{"id":2824,"date":"2024-11-18T09:17:55","date_gmt":"2024-11-18T09:17:55","guid":{"rendered":"https:\/\/damianruiz.eu\/?p=2824"},"modified":"2024-12-17T11:39:44","modified_gmt":"2024-12-17T11:39:44","slug":"le-traitement-de-la-depression-majeure","status":"publish","type":"post","link":"https:\/\/damianruiz.eu\/fr\/le-traitement-de-la-depression-majeure\/","title":{"rendered":"Le traitement de la d\u00e9pression majeure"},"content":{"rendered":"

Damian Ruiz<\/span><\/p>\n

La d\u00e9pression majeure touche entre cinq et sept pour cent de la population am\u00e9ricaine et europ\u00e9enne.<\/span><\/p>\n

Sur le plan th\u00e9rapeutique, la combinaison de m\u00e9dicaments psychotropes et de traitements psychologiques est couramment utilis\u00e9e pour les personnes souffrant de ce trouble. Dans les cas les plus graves, des th\u00e9rapies de stimulation c\u00e9r\u00e9brale ont \u00e9t\u00e9 tent\u00e9es.<\/span><\/p>\n

Les r\u00e9sultats sont ambivalents mais, \u00e0 ce jour, rien ne s’est av\u00e9r\u00e9 suffisamment efficace pour consid\u00e9rer qu’il existe une seule th\u00e9rapie ad\u00e9quate. Cela d\u00e9pendra toujours du patient, de ses particularit\u00e9s et de sa complexit\u00e9.<\/span><\/p>\n

En ce qui me concerne, je travaille sur l’hypoth\u00e8se que chaque trouble psychologique a une composante biologique, probablement une pr\u00e9disposition g\u00e9n\u00e9tique, plus un d\u00e9clencheur circonstanciel. Il n’est pas possible d’agir sur la composante biochimique, car elle d\u00e9termine la tendance, mais on peut agir sur ce qui a \u00e9t\u00e9 ancr\u00e9 dans le psychisme de la personne, qu’il s’agisse d’une exp\u00e9rience v\u00e9cue dans le ventre de la m\u00e8re (Frank Lake, 1914-1982), dans les premiers instants de la vie (Wilfred Bion, 1897-1979, Donald Winnicot, 1896-1971) ou plus tard.<\/span><\/p>\n

Dans tous les cas, les exp\u00e9riences v\u00e9cues avec une composante traumatique claire, qu’elles soient ponctuelles ou sur une p\u00e9riode plus ou moins longue, sont, dans la grande majorit\u00e9 des cas, indispensables pour que la pr\u00e9disposition biologique soit activ\u00e9e et devienne m\u00eame chronique.<\/span><\/p>\n

Imaginons donc une personne qui, dans les profondeurs de son psychisme inconscient, toutes ces informations qui ne peuvent \u00eatre trait\u00e9es par le cerveau rationnel mais qui conditionnent la vie de la personne, vit un conflit de forces psychologiques tr\u00e8s oppos\u00e9es, par exemple la tendance \u00e0 l’autodestruction (pulsion thanatique, Freud, 1856-1939) et la tendance \u00e0 la transgression dans la vie r\u00e9elle, transgression, par exemple, du code moral de l’entourage ou de l’environnement \u00e9thique. Ce sont des \u00e9nergies nerveuses tr\u00e8s puissantes qui peuvent conduire \u00e0 la prostration et \u00e0 la disqualification de la vie.<\/span><\/p>\n

Imaginons que par diverses techniques, analyse des r\u00eaves, exercices projectifs, dialogue th\u00e9rapeutique et analytique, etc. nous d\u00e9couvrons le grand conflit sous-jacent. La question est, dans ce cas, de savoir ce que l’on fait \u00e0 partir de l\u00e0.<\/span><\/p>\n

Les produits psycho pharmaceutiques, auxquels je suis favorable s’ils am\u00e9liorent l’\u00e9tat du patient, peuvent \u00e9galement renforcer le conflit parce qu’ils agissent de mani\u00e8re g\u00e9n\u00e9rique, de mani\u00e8re \u00e0 fournir de nouveaux renforts \u00e0 chacun des combattants.<\/span><\/p>\n

Donc, une fois que le patient reconna\u00eet la lutte interne, les oppositions int\u00e9rieures latentes, et que cela a n\u00e9cessit\u00e9 un travail th\u00e9rapeutique pr\u00e9alable, il faut, \u00e0 mon avis, passer \u00e0 l’action.<\/span><\/p>\n

Mais l’action doit avoir un sens, il ne s’agit pas d’aller se promener, de faire du sport et de se distraire, si seulement c’\u00e9tait aussi simple. L’action doit viser \u00e0 ce que la pulsion d’\u00e9ros (de vie), m\u00eame si elle est en \u00e9tat d’inf\u00e9riorit\u00e9, m\u00eame si la pulsion de mort est beaucoup plus puissante, arrive \u00e0 un point o\u00f9 elle gagne et ram\u00e8ne le patient \u00e0 \u00ab l’existence r\u00e9elle \u00bb.<\/span><\/p>\n

Cette action, au d\u00e9but, doit \u00eatre presque unique, et doit \u00eatre r\u00e9p\u00e9t\u00e9e encore et encore jusqu’\u00e0 ce que la personne l’int\u00e8gre comme une routine, m\u00eame si cela lui demande une \u00e9norme quantit\u00e9 de travail.<\/span><\/p>\n

Dans certains cas, la combinaison d’exercices corporels et d’un certain type de respiration, un sport de contact comme la boxe ou la pratique de la danse africaine, par exemple, peut commencer \u00e0 \u00eatre le point tournant, non pas la solution en soi, mais ce qui initie le changement. Si le patient ne se sent pas capable d’initier ces mouvements, il faudra commencer petit \u00e0 petit et peut-\u00eatre de mani\u00e8re beaucoup plus simple, mais l’action, aussi petite soit-elle, est essentielle. Mais j’insiste, pas n’importe quelle action, mais une action qui a du sens. Personnellement, je d\u00e9teste l’id\u00e9e qu’une personne atteinte d’un trouble psychique non organique doive se distraire ou apprendre \u00e0 le g\u00e9rer pour le rendre plus supportable. Un th\u00e9rapeute doit essayer, par tous les moyens appropri\u00e9s \u00e0 sa disposition, de surmonter le probl\u00e8me ou de le r\u00e9duire de mani\u00e8re significative, et parfois il y parvient, parfois non, mais si l’id\u00e9e de d\u00e9part est limit\u00e9e, il n’y a probablement pas grand-chose \u00e0 faire. Il en va autrement lorsqu’il s’agit d’une v\u00e9ritable maladie organique diagnostiqu\u00e9e et confirm\u00e9e par des tests m\u00e9dicaux.<\/span><\/p>\n

Tout au long de ma vie, outre la psychologie dans ses aspects biologiques et psychanalytiques (surtout jungiens, ma formation), je me suis int\u00e9ress\u00e9 aux questions anthropologiques et \u00e9thologiques, en lisant sur le comportement des animaux, en particulier des primates (Frans de Waal, 1948-2024), mais aussi sur les diff\u00e9rents rituels et actions des tribus primitives utilis\u00e9s pour gu\u00e9rir l’esprit et le corps, et bien que toutes ces informations soient aujourd’hui rejet\u00e9es, <\/span>peut-\u00eatre celles li\u00e9es \u00e0 l’ayahuasca ou \u00e0 d’autres substances hallucinog\u00e8nes, qui peuvent cr\u00e9er une d\u00e9pendance et, bien s\u00fbr, \u00eatre contre-productives pour les personnes dont la structure psychique est fragile, ce<\/span><\/i> sont des informations qui peuvent offrir des aspects int\u00e9ressants \u00e0 prendre en compte.<\/span><\/p>\n

La d\u00e9pression profonde est, \u00e0 l’heure actuelle, tellement personnelle, c’est-\u00e0-dire qu’elle r\u00e9pond tellement \u00e0 l’idiosyncrasie de chaque patient, que les traitements ne peuvent \u00eatre que personnalis\u00e9s. Peut-\u00eatre qu’un jour la science trouvera \u00ab la m\u00e9thode \u00bb, mais aujourd’hui nous devons travailler de mani\u00e8re th\u00e9rapeutique avec toute la complexit\u00e9 proc\u00e9durale que cela implique.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Damian Ruiz La d\u00e9pression majeure touche entre cinq et sept pour cent de la population am\u00e9ricaine et europ\u00e9enne. Sur le […]<\/p>\n","protected":false},"author":4,"featured_media":2819,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[],"tags":[],"class_list":["post-2824","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry"],"yoast_head":"\nLe traitement de la d\u00e9pression majeure - Dami\u00e1n Ruiz<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/damianruiz.eu\/fr\/le-traitement-de-la-depression-majeure\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Le traitement de la d\u00e9pression majeure - Dami\u00e1n Ruiz\" \/>\n<meta property=\"og:description\" content=\"Damian Ruiz La d\u00e9pression majeure touche entre cinq et sept pour cent de la population am\u00e9ricaine et europ\u00e9enne. 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