Reactive depression: what is it, symptoms and common causes

We speak of reactive depression when we want to refer to a mood disorder that occurs in response to an external event or several. It is the classic depression, the most common. The one we think of when we imagine a depressed person. What we probably cannot imagine or understand with the same intensity is how deep the pain of these people reaches.

We will present a little information about its causes, what are the most frequent clinical manifestations and in what ways we can improve the lives of people with reactive depression.

• Related article: "Are there several types of depression?"

Causes of reactive depression

The distinction between endogenous and reactive depression was made by Paul Julius Moebius in the 19th century. This differentiation assumes that there is a distinction between depressions that occur from biological causes and those that occur from psychosocial causes. The truth is that although the empirical support for this supposed distinction is far from being conclusive, it can be useful to communicate quickly between healthcare professionals and quickly know what to do face.

In reactive depression, a disorder that women have a 10 to 25% risk of developing in their lifetime and For men it ranges between 5 and 12%, the disorder occurs after the presence of a stressor that causes the development of depression. Imagine a breakup, the death of a close friend, the loss of a job, or any type of life change that is perceived as very stressful and uncontrollable.

What is important in depression, beyond the objective severity of the event, is how it is perceived as a threat. Each individual has different coping skills, and for this reason each person experiences problems with more or less difficulty. What for one may be a traumatic event that can be recovered after 2 weeks, for another it may be a blow that leaves him emotionally destroyed. For this reason, in the evaluation of the patient we must bear in mind what are the coping skills that the patient possessed before the event.

Symptoms and signs

Reactive depression is always a complex and heterogeneous clinical picture, no two cases are the same. An added problem is that most of the symptoms are not exclusive to depression, and it is also difficult to differentiate what is an adjustment disorder after a very stressful situation from what has become a well reactive depression settled. As a guide, it is possible to group depressive symptoms under five different categories.

Mood symptoms

Sadness is present in 9 out of 10 patients with reactive depression and it is usually the main complaint of those who gather the courage to come for consultation. In most patients this sadness manifests itself in the form of hopelessness and permanent helplessness. It is the feeling that the future holds nothing good, that all the positive is over and there is nothing left but misery and misery. In the most serious cases, sadness can be overshadowed by a feeling of emptiness so great that they deny feeling anything. As if they were internally dead.

In children, on the other hand, more than dejection they manifest irritability or instability. Many youngsters whose parents undesirably separate express depression through explosions, bad answers, or temper tantrums over issues that were never a source of trouble.

Motivational symptoms

Reactive depression causes patients to lose interest in activities they used to like. He doesn't want to keep doing them, nor are they satisfying when he does them. They lose their favorite hobbies, their daily routine, and they have stopped enjoying themselves in general. Even the energy is reduced, to the point where the person has so little strength that getting up and showering can be a great victory.

The movements are very slow and expensive, they require a lot of energy. This psychomotor retardation is sometimes so severe that patients fall into a so-called depressive stupor, a catatonic-like state that looks like almost total motor paralysis. The heterogeneity in the symptoms allows us to also find patients who instead of being slowed down are very agitated and cannot stop biting their nails or smoking restless.

Cognitive symptoms

In the same way that it happens with the movements, the thought is slowed down. It is so difficult for them to think that those who have a minimally demanding job are unable to perform normally. In children, for example, academic performance drops suddenly, reflecting a lack of concentration due to depression. Not only concentration, memory is also impaired. In depressed elderly patients, these memory problems can be confused with dementia, but the non-progression of memory impairment is what indicates whether it is depression or not.

The depressed person evaluates everything negatively. He thinks that he is worthless, that the world is a terrible place and that the future is black. They have a biased style of thinking that prevents them from seeing anything other than through pessimistic glasses, perpetuating depression. Depression sometimes leads to mood-congruent hallucinations, for example blaming or accusing voices.

Somatic symptoms

Although vegetative symptoms are more characteristic of endogenous depressions, we also find sleep problems such as hypersomnia or insomnia in reactive depression. In fact, in many patients sleep disturbance is the first symptom to appear and the last to disappear. Body aches such as headaches, digestion problems, muscle or lower back pain.

Interpersonal symptoms

When you stop doing activities, you also stop seeing your friends, it is usual for the social sphere of the patient who falls into a reactive depression to gradually deteriorate. These people reject social contacts because they are no longer pleasant and have no energy, and others end up giving up trying. Total social isolation can be achieved, since social contact ends up generating anxiety, overexertion and feelings of failure.

Treatment of reactive depression

The treatment first involves establishing a bond with the patient and that this person counts on us for their improvement. Once you feel truly understood, you may agree to start making up lost activities and becoming behaviorally activated, regaining previously lost social life. In parallel but always little by little, we must try to identify the negative thoughts that cloud the thinking of the depressed patient and apply cognitive restructuring. Pharmacological therapy is also indicated by antidepressants Like the SSRI, ISRN or tricyclics for example.

Due to the reactive nature, The emotional processing of that stressful situation that has caused the depression will also be addressed.. A poorly managed grief or an emotionally unprocessed life experience can be the subject of intervention. The psychologist will help the patient to acquire coping skills and emotion management to be able to turn the page. The memories will still be painful and sad, but they shouldn't interfere with the person's normal functioning.