Scientific studies have shown that depression is more common in women than in men. A study has now found an explanation for this gender difference. (Image: sompong_tom/fotolia.com)
"All I see is gray" – Depression
Depression is a common mental disorder that manifests itself in depressed mood, loss of interest in pleasurable activities, lack of energy, feelings of guilt, lack of self-esteem, disturbed sleep, loss of appetite, and lack of concentration. Depression is also accompanied by obsessive fears. These problems can become chronic or recur. Restrict the affected persons considerably in the organization of the everyday life. Depression also very often leads to suicide. Factors involved in depression include genetics, brain biology and chemistry, and life events such as trauma, loss of loved ones, cuts in relationships, early childhood experiences, and generally stressful situations.
Depression can affect people at any age, but symptoms of long-term depressive disorder begin in the teen years or twenty-somethings. Most chronic adult mood and anxiety disorders begin with high levels of anxiety in children. In fact, children's anxiety symptoms put them at high risk of developing depression as adults.
Depression occurs as a comorbidity of other serious illnesses, for example, diabetes, cancer, heart problems and Parkinson's disease. Depression exacerbates these conditions, and these conditions exacerbate depression – this spiral can directly threaten the life of the sufferer. Medications for related illnesses can also trigger depression as a side effect.
The risk of suicide is immense in severe illnesses whose companions are depression. Outsiders can hardly tell posthumously whether the deceased took their own life because of depression or because of their primary illness. Depression can come in different forms and degrees of severity. They are generally a serious illness that urgently requires professional treatment. (Image: sompong_tom/fotolia.com)
Depression is described by the current International Classification of Diseases (ICD-10) as a mental syndrome with the main symptoms of markedly depressed and pessimistic mood, decreased drive and increased fatigability, and suicidal thoughts and actions.
Sometimes, however, the depression hides behind purely physical complaints (lavierte or masked depression).
Women and men
Depression is more common among women than men. Biological, hormonal and psychosocial factors play a role, as do life cycles. Women, for example, are particularly likely to develop depression after childbirth, when hormonal and physical changes are accompanied by the new responsibility for the newborn.
Men also experience depression differently than women. Women mainly report feelings of sadness, worthlessness and guilt; men are more likely to feel tired and irritable, lose interest in their favorite hobbies and have trouble sleeping.
Men also turn more to alcohol and drugs when depressed, and their complaints are more likely to be expressed in frustration than in sadness. They behave discouraged, angry and become abusive. Some men throw themselves into work to avoid talking about the depression with family or friends or behave recklessly. Although depressed women commit more suicide attempts, more depressed men die by suicide.
The "typical male" way of dealing with depression makes it difficult to get help – firstly, they refuse to accept help, and secondly, it is often not obvious to other people that the cause of the noticeable behavior is depression.
Alcohol and drug abuse, insults, and inconsideration are also classic for dissocial characters, narcissistically disturbed people, or, without naming a mental disorder, egocentric people. Depressed men express in this way a deep suffering which they cannot openly articulate. Women suffer from depression much more often than men. (Image: boryanam/fotolia.com)
Symptoms and signals
Depression causes cognitive, psychomotor, and other dysfunctions such as fatigue, poor concentration, loss of sexual desire and pleasure in almost all pursuits, sleep disturbances, and a sense of dejection.
Typical complaints of a depression in the mental-emotional area are a depressed mood, which is accompanied by a lack of drive, desire and joy in all activities, including those that were previously enjoyed. Those affected also report feeling-. Lack of interest towards – actually beloved – persons. Some people are afflicted by difficulty concentrating and obsessive brooding, while others have unfounded, z.T. are at the mercy of delusional ideas of guilt, failure or impoverishment. Sleep disturbances, thoughts of suicide, and even completed suicide occur. On the physical level, heart complaints, headaches, sore throat, back and limb pain, constipation, loss of appetite, weight loss, menstrual disorders in women, and decreased sexual desire in both sexes are evident.
Depressed people often attempt and frequently complete suicide. There may also be symptoms that are essential to other mental disorders, making diagnosis more difficult: Anxiousness, for example, is also a sign of anxiety disorders, and these in turn can accompany or develop into depression.
Patients with all forms of depression often try to control their sleep disorder with alcohol or other drugs – however, doctors often confused cause and effect here in the past. Depression is far less likely to be the trigger for alcoholism than earlier researchers had suspected.
Meanwhile, heavy smoking is typical for depressives, just as they generally neglect their health – if life no longer brings any joy, there is also no point in trying to live a long and healthy life. Sleep disturbances are one of the non-specific symptoms of depression. (Image: Doreen Salcher)
Depressive symptoms can be clearly explained as a result of direct injury to the brain after a stroke, brain tumors or accidents, as well as other organic triggers, for example, hypothyroidism.
In most cases, however, many factors play a role in depression: genetics as well as neurobiochemistry. Today, an imbalance of various neurotransmitters is considered a major factor in depression. In particular, a low release of serotonin, which sets our "feelings of well-being" in motion, can be seen in depression.
Another factor is persistent stress in the organism, which can be measured by certain hormones and is increased in depressives. We speak of depressive moodiness when the symptoms are mild and temporary. During pregnancy and after childbirth, hormonal changes can temporarily promote depressive symptoms, which, however, disappear. Depressive symptoms also occur reactively, i.e., in response to crisis events such as loss, illness, or as a result of ongoing psychological stress (exhaustion depression).
In addition, depression is sometimes due to disturbed biorhythms, as evidenced by mood changes during the course of the day, altered waking and sleeping rhythms with disturbances in falling asleep and staying asleep, or seasonally dependent depression with increased incidence in seasons with little light.
Genetic factors play a significant role in the risk of developing depression, especially melancholic depression, psychotic depression and depressive episodes within bipolar disorder. British researchers found chromosome 3p25-26 in more than 800 families with recurrent depression. Scientists suspect that up to 40% of all people who develop depression have a genetic predisposition to it. Environmental and other factors are responsible for the remaining 60%. Impaired release of the neurotransmitter serotonin is seen in many people with depression. (Image: Zerbo/fotolia.com)
In most clinical depressions, neurotransmitter functions are disrupted. Neurotransmitters are messengers that carry signals from one area of the brain to another. Many different neurotransmitters serve different purposes in this process. Three of the most important for human emotions are serotonin, dopamine and norepinephrine.
In a normally functioning brain, neurotransmitters interact with a series of neurons, with a signal that is as strong in the second and subsequent cells as it was at the beginning. But in people with depression, these neurotransmitters don't function as usual, so the signal is either weakened or interrupted before it passes the next nerve cell.
Physical illness can lead to depression because pain and discomfort make it difficult to do things you want to do. While low moods should not be confused with clinical depression, people with chronic pain are four times more likely to suffer from depression than people without pain.
Chronic physical illness generally puts people at higher risk of developing anxiety disorders or depression. The symptoms of a physical illness, as well as some treatments, can lead to a lifestyle that severely disrupts the lives of sufferers and causes them financial hardship. In addition, their social life often breaks down. Professional life.
Conversely, depression increases the risk of developing physical diseases, for example, heart problems, stroke and diabetes. Researchers also found that young people with depression get more arthritis and digestive system diseases.
In women, depression aggravates the consequences of breast cancer. Danish researchers, in studies of 45.000 women with early-stage breast cancer found that 13% of patients prescribed antidepressants died within five years of diagnosis. Women who never needed such medications had a slightly lower mortality rate: 11%.
As is usually the case with depression, various factors come together here. Initially, depressed women are less likely to start cancer therapies suggested by doctors. How tumors can grow. Form metastases. Cancer doctors should therefore be very careful with women who have previously suffered from depression and perhaps seek additional psychotherapeutic advice to convince them to participate in therapy. Other problems arise from the accompanying symptoms of depression: the lack of concentration causes them to take their medication irregularly, as does hopelessness. It is not uncommon for depression to cause patients to discontinue cancer treatment.
The psychosomatic aspects of cancer cures have not been sufficiently studied to say precisely whether the feelings of pessimism and futility typical of depression promote cancer. However, self-suggestion is effective for a great many diseases. Most likely also associated with cancer. A, casually said, "everything will be all right" feeling or even just a positive view of the world despite illness has a direct effect on neurotransmitters – and also on those that can set healing processes in motion, such as dopamine. Aging is associated with changes in the cardiovascular system, which can also directly or indirectly affect the brain and promote depressed moods. (Image: athomass/fotolia.com)
The aging brain
Aging is associated with changes in the functions of various organs. Changes in the cardiovascular system also have a direct or indirect effect on the brain, with consequences for the nerves and thus for the senses and perceptions. This, in turn, can lead to various psychiatrically diagnosed diseases.
Clinical depression, however, is not a normal process of aging. Most seniors feel good about their lives – despite increasing physical problems. However, depression can also be difficult to detect in the elderly. They show few obvious symptoms. Some elderly people who suffer from depression feel tired, have problems sleeping, or seem grouchy or depressed. confused. However, confusion and cognitive complaints also characterize Alzheimer's disease and other nervous and brain diseases.
Older people are more likely to suffer from conditions such as heart disease, stroke, or cancer, which in turn can lead to depression. Or they take medications whose side effects include depressed moods. However, some seniors suffer from depression that has a physical cause, for example, depression in arteriosclerosis or vascular depression. When the blood vessels harden, less blood flows to the organs, including the brain. This leads to the bad moods, but also to the risk of heart or brain attack.
Seniors who suffered from depression as young people are at greater risk of developing depression late in life than those who did not have the condition early in life.
Gender (sex characteristics) is a partial, but at the same time incomplete, explanation of why people develop this illness. The same number of men. Women get melancholic depression. However, studies show that women suffer much more from non-melancholic depression than men do.
Hormonal changes during puberty increase the risk of depression in girls. However, fluctuations in emotions are completely normal during the teenage years – this is due to changing hormone levels. They alone do not cause disorders of the depressive type. However, sociopsychological problems may play a role in depression: Eruptive sexuality and identity formation as well as conflicts with parents, prere to perform in school, sports and other areas of life.
After puberty, the numbers of women with depressive disorders are higher than for men. Because women enter puberty earlier than men, they also develop the disease earlier than men do. stress is considered to be a major influencing factor in the occurrence of depression. It often acts as a trigger for the onset of the disease. (Image: REDPIXEL/fotolia.com)
Stress is an important trigger for depressive disorders – and an equally underestimated one. Between stress that depresses someone in the short term and clinical depression, while not worlds apart, there are serious differences.
Prolonged stress increases a person's risk of depression in his or her later years. This includes growing up with abuse or emotional neglect from parents, divorce or loss of a loved one.
Severe depression is an enormous burden not only for the sufferer, but also for society as a whole. They are also called clinical depression, which means that they need clinical treatment. Home remedies" are not enough, and some methods of laymen and – much worse – of charlatans can be fatal without exaggeration. These mental disorders massively affect the social. Emotional behavior patterns of the depressed person. Appetite and sleep no longer function, those affected can hardly cope with their everyday life. Life does not seem worth living to them. In industrialized countries like the U.S. and Germany, major depression ranks among the most common mental disorders – first in the U.S. and sixth in Germany, although the diagnostic criteria in the two countries are not identical.
Persistent depression results from a cocktail of influences: Mental, physical and emotional – personality, temperament, environment and genetics. People with persistent depression have more parents, brothers and sisters who also struggle with severe depression.
This form is considered less severe because fewer symptoms characterize it than major depression. However, the diagnosis is not simple. Because symptoms must persist for at least two years to warrant the definition – as opposed to two weeks for major depression.
Treatments include medication and psychotherapy – cognitive behavioral therapy and interpersonal therapy have shown success. The most effective method today is considered to be a combination of medication and psychotherapy.
Psychotic depression or major depression with psychotic features is a serious condition – those affected suffer from a combination of depressed mood and psychosis. The psychosis manifests itself in delusions of a nihilistic nature, such as the belief that catastrophes are inexorably approaching.
Unlike other forms, psychotic variants of the disorder are characterized not only by depressive symptoms but also by hallucinations in which patients see or hear things that are not there. Delusions characterize irrational fears and thoughts.
Psychotic depressives often become paranoid or believe that their thoughts do not belong to them, or that other people could read their thoughts.
These symptoms overlap with the paranoid form of schizophrenia. One difference, however, is that depressives, at least in their hallucinations, are usually aware of their unreal character.
In their delusions, the different sufferers oscillate between the fear of “being crazy”, the need to “hide these sick thoughts” and are ashamed of it. Because they then do not confide their thoughts to a relative, friend or doctor, it is difficult to diagnose this form of depression.
Other factors that make it difficult for sufferers to seek adequate therapy are:
1) People with these nihilistic ideas, irrational as they are, often rationalize them through input from an appropriate milieu. While they hide these thoughts in everyday life, they reveal their fantasies to “like-minded people”. They can join apocalyptic sects or slip into “broken” subcultures where it is “normal” to stay up at 4 a.m. with a blank stare and no hope.00 to sit at the counter. Caution: suicide risk is also high in psychotic depression, and the wrong friends increase it further.
From the astrologer who explains their feeling of worthlessness and their “premonition” of the end of the world with a square between Pluto and the Sun in their birth chart to the “reincarnation therapist” who persuades them that in a “previous life they were a woman who was raped” – whoever has the hopelessness of depression mixed with the delusion of psychosis is predestined to be a victim of the psycho market.
2) Not only misdiagnosis, but also overlap complicates orderly therapy. Psychotic depressive phases are also familiar to bipolar patients, often in the transition from a manic to a depressive phase.
In addition, the borderline between psychotic depression and paranoid schizophrenia is unclear: Psychotic depressives not only develop delusions similar to those of schizophrenics, schizophrenics also go through depressive phases. Some people diagnosed with schizophrenia previously suffered untreated depression, in which they fueled dark thoughts but remained clear-headed. Some women develop signs of depression after the birth of their child, which are probably due to the changes in hormone balance and the new life situation. (Image: highwaystarz/fotolia.com)
Depression after birth
Many mothers are familiar with the “postpartum baby blues” after child birth, which usually includes mood changes, crying spells, anxiety and sleep disturbance. This phase usually begins in the first two or three weeks after birth and lasts for about two weeks. But some mothers experience more serious, longer lasting depression. Rarely, a psychotic disorder also develops.
Mothers who suffer from this depression interact little with their babies, nursing them less at the breast, reading less with them, and playing less. The exact cause of this disorder is unknown, but hormonal changes after birth seem to trigger the symptoms. In addition, there are feelings of being overwhelmed by the new life situation, unrealistic ideas about motherhood, stress due to the change in daily life and job, feeling less attractive than before, and building a new identity for themselves.
Seasonal affective disorder
This form occurs mainly in autumn and winter, when days become short and dark. The cause is a lack of sunlight, and that's why people experience the depressing moods even in spring and fall, when rain clouds obscure the sun, they live in dark places or work in dark offices. People who are sensitive to these depressive feelings quickly develop the symptoms when the sun is absent.
Several theories bring possible aspects to the fore: a delayed transport of the “happiness-bringing” serotonins in the brain, abnormal daily rhythms or an altered sensitivity of the retina (retina) to light irradiation.
Psychotherapies and antidepressants are hardly suitable for therapy, but light therapy promises success.
Bipolar disorder is characterized by extremes: sufferers fluctuate between euphoria and deepest despair. Everyone knows highs and lows, but these moods oscillate between black and white in bipolars and significantly affect their everyday lives.
These are depressions with unusual features. Unlike severe depression, sufferers respond to positive impressions and change their moods. Their symptoms differ from those of other depressives: they sleep too much, they have bouts of cravings, they are particularly sensitive to rejection by other people, their arms and legs feel heavy, and patients feel like they are “paralyzed”.
“Atypical depression used to be considered a form of depression. Atypical depression called depression with atypical features, means depressed mood can brighten in response to positive events. Despite its name, atypical depression is not uncommon or unusual. It can affect how one feels, thinks and behaves, and it can lead to emotional and physical problems.” Definition of the Mayo Clinic, USA
Genetic predisposition seems to play little role; rather, it is a sociopsychic disorder. Caused by alcohol and drug careers, life disruptions such as divorce, loss of a partner, or physical abuse.
Sufferers respond well to psychotherapies and medications; antidepressants are successful.
Melancholic depression is a severe form of the illness in which sufferers feel they no longer feel anything and have lost the joy of life. However, its mood can be stimulated, which distinguishes it from other major depressions.
Affected persons are distrustful, suffer from melancholy and deep grief. The mental state of those affected fluctuates between melancholy and sadness, these people harbor a lot of mistrust and are very critical. But there are also positive features of this illness such as reliability and self-control.
Sigmund Freund wrote: “Melancholia is psychologically distinguished by a deeply painful disgruntlement, a suspension of interest in the external world, by the loss of the capacity for love, by the inhibition of all achievement and the lowering of the sense of self, which manifests itself in self-reproach and self-abuse and increases to the delusional expectation of punishment.”
Slow movements “as if in slow motion,” especially in the morning, lack of hunger pangs, and weight loss are typical. They may respond to positive stimuli in the short term, but fall back into a state of melancholy. They wake up very early, without any external reasons for this, and appear to outsiders as “sleepwalkers. Sufferers also feel “thrown back in time” and spatially enclosed. They cannot open themselves to the future, but live in the past. Often they are excessively neat.
The psychiatrist Walter Schulte (1910-1972) described the behavior as follows: "Melancholic patients do nothing of their own accord to bring about an encounter. There is a lack of the necessary decisiveness. You are introverted and isolated. Their thoughts revolve (they suffer from this) in a self-tormenting, anxious and hypochondriacal way around a single ego-related point, without being able to adjust to another subject, even if it is only the banality of everyday life."
Detect depression early
Those who suffer from depression show it by changing their facial expressions, gestures and voice. The affected persons lose weight. Complaining of headaches as well as stomach aches. In addition, a disinterest in everything that previously gave them pleasure is noticeable.
They withdraw: Friends and relatives recognize depression in a person with whom they otherwise have a good relationship by the fact that he or she does not get in touch, does not respond to phone calls, no longer appears in the pub, the club or gossip on the street.
Social withdrawal can also have other causes. People change, the friend of the past has new interests and seeks new friends. Or he may be sitting in his apartment. Secretly writes a novel.
What is essential for depression, however, is that all these physical and social abnormalities are accompanied by an extremely negative view of the world in general and of one's own life in particular. Friends notice this in sentences such as "there's no point to it all," "all I see around me are walls," "I don't feel like it anymore" … Such early signals are not to be trifled with: More than with almost all other mental disorders, depressives kill themselves.
So if you notice such signals, don't just leave them there. Also, don't be dismissed when sufferers say "it's nothing," or "everything is fine". Question patiently and in an open conversation what is going on.
Very important: Do not relativize. Don't say "it's not that bad," "you're exaggerating," or "it'll be okay.". This not only unsettles those affected. Unintentionally confirm their bad image of themselves. It is also medically wrong: First, a person in depression is not exaggerating when he describes the world in the blackest colors, but describes his real perception. Secondly, nothing "gets better" on its own in a depression.
On the contrary, sufferers now need professional treatment from doctors, psychiatrists and psychotherapists, and you can gently steer the conversation in that direction. But this only works if you gain their trust one hundred percent and they believe that you take them seriously. Men are much more likely to commit suicide when depressed than women, also because it is more difficult for them to open up about their problems to other people. (Image: Paolese/fotolia.com)
Suicide among depressed men
Although more women suffer from depression than men, the suicide rate among depressed men is extremely high. According to Professor Manfred Wolfersdorf from Bayreuth, one of the reasons for this is the lack of ability of men over the age of 50 to talk about their psychological problems.
Few men who suffer from depression go to the doctor because of their psychological distress, but because of the headaches, stomachaches or fatigue associated with depression. The diagnosis of depression hits many traditionally socialized men to the core, firstly because they suffer massively from their illness and secondly because they want to live up to the role model of a strong man.
Feelings" do not fit into this role model. Sufferers grew up with slogans like "Indians don't know pain," "Don't be like that" and never learned to talk about their feelings. Instead, it was considered a strength for them to solve problems on their own.
For men suffering from depression, such behavior is fatal: A clinically diagnosed depression, in contrast to a simple mood, is characterized by the fact that those affected isolate themselves more and more and need help from understanding people. Every conversation about their problems helps them.
Traditional men who suffer from depression thus suffer threefold. Firstly, they suffer from the symptoms of the disease, secondly, they have no one to talk to about their complaints, and thirdly, they see themselves as weaklings because of their complaints. This also explains an extremely high suicide rate among men with depression.
In addition, there are specific stresses on men who fill traditional roles. If you are the sole breadwinner, then the fear of unemployment, financial hardship and the prere to perform at work will lead to permanent stress. Their patriarchal socialization makes them feel like failures if they can't "stand their ground".
The socio-psychological burden here is enormous even in non-depressed men. But if someone has a genetic disposition or is burdened by unprocessed life experiences, then severe depression can follow.
WHO estimates that over one million people take their own lives each year. The German Society for Suicide Prevention says suicide is one of the most common causes of death in Germany and 2 out of 3 of those affected suffer from depression. The conventional therapy consists of the medicinal. The psychotherapeutic treatment. Depression is usually treated with antidepressants (serotonin reuptake inhibitors), neuroleptics or even tranquilizers (lorazepam, diazepam). The latter can be addictive and should only be used in severe cases and temporarily. In addition, behavioral therapy, cognitive talk therapy and psychoanalytically oriented procedures are considered helpful psychotherapies recognized by the public health insurance companies. In addition, however, there are many other beneficial forms of psychotherapy, which z.B. systemic, solution- or body-oriented, hypnotherapeutic or even energetically oriented, such as tapping acuprere, which is becoming increasingly popular.
Naturopathic treatment options for depression
For mild forms of depression and as an additional treatment, experience shows that naturopathic methods are well effective, even though scientific evidence is available for very few of them so far. An exception is probably the best-known plant against depression, St. John's wort (Hypericum perforatum), which has already been able to convince in some studies and is now partly subject to prescription by doctors. Its mood-lifting effect unfolds in tea and tablet form, as drops or injections, and it is particularly suitable for the therapy of seasonal depression. Also lemon balm, the Indian basil and the rose are used in herbal medicine. In addition, light therapy does a good job of compensating for the lack of natural light. As a relaxation method, yoga is well suited for stress reduction and stress management, which can have a preventive effect on depression. (Image: Rido/fotolia.com) From the area of relaxation procedures, which serve an appropriate stress processing, meditation, yoga, Tai Chi, autogenous training, progressive muscle relaxation or the learning of certain breathing techniques are to be mentioned. Many people have also been helped by the accompanying use of homeopathy, Bach flowers, acupuncture and kinesiology.
In traditional Western medicine, the state of excessive sadness was called "melancholia" (translated as "black bile"), named after the bodily juice that, in excess, was thought to cause dejection in the Galenic model of medicine. Accordingly, the liver and intestines were treated centrally. Even today, the liver is considered in the naturopathic view and treatment of depression, v.a. due to their detoxification function and the central importance for the entire metabolism. Supportive and preventive is absolutely recommended sufficient exercise in the fresh air (running, cycling, walking, swimming) and fresh food rich in vitamins and minerals to avoid acidification of body ties. (Jeanette Vinals Stein, Somayeh Khaleseh Ranjbar, added by Dr.