Depression Causes, Symptoms& TherapyDepression – or just "depression" – is a serious mental illness, which is often overlooked or confused with other illnesses due to its varied and often unspecific symptoms. However, depression should always be treated professionally – the earlier, the greater the chances of success of psychotherapeutic help.
Symptoms and symptoms of depression How to tell if you have depression
Basically, one speaks of three classic main symptoms of depression. Major Depression):
A deep, uninterrupted dejection that lasts for at least two weeks; joylessness, or. Loss of interest
lack or. No interest in social contacts, work and hobbies; attempts to encourage people close to you come to nothing
Persistent inner emptiness, listlessness and constant fatigue; even getting up in the morning becomes an effort
The secondary symptoms of depression
The following accompanying symptoms are most commonly cited in association with depression:
– Undefinable feelings of guilt, self-doubt and self-reproach (often!) – Sleep disturbances – Restlessness, strong nervousness, inner agitation – Increased consumption of alcohol and tobacco – Increased irritability and aggression (especially in men) – Concentration and attention disorders – Loss of sexual desire
When depression manifests itself in "somatic symptoms"
Although depression is a disease of the psyche, it can also be manifested only by physical complaints. If your doctor cannot diagnose an organic cause, you may have a "somatization disorder" or somatized depression. These signs are for the diagnosis. Subsequent therapy resp. Treatment important information.
Most common symptoms are:
– Cardiovascular complaints – Headaches and back pain – Stomach and intestinal problems – Sleep disturbances – Loss of appetite; less frequently: attacks of ravenous appetite
Up to 50 percent of the risk for affective disorders is genetically predisposed or acquired in early childhood. In addition, other stresses that can trigger depression occur during the course of life. Unfavorable working and living conditions also increase the risk of depression.
Depression in conjunction with other mental illnesses
Since depression often occurs together with another mental illness, a careful diagnosis is important, because any therapy (including psychotherapy) can only be successful in the long term if the possible
Concomitant diseases depression can be treated in a targeted manner. These include:
– Anxiety or panic disorders – Dependency disorders – Dementia disorders – Eating disorders – Personality disorders
The most common organic diseases that can co-occur with depression include diabetes mellitus and cardiovascular disease.
Not all depression is the same An illness with many faces
Chronic depression
About seven percent of the population is affected by years of mild depressive symptoms (dysthymia), much of it since young adulthood. In addition, about 20-30 percent of depressive episodes (major depression) can become chronic. "Chronic depression" is not clearly defined, but depressive symptomatology persists over a period of at least one year and is often accompanied by other mental illnesses such as anxiety or obsessive-compulsive disorders, eating disorders, personality disorders, and drug and alcohol abuse.
Chronically depressed patients can hope again
symptoms and sequelae of chronic depression:
– Persistent depressive symptoms over a period of at least one year, even after several adequate attempts at therapy. Risk factors of chronic depression often lie in the patient's childhood. – High level of distress, severe impairment of self-confidence and self-esteem. – Job loss, lack of relationships, social isolation, loneliness and self-sacrifice. Increased risk of addictive disorders and increased risk of suicide.
Experience shows that chronic depression is often difficult to treat. Almost all patients have already had several unsuccessful attempts at therapy and feel a high level of suffering. You can now benefit from the highly effective CBASP ("Cognitive Behavioral Analysis System of Psychotherapy") procedure. It is the only psychotherapy program in the world specifically designed to treat chronic depression. According to the latest clinical studies, this innovative treatment approach, which is based among other things on a personal but controlled confrontation strategy between the patient and the therapist, gives sufferers justified hope of a noticeable and lasting improvement in their life situation.
From the vast majority of our chronically depressed patients we receive positive feedback about the therapy with CBASP. This encourages us to further expand these treatment options within the Oberberg Clinics.
Somatized depression
It manifests itself in physical complaints (such as palpitations, headaches, digestive disorders or dizzy spells) for which there are no organic causes.
Melancholic depression
Negative mood is particularly severe, sufferers often report that they can no longer feel anything ("feeling of numbness"), emotional vibratory capacity is severely restricted, very often there is a pronounced morning low.
Psychotic depression
It occurs together with delusions and/or hallucinations; its symptomatology is often more severe, the depressive phases last longer, and the risk of suicidality and also of relapse are higher.
Bipolar depression (see also bipolar disorders)
Bipolar disorder occurs more frequently in families (genetic risks) and consists of an alternation between episodes with elevated mood, increased drive and activity (hypomania or mania) and again phases with a low mood with reduced drive and low activity (depression). The phases often alternate, and so-called mixed states also occur (phases with both hypomanic and depressive symptoms). At the onset of bipolar disorder, most patients develop a depressive episode, which differs in some respects from unipolar depression (major depression with only depressive episodes). Typical for "bipolar depression" are u. a. an early onset of the disease, more frequent episodes, each with a shorter duration and a rather abrupt onset and end, as well as the frequent occurrence of so-called atypical symptoms such as increased sleep (hypersomnia), irritability and weight gain.
Reactive depression (adjustment disorder)
This adjustment disorder arises as a direct reaction to a stressful event for the sufferer. This can be the loss of a close person, a separation from the partner, a divorce or even a deep grievance. An adjustment disorder may pass on its own after a few weeks, but a longer duration is also possible, which can then be treated therapeutically. It depends on the person whether the adjustment disorder changes into another form of depression. Particularly at risk are people who have low self-esteem and little self-confidence, who are overly conscientious or have a certain perfectionism; in addition, people who strive for recognition, tend to feel guilty, cannot act out aggressions, cannot say no or like to cling to other people, or are afraid of losing their partner.
Postpartum depression
A distinction is made between the so-called baby blues, a mood disorder that occurs on average in the first 3 to 5 days after around 40 to 70 percent of all births, and "real" postpartum depression, which occurs in one in ten births and can usually be treated on an outpatient basis – unless it is accompanied by suicidal thoughts. Severe "postpartum psychoses" occur rarely (1 to 2 cases per 1000 births); they generally require inpatient therapy. More about postpartum depression. The depressive phases begin. ends in each case at certain times of the year. The best-known form of SAD is "winter depression," which is often accompanied by atypical symptoms (increased need for sleep, craving attacks, preserved ability to vibrate). Symptoms usually improve with adequate light therapy.
Depression in old age
Although it is the most common mental illness among people over 65, it is not always easy to diagnose. A large proportion of depressions in old age remain undiagnosed – despite good treatment options. Often unspecific, mainly physical complaints are in the foreground and "mask" the underlying depression. In addition, depression in the elderly often occurs "insidiously" over a longer period of time, thus complicating diagnosis.
Affective disorders
"Affect" refers to intense but transient emotions ("surge of emotion") triggered by external occasions or internal psychological processes. Affective disorders (in ICD-10 v.a. under F30-F39) mental disorders are summarized, in which the change of the expression and the appropriate flexibility ("ability to vibrate") of the emotional experience and expression (facial expressions, gestures) are in the foreground. However, perceptions, thinking, and behavior are often altered in affective disorders.
Main groups of affective disorders:
– Depressive episode – Major depression (ICD-10: F32) – Recurrent depressive disorder (ICD-10: F33) – Manic episode (ICD-10: F30) – Bipolar affective disorder (ICD-10: F31) – Persistent affective disorder (dysthymia, cyclothymia) (ICD-10: F34)
If the symptoms cannot be assigned to any of these groups of clinical pictures, they form their own groups in the ICD-10 as "other" (ICD-10: F38) or "unspecified affective disorders" (ICD-10: F39). When brain-organic causes are present, affective disorders (with depressive, bipolar, or manic manifestations) are classified as Organic Affective Disorders (ICD-10 F06.3) diagnosed.
Affective disorders are easily treatable in most cases
Treatment is provided for moderate severity and above using an overall treatment plan that usually includes psychopharmacological with psychotherapeutic approaches as well as complementary specialist therapies. In the treatment of bipolar disorders, medications to stabilize the mood are. Phase prophylaxis usually indispensable. To date, the most effective psychotherapeutic treatment concepts for depression have proven to be cognitive behavioral therapy or depth psychology-based psychotherapy.
High-functioning depression
Affected by a
High-functioning depression From the outside, they usually do not show the familiar signs of a classic depression. For this reason, people with high-functioning depression often experience less understanding from their environment and run the risk of seeking help less often, despite great suffering prere. Between the symptoms of depression. There are numerous overlaps between the symptoms of a burnout syndrome and those of a depression. This often makes the diagnostic delimitation in the run-up to treatment and therapy difficult.
Managers, executives, public servants, teachers and doctors as well as other "helping professions belong to occupational groups Particularly at risk Are at risk of developing a burnout syndrome. However, they sometimes react with surprise when, after a precise diagnosis, it turns out that their complaints and symptoms already correspond to a depression – which has then mostly developed from an existing burnout syndrome – and should already be treated by psychotherapy. In fact, depression can develop from an untreated burnout syndrome after continuous work-related stress, but depression is neither synonymous with a burnout syndrome nor with any other mental illness.
Depressive people, like burnout sufferers, often take refuge in the "depression" social isolation. On the other hand constant irritability more symptomatic of a burnout syndrome. At the same time, depression causes symptoms that burnout does not usually cause, such as reduced self-esteem, impaired self-confidence or suicidal thoughts. Through a professionally conducted diagnosis, the right help can be found for the patient, according to their illness, through therapy or treatment. psychotherapy are identified.
Causes of depression The disease is always triggered by several factors
Statistically, at least one in three people will suffer from depression in the course of their lives. Women are affected about twice as often as men. To date, the development of depression has not been fully clarified scientifically. It is considered certain that several aspects always contribute to the development of depression (multifactorial development).
The clinical picture of depression develops particularly frequently after severe psychological stress, which are not (can not) be properly processed – for example, by the death of a partner or a relative, a divorce, or a divorce. This can be caused by separation, persistent difficulties at work, the loss of a job, or the start of a new phase in life such as parenthood or retirement.
It can affect anyone: Statistically, one in three people will suffer from depression in the course of their lives. It is therefore important to interpret the signals of the psyche and the body correctly in order to enable diagnosis, treatment and therapy. The situation can also be a challenge for family members.
In most cases, there is no "one" cause that can trigger depression. This usually requires several risk factors at the same time:
– genetic predisposition – certain personality traits – persistent stress (relationships, school, education, work, financial burdens, etc.) – a certain amount of stress.) – traumatic experiences (z. B. Victims of a criminal act; experiences of abuse or neglect) – Personal experiences of loss (due to death or separation, but also loss of status, etc.) – Personal loss (due to death or separation, but also loss of status, etc.).) – Phases of biological and psychosocial changes, z. B. due to a hormonal change, especially in women after pregnancy or menopause
Physical illnesses can also trigger depression. The most common somatic risk factors for an additional depressive illness are:
– Sleep disorders – severe, chronic and incurable diseases – diabetes mellitus – dementia – other physical causes such as heart attack and stroke
Thus, physically chronically ill people have about twice the risk of additionally suffering from depression compared to organically healthy people.
By the way, depression is not a question of age: even children and adolescents can develop depression, and depression can also occur – even for the first time – well into old age.
Early and professional therapy increases the chance of successful treatment of depression.
How depression differs from grief?
In fact, the depressed, sad mood (sometimes far beyond depressed mood) of sufferers during a depression phase resembles those feelings one feels after losing a loved one. Yet even grieving people can laugh and feel joy in between. People with major depression cannot do this, because it is a disease or an illness. Disorder that requires treatment. In addition, grievers' moods improve over time, and they experience their gloomy moments less frequently and for shorter periods of time. However, if several risk factors are present, grief may well turn into depression.
You should not ignore a depression in any case. You can probably overcome a mild depressive mood or the preliminary stages of a mild depression by, for example, consciously taking a break from your everyday life for a longer period of time, fulfilling a long-cherished wish or simply taking a vacation. The symptoms of depressive episodes or depression itself may also temporarily subside somewhat.
However, we would strongly recommend that you consult an expert as soon as possible if you have a well-founded suspicion of depression, in order to obtain the correct diagnosis, treatment and therapy, and to counteract the risk of possible chronicity.
Unfortunately, depression is often the main cause of people taking their own lives. 90 percent of the 10.000 people who die from suicide each year have suffered from a psychiatric disorder, most commonly depression. Schizophrenia and addictive disorders are also not uncommonly associated with a greatly increased risk of suicide.
Treatment and therapy of depression We advocate a more open approach to mental illness
Public awareness of mental illness has changed in recent years in favor of a more enlightened point of view. Therefore, no one need be ashamed to have mental problems and psychological complaints treated professionally – on the contrary: in many patient discussions and with relatives, it has been shown time and again that an open approach to the disease supports therapy.
There was a gray veil over my life almost all the time, but I didn't know what was wrong with me. Some days I just wanted to stay in bed, do nothing and see no one. These phases could last several weeks. Today I know that I probably suffered from my depression much longer than necessary.
Most people suffering from depression can be helped by professional psychotherapeutic treatment. With an individual, disorder-specific therapy, depressive episodes can even disappear completely.
While until a few years ago people spoke of "cure", modern psychiatry now prefers the terms "Remission" (extensive reduction of symptoms for a period of at least 6 months) and "Recovery" (Symptom-free "recovery" with a normalization of the risk of new illnesses).
The often still predominant focus on symptoms, complaints and deficits is replaced in the Oberberg Clinics by a holistic approach with a view to supportive factors (support), resources (abilities, "healthy parts") and, in particular, the individual's own personal development Resilience ("resilience", "stress resistance") supplemented.
Treatment depends on the severity of the depression. For mild depression, psychotherapy is usually used; for moderate and severe depression in particular, antidepressant medication, appropriate psychotherapy, or a useful combination of both are usually used – at least if the patient can tolerate or is willing to put up with the side effects of the medication. The effect of antidepressants sets in after only one to two weeks. Usually reaches full strength after about four to six weeks. Combination therapies of medication and psychotherapy are particularly indicated for severe and chronic depression. We always make sure that the dosage of the psychotropic drugs used has as few side effects as possible.
Important: There are many different successful psychotherapy approaches to treating depression. As an Oberberg patient, you can always discuss in detail with your team of therapists which individual evidence-based treatment concept promises the greatest therapeutic success for you. However, you should always expect that every psychotherapy requires a certain degree of cooperation, patience and perseverance. Learn more about therapies for depression.
In our clinic, we work with each patient to tailor a treatment and therapy for depression to their individual needs. We use scientifically based guidelines for orientation. The distinctive feature of our therapy programs is the individual application of established. Innovative procedure with high intensity at the highest level.
The Oberberg Clinics for Depression We don't just treat patients, we treat them like our guests
At the Oberberg Clinics for Psychiatry, Psychosomatics and Psychotherapy, we support people in severe mental crisis situations with efficient treatment concepts. We firmly believe in the interaction of humanity, connectedness and evidence in a first-class environment, characterized by a warm atmosphere of mindfulness, kindness, respect and mutual trust.