Κατάθλιψη

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Στην καθημερινή ζωή με τον όρο κατάθλιψη εννοούμε μια κατάσταση θλίψης και μελαγχολίας, αυτό συνήθως είναι παροδικό και μάλλον οφείλεται σε κάτι σχετικά ασήμαντο και επουσιώδες. Η κατάθλιψη διαφέρει από την Κλινική Κατάθλιψη η οποία χαρακτηρίζεται από συμπτώματα που διαρκούν πάνω από δύο εβδομάδες και είναι τόσο σοβαρά ώστε να επεμβαίνουν στην καθημερινότητα ενός ατόμου.

Στην ψυχιατρική ο όρος κατάθλιψη μπορεί επίσης να έχει αυτή τη σημασία αλλά συνήθως αναφέρεται σε μία ψυχική ασθένεια και ειδικά όταν δεν έχει φτάσει σε επίπεδο υψηλής σοβαρότητας ώστε να χορηγηθεί αυτή η διάγνωση. Η κατάθλιψη αποτελεί το τέταρτο στάδιο του μοντέλου της Κιούμπλερ-Ρος για την αποδοχή του θανάτου.

Όταν κάποιος έχει κατάθλιψη συνήθως περιγράφει τον εαυτό του ως λυπημένο, απεγνωσμένο, αποθαρρυμένο και απογοητευμένο.

Αίτια της κατάθλιψης[Επεξεργασία | επεξεργασία κώδικα]

Η κατάθλιψη μπορεί να οφείλεται σε διάφορους παράγοντες που ενεργούν μόνοι τους ή και συντονισμένα.

Περιβάλλον[Επεξεργασία | επεξεργασία κώδικα]

Αντίδραση σε καταστάσεις, όπως η απώλεια ενός αγαπημένου προσώπου ή η μετακόμιση από ένα σπίτι σε ένα άλλο. Τα μονότονα περιβάλλοντα μπορεί να είναι καταθλιπτικά. Όταν κάποιος δεν μπορεί να ελέγξει το περιβάλλον του, η κατάσταση αυτή μπορεί να φέρει αισθήματα ανημποριάς. Οικογενειακές διαφωνίες ή οικονομικές δυσκολίες μπορεί να επιφέρουν κατάθλιψη. Άλλα αίτια κατάθλιψης είναι οι κλιματικές συνθήκες, όπως η βροχή ή η συννεφιά, η μοναξιά και το αίσθημα ότι οι άλλοι άνθρωποι δεν νοιάζονται για εμάς.

Ψυχολογικοί παράγοντες[Επεξεργασία | επεξεργασία κώδικα]

Μερικές φορές η κατάθλιψη μπορεί να προκληθεί από εσωτερικά προβλήματα. Πεσιμιστικές ιδέες ή έλλειψη αυτοσεβασμού μπορούν να οδηγήσουν σε κατάθλιψη. Ασθένειες και αλλαγές στην ψυχολογία ενός ατόμου που συμβαίνουν στην ψύχωση και την άνοια μπορούν επίσης να οδηγήσουν σε κατάθλιψη.

Βιολογικοί παράγοντες[Επεξεργασία | επεξεργασία κώδικα]

Αυτοί ποικίλουν αλλά γενικώς περιλαμβάνουν κληρονομικούς όμως να αμφισβητείτε απο την επιστημονική κοινότητα[1] , νευρολογικούς, ορμονικούς και εποχιακούς παράγοντες. Επίσης μπορεί να σχετίζονται με κάποια ασθένεια.

Ψυχικές διαταραχές με Κατάθλιψη[Επεξεργασία | επεξεργασία κώδικα]

Θεραπείες κατάθλιψης[Επεξεργασία | επεξεργασία κώδικα]

[5] και με τους γιατρούς να παραπλανούν το κοινό[6][7] ,αναστολείς της μονοαμινοοξειδάσης (MAOIs), τρικυκλικα

  • Ψυχοθεραπεία (Γνωσιακή - συμπεριφοριακή ψυχοθεραπεία)
  • Ηλεκτροσπασμοθεραπεία (ECT)
  • Επαναληπτικός Διακρανιακός Μαγνητικός Ερεθισμός (repetitive Transcranial Magnetic Stimulation, rTMS). Πρόκειται για νέα μέθοδο, η οποία έχει λάβει την έγκριση του Αμερικανικού Οργανισμού Φαρμάκων και Τροφίμων (FDA).[8] Η θεραπεία με επαναληπτικό διακρανιακό μαγνητικό ερεθισμό χορηγείται μέσω ενός ηλεκτρομαγνητικού πηνίου, που βρίσκεται σε επαφή με το τριχωτό της κεφαλής.[9] Μέσω αυτού δημιουργούνται επαναλαμβανόμενοι πολύ μικρής διάρκειας ηλεκτρομαγνητικοί παλμοί, οι οποίοι διεγείρουν τα αντίστοιχα εγκεφαλικά κέντρα, που βρίσκονται κάτω από το σημείο επαφής του πηνίου. Με τον τρόπο αυτό, ενισχύονται τα θετικά συναισθήματα ή καταστέλλονται τα αρνητικά, ανάλογα με το ποιό κέντρο του εγκεφάλου επηρεάζει το πηνίο. Η μέθοδος αυτή βασίζεται στην ίδια φυσική αρχή με την ηλεκτροσπασμοθεραπεία (ECT), δηλαδή στη ρύθμιση της ηλεκτρικής δραστηριότητας του εγκεφάλου, ωστόσο, σε αντίθετη με την ηλεκτροσπασμοθεραπεία, δεν απαιτείται αναισθησία. Ο επαναληπτικός διακρανιακός μαγνητικός ερεθισμός είναι μία θεραπευτική επιλογή σε ασθενείς που δεν ανταποκρίνονται ικανοποιητικά στη φαρμακευτική αγωγή ή υπάρχουν αντενδείξεις στη λήψη φαρμάκων.[10]
  • Κρύα Υδροθεραπέια[11]

Κατάθλιψη και άσκηση[Επεξεργασία | επεξεργασία κώδικα]

Αρκετές έρευνες της τελευταίας δεκαετίας δείχνουν ότι η συστηματική συμμετοχή σε προγράμματα άσκησης και φυσικές δραστηριότητες, μειώνουν τα επίπεδα της κατάθλιψης[12] [13] [14] [15] [16] [17] . Τα άτομα με κατάθλιψη τείνουν να κάνουν καθιστική ζωή και να μην ασχολούνται με σπορ και φυσικές δραστηριότητες. Έτσι, τίθεται ένα ερώτημα αν είναι η κατάθλιψη που δημιουργεί τάσεις αδράνειας ή αν η καθιστική ζωή επιτείνει το πρόβλημα της κατάθλιψης. Βεβαίως, είναι πλέον παραδεκτό, ότι τα σπορ και οι φυσικές δραστηριότητες συνεισφέρουν στη σωματική και την ψυχική υγεία των ατόμων. Επιπλέον, τα άτομα που είναι κινητικά δραστήρια έχουν λιγότερες πιθανότητες να αναπτύξουν κατάθλιψη[18].

Τα άτομα δε που έχουν ήδη κατάθλιψη, μπορούν να προσφύγουν σε ψυχολογική ή φαρμακευτική υποστήριξη, αλλά μπορούν ταυτόχρονα να προσφύγουν και στα σπορ κα τις φυσικές δραστηριότητες και να βοηθηθούν ουσιαστικά. Στην κατεύθυνση αυτή υπάρχει ένα καλό και ένα κακό. Το κακό είναι ότι η συμμετοχή στα σπορ δεν είναι ένα χάπι που πρέπει να πάρει κανείς γρήγορα και εύκολα. Το καλό είναι ότι τα σπορ δεν έχουν οικονομικό κόστος, και κυρίως, ενεργοποιούν εσωτερικά τα άτομα, να παλέψουν μόνα τους και να ξεπεράσουν τα προβλήματά τους. Τα άτομα δηλαδή, μέσα από τα σπορ καταλαβαίνουν, ότι όσο προσπαθούν, τόσο βελτιώνονται. Το πετυχαίνουν αυτό μόνα τους, χωρίς εξωτερική βοήθεια. Μόλις το καταλάβουν αυτό αυξάνεται η σιγουριά και η αυτοπεποίθησή τους. Πρώτα αυξάνεται η σιγουριά και η αυτοπεποίθησή τους για τα σπορ, αλλά πολύ γρήγορα αυτή η αίσθηση μεταφέρεται σταδιακά σε καθημερινά πράγματα και έγνοιες, στη δουλειά, στο σπίτι, στις κοινωνικές σχέσεις.

Κλινικές παρατηρήσεις και επιδημιολογικές έρευνες, έχουν δείξει ότι η σωματική δραστηριότητα μπορεί να μειώσει τον κίνδυνο εμφάνισης και ανάπτυξης κατάθλιψης στα άτομα γενικά, να περιορίσει τα συμπτώματα σε καρδιοπαθείς με ελαφριά και μέτρια κατάθλιψη, σε ασθενείς με ψυχιατρικά περιστατικά, και να μετριάσει αρνητικά συναισθήματα και την κατάθλιψη σε άτομα της τρίτης ηλικίας. Μέσα από την άσκηση, επέρχεται επίσης ο έλεγχος του βάρους και η βελτίωση της σωματικής εικόνας, περιορίζοντας ταυτόχρονα και τα συμπτώματα της κατάθλιψης[19]. Έτσι λοιπόν, για τη μείωση των συμπτωμάτων της κατάθλιψης μπορούν να οργανωθούν προγράμματα παρέμβασης, τα οποία περιλαμβάνουν φυσικές δραστηριότητες. Ακόμα και σε άτομα με μανιοκατάθλιψη, παρεμβατικά προγράμματα φυσικών δραστηριοτήτων, φαίνεται ότι έχουν ευεργετικό ρόλο στη βελτίωση της ψυχικής τους υγείας.[20][21]

Γιατί η άσκηση βοηθάει στον περιορισμό της κατάθλιψης. Σε γενικές γραμμές, η συμμετοχή σε σπορ και προγράμματα άσκησης και ανεβάζει τη διάθεση και οδηγεί στη μείωση των επιπέδων της κατάθλιψης. Η άσκηση αλλάζει τη διάθεση, μέσω της ρύθμισης του άγχους, της βελτίωσης της αυτοεκτίμησης και της εικόνας του σώματος και της ανόδου της αυτοπεποίθησης. Επίσης, η άσκηση, αλλάζει ή ρυθμίζει καλύτερα μια σειρά φυσιολογικών μηχανισμών στα άτομα με κατάθλιψη, όπως είναι η έκκριση των ενδορφινών, οι αυξομειώσεις στη θερμοκρασία του σώματος, κτλ.[22]

Ποιες είναι οι μορφές άσκησης που βοηθάνε περισσότερο; Και η αερόβια και η αναερόβια άσκηση μπορεί να μειώσει τα επίπεδα της κατάθλιψης. Η μέτριας έντασης άσκηση[23] [24] [25] [26] [27] φαίνεται να είναι αποτελεσματικότερη για την παραμονή στην άσκηση των ατόμων αυτών.Το περπάτημα[28] ειναι ευεργετικότερο απο το τρέξιμο(μέτριας έντασης) και κυριως σε καθαρο αερα[29] [30] (ο ιονισμένος αέρα είναι κοντά σε καθαρό περιβάλλον) είναι ευεργετικοτερα για τον οργανισμο[31][32][33][34] [35][36] [37],και γρηγορο τρεξιμο (σπριντ) αυξανουν αρκετα την διαθεση.Και η άσκηση με αντιστάσεις μπορεί να χρησιμοποιηθεί στη θεραπεία μέτριας και έντονης κατάθλιψης. Δεν έχουν βρεθεί αρνητικές επιδράσεις της άσκησης σε πληθυσμούς ατόμων με κατάθλιψη. Στην πραγματικότητα, όλες οι μορφές άσκησης είναι το ίδιο αποτελεσματικές.[22][38]

Για μια πιο συστηματική υποστήριξη των ατόμων με κατάθλιψη, υπάρχει ανάγκη συνδυασμού της άσκησης με άλλες μορφές θεραπείας, όπως είναι οι ομάδες συζήτησης, οι ομάδες αυτο-βοήθειας ή άλλες γνωστικές θεραπείες. Ίσως, μερικά ψυχολογικά προβλήματα, όπως αυτά που σχετίζονται με την κατάθλιψη να χρειάζονται απλά, μια εσωτερική ενεργοποίηση από τα άτομα, για να μετριασθούν. Η άσκηση και η συμμετοχή σε φυσικές δραστηριότητες προσφέρουν αυτή την ενεργοποίηση. Η δυσκολία, βέβαια, για τα άτομα με κατάθλιψη, είναι να πεισθούν για την αξία της άσκησης. Και επειδή, όλες οι μορφές άσκησης έχουν μέσα τους το στοιχείο του παιγνιδιού της διασκέδασης και της εκτόνωσης, από τη στιγμή που θα αρχίσουν να γυμνάζονται, επικοινωνούν με άλλους, ενεργοποιούνται πνευματικά και σωματικά, αντιλαμβάνονται αλλαγές στο σώμα τους και τη διάθεσή τους.[39]

Κατάθλιψη και Διατροφή[Επεξεργασία | επεξεργασία κώδικα]

Έρευνες έχουν δείξει ότι υπάρχει σχέση του τρόπου διατροφής[40][41] με την κατάθλιψη. Οι καταθλιπτικοί έχουν έλλειψη από πολλών ειδών βιταμίνες[42][43](λόγω πολλών στρεσογόνων ορμονών που τις καταστρέφουν), και κυρίως διατροφή με υψηλά σάκχαρα[44][45] [46] ,με πολλούς καφέδες (λόγω της καφείνης)[47],τα άτομα που καταναλώνουν πολλά γαλακτοκομικά[44] και με υπερβολική κατανάλωση αλκοόλ[48] [49] [50] [51] [52] [53]. Επίσης έχει παρατηρηθεί ότι τα άτομα με κατάθλιψη έχουν πιο χαμηλή χοληστερίνη[54] [55] [56] [57] [58] [59] [60] [61] [62] [63] από το κανονικό,η μεσογειακή διατροφή είναι αρκετά αποτελεσματική (λόγο πλούσιο ελαιόλαδο[64] , και ιχθυέλαιο (Ω-3)[65] [66] [67] [68] [69] [70] [71] [72] [73] [74] [67] [75] [68] [74] [72] [74] [76] [77] [78] [79] [80] [81] [82] και κυρίως λαδερά ψάρια (σαρδέλες) [67] [83] [84] οπού συσχετίζετε με την διατροφή.

Υπαρχουν ακομα αρκετά βότανα οπου έχουν δείξει ότι έχουν αντικαταθλιπτική δράση όπως Ashwagandha [85] [86],Brahmi [87],Camu-Camu,Cat’s Claw,Damiana,Ginkgo Biloba [88] [89] [90] [91] [92] [93],Golden Root [94] [95],Gotu Kola [96],Horny Goat Weed [97],Korean Ginseng [98],Licorice [99],Magnolia [100],Marapuama,Noni [101] [102][103][104],Passion Flower,Saint John's Wort [105] [106] [107] [108] [109] [110] [111] [112] [113] [114] [115] [116] [117] [118] [119] [120] [121] [122] [123] [124] [125] [126] [127] [128] [129] [130],Schizandra [98],Suma,Turmeric [131]

Πολλες έρευνες έχουν δείξει οτι λινέλαιο βοηθαει αρκετά στην διάθεση [56] [65] [67] [69] [70] [71] [72] [73] [75] [77] [83] [132]

Βιταμίνες - Μέταλλα - Ιχνοστοιχεία - Αμινοξέα[Επεξεργασία | επεξεργασία κώδικα]

Μερικές βιταμίνες μπορεί να λείπουν από τον οργανισμό ωστόσο όταν αποκατασταθούν στα φυσιολογικά πεδία η κατάθλιψη εξαφανίζεται. Μερικές από αυτές είναι τα αλκαλοειδή Galanthamine, [133] και η Πιπερίνη (πού βρίσκετε στο πιπέρι). [134]

Αρκετά αμινοξέα έχουν δείξει οτι μπορούν να βελτιώσουν την διάθεση (λόγω έλλειψης στον οργανισμό)όπως 5-HTP (5-Υδροξυτρυπταμίνη) [135] [136] [137] [138] [139] [140] [141] [142] [143] [144] [145] [146] [147] [148], Acetyl-L-Carnitine [149] [150] [151] [152] [153] [154] [155] [156] [157] [158],Glutamine [159] [160],Methionine [161] [162],Phenylalanine [148] [163] [164] [165] [166] [167] [168] [169] [170] [171] [172] [173] [174] [175],η Proline αλλά μπορεί να προκαλέσει εκνευρισμό,η S-Adenosylmethionine (SAMe) [176] [177] [178] [179] [180] [181] [182] [183] [184] [185] [186] [187] [188] [189] [190] [191] [192] [193] [194] [195] [196] [197] [198] [199] [200] [201] [202] [203] [204],η Taurine,η Threonine[205],η Tryptophan [135],η Tyrosine [206] [207] [208] [209] [210] [211] [212] [213] [214] [215] [216]

Η έλλειψη μετάλλων σε έναν οργανισμό μπορεί να είναι αιτία εμφάνισης κατάθλιψης π.χ. όταν υπάρχει έλλειψη σε βρώμιο. [217], στους ηλικιωμένους με έλλειψη ασβεστίου [218] [219], σε Χρωμιο [220] [221] [222] [223] [224] [225],λίθιο (σε σωστές ποσότητες),σε έλλειψη Μαγνήσιο (όμως υπερβολική χορήγηση μπορεί να δημιουργίσει πάλη κατάθλιψη) [226] [227] [228] [229] [230] [231] [232] [233] [234] [235] [236] [237],Μαγγάνιο (σε μερικες μορφές κατάθλιψης),σε Κάλιο [234] [238] [239],σε Σελήνιο [240] [241] [242] [243] [244] [245] [246],να υπάρχει ανεπάρκεια σε Ψευδάργυρο [247] [248] [249] [250] [251] [252] [253]

Μερικές βιταμίνες που μπορεί να εχει ανεπάρκεια ο οργανισμός και να παρουσιαστεί κατάθλιψη ειναι η Βιοτίνη [254] [255] [256] Cytidine Diphosphate Choline (CDP-Choline) [257],Φυλλικό Οξύ [179] [258] [259] [260] [261] [262] [263] [264] [265] [266] [267] [268] [269] [270] [271] [272] [273] [274] [275] [276] [277] [278] [279] [280] [281] [282] [283] [284] [285] [286],Ινοσιτόλη [281] [287] [288] [289] [290] [291] [292] [293] [294] [295] [296] [297] [298],Nicotinic Acid [299] [300],PABA, η Βιταμίνη B1 [301] [302] [303] [304] [305] [306] [307] [308], η Βιταμίνη B2 [309] [310],,η Βιταμίνη B5 [311] [312] [313] [314] [315], η Βιταμίνη B6 [285] [309] [316] [317] [318] [319] [320] [321] [322] [323] [324] [325] [326] [327],η Βιταμίνη B12, [179] [264] [281] [285] [328] [329] [330] [331] [332] [333] [334] [335] [336], η Βιταμίνη C [323] [337] [338] [339] [340] [341] [342] [343] [344],η Βιταμίνη D [345] [346] [347] [348] και η Cytidine Diphosphate Choline [257].

Έρευνες έχουν δείξει ότι πολλές ορμόνες παίζουν αρκετό ρόλο στην κατάθλιψη οπού μερικές φορές είναι κατω απο το κανονικο οπως, η Androstenedione [349],DHEA (Dehydroepiandrosterone) [350] [351] [352] [353] [354] [355] [356] [357] [358],Μελατονίνη [359] [360] [361] [362] [363],Pregnenolone [364] [365] [366] [367] [368] [369] [370] [371],Προγεστερόνη [372],η χαμηλή ενδογενή τεστοστερόνη (κυρίως στους άνδρες) [373] [374] [375] [376] [377] [378] [379] [380] [381] [382],τριϊωδοθυρονίνη (Τ3) [383] [384] [385] [386] [387] [388] [389]

Παραπομπές[Επεξεργασία | επεξεργασία κώδικα]

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  3. Kirsch, Irving (1 January 2002). "Yes, there is a placebo effect, but is there a powerful antidepressant drug effect?". Prevention & Treatment 5 (1). doi:10.1037/1522-3736.5.1.522i. http://alphachoices.com/repository/assets/pdf/EmperorsNewDrugs.pdf. 
  4. Breggin, P. (2003/2004). Suicidality, violence and mania caused by selective serotonin reuptake inhibitors (SSRIs): A review and analysis. International Journal of Risk & Safety in Medicine, 16, 31–49.. http://www.breggin.com/31-49.pdf. 
  5. Whitaker, R. (2005). Anatomy of an epidemic: Psychiatric drugs and the astonishing rise of mental illness in America. Ethical Human Psychology and Psychiatry, 7, 23-35.. http://freedom-center.org/pdf/anatomy_of_epidemic_whitaker_psych_drugs.pdf. 
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Πηγές[Επεξεργασία | επεξεργασία κώδικα]

  • Martinsen, E.W. (2008). Physical activity in the prevention and treatment of anxiety and depression. Nord J Psychiatry, 62, 25–29.
  • Θεοδωράκης, Γ. (2010). Άσκηση, ψυχική υγεία και ποιότητα ζωής. Θεσσαλονίκη. Εκδόσεις Χριστοδουλίδη.
  • Landers D., & Arent, S. (2007). Physical activity and mental health. In G. Tenenbaum, & R. Eclund (Eds.), Handbook of sport psychology (pp. 469–491). New Jersey. John Wiley & Sons, Inc.

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