[Workplace Psychology]Don’t think it’s a middle-aged man’s crisis, sudden change in work performance, beware of depression

Text◆/Hong Suqing “Today’s Health”

Familiar tasks become overwhelming? Do you have to “force yourself” to go to work every day?

In fact, you may be depressed without even realizing it!

(Taipei News) A man in his 50s has worked hard in the company for more than 20 years. Last year, he gradually began to feel that his work was “unsatisfactory” and his performance was not as good as before. After two transfers and no improvement, he decided to retire. But after leaving the workplace, it did not become easier. Within just one month, his symptoms of anxiety and depression worsened significantly, and he even had thoughts of death all day long. It was only after seeking medical treatment that he found out that he was suffering from depression. After treatment, his symptoms improved a lot. .

Seeing a client with chest tightness, palpitations, and trembling hands

Depression manifests itself differently in men and women. Psychiatrist Zhu Zhisheng pointed out that most boys will first seek medical treatment for physical symptoms, including dizziness, headaches and gastrointestinal symptoms. Although some patients are obviously depressed at the beginning, they are often reluctant to see a doctor because they are afraid that their colleagues and directors will know.

There are also some patients who initially manifest themselves as “anxiety”. When they need to contact customers or superiors at work, they develop chest tightness, palpitations, hand tremors and other symptoms. At first, they thought it was a physical problem, and even went to the cardiology department, thoracic department, etc. Gastroenterology visit. Until a few months later, if the problem is not solved and the anxiety disorder is not treated well, the chance of developing comorbid depression increases!

“Usually, those who actually step into the clinic for help often have their work affected and feel that their work performance has deteriorated. For example, they feel anxious and powerless even in meetings that they could handle with ease. Even if subordinates dare not say it explicitly, their peers gradually feel that When they notice abnormal symptoms, patients feel that their work efficiency has become worse, and they are even criticized by their superiors.”

It is worth noting that male patients with depression often feel that they are not working hard enough, and even cry to themselves, “I need to relax a little more, I need to work harder,” but these measures often have little effect.

How to help men detect abnormalities early? He pointed out that the more common emotion of male depression is “irritability”. Family members may feel that “he has become irritable and difficult to get along with”, and friction with colleagues has begun to increase, and they feel that he “is not the same as before.” In addition, absolutely Most patients seek medical treatment because of “insomnia”. “Because of long-term insomnia and poor work performance,” depression becomes more and more serious.

Sudden irritability and increased friction with colleagues

Other symptoms include fewer social activities, almost all the time staying at home and not going out, almost all sleeping, and a significant decrease in energy. Or there is no sense of fulfillment at work. In the past, I would be happy when I got a case, but now I am not happy. I just “work for work.”

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria, the nine symptoms of depression include melancholy, loss of interest, insomnia, mental retardation, weight changes, feelings of guilt, loss of energy, inability to concentrate, suicidal thoughts… Etc., if at least one of the first two symptoms appears, combined with other symptoms, there are at least five symptoms in total, and the symptoms last almost all day, last for more than two weeks and affect the function, it may be depression and you must seek medical treatment.

Symptoms caused by stress do not require medication

He pointed out that if depressive symptoms appear accompanied by stressful events, the mood will be better after the event. Medication may not be needed, and psychological consultation may be considered. But if the symptoms still reappear after the stress is over, or even feel troubled, or the “self-function” (the function of taking care of oneself), “interpersonal function” (communication between people), or “social function (work) “When any of the three major functions is affected, active medical treatment is encouraged.

“Especially for men who are originally unwilling or afraid to seek medical treatment, the threshold for medical treatment can be lowered even lower. As long as they feel that they have functional decline or related problems, they should seek medical treatment and seek self-mental health.”

Decreased brain elasticity, a period of high risk for depression in middle age

Currently, common medications used for depression include “selective serotonin recovery inhibitors” (SSRIs), “norepinephrine and serotonin recovery inhibitors” (SNRIs), and other categories. There are about 10 common antidepressants.

Antidepressants are sometimes combined with low-dose antipsychotics to treat depression.

In addition to oral medication, there are also electrical stimulation treatments. In the early years, it was electroconvulsive therapy (ECT), and now it is non-invasive transcranial magnetic stimulation therapy (rTMS). There are also non-pharmacological treatments including psychotherapy, cognitive behavioral therapy and mindfulness-based stress reduction.

It takes three weeks for severe depression medication to be effective

Zhu Zhesheng pointed out that the main theory of transcranial magnetic stimulation (rTMS) is that the activity of the dorsal prefrontal lobe of the left brain of patients with depression is reduced. Therefore, high-frequency rTMS stimulation is used to stimulate the cerebral cortex about two to three centimeters below the brain through a magnetic field. Microcurrent stimulation is induced to increase blood and activity in emotion-related brain areas, thereby improving depression. Currently, the Ministry of Health and Welfare has approved the indication for “refractory depression”, but it is not covered by the National Health Insurance.

In addition, for patients with severe depression (refractory depression) who have acute suicidal ideation, because it may take two to three weeks for general drugs and rTMS to take effect, but patients cannot wait that long, nasal spray drugs can be used at this time. After treatment, suicidal ideation will decrease rapidly within a week or even within 24 hours after taking the drug.

Brain elasticity decreases with body degeneration

Modern people’s lives are stressful, and the prevalence of depression is also increasing year by year. It is worth noting that some people feel that “the pressure is not much different, but why do they feel unable to control the same stressful event that was fine before?”

He pointed out that this is because the brain’s ability to face stress will decrease with the degeneration of the body, such as cerebrovascular degeneration, or due to comorbidities such as diabetes and hypertension, which means that “brain elasticity” decreases. The pressure that was bearable in the past has now become unbearable!

“For example, the sandwich family in their 40s, with seniors and juniors, not only have filial piety expenses, children’s expenses, but also mortgages to pay. They may have just been promoted to supervisors and are taking on responsibilities at work. At this time, although their health and physical strength are It’s not bad, but it’s almost like facing the ‘three highs’, which will make the brain elasticity worse. Therefore, for both men and women, middle age is a relatively high risk period for depression!”

Lifestyle “Brain Strengthening” Anti-Inflammation

He suggested that you can “strengthen your brain” through brain-boosting and anti-inflammatory diet, exercise, and lifestyle to reduce the concentration of inflammation! For example, do not sleep at home all the time during the holidays. If the symptoms are mild, you can go for a brisk walk or run outdoors, or even go for a walk in the park and bask in the sun. A regular schedule, sleep, and regular exercise are also important.

“In addition, practice ‘mindful’ breathing, which simply means ‘being in the present moment’. Just pay attention to your breathing. Set your mind on your breathing and pay attention to the incoming and outgoing breaths, three to five times a day, three to five times each time. Minutes can effectively improve your parasympathetic ability and don’t let your sympathetic nerves become too strong! Your brain will be focused on the present moment and your mood will calm down.”

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