چه کسانی بیشتر در معرض افسردگی‌ هستند؟/مشخصات افراد افسرده

چه کسانی بیشتر در معرض افسردگی‌ هستند؟/مشخصات افراد افسرده

افسردگی می‌تواند یک بیماری روانپزشکی یا از انواع بیمارهای دیگری بروز پیدا کند‎

 

«افسردگی: بیایید حرف بزنیم»؛ این شعار سازمان بهداشت جهانی در سال ۲۰۱۷ و با هدف افزایش توجه و آگاهی عموم مردم نسبت به موضوع افسردگی بود که البته همچنان مورد توجه سازمان‌های بهداشت و سلامت جهانی است. افسردگی اگرچه جغرافیای خاصی نمی‌شناسد اما در ایران هم روز‌به‌روز بر تعداد مبتلایان به این بیماری افزوده می‌شود.

 

بحران اقتصادی این روزهای ایران، فشارهای روانی را افزایش داده که به عقیده بسیاری از روانشناسان و جامعه‌شناسان، تاثیر این وضعیت در ماه‌های آینده بیشتر مشخص خواهد شد که البته برآوردهای ابتدایی نشان از افزایش آمار طلاق، نزاع خیابانی و … دارد. پرسش اینجاست در شرایطی که علاوه‌بر زمینه‌های ژنتیکی و ارثی در شرایطی که اقتصاد و کار جامعه، زمینه‌ساز افسردگی است چگونه می‌توان این بیماری را به موقع تشخیص داد و راه‌های مقابله با آن چیست. دو روانشناس در گفت‌و‌گویی از عوامل زمینه‌ساز افسردگی، راه‌های شناخت و روش مقابله با آن می‌گویند.

 

افسردگی چیست و افراد افسرده چه مشخصاتی دارند؟

جلالی ندوشن روانپزشک، روان‌درمانگر و استادیار گروه روانپزشکی دانشگاه علوم پزشکی ایران در پاسخ به این پرسش می‌گوید: «مهمترین علامت افسردگی یکی از دو حالت زیر است: یا فرد احساس غم و اندوه می‌کند که ممکن است این غم و اندوه به حالت گریه کردن، احساس غمگینی، احساس سرحال نبودن یا همان حالتی که در بین مردم معروف به افسرده یا دپرسی است، خود را نشان دهد.

 

مشخصه دوم اینکه فرد احساس مثبت و علاقه خود را نسبت به کارهایی که پیش از این معمولا برای او لذتبخش بود، از دست می‌دهد. اگر یکی از این دو حالت بروز کند علایم افسردگی است. اما علایم دیگری هم همواره در کنار این دو عامل وجود دارد؛ شامل تغییراتی در خواب؛ کم خوابی یا پرخوابی، کاهش انرژی، تغییر در اشتها و مواردی همچون احساس ناامیدی یا فکر کردن به خودکشی است.

 

برای اینکه مشخص شود فردی مبتلا به افسردگی است لازم است یکی از دو حالت اول در کنار علایم بالا وجود داشته باشد تا پزشک تشخیص افسردگی دهد. البته این تغییرات باید یک دوره تداوم داشته باشد و دست‌کم این اختلالات دو هفته طول بکشد تا احتمال تشخیص افسردگی مطرح شود. علاوه‌براین موارد، ما همواره تاکید می‌کنیم که فکر خودکشی باید به عنوان یک علامت برای فرد و اطرافیان او تلقی شود و اگر کسی مدام به این موضوع فکر می‌کند باید به پزشک مراجعه کند.

  

در صورت بروز عوامل افسردگی چه کاری باید انجام داد؟ 

افسردگی می‌تواند یک بیماری روانپزشکی باشد یا به‌ صورت تظاهری از انواع بیمارهای دیگری بروز پیدا کند. علاه براین مصرف برخی از داروها ممکن است باعث افسردگی شود. وقتی فردی دچار افسردگی می‌شود باید عامل بروز آن مشخص شود. پس این تشخیص، متخصص می‌خواهد و خوددرمانی جایی ندارد. در مرحله اول باید به یک پزشک عمومی یا روانپزشک مراجعه شود. اگر فرد دسترسی به روانپزشک دارد بهتر است به روانپزشک مراجعه کند. اگر هم امکان دسترسی به روانپزشک وجود نداشته باشد، پزشک عمومی یا پزشک خانواده می‌تواند تشخیص اولیه را انجام دهد اما در مرحله بعد مراجعه به متخصص ضروری است. ذکر این نکته هم ضروری است که افسردگی متغیر است و می‌تواند از حالت خفیف تا شدید باشد و متناسب با شدت افسردگی باید معالج انتخاب شود.

 

آیا کودکان هم افسرده می‌شوند؟

بله، افسردگی از کودکی تا سالمندی وجود دارد و در دو طیف کودکی و سالمندی ممکن است علایم متفاوتی داشته باشد. در مورد کودکان پیچیدگی بیشتر است که البته از یک سنی به بعد، کودکان می‌توانند شرایط روانی خود را تشخیص دهند. در سن‌های پایین‌تر ممکن است به شکل بی‌قراری، بی‌تابی و ناتوانی، پرخاشگری و تحمل نکردن ناکامی رخ دهد. هر کدام از این عوامل در صورت شدت، می‌تواند علایم افسردگی در کودکان باشد. اگر کودکی یک سری از مشکلات رفتاری داشته باشد که باعث شود مانع از تربیت نشود نیاز است که کودک به پزشک مراجعه کند. از لحاظ درمانی و تشخیص هم موضوع برای سالمندان تا اندازه‌ای مشابه است.

  

افسردگی سالمندان معمولا چه مشخصاتی دارد؟

افسردگی در سالمندان ممکن است با شکایت جسمی و دردهای پراکنده همراه شود. مشخصه اصلی افسردگی در سالمندان، پراکنده بودن درد است که عموما با درمان‌های معمولی پزشکی قابل درمان نیست. فرد سالمند ابتدا و در مرحله اول از افسردگی شکایت نمی‌کند و از دردهای بدنی می‌گوید که البته این دردها با دارو و درمان مربوط به آن درد بهبود پیدا نمی‌کند و نیاز به درمان افسردگی وجود دارد.

  

با افسردگی فصلی چه باید کرد؟ چه کسانی مستعد افسردگی پاییزه هستند؟

خلق‌وخوی انسان واکنش‌پذیر است و وقتی ما تغییری در نور یا یک خبر بد می‌شنویم ممکن است خلق تغییر کند. وقتی ما از بیماری افسردگی حرف می‌زنیم باید دو هفته طول بکشد و تاثیر منفی بر عملکرد بگذارد. در مورد افسردگی فصلی که معمولا در پاییز یا زمستان رخ می‌دهد ممکن است شدت افسردگی بیشتر شود. کسانی که استعداد افسردگی دارند ممکن است در این فصل‌ها، افسردگی دوباره برگردد یا اینکه شدت پیدا کند. روند درمان افسردگی فصلی، فرقی با افسردگی عادی ندارد و ممکن است درمان کمکی بیشتری نیاز داشته باشد. کاهش شدت نور و کاهش طول روز باعث می‌شود که انسان روحیه غمگین‌تری داشته باشد و این در اشخاصی که استعداد افسردگی بیشتری دارند، ممکن است بیشتر رخ دهد.

  

ترنسکشوال‌ها بیشتر نیاز به مراجعه به پزشک دارند؟

آمارهای رسمی می‌گویند که ترنسکشوال‌ها به دلایل مختلف، پتانسیل بیشتری برای افسردگی دارند و براساس برخی آمارها، بیش از ۴۰ درصد این افراد دست‌کم یک بار اقدام به خودکشی را تجربه کرده‌اند. صابری، روانشناس متخصص در زمینه دوجنسی‌ها درباره این موضوع می‌گوید: «افراد ترنسکشوال طبیعتا مواجهه بیشتری با مشکلات روانی از جمله افسردگی دارند که در بعضی با تغییر شکل جنسی افسردگی کاهش پیدا می‌کند که البته برعکس این موضوع هم هست و ممکن است دچار سرخوردگی شوند. یکی از موارد مهم پیش از عمل توجه به همین افسردگی است.

 

بعضی نیاز به مشاوره درمانی دارند و بعضی هم نیاز به دارو. کسانی هم که مراجعه می‌کنند باید دایم پیگیر سلامت روان باشند و این روند درمان بعد از عمل هم باید ادامه پیدا کند که البته بیشتر آنها بعد از عمل مراجعه نمی‌کنند. طبیعتا این افراد اگر در دوران کودکی موردتوجه قرار بگیرند و به روانشناسان مجرب مراجعه کنند امکان دارد با برنامه‌های درمانی مواردی را که خیلی حاد نشده، تغییر دهند. هرچند که این نظریه مورد ایراد است چون برخی معتقدند که این عارضه در ۵-۴ سالگی بروز پیدا می‌کند و نمی‌توان آن را تغییر داد. بعد از تشخیص ترنسکشوال‌بودن یک فرد، حتما نیاز به روانشناس هم برای والدین و هم خود افراد وجود دارد و این مراجعه به روانشناس ضروری است.

 

وقتی فردی دچار افسردگی می‌شود باید عامل بروز آن مشخص شود‎

 

رابطه من با افسردگی

الهه. س | کاملا بستگی دارد توانتان برای مقابله با بحران چگونه باشد و تا کجا مقاومت کنید. ضربه اول اگر جواب نداد، آنقدر محکم‌تر و بیشتر می‌زند تا بالاخره شما را از پای درآورد و بفرستتان بغل افسردگی. شاید بسیاری از ما در طول زندگی‌مان حالاتی شبیه افسردگی را تجربه کرده باشیم. حتی در حدی که خلقمان پایین آمده باشد. اما یک جایی، شرایطی برایت هماهنگ می‌شود. نه، بهتر است بگویم هماهنگ می‌کنی تا بیاید و بنشیند در زندگی‌ات. بدبختی می‌دانید چیست؟ هیچ چیزش شبیه یک بیماری نیست. نه بدنت درد می‌گیرد و نه آبی از بینی‌ات روان می‌شود. روزی باور می‌کنی که افسرده شدی که سگ سیاهی تو را در آغوش گرفته و این بار این آغوش خستگی‌هایت را برطرف نمی‌کند. من روزهای زیادی در آغوش سگ سیاه افسردگی بودم. بغلی که آنقدر سفت و محکم است که تمام رمقت برای ادامه زندگی را می‌گیرد. دنیا به همان سیاهی و تاریکی می‌شود. دیگر هیچ چیزی تو را سر شوق نمی‌‌آورد و هر روز تو را دعوت می‌کند در آغوشش بی‌حرکت بمانی. اما من نخواستم که تنم بوی تعفن افسردگی را بگیرد. افسردگی برای من شبیه باتلاقی بود که این بار اتفاقا اگر دست و پا نمی‌زدم بیشتر فرو می‌رفتم. جالب است که اینجا هم در مواجهه با این بیماری همچون سرماخوردگی انواع و اقسام نسخه‌های خانگی وجود دارد. نگاهی به اطرافتان بکنید.

 

رفتارمان با کسی که دچار افسردگی شده چگونه است؟ من می‌گویم:«پاشو یه تکونی به خودت بده»، « برو سفر»، « زنگ بزن با چهارتا رفیق برو بیرون، خونه نشین» و… واقعا فکر می‌کنیم کسی که افسرده است به فکرش نمی‌رسد این کارها را بکند؟ مسأله کنده شدن از آغوشی است که او را سفت چسبیده است. گفتم من نخواستم، فکر می‌کنید بار اولم بود و خیلی متمدنانه با آن برخورد کردم؟ یک روز صبح از خواب بیدار شدم و دیدم بغل یک سگ سیاه هستم که نمی‌گذارد شور و شوق زندگی داشته باشم؟ بعد با خودم گفتم: «ئه! ببین کی اینجاست! دختر افسرده شدی و پاشو شماره دکتر روانشناس را بگیر و برو تا درمان شوی.» 

 

طبیعی است که رفتارم اینگونه نبود. بارها بعد از هر بحران حتی همین روزمرگی‌ها دچار پایین آمدن خلق و مرحله بعدی افسردگی شدم. اما شبیه همان نسخه‌های خانگی، خوددرمانی کردم. اتفاقا در کوتاه مدت هم جواب می‌داد، اما در دوره بعدی، در مواجهه با بحران، درد، رنج، شکست و… هر بار میزان درگیر شدن با افسردگی برایم حادتر بود. دوست دارید دقیق‌تر برایتان بگویم؟ روزهایی بود که با احساس شکست زیادی روبه‌رو شدم. در حقیقت شکستی هم خورده بودم. دو هفته ابتدایی با ۵ کیلو وزن کم کردن ناخواسته گذشت. روزهایم را با چرخیدن در فضای مجازی می‌گذراندم و کار خاصی نمی‌کردم. اگر از گرسنگی رو به موت نمی‌شدم، برای خوردن هم از جایم بلند نمی‌شدم.

 

پسرم آن روزها کوچک بود و به مراقبت من احتیاج داشت. اما من حتی متوجه نبودم پسرم چگونه بزرگ می‌شود. هر روز یک تخم مرغ نیمرو می‌کردم و می‌دادم بخورد. آن زمان یکی در میان به مشاور مراجعه می‌کردم. تا اینکه یک روز در یکی از همان گشت‌وگذارهایم در فضای مجازی با نوشته‌ای روبه‌رو شدم که باعث شد تکانی به خودم بدهم. من حالم موقتا خوب شده بود. دنبال زندگی بودم. اما درمان نشده بودم. بنابراین در بحران بعدی که اتفاقا توان این را داشت که مرا برای همیشه از پا بیندازد، افسرده شدم. این بار، نشانه‌ها را به خوبی می‌شناختم. بوی باتلاقش برایم بسیار آشنا بود و می‌دانستم باید در این باتلاق دست و پا بزنم. با این حال که فکر می‌کردم حواسم به خودم هست، افسردگی آنقدر بر من مستولی شده بود که پیش از یک عمل جراحی آرزو می‌کردم کاش به هوش نیایم و زندگی تمام شود. رسیدن به مرگ و خودکشی یکی از مهمترین افکاری است که سراغ فرد افسرده می‌آید. وقتی شور و شوق زندگی نداشته باشی، پس لزومی ندارد به آن ادامه دهی. فشار سگ سیاه افسردگی آنقدر روی گلویم زیاد شد که با خودم گفتم باید از این درد و رنج مدام خلاص شوم. اما خلاصی برای من خودکشی نبود این بار. کار را راحت کردم.

 

تماس با یک مشاور خوب. اوایل هفته‌ای دوبار، بعد هفته‌ای یک بار و حالا بعد از یک سال دو هفته یک بار نزد مشاورم می‌روم. من این را خوب می‌دانم اگر جلساتم را ادامه نمی‌دادم در یکی از آن شب‌هایی که نحوه خودکشی را تصویرسازی می کردم، کارم را تمام می‌کردم. رفتن پیش مشاور هم دقیقا شبیه همان جمله «دوره درمان را کامل کنید.» داخل بروشورهای داروهای شیمیایی است. باید دوره درمان را کامل کنید. باید تمام ریشه‌ها و مشکلاتی که باعث شدند شما افسرده شوید را بشناسید تا درمان شوید. بعد از این شما اینقدر قوی خواهید شد که هیچ سگ سیاهی، هر چقدر قوی و بزرگ نمی‌تواند شما را در بغل بگیرد.

  

منبع: سلامت نیوز

 

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