and trying to understand them.

The next, most important stage, involves the person trying to forgive themselves for the negative emotions they felt towards this parent.

The final healing stage involves the person wanting to share their experiences with this parent without blaming them.

If approaching depression from Lowen’s perspective (about the loss of faith as the cause of depression), healing will occur as lost faith is restored.

In this process, it seems that the person will go through the same stages outlined by Liz Burbo. This is because to heal, a person must work on themselves, uncover their internal problem, recognize and understand it. From Lowen’s perspective – understanding that the parent who once undermined trust did so unintentionally, due to not knowing how to behave or being unable. And then – to forgive. Forgiveness always brings relief to the soul and is the beginning of healing.

Wishing you strong faith in yourself, in your loved ones, and in life itself, so that no difficulties can lead you to depression.


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