Depression – severity and courseDepression and depressive disorders are widespread diseases, the frequency and severity of which are very often underestimated. According to the Federal Ministry of Health up to 20 out of 100 people at least once in their life from depression. The many facets of depression, however, make it difficult to define as a Disease tangible. So how do you recognize a depressive disorder, how is it diagnosed and what are the differences in different age groups??
What is depression?
With depression our mood, as derived from Latin, depressed or pulled down. A lack of interest and drive pairs with diminished capacity and a basically changed mood. In some cases, depression occurs as a separate event. But also longer episodes or recurrent depression are possible. In these cases, sufferers often face the challenge of managing their daily lives and job demands with the burden of depression. Meeting these obligations under the influence of the psychological challenge of depression can seem like an unbearable burden. In the worst case scenario, depression develops into a Suicide risk.
Social prejudices against mental illnesses, as well as depression, place an additional burden on those affected. Mild forms of depression can sometimes without medication be treated. For moderate or severe cases, medication support in conjunction with a professional therapy necessary.
How common is depression?
With 5.3 million new cases among adults in Germany within one year, depression is a very present mental illness. At 25-40% of those affected is the depressive phase is unique at. 10-15% of sufferers, however, suffer from chronic courses. Depression occurs at any age, but is older people are more likely to have than in young. Also are affected more often in women than men.
Causes of depression
The multiplicity of causes often leads to the fact that different factors at the Development of depression are involved. have an influence on those affected. can trigger a depression as a direct consequence. The exact triggers are individual to each sufferer. Increasing over time. At some point can no longer cope. Also traumatic experiences from childhood and genetic factors play a role in whether and how quickly a person becomes depressed. Depressions are therefore not purely physical or psychosocial causes to be determined. Both factors complement each other and must be examined together in order to work out the individual cause of depression in the sufferer in each case.
The following Causes can promote depression:
– Loss and separation (in job/study/school) – Unemployment – Illness and/or accidents – Childbirth (postpartum depression)
Whether these causes lead to depression or not also depends on whether, how stable other external and internal resources of the affected person are are. The possibility of coming out Vitality, enjoyment of life and the own optimism to draw on or also supported by family and friends under certain conditions protects against depressive disorders. However, if one or more of these resources fall away in addition to the stressful events or causes, stress and the development of depression becomes more likely. Not only negative events promote depression. Also positive, but for this severely life altering Events can trigger depression. The Corona pandemic has a strong influence on the development. Also treatment of depression taken worldwide. Already the concern, which arose with regard to the Corona developments, was particularly reflected in the situation of already depressed people in Germany. According to the Deutsche Depressionshilfe every second person who becomes depressed due to Corona. Above all, measures such as prolonged lockdowns, worsened the course of the disease and the care of mentally ill people enormously. Almost half of the patients took in the 2. Lockdown a worsening of their depression, to the point of suicide attempts, true. Treatment appointments also became scarce due to the Corona pandemic. More than one in five patients is waiting for a treatment appointment.
Lack of social contacts, Lack of exercise and a Lack of daily structure as well as extended bedtimes have an additional negative effect on those affected. 44% of those diagnosed with depression indicated that your illness worsened by corona have. 8% reported by Suicidal thoughts or suicidal impulses. However, the general population also took a particularly close look at the 2. Lockdown of the Corona pandemic as even more stressful perceived.
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Symptoms of depression
Depression or depressive disorders are often only recognized at a late stage. Many sufferers skip over any symptoms and do Changes in behavior as phased off. This is why friends and family are often a great help in pointing out the first symptoms of depression. Among the main symptoms of depression include:
– depressed mood – lack of interest and joy – as well as lack of drive and increased fatigability
Depression is often characterized by depressed mood or even a certain Empty of those affected. It is often not so much an excessive sadness as an inability to express own perceive feelings to be able to. Also the disinterest of previously popular and meaningful activities is an important feature of depression. What previously triggered enthusiasm and passion is now joylessly executed or even completely abandoned. The listlessness shows itself not only with larger obligations, but also with everyday tasks. Affected persons already feel depressed by simple tasks such as shopping or tidying up overloaded. Sufferers seem powerless, their facial expressions petrified. Also the Decisiveness leaves after.
Further Additional symptoms/ secondary symptoms are manifested, for example, by:
– Decreased attention and ability to concentrate – Decreased self-esteem and self-confidence – Feelings of guilt – Pessimistic outlook on the future – Suicidal thoughts or actions – Loss of appetite
Diagnosis of depression
The WHO 5 questionnaire on well-being, for example, provides information about the patient's own state of health. The General Depression Scale (ADS) can also be used as a guide for initial self-assessment. If a Change in mood and drive joyfulness perceived and indications from self-tests point to a endangered mental stability interpret, should Specialist consultation by a psychological Psychotherapists or a Psychiatrist occur. This raises a psychopathological findings and records the previous course of the disease. On this basis a final diagnosis is made. The variety of causes. symptoms helps in the diagnosis of depression. Depending on the severity and number of symptoms, a distinction is made between more easily, moderate and severe depression differentiated. As a guideline: If in the course of two or more weeks at least two of the three main symptoms and additionally at least two secondary symptoms If the main symptoms are present, depression can be amed. Not all symptoms are always present, the severity of the clinical picture can also vary among sufferers.
The severity of the diagnosed depression depends on the number of main and secondary symptoms:
depression – forms and course
Depression has many faces. For example, some sufferers sometimes have the impression that they are on the The road to recovery are, before they suddenly again in the middle stuck in a depressive phase. Also development of depression must be taken into account when determination of the form of the disease be considered. A distinction is made between primary and secondary depression. Primary depression develops on its own, whereas secondary depression develops as a result of a medical illness factor or a other mental illness developed. For a better way of dealing with the illness, it is important to determine exactly what type of depression is involved in the individual case. Only in this way can the depression be treated in the long term and, above all, with foresight or Relapses should be avoided.
depressive episode
The Depressive episode shows symptomatically by depressed mood, loss of interest as well as joylessness and listlessness. It occurs in all three degrees of severity, with moderate and severe episodes also being psychotic symptoms, like delusions and hallucinations, carry with it. Occur two or more depressive episodes occur, one speaks of a recurrent current depressive disorder. However, if the depressive episode lasts only a few days and is responsible for recurring, one speaks of a recurrent brief depressive disorder. The recurrence of the depressive episode in these cases is usually distributed once a month for at least a year. A chronic depression is present when a depressive episode longer than two years without improvement persists.
unipolar depression
occurrence in the several depressive episodes in the course of life on, one speaks of a recurrent unipolar depression. This is the most frequent diagnosis in sufferers. Away from the episodes that occur are affected in most cases completely healthy. The length of time between depressive episodes may vary. Through Therapy and self-help mechanisms can sufferers in many cases Avoiding relapses of depressive episodes.
Bipolar depression
The bipolar affective disorder is often also referred to as "manic-depressive disorder" denotes. Sufferers of this form of depression experience both depressive as well as manic, i.e exaggerated cheerfulness, phases. In these phases there is a imbalance of emotions. Between the phases, the state of mind the affected person in turn often balanced.
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dysthemia
The dysthemia belongs to the persistent affective disorders. It describes a chronic, at least two years persistent depressive mood with less severe symptoms. In addition to dysthemia, there may also be a full-blown depressive episode develop. The simultaneous occurrence of a dysthemia and pronounced depressive episode is then called double depression referred to as. Young adults are more likely to be affected by dysthemia. In old age, they are usually the result of a depressive episode or a great mental stress, like a Bereavement.
Atypical depressive episode
In atypical depressive episodes remain the positive emotions and Reactions receive. This characteristic makes the atypical depressive episode difficult to recognize. However, in some cases this form of depression leads to Weight gain, higher need for sleep and increased sensitivity personality.
Psychotic depression
It may happen that people with depressive disorders have the awareness of reality losing. You suffer from Psychosis, often accompanied by hallucinations or delusions. The self is questioned in the process, and in some cases there is also a delusions of persecution added. Sufferers in such a phase sometimes become paranoid, The depressive episodes can be of varying length between episodes and can be of different severity.
Depression in children and adolescents
The titled widespread disease depression is also children and adolescents not stop. It is even one of the most common mental illness in these age groups. If someone in the family environment already suffers from depression, children and adolescents are at increased risk of developing depression themselves. All degrees of severity of depression occur. However, the symptoms of depression in children differ. adolescents differ markedly from those of adults. However, when a diagnosis is made, the same criteria apply as for adults. In most cases, a Depression in children and adolescents shorter than in adults. The chances of complete recovery are with children higher. In adolescence, on the other hand, there is more often than in adults to relapses. In many cases Probability high, that the adolescent sufferers have the illness with into adulthood take.
It is often difficult to clearly identify depression in children and adolescents. Adolescent developments cloud the picture, because temporary depressive symptoms are often part of normal adolescence. Other behavioral disorders in children are. Adolescents often in the foreground. irritability and rebellious Behavior is noticed more quickly in social life and at school, depressive Symptoms are observed comparatively less. The manifestations of depression in children and adolescents also differ enormously.
Symptoms of depression in children and adolescents
The characteristics and symptoms of depression differ depending on age and stage of development. In Infancy are observed frequent crying, increased irritability and apathy. School children on the other hand express themselves already more concrete to their perceived sadness and listlessness. Mostly show here concentration– and Memory problems as well as Fears of the future. Adolescents already develop adult-like symptoms, suffer from mood swings and lose drive and interest at the environment.
Regardless of age, gender or life situation, depression burdens and takes over the lives of those affected. Self-tests and attentive observation help to identify first Warning signs to be better interpreted and actively avoided Counteracting deterioration. A professional therapy is an important help especially in severe courses, but also in less severe episodes.