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Autogenic training

Auto-training was proposed by the German neurologist Schultz back in the 30s of the last century, but was recognized and widely used in medicine only by the mid-50s. In fact, the method is a combination of meditation and self-hypnosis, Schultz took the most essential, in his opinion, elements of Indian yoga and adapted them for European perception, completely abandoning the religious and mystical component.

Auto-training is quite successfully used outside of medicine; for example, at one time it was part of the Arsenal of psychological training of many athletes. The use of the method allows you to quickly restore strength and overcome psychological barriers and achieve maximum efficiency from the physical capabilities of the body.

In psychiatry and neurology, auto-training is used for the treatment of various phobias and neuroses, in practice, this technique is an alternative to hypnotic effects, with the difference that the role of the hypnotist is the patient himself.

Like most other psychotechnical techniques, it is necessary to learn auto-training under the supervision of a specialist. The matter is not only that at wrong application of a method it is possible to worsen the condition (though small, but such risk really is present), but also in complexity of independent development, especially if there is no experience of similar practices in the past.

The whole process is divided into three stages: entering into a trance, pronouncing affirmations (suggestions) and exiting a trance. Perhaps the most important stage in the development of auto-training is the first, the depth of trance is usually less than the external suggestion carried out by a hypnotist. To enter into a trance, concentration is applied on the physical sensations of the body, alternately causing a feeling of heaviness and heat in the limbs, slowing breathing and heartbeat, coolness in the forehead, heat in the abdomen.

The development of auto-training takes time, rarely anyone can achieve tangible results from the first time. It is important not to force the process, to allow it to proceed naturally, with the manifestation of some perseverance and the correct use of technology the result is sure to be. We will not go into the details of the process now, they are described in detail in the relevant literature, and in any case, as I said, self-development of the method is not recommended, and an experienced coach in live communication will explain everything better than I can do it from the pages of the book.

After reaching the trance state, a mental repetition of the so-called affirmations, self-hypnosis formulas is carried out. In their preparation, too, it is desirable to consult with a specialist, there are a number of rules that should be followed. So, for example, it is not recommended to pronounce affirmations with a negative value, the prefix “not“. That is, instead of “I’m not worried“, it is better to repeat to myself “I’m calm.” In depression, affirmations are formulated in the appropriate direction: “ I’m calm“,” I’m good“,” I’m happy“,” good mood” and so on.

Out of the autogenous state should be gradually, positive affirmations are replaced by pronouncing the formulas of rest: “I rested“, “I am calm“, “I am full of strength“, “I will stand on the count of 3“; start a mental countdown and on the count of 3 or 5 open your eyes and exit the accepted posture for the process.

Conduct anger management ought to be sitting, when lying is a good chance to sleep and disrupt the process. The classic in auto-training is considered to be “the pose of the coachman”: the practitioner sits on the edge of the chair, the forearms of the hands are located on the knees, the hands hang down, the head is lowered. In such pose good relaxation, half-sleep is reached, but it is usually not possible to fall asleep at the same time. To do better in a darkened room, but not in complete darkness, as in the absence of vision, other senses become aggravated, which distracts and does not allow to achieve the necessary concentration. Complete silence is also undesirable for the same reasons, as long as there were no sharp stimuli.

Experts recommend to study three times a day, for 20-40 minutes. With the acquisition of experience, entering into a trance will take less time and, accordingly, the total time of each process will decrease. In addition, auto-training sessions contribute to high-quality rest of the body, as a result, the time allotted for sleep can be reduced, due to which the necessary time for training will be released.

The effectiveness of self-training is individual and largely depends on the suggestibility of a person. Good results can be obtained to overcome various phobias, including social, fear of unusual situation, public speaking. By relaxing you can achieve a temporary reduction in the level of internal tension, anxiety, insomnia. As for the treatment of depression, I am more skeptical.

In the initial period of training I received tangible progress in terms of overall improvement of health, reduce anxiety, increase activity, greater energy. But these phenomena were temporary. First, it is of course symptomatic treatment, the effectiveness of suggestion must be constantly maintained, and, stopping classes, you can quickly return to the previous state. Secondly, in fact, auto-training is the process of suppressing negative emotions by layering the inspired positive, problems and conflicts are not resolved, but only overlap with the constant repetition of affirmations. That is, there is neither a vacuum of suppressed energy, nor the cessation of its further accumulation, it is obvious that this can not be the best method to combat depression.

In order to achieve a sustainable result, positive affirmations alone are not enough, first of all, it is necessary to clear the consciousness, to give an exit to the accumulated tension. But even this does not guarantee getting rid of the problem, a conscious negative, although it loses a significant part of its negative charge, still remains in memory as a negative. In order to finally get rid of it, it is necessary to carry out the practice of replacing the negative state with a positive one, to create a positive emotional anchor to a traumatic situation. In this case, mental or verbal affirmations are not effective enough. Much better results can be achieved by using modern techniques of neurolinguistic programming, which we will discuss in the appropriate Chapter.

In my case, the rise from auto-training was observed for two months, after which the reality took its toll. In addition to short-term rest, I have not received any benefits from classes, too strong were my internal conflicts in order to be able to suppress them in this way. However, the skills obtained as a result of a variety of auditory training, extremely useful in the development of other similar techniques, which requires entering into a trance, such as qigong and transcendental meditation.

Summing up, we can say that, despite the presence of a certain positive effect associated with the training techniques of relaxation and deep rest, as well as a temporary reduction of disturbing symptoms, auto-training can not be a radical means to get out of depression. Too narrow focus of this method and the obvious limitations of the results have led to the gradual oblivion of auto-training as a means of Arsenal of modern psychiatrists and psychotherapists.

Psychedelic drugs

The term “psychedelics” was proposed by psychiatrist Humphrey Osmond and translated from Greek means “manifesting the soul” (psyche – soul, and delic – explicit, manifesting). These include preparations both chemically obtained, such as LSD, MDMA and DMT, and the active substances of various plants found in the wild: Mexican cacti, some species of poisonous mushrooms, vines in the Amazon jungle. Action psychedelics is primarily to change the usual perception of the world and achieve a special state of consciousness. This experience can be both positive and extremely negative, dangerous for the human psyche.

The history of medical use of psychedelics begins with the discovery and accidental use of LSD-25 by Swiss chemist albert Hoffman in 1947. While working in the laboratory, Hoffman spilled a negligible amount of the drug on his hand and, without suspecting anything bad, went home on his bike. Hoffman’s report on how he rode his bike through the streets of Basel under the influence of a large dose of LSD, became a legend. On the way he had a strong change in the perception of the surrounding space, there were fantastic vision, like a dream. The visions intensified and after he got home, Hoffman was scared he was going crazy. His neighbor he took for the evil witch, Hoffman seemed that his conscious possession of demons; deciding that is on the verge of death, Hoffman was asked to call him doctor.

By the time the doctor arrived, the crisis had passed, to his surprise, Hoffman felt himself full of strength and energy, as if reborn into the world. This state of health lasted all day. Hoffman wrote a report on his unusual experiences to the immediate supervisor, Dr. Arthur Stoll, whose son, a Zurich-based psychiatrist, became interested in studies of the effects of LSD in clinical settings. His report on the effects of LSD-25 on a group of healthy volunteers and psychiatrist patients, published in 1947, immediately became a sensation in the scientific world.

Initially, the LSD has high expectations regarding modeling them psychotic States similar to that experienced by patients with schizophrenia. It was assumed that this simulation will help to better understand the causes of schizophrenia, and to find effective drugs for its therapy. It soon became clear that the nature of the visions provoked by taking LSD had nothing to do with schizophrenic psychoses, and such studies were curtailed for lack of prospects.

But suddenly LSD was quite effective in psychotherapy of neuroses. The fact that under the influence of this drug as it eliminates the barrier between the unconscious and consciousness, greatly facilitates access to the displaced material that POPs up in the patient’s mind in large quantities in the form of awakened memories and unexpected insights. This description is undoubtedly a simplification of the mechanism of action of psychedelics, but for the purposes of our study it is enough.

Thus, psychodynamic processes occur much faster than traditional psychoanalysis, the doctor no longer has to break through the protective mechanisms of the patient’s psyche, which are weakened by the action of drugs.

Great work in the field of psychedelic therapy was carried out by the American psychiatrist of Czech origin Stanislav Grof. With this name we still have to repeatedly encounter in the course of our narrative, and so it makes sense to talk about it in more detail.

Stanislav Grof is an outstanding doctor and scientist who has devoted more than forty years to the research of unusual States of consciousness and spiritual growth, one of the founders and the most prominent representatives of transpersonal psychology. Some researchers compare it to the scale of contributions to modern psychology, with such giants as Sigmund Freud and Carl Gustav Jung.

Grof was born in Prague on July 1, 1931. From 1956 to 1967, S. Grof worked as a practicing psychiatrist, actively studying at that time the psychoanalytic model of consciousness and its application in the treatment of neuroses. During the same period he was actively studying psychoanalysis. In 1959, the Grof was awarded the Kuffner prize, a national Czechoslovak award given annually for the most outstanding contribution in the field of psychiatry. Since 1961, he has led research on the use of LSD and other psychedelics in the treatment of mental disorders in Czechoslovakia.

In 1967, as a fellow of the Foundation for support of psychiatric research (USA), Grof received the opportunity to undergo a two-year internship at Johns Hopkins University and subsequently continue his research activities at the Maryland center for psychiatric research. From 1973 to 1987, S. Grof lives and works at the Esalen Institute (big sur, California). During this period, together with his wife Christina, he develops the technique of holotropic breathing, an original method of psychotherapy, self-knowledge and personal growth, which we will discuss later in this book.

Grof is one of the founders of the international transpersonal Association (ITA) and has long been its President.

Currently, S. Grof is a Professor of psychology at the California Institute of integral studies. In addition to his main activities, he conducts training seminars for professionals (“Grof Transpersonal training”), as well as lectures and seminars around the world. Stanislav Grof is the author and co-author of more than one hundred articles and fourteen books translated into twelve languages.

The first acquaintance of Grof with the action of LSD occurred in Czechoslovakia in 1956. At that time, Sandoz, a company engaged in the industrial production of the drug, provided free samples to psychiatrists around the world in exchange for information about its effects.

Here is how about this experience tells himself Grof:

“I began to feel the effects of LSD forty-five minutes after taking it. At first it was a slight malaise, dizziness and nausea, then these symptoms disappeared and were replaced by a demonstration of incredibly colorful abstract and geometric visions, alternating in front of my mind’s eye with the speed of pictures in a kaleidoscope. Some of them resembled exquisite stained glass Windows in the medieval Gothic Cathedral, and others – Arabesque Muslim mosques. To describe the finesse of these visions, I would compare them to Scheherazade’s “a Thousand and one nights” and the stunning beauty of the Alhambra and Shanda – these were the only comparisons that came to my mind at the time. Today I am sure that my psyche has somehow generated a wild set of fractal images, like graphic images of nonlinear equations, which can give a modern computer.

As the session went on, my experiences wandered around and around this realm of aesthetic delights and were replaced by an unexpected encounter and confrontation with my subconscious. It is difficult to find the words to this intoxicating Fugue of emotions, visions and illuminating insights concerning my own life and existence in General, which suddenly became available to me at this level. It was so profound and overwhelming that it immediately overshadowed my earlier interest in Freud’s psychoanalysis. I couldn’t believe how much I’d learned in those few hours. A breath-taking feast of colors and an abundance of psychological revelations – they would be enough in themselves to turn my first acquaintance with LSD into a truly memorable event.

This day marked the beginning of my radical divergence from traditional thinking in psychiatry and the monistic materialism of Western science. I came out of this experience that touched my very essence, shaken by his power. At the time, I did not believe that the potential for mystical experience was natural to any human being by right of birth, and attributed it all to the effects of LSD. I felt that the study of unusual States of consciousness in General, and especially those caused by the effects of hallucinogens, as far as I can imagine, is the most interesting area of psychiatry. I realized that, under the right conditions, the conditions caused by the effects of hallucinogens-far more than just dreams, which play such a crucial role in psychoanalysis – really are, if you use the words of Freud, “the Royal way to the subconscious.” And, right there and then, I decided to devote my life to the study of unusual States of consciousness.”

Stanislav Grof, “When the impossible is possible»
His vast research experience on the use of LSD Grof summarized in the book ” the Field of the human unconscious.” In this study, Grof significantly expanded psychoanalytic cartography of the psyche, introducing the concept of transpersonal area, that is, part of the human consciousness, beyond his personal experience. The discussion of this undoubtedly interesting point of view is beyond the scope of this book, and I refer those interested in the topic directly to the mentioned work of the Grof himself.

We are interested in the information presented in the section “Psychodynamic experiences in LSD sessions“, in which the Grof describes the experience of its patients regressing under the influence of the drug in childhood and aware of long-forgotten early traumatic experiences:

“The experiences in this category come from the individual unconscious and from the spheres of personality available in the ordinary state of consciousness. They belong to the most important memories, emotional problems, unresolved conflicts and suppressed material of different periods of human life. Most phenomena occurring at this level can be interpreted and understood in psychodynamic terms. When deciphering, they require knowledge of the basic principles of the dynamics of the unconscious, given by Freud, and especially the mechanisms responsible for dreams, as well as familiarity with certain specific characteristics of LSD States and their symbolic language. Simple psychodynamic experiences take the form of re-living the emotionally intense (traumatic or beneficial) events of infancy, childhood, and later periods of life and re-examining attitudes towards them. More complex experiences are the embodiment of fantasies, dramatization of dreams filled with desires in reality, dreams taken from movies, and a complex mixture of fantasy and reality (highlighted by me. – Primas’. ed.). In addition, the psychodynamic level includes a variety of experiences that contain important unconscious material, appearing in a hidden form of symbolic masks, protective distortions and metaphorical hints.

Psychodynamic experiences are particularly common in the course of psycholytic therapy in mentally ill people and in uncontrolled LSD sessions in people with serious emotional problems. Much less often they occur in sessions of emotionally stable persons, whose childhood was relatively calm. In psycholytic therapy, psychodynamic experiences can predominate in several initial sessions, following each other, before being resolved and integrated, that is, included in the conscious experience, the underlying unconscious material is comprehended and the patient can move to the next level. In psychedelic therapy, such biographical material is worked out in the initial and final periods of the session. Sometimes psychodynamic experiences can predominate throughout a high-dose session, although preprogramming and the overall situation with this form of LSD therapy contribute to experiences at deeper levels of the unconscious. They will be described later (perinatal and transpersonal phenomena).

The phenomenology of psychodynamic experiences in LSD sessions is largely consistent with the basic concepts of classical psychoanalysis. If psychodynamic sessions were the only type of LSD experience, they could be considered as laboratory evidence of the main Freudian prerequisites. Psychosexual dynamics and fundamental conflicts of the human psyche, as they are described in Freud, with extraordinary clarity and vitality are manifested even in the sessions of naive newcomers, never subjected to psychoanalysis, not familiar with psychoanalytic literature and have not experienced any direct or indirect effects of this direction. Under the influence of LSD in these individuals experiencing a regression into childhood and even early infancy, revive in memory the various psychosexual traumas and complexes of sensations related to infantile sexuality, and confronts conflict, including the activity of various libidinal zones”.

S. Grof ” Areas of the human unconscious»
Remember the sentence I highlighted in the text. We’ll get back to him later.

In the Soviet Union experiments with LSD conducted by Kiev psychiatrist Maria Telishevska receiving convincing results in the treatment of patients with alcoholism. It is no secret that in the formation of alcohol dependence psychological factor is important. The results of the research Teleshevsky was published in the monograph published in 1964 by the publishing house “Medicine”.

Further developments are well known. The massive abuse of psychedelics and primarily LSD, which resulted in a whole “psychedelic revolution” of the 60s, could not but cause a response from the authorities, outlawed not only LSD and its analogues, but also imposed a ban on medical research with their use. Without casting the slightest doubt on the correctness of the decision in respect of restrictions on the mass availability of the drug, it is necessary to Express regret about the hasty prohibition of further study promising drugs in psychotherapy.

After reading this Chapter, perhaps someone will be tempted to experiment with psychedelics on their own. You do not need to do this in any case. First, it is illegal, and by purchasing such drugs on the black market, you should be aware that you are breaking the law and can cause serious trouble. Secondly, you can never be sure what exactly you sold under the guise of LSD or MDMA. No one guarantees the quality of the drug, the dosage is also uncontrolled. Moreover, under the name “ecstasy”, for example, sold dozens of tablets with a variety of chemical components, it may very well be that MDMA in the tablet is not at all and it consists of some absolutely you do not need psychostimulators, mixed with heroin.

And most importantly. Even applying yourself clean psychedelics and in the correct dosage, you run the risk of irreparable harm to your mental health. This is no exaggeration. The flow of unconscious material can be so strong and so shocking that the human psyche will simply not be able to bear it, to cope with the volume and intensity of experiences. The result may be an even greater flight into the disease, aggravation of all symptoms, until irreversible changes.

A prerequisite for therapy with psychedelics is the presence of an experienced specialist who can guide you through this test, to prevent, if necessary, a severe crisis, to return to reality, to help correctly interpret what is happening.

I believe in the future of psychedelic therapy. Even now we can observe the gradual rehabilitation of the medical use of such drugs. In Switzerland, since 2008, the use of LSD in the treatment of cancer patients and other terminal conditions is allowed. Dr. Mithofer in the United States provides MDMA-based psychotherapy to sexually abused women with very good results.

Let’s wait for the full legalization of psychedelic therapy, no need to engage in Amateur activities, the risk is too great. In addition, currently there are other, non-drug and completely safe methods of working with consciousness, which we will discuss below. One of these methods is auto-training.

Psychotherapy

It is generally recognized that the combination of psychotherapy with drug therapy is more effective than the use of each of these methods separately. They are not alternatives to solving the problem, but, on the contrary, complement each other perfectly. When conducting psychotherapy is of great importance the activity of the patient, his involvement in the process. Active participation of the patient allows him to develop certain behavioral skills and mechanisms of self-regulation, which teach to cope effectively with difficult life situations and increase the chances of a person not to fall into repeated depression in the future.

The most common currently and effective in the treatment of depressive disorders are three types of psychotherapy: psychodynamic, based on the work of Freud and his followers and the methods of psychoanalysis developed by them, behavioral therapy and cognitive psychotherapy.

According to the psychoanalytic concept, the cause of depression is unresolved and suppressed unconscious conflicts. This approach was most detailed in Freud’s book “Sadness and melancholy”. According to his ideas, the basis of depression is laid in infancy, when the child is taken from the mother’s breast. The resulting mental trauma and lack of adequate compensation cause a state of dissatisfaction and the development of self-esteem disorders, leading ultimately to the development of depression in adulthood. The views of Freud on depression was developed in the works of Melanie Klein and Donald Winnicott.

The merit of the psychoanalytic school is a detailed study of the core of depression and a correct indication of the role of unconscious factors in its development. The task of the therapist in the conduct of psychoanalysis is the discovery of repressed traumatic situation, the awareness of her patient, re-experiencing and healing. At the same time, the psychodynamic school pays insufficient attention to other sources of unconscious conflicts that are not directly related to the traumatic removal from the mother’s breast. Its big drawback is also the neglect of social factors and traumatic situations from the present, which can lead to the development of a depressive episode. Psychoanalysis is a long process, sometimes treatment can be delayed for many years, which limits the widespread use of this method in successful therapy of depression.

Behavioral psychotherapy appeared in the Arsenal of psychotherapists relatively recently, finally formed into a whole doctrine, it was only in the 50s of the last century, after which it quickly gained popularity and developed in several directions. Common to all types of behavioral therapy is the idea of human behavior as a result of training, which radically distinguishes it from psychodynamic concepts. Behavioral therapy is aimed at solving the current problems of the patient by changing behavioral patterns, passivity, rejection of pleasure, isolation from the environment.

The Creator of cognitive therapy is Aaron Beck, who has tried to combine the best of both approaches. Cognitive psychotherapy combines the work with the actual problems of the patient, and with his deep beliefs and perceptions. Beck believes that the cause of the depressive disorder is inherent in the patient’s worldview and interpretation of the events happening to him. The aim of cognitive therapy is to change the patient’s negative thinking to positive by careful individual work and detection of cognitive, mental errors in the patient’s reasoning.

Currently, the last two methods are often combined into one called “cognitive-behavioral therapy”. From the name it is clear that in this way an attempt is made to combine both approaches, correction and behavioral and mental errors. Perhaps it is no exaggeration to say that cognitive-behavioral therapy is the most common type of psychotherapy now. Its popularity is explained by the relative brevity, especially in comparison with psychodynamic therapy, in which treatment can last for years, and the resulting relative cheapness, a large number of empirical (experimental) data confirming its effectiveness.

On average, ten to twenty psychotherapeutic sessions are required to achieve some result. In my case, it took more than fifty. I visited a therapist for a year and a half, once a week, each session lasted about an hour. During the sessions, we discussed the situations that concern me from today’s life, possible options for their development and what effect they can have on my life.

In favor of cognitive-behavioral therapy, I can say that first of all, some effect is achieved due to the fact of communication with the therapist. If the latter manages to establish reliable contact with the patient, to create a trusting relationship, the very expression of accumulated fears, the opportunity to share them with someone in a safe environment, “pour out the soul” already leads to some subjective changes in the emotional status of the patient. In my case, it happened that way, after a short period of rubbing, I quickly opened up to the therapist and immediately felt some relief. Passing sessions after that was no longer a burden, on the contrary, I was looking forward to them. Also, therapy really helped me to deal with some hypertrophied fears, to realize that their consequences may not be as severe as I initially thought.

The thing is that, being in a depressed state, you do not delve into the essence of your problem, it scares and disarms you so much that you continue to engage in its mental chewing on a superficial level, do not take the next step, just feel that it will continue to be bad and scary. The role of the therapist is to take you by the hand and mentally go through this path, critically evaluate it, do what the patient is not able to do on their own. It is important to avoid any pressure on the part of the therapist, it should only help you to understand the hypertrophy of the problem by asking questions, offering to evaluate the possible variants of development of events.

As a result, your problem does not disappear, but its value, significance, if very roughly, decreases.cognitive-behavioral therapy does not eliminate the source of your pain, but teaches you to live with it. Well, that might be justified, too. Such therapy did not cure me, and I did not take less drugs, but in some situations I began to feel more confident, less fixated on certain problems that worried me at that time.

As for psychoanalysis, I have only a brief experience of this procedure, which I interrupted after several sessions, and I still believe that I did the right thing. For all the fidelity of the theoretical basis of the method, to its practical results, I am extremely skeptical. First, it repels the duration and cost of the process. Secondly, the method is extremely subjective, very much depends on the personality of the psychoanalyst, his ability to correctly interpret the signs that your subconscious mind gives.

I also have strong doubts about the treatment of the depressive disorder itself by psychoanalytic methods. It seems to me that psychoanalysis can be effective in cases where the cause of neurotic disorder is reduced to some one suppressed root episode. This occurs in the pathogenesis of various phobias and obsessive-compulsive conditions. If the therapist manages to get to the displaced episode and help the patient to realize and relive it, then there is a recovery or a marked reduction in symptoms. To illustrate, we can consider the example given by Freud in lectures on the introduction to psychoanalysis, I will allow myself to give this passage as a whole:

“Nineteen-year-old blooming gifted girl, the only child of her parents, whom she surpasses in education and intellectual activity, was an unruly and playful child, and in recent years without apparent external causes has turned into a nervous. She is very irritable, especially against her mother, always unhappy, depressed, prone to indecision and doubt, and finally admits that she is not able to walk alone in the squares and large streets. We will not deal with her difficult painful condition, requiring at least two diagnoses, agoraphobia and neurosis of obsessive-compulsive conditions, but will focus only on the fact that this girl has also developed a ceremonial bedtime, from which she makes her parents suffer. We can say that in a sense, any normal person has his own ceremonial laying down to sleep or requires compliance with certain conditions, the failure of which prevents him from falling asleep; he clothed the transition from a state of wakefulness to sleep in certain forms, which he repeats in the same way every evening. But anything that requires a healthy sleep environment can be rationally understood, and if external circumstances cause the necessary changes, then it is easily obeyed. But the pathological ceremonial is uncompromising, it is able to achieve the price of the biggest victims, and it is in the same way covered by the rational justification and at superficial consideration it seems different from normal only by some exaggerated carefulness. But if you look closer, you can see that the veil of rationality is too short, that the ceremonial includes requirements that go far beyond rational justification, and others that directly contradict it. Our patient as a motive for their night precautions leads to the fact that she needs to sleep and it should eliminate all sources of noise. To this end, she acts in two ways: she stops the big clock in her room, all the other clocks are removed from the room, she does not tolerate even the presence of her tiny clock on the bracelet in the nightstand. Flower pots and vases are made on the Desk so that they could not fall at night, break and disturb her in her sleep. She knows that all these measures can only have a seeming justification for demanding peace, the ticking of a small clock can not be heard, even if they remained on the bedside table, and we all know from experience that the uniform ticking of a clock with a pendulum never interferes with sleep, but rather acts sleepy. She also recognizes that the fear that flower pots and vases left in their place at night can fall and break themselves is unlikely. For other requirements of the ceremony she no longer refers to the need of rest. Indeed, the requirement that the door between her room and her parents ‘ bedroom remain half-open, the fulfillment of which she achieves by inserting various objects into the half-open door, it seems, on the contrary, can become a source of disturbing noise. But the most important requirements apply to the bed itself. The pillow at the head of the bed should not touch the wooden headboard. A small pillow for the head can lie on a large pillow only as forming a rhombus; head then she puts exactly along the long diagonal of the rhombus. The feather bed (”Duchent”, as we say in Austria), before it can be covered, must be whipped so that its edge at the feet became quite thick, but then it will not miss the opportunity to smooth this accumulation of feathers again.

Let me go around the other, often very small details of this ceremony; they would not teach us anything new and would take us too far from our goals. Do not lose sight, however, that all this is not so smooth. At the same time, it does not leave the fear that not everything is done properly; everything must be checked, repeated, the doubt arises about one or the other precaution, and as a result, it takes about two hours, during which the girl herself can not sleep and does not allow frightened parents to sleep.

The analysis of these torments was not as simple as in the case of the obsessive action of our first patient. I had a girl to do suggestive hints and propose interpretations, which every time she was rejected with a resounding “no” or accepted with contemptuous doubt. But this first negative reaction was followed by a period when she herself was engaged in the possible interpretations proposed to her, selected the appropriate thoughts, reproduced memories, established connections, until, on the basis of her own work, she accepted all these interpretations. As it happened, it is also more inferior in the performance of the obsessive precautions and before the end of treatment declined from just ceremonial. You should also know that the analytical work, as we now do, directly excludes the sequential processing of a single symptom until its final clarification. Moreover, sometimes you have to constantly leave one topic in full confidence that you will return to it again in another connection. The interpretation of the symptom that I am about to tell you is thus a synthesis of results that, interrupted by other work, take weeks and months to produce.

Our patient is beginning to gradually realize that during her sleep preparations, she removed the clock as a symbol of the female genitals. Watches, which can be symbolically interpreted in a different way, acquire this genital role due to the periodicity of processes and the correct intervals. A woman can boast that her menstruation occurs with the correct clockwork. But especially our patient was afraid that the ticking of the clock would interfere with sleep. The ticking of the clock can be compared to the pulsation of the clitoris during sexual arousal. Because of this unpleasant feeling she really woke up repeatedly, and now this fear of erection was expressed in the requirement to remove from herself at night running hours. Flower pots and vases, like all vessels, are also female symbols. The precaution that they do not fall and not break, therefore, not devoid of meaning. We know a common custom to break a vessel or plate during the engagement. Each one present takes a shard that we should understand how the waiver of claims for the bride from the point of view of the marriage custom to monogamy. Regarding this part of the ceremony the girls got a memory and some thoughts. Once as a child, she fell with a glass or clay vessel, cut her fingers, and was bleeding heavily. When she grew up and learned the facts of sex life, she had a frightening thought that on the wedding night she would not bleed and she would not be a virgin. Her precaution against the fact that the vase did not break, means, thus, the denial of the entire complex, associated with virginity and bleeding at the first intercourse, as well as the denial of the fear of bleeding and opposite to him the fear of] not to have bleeding. To prevent the noise for which it took these measures, they had only a remote relationship.

The main meaning of her ceremony, she guessed one day, when she suddenly realized the order that the pillow did not touch the headboard. Pillow for her has always been a woman, she said, and the vertical wooden backrest – man. Thus she wanted – by magic, I might add – to share a man and a woman, i.e. to separate the parents to prevent them before the marital act. This same goal she tried to achieve before, until the introduction of ceremonial, more direct way. She feigned fear, or used existing tendency to fear in order not to give close the door between the bedroom and the nursery. This requirement still remains in her present ceremonial. Thus she created itself opportunity eavesdrop on for parents, but, using this opportunity, she once acquired insomnia, which lasted months. Not quite pleased with the opportunity to interfere with her parents in this way, she sometimes made sure that she slept in the marital bed between her father and mother. Then the “pillow” and”headboard” really couldn’t connect.”

From this example, it becomes clear that the success of the interpretation of painful symptoms in psychoanalysis is very dependent on the professionalism of the therapist, requires patient work and really helps in a number of disorders lead to recovery. The problem is that in the case of depression, it is rarely possible to identify any one episode from the patient’s past, which served as the direct cause of the disease. There are many such episodes, they are superimposed on each other, increase internal tension, until it finds a way out in the symptoms of the disease. Obviously, a lot of work needs to be done to identify and work out, one after another, each such traumatic event. And of course, psychodynamic therapy does not help the patient to solve his problems with real events occurring in the present.

Data on the effectiveness of psychoanalysis in depression are contradictory and, at least for me, unconvincing. Effective and reliable tools for detecting suppressed unconscious material in the Arsenal of psychoanalysts today I do not see. But they existed and were actively used in the 60s of the last century. Such tools were psychedelic drugs.

Antidepressants

Antidepressants

My first antidepressant was Prozac.

I do not know why I decided to appoint him to Cromwell Hospital. Once considered revolutionary, the drug is currently not the antidepressant of choice, there are significantly more effective analogues. In addition, in my case, I needed a drug of a completely different group. But first, let's talk a little bit about the history of antidepressants and their classification.

Nerve cells are connected to each other by means of special contacts, called synapses and consisting of the ends of the connected nerve processes, separated by synaptic or interneuronal gap. When a nerve impulse is transmitted from the end of one of the processes, neurotransmitters are released, which we have already mentioned above, and, migrating through the interneuronal gap, reach the receptor of the cell that perceives the impulse.

All antidepressants, regardless of the mechanism of action, have a therapeutic effect, increasing the concentration in the synaptic gap between the neurons of the brain of one or more neurotransmitters at once – serotonin, norepinephrine and dopamine.

The history of antidepressants, like many other drugs, began by accident, with the discovery in 1957 of antidepressant properties in a number of anti-TB drugs and the proposal to use these side effects in the treatment of patients with depression. The first such drug was iproniazid.

Iproniazid, as well as its analogues, refers to the so-called non-selective and irreversible inhibitors of monoamine oxidase (MAO), the enzyme responsible for the destruction of brain-secreted mediators. It is clear that when it is suppressed, the concentration of mediators increases, which leads to a positive therapeutic effect. Other drugs of this series include imipramine, isocarboxazid, nialamide, as well as derivatives of amphetamine – tranilcipromin, pargyline. A big disadvantage of MAO inhibitors is their toxicity and the need to follow a special diet during their use in order to avoid the development of “serotonin syndrome”, poisoning the body with an excess of serotonin.

In particular, while taking MAO inhibitors should avoid eating foods such as cheeses, smoked meats, marinades, bananas, sauerkraut, legumes, yeast extracts and brewer’s yeast, red wine, beer, chocolate, caffeine, dairy products. The fact that these products in the human body do some special amino acids: tyramine, its metabolic precursor Terezin and tryptophan. Tyramine, as well as serotonin, is cleaved by monoamine oxidase and has the ability to increase blood pressure; accordingly, its excessive accumulation can lead to the development of hypertensive crises. Tryptophan also serves as a source for the production of serotonin in the body.

Serotonin syndrome is a dangerous condition, manifested by agitation and confusion, trembling limbs, respiratory failure, fever. In severe cases, it can lead to the death of the patient. MAO inhibitors are also incompatible with a range of medications, such as psychostimulants, antidepressants of another chemical group, cough medicines containing sympathomimetics, and many others.

Work to eliminate these deficiencies of the first antidepressants led to the synthesis of selective Mao inhibitors, the next generation of agents that require less restrictions on their appointment. These include Moclobemide, Pirlindola (Pirazidol) Eprobemide and Metralindol. However, due to the current presence of antidepressants with fewer side effects, MAO inhibitors are now rarely used for special indications. In particular, they are well established in the treatment of atypical depression.

The next group of antidepressants on the market were tricyclic antidepressants. They had less side effects and did not require a special diet. Tricycles are also compatible with a large number of other drugs. These include amitriptyline, nortriptyline, imipramine, anafranil, trimipramine and others.

Part of the tricyclic antidepressants, along with the actual antidepressant, also has an anti-anxiety and sedative effect, this group includes, for example, amitriptyline and trimipramine. In the action of others, such as imipramine and nortriptyline, expressed, on the contrary, the stimulating effect.

In General, tricyclic antidepressants are quite effective drugs for the treatment of depression, they affect the exchange of several mediators and are characterized by a relatively fast time of therapeutic effect, compared with drugs of other groups. Their great disadvantage is the indiscriminate effects and the presence of serious side effects – lethargy, drowsiness, dry mouth, constipation, inhibition of libido and erection.

Selective serotonin reuptake inhibitors (SSRIs) became the latest class of antidepressants, which gained huge popularity due to the selectivity of action and the presence of fewer side effects. As the name implies, the drugs of this series inhibit the reuptake of nerve endings already isolated in the intersynaptic gap of serotonin, which leads to an increase in its concentration and enhance its inherent effects. The first drug of this series was the famous Prozac. With his appearance, many predicted the beginning of a revolution in the treatment of depression, the final solution to the problem. This of course did not happen. SSRIs are really convenient to use and less poison the patient’s life with side effects, but the price for this is their lower efficiency, compared to tricyclics and MAO inhibitors.

In addition to Prozac (fluoxetine), this group includes sertraline (zoloft), paroxetine (paxil), fluvoxamine (Luvox), estsitalopram (Cipralex), citalopram (CELEX). Despite the lower frequency and severity of side effects, SSRIs are all the same from them is not free. The most common are insomnia or, conversely, drowsiness, headache, tremor, fatigue, sweating, nausea, libido and potency disorders, ejaculation delay.

Subsequently, selective drugs with the same mechanism of action as SSRIs acting on the exchange of other neurotransmitters were synthesized:

Selective norepinephrine reuptake inhibitors (SSRIS))

Reboxetine (Edronax), Atomoxetine (Straterra) are usually well tolerated and have a pronounced activity in melancholic depression.

Selective inhibitors of reverse takeover serotonin and noradrenalina (Sossin)

Venlafaxine (Effexor), DULOXETINE (Cymbalta), Milnacipran (Ixelles)

Modern antidepressants with small side effects, are more effective than SSRIs and SSRI, are approaching in this respect to tricyclic antidepressants. Proved to be effective in the treatment of severe depression.

Selective reuptake inhibitors of norepinephrine and dopamine (Cesnid)

Bupropion (Wellbutrin, Zyban)

A very interesting drug, has a pronounced energizing and stimulating effect, some researchers even treated previously to psychostimulants. It is effective in melancholic depression, has a disinhibiting effect on the libido, which distinguishes it from most other antidepressants that have the opposite effect. An interesting feature of Bupropion is to reduce the thrust to the use of nicotine, for use for this purpose it is produced under the commercial name “Zyban“.

Noradrenergic and specific serotonergic antidepressants (Nassa)

Mianserin (Lerivon, Bonseron) and Mirtazapine (Remeron)

Drugs in this group affect the metabolism of norepinephrine and serotonin, it is blocking the serotonin receptors responsible for the side effects at prima SSRIs, such as nausea, decreased libido, nervousness, insomnia. However, they have a pronounced sedative effect and contribute to weight gain, through the effect on insulin metabolism, increased appetite and water retention in the body.

Specific serotonergic antidepressants (SSA)

For drugs in this group include Trazodone (Desyrel, Trittico) and its newer derivative of Nefazodone (Serzon).

SSA, as well as Nyssa, block the “bad” receptors of serotonin and do not cause some side effects inherent in the classic SSRI. Trazodon, for example, has a stimulating effect on potency in men and can even lead to the development of priapism, painful long-term erection, requiring, approximately in every third case, surgery.

Nefazodon has a strong hepatotoxicity, which limits its use, it is currently banned for sale in the United States.

In General, there are several common stereotypes about antidepressants. Some patients believe that taking psychotropic drugs or even a consultation with a psychiatrist are equal to recognizing themselves as crazy and continue to endure their suffering, hoping that everything will resolve itself. This is self-deception, and self-deception is very dangerous. In any case, it is impossible to allow the chronification of the process, the earlier adequate treatment is prescribed, the more likely the positive outcome of the disease. It should be understood that depression is the same disease as hypertension or gastric ulcer, and requires appropriate therapy, the disease can not be anything shameful.

Another common opinion is the hypertrophied danger of taking antidepressants, an exaggeration of the degree of harm they cause to the body. Many people think that a serious dependence develops to antidepressants, almost as to drugs, and, having hooked on them once, it will be almost impossible to get off. This is certainly not the case. Antidepressants are designed for long-term use, and most of them do not cause any undesirable effects after completion of treatment and discontinuation of their use. There are some exceptions to this rule, which I will discuss later in this Chapter.

There are also concerns, mainly from creative professionals, about the possible negative impact of psychotropic drugs on creativity. What can we say about this? Yes, a number of drugs (not all!) has a sedative effect and enhances the braking processes in the brain. But if you suffer from depression, your creativity will be weakened in any case, and it is in your best interest to get out of this state as soon as possible. Antidepressants, with all their shortcomings, make it possible to bring your mind in order in the shortest possible time, compared to other treatments. In addition, the positive effect of their reception in most cases overlaps the negative and creative abilities can even improve on the background of taking drugs, compared with the same abilities in the absence of adequate treatment.

A big disadvantage of almost all antidepressants is the slowness of the effect, in most cases it takes at least 2-4 weeks to start the actual antidepressant action. Anti-anxiety or, on the contrary, a stimulating effect, may develop earlier. This feature causes certain difficulties in the selection of the drug for the treatment of a particular patient.

First of all, the doctor should evaluate the type of depressive disorder and prescribe an antidepressant to the patient, which has the necessary characteristics to combat this type of disease. For example, in case of anxiety depression should choose a drug with a sedative component of the impact, with inhibited, on the contrary, with stimulating.

Specific drugs are selected depending on the degree of disease. With mild depression, it is even possible to dispense with the appointment of herbal preparations based on St. John’s wort, which have moderate antidepressant activity.

St. John’s wort has practically no side effects, except for the phenomena of photosensitization, increasing the sensitivity of the skin to ultraviolet radiation: during its reception, it is contraindicated to sunbathe and visit the Solarium.

At an average, and in some cases of mild depression the drugs of choice are inhibitors of reuptake neurotransmitters, the SSRI, NARI, Sossin, Sioned. In severe depression, large doses of tricyclic antidepressants are prescribed, combined with drugs of another group. MAO inhibitors have proven themselves in the treatment of atypical depression, in which the symptoms of classical depressive disease are not expressed, vegetative disorders, anxiety prevail, the reverse cycle of daily mood fluctuations is characteristic, in the morning the emotional state is better than in the evening.

Two important factors should be taken into account when assessing the effectiveness of antidepressant action on a particular patient. It’s time and dosage. To develop the effect, it is necessary to give the drug a time of at least a month, after which, depending on the results, you can adjust the dosage upward or downward. If the result is unsatisfactory and after adjustments, which may be several, the doctor should either change the drug, or Supplement its effect with the appointment of another antidepressant.

It is clear that the selection of the drug occurs by trial and error, it may take many months before it is possible to determine the optimal scheme of drug treatment. The General rule of drug therapy for depression is to achieve the disappearance of all its symptoms, after which treatment continues for at least six months, after which a gradual decrease in dosage begins, until the complete abolition of the antidepressants used.

Unfortunately, this tactic is not always effective. Antidepressants do not treat the cause of depression, they only remove its symptoms, and if during treatment nothing has changed in the patient’s life, the traumatic factors have not gone or have not been worked out, the likelihood of relapse is very high.

It is important to keep in mind that antidepressants are incompatible with alcohol. First, there may be a cumulative sedative effect from the simultaneous intake of alcohol and a number of antidepressants used to treat anxiety depression. Can develop serious poisoning of the body, up to the suppression of the respiratory center and death. Secondly, alcohol further enhances the processes of inhibition in the brain of patients with melancholic depression. And thirdly, the interaction of alcohol and a number of psychotropic drugs has not yet been fully studied and the neurotoxic effect on the brain tissue of their metabolic products is not excluded.

As I said above, most antidepressants are not addictive and addictive. Antidepressants are designed for long-term, in some cases even life-long use. Very many of them do not cause any withdrawal syndrome. But for some drugs, there are certain difficulties associated with discontinuation of their use. Of those antidepressants that I have taken, these include Paxil and Effexor (Venlaflaxine).

The paxil by itself, the drug is very effective. It belongs to the SSRI, inhibits the reuptake of serotonin in the synaptic cleft and is in this respect stronger than Prozac and Zoloft. An additional advantage of Paxil is its positive effect on the treatment of social phobia, patients become more sociable, social activities frighten them to a lesser extent. At the same time, Paxil has a short half-life from the body, and therefore the risk of withdrawal syndrome at the termination of its reception is quite high.

I took paxil for about two months and was dissatisfied with its effect, but trying to switch to another drug, experienced serious unpleasant effects, the mood has deteriorated, increased the frequency of panic attacks, I almost could not normally perform their social functions. I had to go back to him, given the fact that the second time to remove the drug is already under the supervision of a doctor and with great caution.

The effector did not come to me from the first days, I had difficulty sleeping, severe dizziness and stopped taking it less than a week after the start of the course. Personally, I didn’t have withdrawal syndrome, but I’ve met a few reviews online from people who have taken it significantly longer than I have, and for whom the rejection of the Effector has become a big problem.

Below I will briefly describe my experience of taking other antidepressants.

As I said, Prozac was my first psychotropic drug. I knew that the action of SSRIs, to which he belongs, develops slowly, but nevertheless laid great hopes on him, believing that bringing back to normal the disturbed balance of serotonin will eliminate all manifestations of my disease.

Prozac was released on the pharmacological market in the mid-80s of the last century and quickly gained immense popularity, becoming a cultural phenomenon, imprinted in several popular works of literature. With the advent of great hopes were linked, there were concerns about the decline of psychoanalysis, the uselessness of all the others that existed on the day of antidepressant drugs. Minimal, compared with MAO inhibitors and tricyclics, the number of side effects allowed to take it daily, without making significant changes in your lifestyle, a kind of lifestyle drug.

But it turned out that for better portability you have to pay less efficiency. I took Prozac for three months, initially 20 mg in the morning, then this dose was doubled. It was the most useless antidepressant I’ve ever been prescribed. It did not have any positive effect on me, these three months I add to the previous six, conducted without receiving adequate therapy.

As a result, I changed not only the antidepressant, but also the attending physician. The next in the list of my drugs was zoloft, the same SSRI, but more modern and considered more effective. I took it for a few months, and it had some antidepressant effects. Do zoloft stronger than Prozac, but the normalization of the exchange of serotonin for me was not enough, and I switched to Remeron.

The advantage of this drug is the effect on the metabolism of not only serotonin, but norepinephrine. Don’t know why, but it was in my case practically useless. In addition to some anti-anxiety action, I did not feel anything and two months later was transferred to the drug from the same group Lerivon (Mianserin).

Lerivon has a strong sedative effect, he removed the alarm, but with it eliminated any desire for any activity during the day. I had a feeling that I was wearing a helmet on my head, which protected my mind from any influence of the outside world, both negative and positive. On Lerivone I first felt a good antidepressant effect, in General, the drug for me was quite effective, and I took it for about six months. Its huge drawback is the water retention in the body and increased appetite, leading to rapid weight gain. For the first three months I added 10 kg, instead of 75 kg I began to weigh 85 kg. Before the therapy I did not think it was a big problem, but very quickly I realized that this weight strongly poisons my life. Dissatisfaction with my appearance and physical discomfort did not contribute to the improvement of my emotional state. In addition, the complete reduction of symptoms has not occurred, despite the constant increase in dosage.

As a result, I decided to turn to tricyclic antidepressants and started taking amitrip-Tylin. This is a very effective drug. With the right dosage, it can really eliminate all the symptoms of depression. In my case, this happened at 150 mg per day, which is not a very large, average dose. Amitriptyline affects the exchange of all three major mediators and has a pronounced sedative effect, in some sources indicate its stimulating, at a certain dosage, the effect, I did not notice.

Together with depression, amitriptyline cuts off all the emotions from a person, most of the day I was half asleep, slept for 10-12 hours a day. About any pleasure from life of the speech and could not be, I turned into the robot which did not test not only sufferings, but also in General more than anything. Besides, I have developed a normal weight for tricyclics, the side effects: constant thirst and dry mouth, severe urinary retention, confusion in thought and action, slow speech, almost totally killed libido and potency. The most unpleasant was the feeling of dullness, each thought had to be formulated with difficulty, suddenly the vocabulary became poor, writing a short e-mail became a big problem for me.

With all this, depression and anxiety was not, objectively, I no longer felt related to them of torment, the life of the vegetable was preferable to constant fear and depression. This went on for another 8 months, in full compliance with the existing medical doctrine, my doctor (the third in a row) and I achieved a complete reduction of symptoms in two months and waited another six months before the start of the dosage reduction.

With a decrease in the amount of amitriptyline taken, the symptoms began to return strictly in the same order in which they disappeared. I wasn’t just disappointed. I realized that drug treatment in my sense is simply meaningless without addressing the real causes of depression, which I still had a long time to understand. But this was still far away, and I had to think what to do next. I did not want to return to the previous dose of amitriptyline and drag out my former existence. All this time I was supported by the hope for a cure, the fact that in six months or a year everything will end and I have to endure this time, only temporarily live the life of a vegetable. The prospect of a permanent existence in this mode did not suit me.

I changed another psychiatrist. In fact, such throwing does not make much sense, in drug therapy of depression there is a certain pattern, which is followed by more or less versed in the subject of doctors. I see my behavior as another manifestation of illness, a break from reality, in the hope of finding a miraculous deliverance.

In this state, I began to combine drugs. Having reduced the dose of amitriptyline twice to feel something, I consistently added fluvoxamine, zoloft, paxil to it, without achieving a satisfactory result.

So here is a blind I picked up for myself an effective drug. They found Trazodone (Desyrel). These days, this antidepressant is not very popular, preference is usually given to serotonin drugs like Zoloft and Paxil, but I suddenly went very well. Expressed antidepressant effect I felt a few days after starting, which is unusual for most of these drugs. It was combined with a good anti-anxiety effect, due to the sedative nature of trazodone, but softer, not causing total dullness, as in the case of amitriptyline. Another advantage of trazodone was its positive effect on sexual function, as I wrote above, because of this effect, it is sometimes prescribed as an auxiliary drug for the treatment of erectile dysfunction, including that caused by taking other antidepressants.

In this combination, Amitriptyline + Trazodon, I lasted quite a long time. There was some compromise between depression and emotional stupidity, I was somewhere in the border area, not falling in any direction. Health is of course the name was not, moreover, such a therapeutic approach is wrong, because of incomplete reduction of the symptoms of depression leads to its stable of chronification. But what was I supposed to do?

The last time you start taking the drug in my case was Wellbutrin. Unfortunately, today it is not officially delivered to Russia and can be purchased only on Western websites. The drug is very interesting, and we can only regret that it is not available to most Russian patients. Its peculiarity is the effect on the exchange of dopamine and norepinephrine, as a result of Wellbutrin has a stimulating effect and is effective in the treatment of anhedonia, the inability to enjoy life. This is manifested in the disinhibiting effect on the libido, and in the General increase in human sensuality.

Wellbutrin suited me, I took the usual therapeutic dose, 150 mg every morning, combining it with trazodone and amitriptyline. The dosage of the latter varied depending on the effectiveness of other methods used by me at different times to combat the disease. For this cocktail I continued to hold on to the last two years. Manifestations of depression at the same time significantly reduced, but still not completely disappeared. I did not experience more panic attacks due to the sedative effect of trazodone and amitriptyline and could remain relatively active due to the stimulating effect of Wellbutrin. Actually tonight I took sadatoki to sleep, and stimulants to Wake up.

This regime is by no means universal, and the selection of antidepressants should be made individually in each case. But I hope that the information in this Chapter has given you some insight into the mechanism of action of various drugs and can help you in finding, together with your doctor, a suitable antidepressant or a combination of them.

Can antidepressants cure depression? In some cases. If the depressive episode occurred for the first time, was diagnosed in time and has not yet had time to be chronicled, if the correct treatment is prescribed from the beginning of the disease, and the traumatic situation was resolved during the course of therapy, then Yes, there is a chance that only drug therapy can defeat depression.

Unfortunately, this is not always the case. In most cases, antidepressants allow the patient to gain time, give a break, during which it is necessary, using psychotherapy and other methods, to cope with the cause of the disease, to deal with their own mental blocks and change the attitude to the traumatic situation.

To do this, it is important to undergo courses of psychotherapy.

Do you have depression?

Do you have depression?

Many people think that depression is a bad mood. This view is certainly wrong, if you are a living person, then you have inevitable periods of emotional decline and recovery. Depression begins when you lose the ability to cope with such downturns. If a healthy person is yelled at by the boss, his mood will certainly deteriorate, this is completely normal. Such a person will stay in a bad mood for some time, but then inevitably he will be distracted, will work this negative on an unconscious level and will live on. There may be situations when the" precipitate " will still remain for a long time (how to deal with this, I'll tell you below), but nevertheless this episode will not poison the rest of a healthy person's life.

When depression is different. The most common signs of its presence are causeless bad mood, loss of the ability to enjoy life and increased fatigue for at least two weeks. Under the wanton here refers to the lack of daily traumatisierung factor causing an emotional depression. It doesn’t mean that if you’re rude on the bus, you have a reason to fall into melancholy for the next two weeks.

It should also be borne in mind that depression can be masked, that is not manifested through bad mood, and any somatic factors, disorders at the level of organs and systems of the body. Such depression is also unpleasant because it is poorly diagnosed. This is exactly what happened in my case, six months I was treated for anything, but not for depression. During these six months, I managed to undergo treatment for thyroid insufficiency, gastroesophageal (gastro-esophageal) reflux, gastric erosion, irritable bowel syndrome, chronic myocarditis, giardium and a number of other diseases.

Fortunately, there are quite objective methods for diagnosing depression. To assess the presence and severity of the disease, specialists use several scales, such as the Hamilton, Beck or Gotland scale. All of them are a set of questions, for each of which there are several possible answers, estimated by a different number of points. It is believed that the assessment should be made by a psychiatrist, and this is correct. It is always easier for a specialist to objectively assess the accuracy of your answers, clarify unclear points, ask leading questions.

At the same time, if you suspect that you have a depressive disorder and think that you are able to answer the questions as honestly as possible, it makes sense to test yourself before you run headlong to a psychiatrist. A negative answer may not always be correct in the case of self-test, but a positive is a sufficient reason for a visit to a specialist.

For independent work more than others suitable scale Zang.

Zang scale for self-assessment of depression (ZDRS)

Zang scale for self-assessment of depression (The Zung self-rating depression scale) was first published in the UK and subsequently received international recognition. It is developed on the basis of diagnostic criteria of depression and the results of a survey of patients with this disorder. Assessment of the severity of depression on it is based on the patient’s self-assessment. The scale contains 20 questions, each of which gives an answer to the frequency of occurrence of a particular feature, ranked in four gradations: “rare”, “sometimes”, “often” and “most of the time or constantly.”

Method of application: before starting the procedure, the subject should be acquainted with the method of working with the scale. The scale is filled in by the subject, and the specialist does not take part in its filling. The time required to fill in takes a few minutes.

The total score is determined by the results of the answers to all 20 points.

How it all began

Analyzing now my past, trying to find the causes of depression, I understand that there is no one traumatic situation that led to the development of the disease. Undoubtedly, my childhood experiences played a huge role. I was quite a weak physically and sickly child, and although I’m still not fully aware of everything that scared and traumatized me in the deep past, the intensive therapy I went through at Dr. Janov Center in Los Angeles and months of practice of my method convinced me that the roots of the problem grow from childhood.

At the same time, in full accordance with the causes of depression, set out in one of the previous chapters, in my mind there were a lot of quite conscious traumatic episodes from the less distant past and even the present. All this tension grew like a snowball and did not find a way out, in the end the psyche had to not withstand such pressure and break. That is what happened in August 2002.

At that time, I only suffered from the flu and was still in the recovery period, was weakened physically, residual effects continued to manifest themselves. It so happened that in the same period I was under the influence of chronic stress associated with problems at work and difficult relationships with his girlfriend. Problems have not been resolved for several months, and if the complexity of the working order, I objectively could not have any significant impact, the solution to the problems in my personal life was not due to the blocks, beliefs, blinkers, if you like, that existed in my mind at that time. All this mental stuff accumulated for decades and did not allow me to breathe calmly and carefully analyze the emerging life situations.

One fine morning I woke up and was surprised to find that my heart was beating faster than usual, without any physical or intellectual stress. Without paying special attention to it, I went to work, by the end of the working day to heartbeat the expressed shortness of breath was added. This went on for a few days, but I was really worried when I started daily bursts and drops in body temperature, with nothing obvious associated and not following any sustainable pattern.

My medical education played a cruel joke on me. The emotional sphere at that time had not yet been touched, and I was looking for the cause of ill health in anything but a depressive disorder. By the third week, my condition began to bother me seriously, I developed severe asthenia, I was tired very quickly and could not concentrate on doing any, even the most simple work.

The trip to the therapist and the General examination revealed no abnormalities, except for palpitations. There was a suspicion of myocarditis, which was rejected after a special instrumental examination. The next stage was the elimination of hormonal disorders, a detailed analysis revealed a slightly reduced level of thyroid hormones, and the next stage of my epic began.

On the recommendation of an endocrinologist, I started taking thyroxine, the main product of the thyroid gland, with regular blood tests and monitoring of hormone levels. I must say that the process is not fast and we spent another month to fix the minimum violation that was found in me. Needless to say, it did not produce any results.

Since I did not receive adequate treatment, my condition continued to deteriorate, and now he added disorders of the digestive system. The first was a stable heartburn, after taking almost any food, it quickly led to the development of pain in the stomach and the emergence of erosion of the gastric wall. In addition to thyroid hormones, I started taking drugs to reduce the acidity of gastric juice and was treated with antibiotics for the eradication of Helicobacter pilory, a bacterium that causes stomach ulcers.

As soon as I heal one manifestation of the disease, as she found a way out in something else, now I had to deal with gastroesophageal reflux, an extremely unpleasant disease, manifested by the casting of undigested food and gastric juice from the stomach into the esophagus. Another series of examinations, unsuccessful drug therapy and the proposed surgery aimed at narrowing the diameter of the gastro-esophageal valve. All this against the background of continuous deterioration of the General state of health.

I understood that the operation would not solve anything and would not save me from suffering. It was necessary to find the root cause of the disease, and I went to London, for examination in Cromwell Hospital, one of the best private hospitals in the UK. By this time, I looked so depressed that, to the credit of my therapist, he didn’t have to exhaust me with numerous and unnecessary tests. First of all, looking at my hormonal tests and conducting an external examination, he immediately said that my thyroid is all right, and advised me to immediately throw out all my pills for hypothyroidism.

Then, after asking me in detail about the symptoms of the disease and the effect of the treatment (or rather, its absence), he was the first to utter the fatal word: “Depression”. In other circumstances, I would have been extremely upset by such a diagnosis, but by that time I was so exhausted that I was even glad to see him. Anything to get some certainty and the right treatment. I had no idea what was ahead of me. I was sick by this time for about six months.

Causes of depression

Causes of depression

Without going into details, interesting only to specialists, all causes of depression can be divided into two groups: reactive and endogenous. I must say that this is a very simplified classification, which can be supplemented by depression of the elderly, alcohol and drug depression and some others. But nevertheless, basically it is true and for the purposes of our discussion is sufficient.

Reactive depressions are caused by some external traumatic situation, such as the death of a loved one, loss of a workplace, parting with a loved one(s). Endogenous depressions are based on genetic predisposition and are caused by metabolic disorders of special substances of the brain-neurotransmitters. Neurotransmitters are responsible for the transmission of nerve impulses, for the correct formation and coordinated work of the processes of inhibition and excitation in the brain.

In fact, both of these reasons are interrelated, it is obvious that different people can react differently to the same traumatic situation. A person with initially low levels of neurotransmitters is more likely to get depression than a more fortunate individual. At the same time, if you create a hypothetical situation with the absence of all external traumatic stimuli, there is a high probability that a person even with a very burdened heredity will never know what depression is.

So, regardless of the cause that caused the depression, its biochemical basis is a violation of the exchange of brain mediators, namely serotonin, norepinephrine and dopamine.

Why is it important to know?

Because the drug therapy of depression is based on the alignment of this imbalance, and it should be understood exactly how the lack of a mediator to choose the right drug for treatment. It is quite rare to find a disease in which the exchange of all three mediators is disturbed equally, as there is no ideal antidepressant, equally affecting the exchange of all these conductors of the nerve impulse.

With a lack of serotonin, anxiety depression can develop, in which a low mood is mixed with causeless anxiety, anxiety for insignificant reasons. A deficit of norepinephrine manifests itself by lack of energy, lack of energy, fatigue, and dopamine is responsible for a person receiving pleasure from something, and, accordingly, in violation of his exchange occurs hedonia (loss of sense of pleasure), the food seems tasteless, unfunny jokes, uninteresting reading.

What kind of drugs affect the balance of these neurotransmitters, will be described in the Chapter Antidepressants, now it is enough to just remember this information and listen to your feelings, try to understand what symptoms you have expressed to a greater extent.

It is also important to understand the following. External causes of depression do not always lie on the surface, can not always be realized by man. In this respect, the sometimes used term “causeless depression” is not quite correct, it would be more correct to say”depression, the causes of which are not understood”. In practice, this means the existence of mental material, forced into the subconscious of a person, traumatic situation from the distant past, perhaps from early childhood. The psyche of a person at this age is not completely formed and sufficiently stable, that an adult is a trifle, for a child can have the scale of a universal catastrophe. The child is simply unable to exist in the presence of such a situation, and then the protective mechanism of the psyche triggers, causing displacement and external forgetting of the traumatic episode.

I deliberately write “external”, because in fact the situation has not gone away, it has remained unresolved, suppressed psychic energy continues to exist in the subconscious and bombard from there the psyche of an adult, to influence his actions, beliefs, perception of certain life situations.

To understand this, it is easiest to imagine a psychoanalytic model of the human psyche, consisting of three parts: consciousness, the pre-conscious and the unconscious. Consciousness is a set of thoughts, feelings, experiences of a person that are in his perception here and now. The area of the pre-conscious is the experience, which, although not realized at this moment, but can recover, go into consciousness either spontaneously or under the influence of external influence. The unconscious is a receptacle of instincts that exist on the principle of pleasure and are a source of mental strength and energy of man. Such a division of the psyche is not present in the child initially, and appears as his socialization, education, training standards of behavior adopted in society.

That is, the child is explained that some of his desires are unacceptable and even shameful, as a result, over time, he develops an internal censor, a kind of conscience that monitors the prevention and rejection of such aspirations. But the instinctive impulses are very strong, and so easy to give them up does not work, as a result in the human psyche is a constant struggle between the requirements of society and their own desires. Every mental act and human act, according to Freud, is the result of this struggle.

Such a struggle can wear down the psyche, and to deprive people of the opportunity to exist in society, to prevent this mentality produced a number of protective mechanisms to protect the mind from the ravages of primitive impulses. These include suppression, rejection, displacement, sublimation, projection, rationalization. The presence of these protective mechanisms ensures the preservation of the psyche in a stable state, maintaining the integrity and identity of the individual, in a constant conflict of psychological attitudes.

We are interested in the mechanism of suppression in this case. He is in enforced exile from consciousness of disturbing a person’s memories, causing anxiety, fear, tension. This memory is sent to the storeroom of the unconscious and ideally, if it is not very emotionally charged, should no longer cause a person significant anxiety, finding a way out through any harmless habits, patterns of behavior, mental attitudes.

But in some cases, the traumatic situation has such a strong emotional impact on the child that it continues to manifest itself in the form of externally unmotivated anxiety and sadness. It is in such cases that the patient cannot identify the source of his suffering and speaks of “causeless” depression.

But there is another situation. The cause of depression seems to lie on the surface and is associated with some specific episode from the recent past or present. Over time, the traumatic situation is resolved, it would seem, with it should go away and depression, but very often this does not happen.

The reason is that the realized situation from the present serves as a kind of associative trigger and touches the spiritual strings associated with a similar past negative experience, forced into the unconscious. For example, having received at work a scolding from the chief, a person suffers not only from this fact, but also from the painful unconscious anguish, which can be caused by a simple resemblance of the color of the tie of the head and the father of the patient, who hit him in childhood for some fault.

As a result, a person can change his place of work, completely change his current circumstances, but he does not get better. This small conflict episode served only as a push, the trigger which lifted the muddy Deposit from the bottom of his unconscious. Over time, perhaps, this precipitate will calm down, but with a high degree of probability it is possible to predict the repetition of a depressive episode, if a person once again finds himself in a similar situation in the future. And now imagine how much repressed pain we have accumulated in our entire lives, and you will realize that in fact we all walk on a minefield, risking their daily peace of mind.

How to deal with this? There are several fundamental approaches: you can suppress the painful memories of taking psychotropic drugs, cutting off part of yourself and continuing to pressurize the boiling pot of your unconscious, you can work out your current problems with a psychotherapist and learn to live with these problems, and you can try to throw out the accumulated pain and find true liberation, and with it the integrity of your personality.

Needless to say, the latter is the only way.

What is mental health

What is mental health

How many times have you dreamed about going back to your "pre-depressive" emotional state? Return not at the cost of daily intake of a handful of pills, constant drowsiness, the feeling of a metal helmet, worn on the head, killed at the root of sexual desire, but really, so that without the help of medicines you can laugh when watching comedies, do not poison the life of others with your downcast, perform elementary work for an hour, not for a week. But if you think that's mental health, you're wrong.

Of course, against the background of your current state and what was before the depression, it seems a pipe dream and something completely unattainable, but remember, before the illness, you did not have to experience unmotivated anxiety, emotionally react to some little things and then regret your behavior, be afraid of public speaking and avoid noisy parties? Depression is a very unpleasant disease, but it gives you a chance to reconsider your life, beliefs and values, to uproot the emotional anchors that have settled somewhere very deep in the subconscious, to remove the blocks and restrictions imposed by someone, to get rid of bodily and mental clamps, to regain the ability to feel as you felt in childhood, when the colors were brighter, and the food tastier, and each new day brought a lot of new positive impressions.

Don’t stop at what doctors call “remission,” don’t agree to spend the rest of your life on a “maintenance dose” of antidepressants, it’s not real life, you have the right to demand more.

So what is mental health?

I would like to remind you once again that I do not pretend to be scientific and admit that my vision of some aspects of the problem may differ from the currently accepted medical paradigm. But I have a moral right to my point of view, after all, all these volumes of medical research, mountains of pills, and dozens of hours spent in the therapist's chair didn't give me the result I was able to come to on my own.

Antidepressants and psychotherapy were able to bring me to a relatively stable state, that is, I could go to work, with some very small degree of efficiency to perform their duties, to maintain some minimum necessary social relations with friends and colleagues. At the maximum for me therapeutic dosage of drugs I had panic attacks, which was already a great relief, increased mood, passed insomnia. But at what cost!

I wanted to sleep all day, about any productive work and the speech couldn’t be, I added 10 kilograms in weight, ceased to go in for sports, didn’t test any sexual attraction. For a long time I was sure that I was doomed to such existence until the end of my days, and internally already reconciled with it.

After I started meditative practices, which I will write about in detail below, my optimism increased, I was able to reduce the dose of antidepressants twice the maximum level, at some point I even completely refused to take them. But, unfortunately, this state lasted only a couple of months, the first stress at work drove me back into a deep depression.

But even at the peak of my emotional recovery, I realized that it was difficult to call it recovery. My mood was extremely volatile, I overreacted to the slightest stressful situation, slept badly.

And only now I understand what real emotional health is. This does not mean a constant good mood and the absence of any anxiety and excitement. This condition also refers to the pathological in psychiatry called “germanically”. You may have met such people in your life, I knew two of them, and both of them were scientists for some reason. They could talk and work for hours, almost days, never tired and never listened to anyone, always stayed in some elated euphoric state. At the same time, the lives of others they turned into hell, to communicate, and even more so to live with such people is absolutely unbearable, and they themselves are rarely happy and successful. I don’t think that’s something to aspire to.

By mental health, I mean something completely different. A person is healthy, if in the absence of any external influence his emotional state is stable, he feels balanced, with a slight deviation towards the positive, he is calm, but energetic and collected, able to concentrate on the task and at the same time get satisfaction from his work.

A person should get satisfaction from the process itself, whatever he was doing, to regain the taste of life, the ability to feel, to feel the world as it was possible in childhood. We all understand that the children’s brightness and freshness of sensations lost, and put up with it. But it shouldn’t be like this. To correct this state of Affairs, we first need to understand why this is happening, to discover the causes of this phenomenon of loss of a part of ourselves. About them we will talk in the next Chapter.

For whom this book is written

How to break out of a black hole Part 2

First, some statistics:

The world health organization (who) compares depression with an epidemic that has engulfed all of humanity: depression has already come to the first place in the world among the causes of absenteeism, the second – among the diseases that lead to disability.

Every year about 150 million people in the world lose their ability to work due to depression. Only the us economy, it causes annual damage of more than 50 billion dollars. This amount includes the cost of 290 million lost working days, psychotherapy and disability.

According to who forecasts, by 2020 depression will come out on the first place in the world among all diseases, having overtaken today’s leaders – infectious and cardiovascular diseases. Already today it is the most common disease that affects women.

According to studies conducted in the United States, people prone to depression are twice as likely to die from other diseases.

50 % of those suffering from depression do not seek medical care, and of the remaining only 25-30% get an appointment with a psychiatrist.

Unipolar depression is the leading cause of disability in the United States among children over 5 years.

Special studies have shown that 60 % of patients applying to clinics, detect depressive disorders of varying severity. Meanwhile, as a result of diagnosis by traditional medical methods, which are used in clinics, depression is determined only in 5% of all patients applying there depressive.

Depression is diagnosed in 22-33 % of hospitalized patients, 38 % of cancer patients, 47% of stroke patients, 45 % – myocardial infarction, 39 % – parkinsonism.

Not so long ago, the peak of depression was between the ages of 30 and 40 years, but today depression is sharply “younger”, and it often affects people under 25 years. Among those who were born before 1940, the number of people with depression before the age of 25 is 2.5%. Among those born in 1940-1959, this figure is already 10%. There is no accurate data for later years, but this trend continues to grow.

From 45 to 60% of all suicides on the planet are committed by patients with depression. According to forecasts, in 2020, depression will be the killer number 1.

A depressed person is 35 times more likely to commit suicide than someone outside of it. 50 % of people with endogenous depression and 20% with psychogenic commit suicide attempt. Every sixth it is possible.

The annual catalogue of new antidepressants reaches a thickness of 3 cm.

With a single episode of depression, the probability of relapse is 50 %, with the second – 70 %, with the third – already 90 %.

With depressive disorder, at least one of the spouses divorces occur 10 times more often than in ordinary families.

This book does not claim the status of scientific research, I will not describe in detail the causes and biochemical reactions behind the development of depression, complex mechanisms of action of psychotropic drugs used for its treatment. This is a look at depression from the inside, an attempt to tell about what a person feels, being in such a state, and, most importantly, that you can get out of depression, I did it, and therefore, you should get it.

This is not an easy way, there is no universal method or pill, drinking which could regain mental health. But, if you are among the people described by the soulless statistics in the above quote, the fight against depression should be your most important task, the meaning of life here and now, a goal without which you can hardly expect to achieve all the others.

Believe me, I know what I’m writing. I studied medicine for seven years at the Institute and had to spend another six years studying the problem of depression and methods of its treatment. You will not read this information in medical textbooks and drug instructions, your doctor will not tell you about it either. I am not bound by any shop obligations and am not going to defend my point of view before the ossified medical establishment. I recognize only one criterion-the result and ready for this criterion to withstand any tests and checks. Everything that is written here, I tried on myself, except psychedelics and electroshock, the first – in view of their illegality and absence of the psychotherapists having experience with them, the electric shock simply wasn’t necessary to me, I managed to jump off the train before arrival to this station.

Most of the therapeutic methods used for the treatment of depression, has a varying degree of effectiveness, and to achieve the optimal result requires a combination of them. Any psychiatrist will tell you that taking antidepressants should be combined with psychotherapy sessions. Unfortunately, this knowledge and recommendations of most specialists and limited. Rarely any psychiatrist will advise you to engage in meditation or gymnastics qigong. Even fewer specialists are familiar with the techniques of neurolinguistic programming, and almost no one in Russia knows about the primary therapy of Dr. Arthur Yanov.

There is no need to be afraid of the number of practices offered by me, there is no point in practicing them all. Some of them are described in order to avoid them and not to repeat my mistakes. The basis of my technique is the Primary therapy (primal therapy), developed by Arthur Yanov. I am convinced that without serious study of unconscious material it is very difficult to get rid of the true causes of depression, and I believe that Dr. Yanov’s methods are the most effective at the moment to achieve this goal.

This book describes my personal experience of getting out of depression, and I really hope that it will be useful for someone else. I know that you find it hard to believe that deliverance might know how tired you advice others to “pull themselves together”, the replica “you’re the man!”or “you’re a mother!”, “think about the children/parents/colleagues/interests of the company”, believe me, I went through all this nightmare.

But I would like to warn you. If you suffer from depression, you in any case should not engage in self-medication and perceive this book as an alternative to drug therapy and psychotherapy, on the contrary, the earlier you start treatment prescribed by a specialist, the more chances you will have to get rid of your problem forever. Another thing is that the book can help you in choosing a doctor, to understand the cause of your suffering, to save time and money that you could spend on all sorts of near-medical charlatans and, I very much hope to make the final step, to make a breakthrough to the final recovery.

I give practical advice and exercises that helped me get out of the black hole of depression.

If you, as well as I, unsuccessfully motalis from one specialist to another, if you are treated for all possible diseases in the world, until the present diagnosis, if you go to the pharmacy more often than the supermarket, if the number and color of the tablets already dazzled – this book is for you.

Remember-there is a way out.

Depression. How to break out of a black hole

Depression. How to break out of a black hole PART I

Depression is like a lady in black. If she came, do not drive her away, and invite to the table as a guest, and listen to what she intends to say.

Carl Gustav Jung

Best day of my life

Probably, it would be easier to throw out at once these two huge plastic bags stuffed to the eyeballs with all kinds of psychotropic drugs available in the post-Soviet space. But it was a special pleasure for me to get one multi-colored boxes, each of which meant a certain milestone, a stage in my six-year struggle with depression, to carefully consider them, to cause associated memories and ruthlessly send them to the trash, along with all the pain, fear, suffering that they meant to me.

“Prozac”, Cromwell Hospital, London, obese doctor with unhealthy shortness of breath, first told me “you are depressed“; “Remeron”, ajibedam hospital, Istanbul, $ 800, spent on meaningless tests; “Lerivon”, Moscow, 10 kilograms of excess weight, gained over three months…

Six years. Erased from life, from the most active period of my life, six years of unrealized opportunities, rejected career proposals, ruined personal life, hopeless vegetations.

I deserve this day. Definitely deserved it.

Introduction

Hi.

My name is Anar, I am a doctor, I am 38 years old.

The last 6 of them were stolen by depression.

I have suffered from depressive disorder, generalized anxiety and panic attacks since August 2002. At the peak of the disease, I took three types of antidepressants at the same time, visited a psychotherapist, engaged in various practices from the field of alternative medicine. Despite this, most of every day I spent in a depressed state, panic attacks happened 3-4 times a day, I shuddered from every phone call and appeal to me by name.

At some point I decided to accept it. I decided that I was destined to spend the rest of my days on antidepressants, which though I did not feel good, but which at least gave me the strength to get up every morning from bed and go to work, somehow communicate with the people around me, to perform their social functions.

In the end, it stopped working. I lost my job, my personal life was ruined, I didn’t see any sense in my future existence.

But six months ago, the situation began to change. Now in my life everything is different, I do not take antidepressants, do not feel anxiety and panic attacks, most of the day I am in a calm and positive state. I have a new job that gives me satisfaction, and a girl with whom I plan to connect my life and which is better for me there is no one in this world.

Not so much, you say?

Well, really, a lot of people around you have the same thing and don’t write books about it.

But if you are reading this book, perhaps your life is not so rosy. As a doctor, I have encountered depressive patients in my practice, some of them reached such a stage that they saw no other way out for themselves than suicide.

Then I still did not suffer from depression myself and I can responsibly say: never a person who has not been in this skin, will not understand that he is experiencing a depressed patient, for whom there is no greater happiness, a greater dream than to return to his pre-painful state, to live a normal life, to love and be loved, to enjoy the little joys that healthy people are so familiar that they do not cause any emotions.

So what happened six months ago?

There was no miracle, I did not find a wonderful pill that cured me, did not read any book that recommends “change your attitude to depression” and “think positively“, after which all my problems were resolved.

There are no miracles. There will be no them and in your case-to get rid of depression, it is necessary to work. But my example shows that the reward for work can be huge if you know exactly what to do. It took me 6 years to figure it out, you can get this knowledge in a few hours spent reading this book.

As a doctor, I was well aware of the underlying mechanism of depression, but as a patient, I could not find an effective solution that would stop this ruthless mechanism.

Now I know how to do it. I spent 6 years and over $ 50,000 on medication, psychotherapy, and various spiritual practices. Everything I know, including the only effective way out of depression that I know, I have summarized in a book that I have the honor to offer to your attention.

Just remember that reading the book will not cure you, the technique will have to practice. It is not difficult, does not take much time, and the effect you will feel after the first successful session. Each time it will increase, and, I assure you, the classes will not only not burden you, but, on the contrary, once you feel the effect, you will strive for them with impatience.

The basis of my methodology is based on the theory of primal therapy, Dr. Arthur Janov and methods of neuro-linguistic programming, originally developed by John Grinder and Richard Bandler.

I underwent three weeks of intensive therapy at the primary center in Los Angeles in January 2009, and this experience changed my whole life. I finally figured out how to get to the forgotten childhood memories and the repressed pain they continue to cause us.

It remained to find a method to work with psychological trauma from the present and recent past. This proved to be easier, NLP methods in this regard have shown themselves to be very effective.

To understand why a combination of these methods has had the best effect, you need to be aware of the causes of depression. Any doctor will tell you that the basis of depression is a violation of the normal course of biochemical processes in the brain and the associated metabolic disorders of neurotransmitters – serotonin, norepinephrine and dopamine.

But that’s not what I mean.

Every depression has a reason. Sometimes it can lie on the surface and be realized by the individual, sometimes its causes are buried in childhood injuries and experiences. But most often, even almost always, there is a combination of these two factors, stress in the present causes pain from the past to life. You can read more about this in the Chapter “Causes of depression“.

Dr. Yanov had been in therapy at the time, many celebrities, including Elizabeth Taylor and Barbra Streisand. But his most famous patient was of course John Lennon. Below you can read the memoirs of Dr. Janov about John’s therapy, with which he shared in an interview with the magazine “Mojo”.

In my opinion, Dr. Yanov managed to get to the root of the problem. Primary therapy allows you to reach and throw out suppressed emotions that cause nervous disorders. This is very important, but not always enough. To get rid of depression, you also need to work through traumatic situations that are already in your mind, are recognized by you, but still continue to torment you.

I’m not going to teach you Primary therapy, you have to go to Los Angeles and get it at the Primary center. In this book I describe my experience, undoubtedly positive, and the method that I had to come up with to be able to continue to work with his subconscious to stop the three-week intensive at the Center.

Primary therapy, like any other, is long-term. It does not stop after the first three weeks, and it is quite justified: it is impossible to work out all the unconscious material in such a short time. But I had to interrupt my treatment at the Center, I could not continue to stay in Los Angeles, besides, having lost my job, I already in any case had nothing to pay for the continuation of therapy.

Fortunately, I now have the opportunity to practice my method at home, and I’m ready to share it with you. You will learn how to relive long-suppressed feelings, how to get rid of the pain that has accumulated in your mind for decades, how to get rid of daily stress and work out traumatic memories from the recent past.

I also described in detail my experience of medication and psychotherapy, as well as the experience of various spiritual practices. Some methods worked for me, some didn’t. After reading this book, you will learn how not to make my mistakes and not to waste time and money on useless techniques, learn about the side effects caused by various antidepressants, the exact, and not always harmless, the mechanism of their work.

Here's a partial list of what I've had to try in the last 6 years:

Antidepressants and other medications:

Prozac, Zoloft, Amitriptyline, Lerivon, Remeron, Venlafaxine, Desyrel, Wellbutrin, Paxil, Xanax, Diazepam.

Psychotherapy and body-oriented therapy:

Interpersonal therapy, psychoanalysis, cognitive-behavioral therapy, primary therapy, Rolfing.

Spiritual and meditative practices:

Self-hypnosis, qigong, Scientology, transcendental therapy, holotropic breathing, psychoanalysis, sleep deprivation.

I do not urge you to stop your current treatment, my method is compatible with medication and psychotherapy. There is a high risk of premature and abrupt discontinuation of antidepressants, and they should be taken only under supervision and in consultation with the attending physician. But, practicing my method, you will feel that over time you will no longer need for other types of treatment.

I wrote this book from two points of view – the doctor and the patient. As a doctor, I will tell you about the causes of depression, the mechanism of action and indications for the use of various types of therapy. From me, as a patient, you will learn about the effectiveness of a particular method, side effects of drugs and, finally, that eventually helped me cope with my long-term disease.

I feel better now than I did before my illness. Simultaneous work with suppressed and conscious material gave results that I could not even hope six months ago. But I’m not going to stop there, it’s not enough for me to be just a healthy person in the ordinary sense of the word. Now I have a powerful tool at my disposal, using which I am going to completely clear my mind of the mental debris that has been building up in it for decades. My goal is to return and comprehend my personality, my true self, free from artificially constructed by me or anyone who has ever had an influence on me, psychological barriers, old complexes and beliefs.

Change your life and you. Do not settle for vegetating and suffering for the rest of your life. I know, I know very well that it’s hard for you to believe this right now, but life can really be beautiful and amazing, filled with happiness and meaning. This goal is worth fighting for.

Don't give up, get your life back!

How to Reduce Autumn Anxiety: 10 Ways to Relax

How to Reduce Autumn Anxiety: 10 Ways to Relax

EVEN IF THE STUDY IS LONG GONE, THE END OF THE HOLIDAY SEASON and the beginning of the school year are associated with stress and increased workload. Work is added, in transport there are more people, the weather worsens-and it's time to hone the ability to relax to calmly survive the autumn and winter. We have collected ten ways, the calming effect of which is confirmed by research and which will help to recover, even when it seems that everything collapses and goes out of control.

Drawing

Art therapy has already proved its effectiveness in the treatment of depression, anxiety disorder and other mental illnesses. After all, sometimes it is easier to draw what you feel than to tell. Forget about the lessons of fine ARTS and harsh teacher: here you are not required to clear lines, “correct” composition or a certain combination of colors. Create what you want and how you want, frames (they will be except on canvas) and no estimates, the main thing — come to this lesson consciously: take a break from thoughts and focus on the process. According to the candidate of psychological Sciences and associate Professor of Brooklyn College Jennifer Drake, only fifteen minutes of drawing significantly uplifting.

Meditation

Around meditation many myths — apparently it is complex, confusing and generally only advanced yogis. In fact, for a successful meditation is not necessary to sit in the Lotus position, teach wise (special gestures and finger positions) or pronounce mantras. It is important to choose a quiet place to concentrate on your breathing and try to observe their thoughts. The first time is unlikely to succeed (from the second and third too), but the main thing here is regular practice. Start with short sessions: five to ten minutes a day is enough to form a habit. It is better to meditate in the morning or before going to bed, but even this is not considered a strict rule.

Meditation helps lower cortisol levels in the blood, reducing stress and increased anxiety, but that’s not all. Last year, the society of integrative Oncology updated its guidelines-and now recommends the use of meditation as one of the ways to improve the physical and emotional state of breast cancer. Another study found that various practices for the mind and body, including meditation, mitigate the symptoms of menopause. And neuroscientist Sarah Lazar is convinced that eight weeks of regular meditation sessions can change the physical properties of the brain. During the experiments, Sarah and her colleagues found that the size of the amygdala (the area responsible for the appearance of anxiety, fear and stress) in people practicing meditation, decreased. This was followed by a decrease in the level of stress.

Strolls

Physical activity is useful in any form, and normal walks are also considered. With friends, a partner, a dog or without anyone — it doesn’t matter, just leave the house when you want to relax or calm down, it really helps. Spend more time outdoors and those who have depression. Walking an average of two hundred minutes a week, women noted that they had more energy, they felt better physically and emotionally, and it was easier for them to socialize. And if you increase the duration of walking to seven hours a week, it will help reduce the risk of breast cancer after the onset of menopause — so say researchers from The American cancer society.

Sex

Hugs, kisses and sex are very useful for health — both physical and psychological. So, sex reduces cortisol levels and relieves stress, so that a person feels more peaceful. According to psychologist from Paisley University in the UK Stuart Brody, such a calming effect may occur due to the release of the hormone oxytocin, it is also called the hormone of love and affection. In addition, sex helps to better perceive and control their emotions, increase self-esteem and overall health. But some research does say about the positive impact of sex on memory in women.

Floating

Floating was invented and developed by neuropsychologist John Lilly. Translated from the English term means “swim on the surface” — in fact, this happens during the procedure without any effort. The patient is immersed in water with a high concentration of salt rich in magnesium, so that the density of the water is much higher than the density of the body — and it pushes the person to the surface (as in the Dead sea in Israel). This happens in the sensory deprivation chamber — from the name it is clear that the person in it is almost completely cut off from external stimuli, often-in complete darkness.

Since the procedure appeared recently, it is still poorly studied, so it is necessary to approach it cautiously: it will be useful to consult with a psychotherapist if you have it (after all, not everyone will be comfortable in a small enclosed space alone). On the basis of already conducted studies, we can say that flotation (probably due to magnesium in the salt) helps to relax muscles, accelerate recovery after training, relieve stress, normalize the nervous system and even improve sleep. On the procedure you need to try to relax, although the first time it will be difficult to do: the brain does not understand what it is, it will seem that you are drowning (in fact it is impossible, do not be afraid).

Journeys

It is not necessary to go to the other side of the world — it will be useful to go just for or to another city, provided that there you can feel like a tourist. Studies show that the holidays allow you to break away from the routine, bad weather and problems at work, which helps a person to relieve stress, reduce anxiety and find peace of mind. This effect has a very short — four-day-trip. Even at the planning stage-making a route, booking hotels, buying online tickets to museums-a person is in a good mood: a study conducted at Cornell University, confirmed that waiting for a trip gives a person more pleasure than waiting for the purchase of something tangible, such as a car.

Nurslings

If you have long been thinking about how to get a pet, then this item is for you. In February of this year, Helen Brooks, a lecturer at the Institute of psychology, health and society (Liverpool University), and her colleagues published a systematic review of the impact of Pets on people’s emotional health. After analyzing more than eight thousand articles, they came to the conclusion that Pets helped their owners to better control emotions and helped reduce the severity of symptoms of mental illness.

According to Brooks, this effect was achieved due to the fact that Pets accept people as they are (and the person understands this), and give them unconditional support, which research participants did not receive from their family or friends. According to experts of the mental health Fund, games and walks with Pets, especially with dogs, help to relax and calm the mind. And in moments of despair, caring for Pets can be the only incentive to get out of bed — it helps a person to realize their value and necessity. The main thing-approach the question responsibly: consider the option to take the animal from the shelter and do not forget that any animal should be systematically engaged.

Autogenic training

Those who do not like to do fitness, can exhale: no exercise is not necessary. Autogenous training is a method of therapy aimed at relaxing the body, relieving tension and stress. The first time to conduct sessions of auto-training is better under the supervision of a specialist. It will help to learn how to relax properly-so that it does not lead to deterioration of the patient’s condition, the appearance of anxiety or panic attacks (and this can happen).

Then you can put yourself in emotional order at home. The main thing is not to make the main mistake of all beginners-do not force yourself to relax, everything should flow naturally. The indications of the use of auto-training include not only stress or fatigue, but also anxiety and depression, sleep disorders, irritable bowel syndrome, high blood pressure caused by stress. The results of the studies show that this method of therapy is really suitable for some people.

Massage

What could be better and more pleasant than to spread out on the massage table after a day in the office? Although the benefits of massage for health (for example, that it helps to align the posture or relieve back pain) is still debated, that it helps to relax the body and mind, there is almost no doubt left. In one of the studies, participants who were given a massage, there was a decrease in the level of anxiety. There are many types of massage: hot stones (stone therapy), herbal bags, aromatic, honey, Thai, soap-choose any, but again do not expect anything from them except relaxation.

Music

Music has existed for 250 thousand years, and maybe more — psychologists, anthropologists, musicologists, neuroscientists have long studied its origin, properties, goals and effects. Scientists have made significant progress in the study of the influence of music on the emotional and physical health of a person: for example, they found that music reduces the level of stress hormone (cortisol) and is even able to relieve pain. In a 2013 study, doctors found that listening to music reduces anxiety in people before surgery.

You are certainly without any kind of research I have noticed that after listening to a favorite album becomes easier. In one study, scientists interviewed 834 people to find out what music gives them. It turned out that a lot: music helps different people to think about feelings, to better understand others, to believe in themselves, not to lose heart and to find the meaning of life.

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