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有一部分老人觉得身体有很多不适，最初往往是头疼，

后来逐步发展为背痛、全身痛、心慌、心悸、厌食、腹胀、多汗、全身忽冷忽热等等，


但客观检查并不能发现有相应的器质性疾病。如果有这类问题，其实也是抑郁症的表现。


很多临床患者不解，抑郁症为什么会导致躯体疼痛?


北京安定医院老年病房主任鲍枫解释，在患上抑郁症之后，


人的中枢神经系统会发生改变，突出表现为两种神经递质去甲肾上腺素和5-羟色胺的功能减低。


而这两种神经递质主要起到“神经信使”的功能，在脊髓中有分布，


其功能减低可导致身体传输到大脑的信号产生偏差，


比如说会放大人们对疼痛的感觉，严重者还会影响到躯体疾病的康复。


因此，很多患者被这种疼痛折磨，虽到处求医就诊，却效果甚微。


其实，由于这种“躯体化”的疼痛是抑郁症的症状，因此，


治疗这种疼痛的根本首先是要治疗抑郁症，随着抑郁的好转，疼痛感就会逐渐消失。


由于抑郁症容易反复发生，抑郁症的治疗一般需要三个阶段。


急性期治疗：6~8周，目的是控制症状，尽量达到临床治愈。


恢复期治疗：4~6月，此期间患者病情易波动，原则上应继续使用急性期治疗的药物和剂量，目的是巩固疗效。


维持期治疗：维持治疗剂量或稍减量，目前共识首次抑郁发作维持治疗6~8个月，


有两次以上复发的患者应长期维持治疗，目的是预防复发。


除了药物治疗外，家人还需注意，对抑郁症老人的照顾，要把握一个原则，


既要让老人衣食无忧，又要让老人感到不孤独、有依靠、日子过得充实。


要解决好邻里关系，避免冲突;鼓励老人做一些力所能及的家务，


使其有价值感，鼓励老人有自己的兴趣爱好，避免与社会隔绝。


哈医大四院精神心理科主任张磊晶说，从这两年来就诊的老年抑郁症患者来看，


不少都与老年人帮助子女带孩子有关。在日常接诊过程中，我们发现，


老年人因带孩子引起的抑郁症很多都是隐匿性的。


这种隐匿性的抑郁症症状并不是十分明显，看不出心境的恶劣，


也没有想自杀的念头，但取而代之的是持续性的疲乏、无故的体重减轻、睡眠节律紊乱、


食欲变差、头疼、注意力记忆力下降、腰腿疼痛等，


所以许多老年人就诊时只是强调他们感到疲乏、消瘦、睡眠差等不适，而否认已患有抑郁症。”


张磊晶主任说，这些患者躯体化障碍比较明显，掩盖了患者情绪意志活动方面的症状，


因此好多人辗转各大医院的各个科室，做尽各种检查，结果却都显示没病。

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