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Un tempo la chiamavano forte malinconia oppure esaurimento nervoso, oggi depressione. Al di là della parola più appropriata per indicare quel disturbo dell’umore che rende tristi, apatici e che influisce sul pensiero e sulle azioni quotidiane, oggi sempre più persone accusano malessere mentale, che può avere vari gradi di profondità. E sempre più persone ne parlano, inclusi coloro che sono sulla scena della ribalta. L’ultima in ordine cronologico è stata la cantautrice Levante che con il brano "Vivo", ha portato per la prima volta sul palcoscenico del Festival di Sanremo 2023, il delicato tema della depressione post parto.
Depressione
L’American psychiatric association distingue tra un “disturbo depressivo maggiore” e uno “minore”. Il primo include i malesseri che vengono anche chiamati depressione clinica, depressione endogena, disturbo unipolare e depressione ricorrente. Il minimo comun denominatore sono le anomalie dell’umore che, in varia misura, fanno perdere la gioia di vivere, tolgono il desiderio di svolgere attività solitamente considerate piacevoli e abbassano l’autostima. Le persone depresse si sentono giù di morale per la maggior parte del tempo e possono provano emozioni contrastanti, ad esempio non si divertono più, né vogliono fare le cose che prima amavano fare, si sentono tristi, senza speranza o irritabili quasi tutti i giorni, alcuni iniziano anche a perdere peso. I depressi non troppo gravi possono migliorare sia assumendo farmaci oppure facendo psicoterapia, coloro che soffrono depressione grave, secondo linee guida scientifiche, hanno bisogno della combinazione di farmaci e psicoterapia.
I numeri
La depressione colpisce in prevalenza le donne, ma gli uomini non sono immuni. Le statistiche dicono che un uomo su quattro e una donna su due, nel corso della vita, avrà un episodio depressivo e non esiste un’età tipica di insorgenza. Sono in aumento i casi nei giovanissimi, con depressioni che si manifestano già nell’adolescenza o prima, ma anche negli anziani, con episodi anche tra gli over 70, appunto perché può colpire in tutte le fasi della vita. In Italia, durante il lockdown della primavera 2020, l’88,6% delle persone sopra i 16 anni ha sofferto di stress psicologico e quasi il 50% di sintomi di depressione. È quanto emerge da una survey condotta su 5008 persone attraverso il portale del progetto #PRESTOinsieme. Lato femminile, il numero di donne a rischio depressione nel periodo perinatale è passato dall’11,6% nel 2019 al 13,3% nel 2020, fino al 19,5% nel periodo tra gennaio e settembre 2021 e al 25,5% nel periodo tra novembre 2021 e aprile 2022. Lo dicono i primi dati dell’indagine sull’impatto della pandemia di Covid-19 sul rischio di depressione e ansia nelle madri durante il periodo perinatale pubblicato sull’International Journal of Environmental Research and Public Health a novembre 2022. Insomma il problema è diffuso.
La strategia terapeutiche della Fototerapia
Tra i metodi di cura a cui si ricorre nei casi più lievi c’è la Light Therapy o Fototerapia. Si tratta di particolari lampade che emettono 10mila lux di luce fluorescente bianca e fredda, con una potenza 20 volte superiore alla normale illuminazione interna. Ciò che va fatto è sedersi a una distanza compresa tra i 16 e i 50 cm dalla lampada, con lo sguardo rivolto di fronte alla luce della lampada, per almeno 20 minuti quotidiani. Queste particolari lampade irradiano una luce molto intensa spingendo le nostre cellule a reagire come se stessero assorbendo la vera luce del sole. Il che può aiutare ad alleviare i sintomi. È stato studiato che la minore esposizione alla luce solare nei mesi invernali – che provoca un’alterazione dei ritmi circadiani e una carenza di serotonina – accresce le depressioni stagionali dette Sad, Seasonal Affective Disorder Association di cui, solo nel Regno Unito, ne soffrono due milioni di persone. Da qui l’intuizione di sfruttare la luce contro alcuni stadi depressivi.
La psicoterapia
Esistono varie declinazioni di depressione, che possono essere leggere oppure gravi. Esistono anche diversi tipi di psicoterapia che possono aiutare, ed esempio sistemico-relazionale, psicodinamico o cognitivo-comportamentale. Terapeuta e paziente lavorano sui diversi aspetti legati alla depressione, da quelli meno osservabili e inconsci, a quelli più consapevoli come il contenuto dei propri pensieri, la gestione della quotidianità, delle relazioni importanti e delle problematiche specifiche della singola persona.
Medicina personalizzata
In caso di depressione la medicina personalizzata permette di individuate gli antidepressivi più efficaci per ogni paziente, grazie alla rilevazione dei livelli nel sangue di specifici marcatori, quali l’enzima che metabolizza gli psicofarmaci, oppure i marcatori dell’infiammazione, la carenza di neurotrasmettitori quali serotonina (l’ormone del buonumore) o noradrenalina (l’ormone dell’energia e del piacere), oppure l’oscillazione di altre sostanze prodotte dall’organismo che influenzano l’umore, come gli endocannabinoidi.
Stimolazione Magnetica Transcranica
In caso di pazienti che non rispondono alle terapie più convenzionali, si può ricorrere alla Stimolazione Magnetica Transcranica, una tecnica non invasiva e indolore che produce un campo magnetico capace di stimolare alcune aree cerebrali specifiche e che può contribuire a curare depressioni resistenti ad altre terapie.
Rimedi naturali
Ci sono alcuni estratti che possono aiutare a contrastare i casi lievi di umore basso. Tra questi spicca la passiflora, che ha proprietà sedative, calmanti e ansiolitiche per i disturbi della sfera nervosa. Anche il biancospino contribuisce alla causa. È ricco in vitexina, un principio attivo con proprietà spasmolitiche, sedative e ansiolitiche naturali. La Rhodiola Rosea è una pianta medicinale in grado di contrastare la stanchezza psicofisica grazie alla sua azione adattogeno e alleviagli stati generalizzati di ansia e depressione e combatte gli sbalzi di umore. L’estratto secco di iperico è ampiamente utilizzato per il trattamento degli stati depressivi di entità lieve, tuttavia sono note le interazioni farmacologiche è quindi necessario informare il proprio medico, qualora si stiano utilizzando prodotti a base di iperico.
