The Reactive depression Is caused in reaction to an external event or circumstance. In other words, it is a depressive state that the person experiences in response to a major stressor, such as a breakup of a partner, death of a relative, divorce, loss of employment...
Due to individual differences, a stressful event can cause one person to react with depression while another does not react. For example, before the death of a family member some people can resume their daily life, while others react with depressive symptoms. Most people who have reactive depression can recover within 6 months through cognitive behavioral therapy.
This type of depression can be serious and needs to be treated if it persists for too long a period of time and the person does not recover. However, most people disappear over time and can return to normal behavior. In other words; Reactive depression is temporary, as opposed to major depression which is long term.
Symptoms of Reactive Depression
The clinical of reactive depressions is a little more diffuse than that of endogenous depressions, since these depressive pictures are closely linked to the Personality of the person, something that does not happen with hereditary depressions.
However, there are certain symptoms that are considered typical of this type of depressions. These are:
1. Affective symptoms
In reactive depression there is a clear alteration of the State of mind , Which is depressed and has symptoms such as sadness or loss of interest.
In fact, the inability to experience pleasure with the majority of activities that, prior to the onset of depressive symptoms, were rewarding For the person, is considered the main symptom of this disease.
Likewise, this difficulty to experience pleasure causes a remarkable loss of interest in most things, so the person with depression r Eactiva usually shows without wanting to do anything.
Likewise, irritability and anxiety may occur as a response to mood and the inability to function properly and"pull towards in front".
2. Cognitive symptoms
The affective symptomatology is linked to certain thoughts, which usually maintain and / or aggravate the problems of the mood.
People with reactive depression often have low self-esteem , Much pessimism about his life and future, feelings of guilt , And a thought Marked by the negative aspects of his life.
As we have already mentioned, reactive depression tends to be closely linked to the individual's personality and to the adaptation he makes to the different Stimuli that occur in your life.
In this way, people with these types of depressions may have a personality that is very negative or very perfectionist.
One of these two personality types might explain the tendency to overemphasize the negative aspects, be unable to adapt them, and Thinking centered on pessimism and personal devaluation.
Likewise, reactive depression can provoke feelings of hopelessness and Difficulty concentrating , Think and function properly.
3. Social-motivational symptoms
Likewise, reactive depression usually affects the functioning of the person, both socially, as well as working and personal, and their behavior usually Be marked by a clear lack of motivation.
People with reactive depression usually have low energy on a constant basis, they are often very difficult to do any activity and usually fatigue with ease.
Likewise, their behavior tends to be marked by social withdrawal, unwillingness to communicate with other people and the absence of recreational activities.
All this makes the activity and productivity of a person with reactive depression significantly diminish, and opt for a passive lifestyle and inactive.
Differences with endogenous depression
The main difference between Endogenous depression And reactive depression is clear, the first is caused by genetic factors and the second arises through A poor adaptation of the subject to the different situations or events that he has to live.
However, how can we differentiate one from the other? How can we know if a person suffers from an endogenous depression or a reactive depression?
Being able to differentiate both types of depressions is very important, since although both disorders are similar, they differ greatly in their treatment and evolution.
The main features of reactive depression that differentiate it from the endogenous depression are:
1. Is less socially disabling
As we have seen, reactive depression can vary in its severity, to the point of not becoming a depression (and being a dysthymic disorder).
Thus, in general this type of depression usually affects less the social functioning of the person, and can preserve a certain functioning, things Which does not happen with endogenous depression.
2. It is not psychotic
In endogenous depression, psychotic symptoms can occur as Hallucinations or Delirious ideas .
In reactive depression this does not happen and the mood disturbance does not become so high as to produce delusions in the thought of the person.
3. Does not present endogenous symptoms
In reactive depression there are no somatic and motor symptoms, which are very common in endogenous depression.
Thus, there is no marked loss of weight and appetite, there are usually no changes in movement, and insomnia or excess of dream.
4. It is situational
Reactive depression usually occurs after a stressful event, which overcomes the person's ability to adapt.
This does not happen in the endogenous depression, which, as we have already mentioned, arises through genetic causes, without the need of environmental circumstances.
5. It is a consequence of an adapted personality pattern
Similarly, the person's way of being and his personality pattern dictate the poor adaptation to the environment that causes the depressive picture. In the d Endogenous personality depression has nothing to do with depressive symptoms.
People with endogenous depression usually have a personality characterized by generalized anxiety, Emotional instability , And dependency traits And obsessiveness.
Causes
Unlike endogenous depression, reactive depression does not connote such a high genetic load.
In this way, this type of depression is associated more to the way of being and to adapt to the life and events that the person has, which can Be the origin of depressive symptomatology.
It is for this reason that reactive depression is associated with personality traits marked by anxiety, obsession, Perfectionism , the dependence , the low self-esteem , the Emotional instability Or guilt.
If a person possesses these characteristics in his or her way of being, it is possible that when he or she experiences a difficult or stressful situation, his or her thoughts Focus on the negatives.
When these types of thoughts exceed their intensity and take over the cognition of the person, they can provoke a series of feelings of Sadness, guilt, pessimism or even hopelessness.
If the person is not able to manage these feelings, on the one hand, their negative thoughts will be reinforced, and on the other hand, their Behavior, which will be marked by activities that are in accordance with their state of sadness.
This will make the person less and less exposed to enjoyable activities, receive less gratification from the outside world, and aggravate their Feelings of sadness and their pessimistic thinking.
In this way, maladaptation can lead to a depressive syndrome and make it increasingly difficult for the person to recover his previous state.
Treatment
The response to psychotropic drugs in patients with reactive depression is often worse than patients with endogenous depression.
In this way, this type of depression can often be treated with psychotherapy and without the need for medication.
However, in severe cases the combination of psychoactive drugs (usually Antidepressants SSRIs) and Psychotherapy.
One of the psychotherapies that have shown greater effectiveness in treating reactive depressions is the Cognitive behavioral treatment . This treatment is based, on the one hand, on modifying the thoughts of the person.
Firstly, the person is able to identify his / her negative automatic thoughts (for example, if I call my friend and I do not Takes it because it does not want me) so that later it can evaluate its validity and modify it for a more positive or more neutral.
Subsequently work on the more general ideas of the person (for example: to be happy I have to be successful in everything) and do the same for Modify it by an idea more adapted to reality and therefore less negative.
On the other hand, work is done on the behavior, initiating gradual tasks that the person can do correctly, teaching to manage the time Properly and carrying out a schedule of activities so that the person is exposed to pleasant situations.
Thus, reactive depression is a type of depression closely linked to the person's way of being and to the adaptation that he / she makes to life, which Can improve significantly if one works at improving those thoughts and those behaviors that provoke or reinforce the depressive state.
Depression or dysthymia?
Two distinct types of depression can be distinguished, each with particular characteristics and causes.
One is endogenous depression, an inherited depressive syndrome that arises through genetic causes.
The other type is reactive depression, which, unlike Endogenous depression , Appears as Response to poor adaptation to stressful events.
However, it has been shown that poor adaptation to stressful events does not have to cause a depressive condition and that if it causes depression Experience can vary in severity.
Thus, to delineate these depressive pictures, with the same symptoms and characteristics as the depressions, but of a lesser intensity, it was proposed The term of Dysthymia .
Thus, when we speak of reactive depression, we must first delimit if the intensity of the symptoms is serious and refer to a T Major depressive disorder , Or if it is milder and refers to a dysthymic disorder.
As we have said, it is considered that both disorders have the same nature and the same characteristics, so to differentiate one from the other is Quite simple since only the seriousness of the symptoms should be dictated.
A t Major depression disorder it is characterized by:
1. Presence of a major depressive episode characterized by five or more of the following symptoms during a minimum period of 2 weeks, which Cause high discomfort and social or work impairment in the person.:
Been depressed most of the day, almost every day (feeling sad, empty or crying frequently).
A marked decrease in interest or capacity for pleasure in all or almost all activities.
Fatigue or loss of energy.
Excessive and inappropriate feelings of worthlessness or guilt.
Decreased ability to think or concentrate.
Recurring thoughts of death.
2. There has never been a manic episode.
3. Mood disturbance is not part of schizoaffective disorder or schizophrenia.
He Dysthymic disorder it is characterized by:
1. Chronically depressive mood most of the day on most days for at least 2 years.
2. Presence, while depressed, of two or more of the following symptoms:
Loss or increase of appetite.
Insomnia or Hypersomnia
Lack of energy or fatigue
Low self-esteem
Difficulty concentrating or making decisions.
Feelings of hopelessness.
3. During the two years, the above symptoms have not been present for more than two consecutive months (but would be a depressive disorder).
4. There has never been a manic episode.
Thus, as we see the depressive disorder and the dysthymic disorder are identical, and the only difference they have are the intensity and duration of the symptom.
The symptoms of dysthymic disorder are less intense and, when they are of a higher intensity, they occur for less time.
In fact, if the symptoms of dysthymic disorder were present intensely for more than two weeks, the diagnosis would be changed to disorder Major depressive disorder.
Thus, although they are two different disorders, they only differ in intensity, so when we talk about reactive depression we can refer Both for a depressive disorder (if the symptoms are severe) and for a dysthymic disorder (if the symptoms are milder).
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