Everyone knows these phases in life when everything seems gray. There is nothing to look forward to, listlessness and dejection dominate the day. Such mood lows are usually temporary. Occur in almost everyone. If, on the other hand, we speak of depression in the medical sense, we are dealing with a serious illness that affects the thoughts, feelings and actions of those affected. How to recognize depression, what causes it and how to get it under control.
What is depression?
The colloquial use of the term depression can be misleading. Because even the weather, a bad day at work or a private crisis can be perceived as "depressing". However, these everyday, usually temporary mood swings are not depression in the medical-therapeutic sense. They are a part of life, improve with distraction or encouragement, and disappear all by themselves after a while.
In contrast, "real" depressions are severe mental illnesses from which those affected are usually unable to free themselves without professional treatment.
Types of depression
Not all depression is the same. Mental illness can have many faces and varies greatly from person to person in form, severity and pattern of progression. The three most common types of disorders are:
Unipolar depression: illness with one or more depressive episodes. If recurrent depressive phases occur in the course of a person's life, this is referred to as recurrent unipolar depression.
Bipolar depression (manic-depressive illness): In addition to depressive episodes, there are also manic episodes, which are usually accompanied by an excessively good mood, a strong drive, restlessness or exaggerated optimism.
Dysthymia: In this manifestation, depressive symptoms are less severe but persist for a period of at least two years.
Typical symptoms
"Stressful feelings such as sadness and dejection are part of our lives to a certain extent and fulfill important functions – for example, in the processing of events and in behavioral control," explains Berlin psychotherapist Anna Schmied. "However, if symptoms such as sadness, lack of motivation, and loss of interest persist almost continuously for at least two weeks, it makes sense to seek professional help."
The following three main symptoms indicate depression:
Depressed mood: the depressed mood is present almost continuously, is severe, and lasts for at least two weeks.
Inner emptiness, lack of feeling, loss of interest: The affected person feels empty inside, emotionally dead, and no longer has any interest in social contacts, job, hobbies, etc.
Exhaustion and listlessness become the norm: Depressed people find it particularly difficult or impossible to cope with everyday tasks. Mental and physical exhaustion are the order of the day, so that even getting out of bed becomes a feat of strength – some sufferers do not even get out of bed anymore.
Secondary symptoms of depression
These three main symptoms can be accompanied by other signs of illness. These include:
Disturbances in concentration and attention
strong self-doubt and feelings of worthlessness
Self-reproach and feelings of guilt
Causes and triggers of depression
Depression is usually not due to a single cause or trigger. It rather develops from the interaction of several factors, which can be biological, genetic as well as psychosocial in nature. The extent of the influence of the various factors differs from patient to patient.
Psychosocial factors
Vulnerability – or vulnerability – describes how susceptible a person is to mental disorders. In people with high vulnerability, even a little stress can trigger depression. If a person can cope well with stressful experiences, he or she is said to be resilient.
Whether one is susceptible to depression is considerably influenced by the experiences one has had in one's life. Traumatic experiences such as abuse or neglect in early life increase the risk of developing depression later in life. In addition, the following negative experiences and events can increase the risk for a depressive episode:
Job loss and unemployment
Separation from (marriage) partner
Tension in the social environment
Death of a loved one
A serious illness
Overload situations and stress
In fact, in many cases, sufferers report difficult events before the onset of the illness. However, depressive episodes can also occur seemingly out of nowhere with no apparent external triggers.
Physical factors
In addition to psychosocial triggers, there are also physical causes that can promote the development of depression. For example, if norepinephrine, cortisol, and/or serotonin levels in brain tie are not in balance, this disrupts the exchange between neurons. And that in turn negatively influences feelings and thoughts.
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Genetic predisposition
When it comes to the causes of depression, the question usually arises as to what role genes play in the development of depression – and whether the mental illness is hereditary. It is scientifically proven that some people have a genetic predisposition to depression and others do not. A large number of studies (e.g.B. from twin and adoption research) shows that the probability of developing depression in the course of one's life is three times higher if close blood relatives are affected by it. However, this also means that there is no single gene that is mainly responsible for the disease. There must be additional factors.
Frequency: Who is affected?
According to the German Depression Aid, women are about two to three times more likely to suffer from depression than men. "The causes of the different frequency of the disease have not yet been clearly researched," says psychotherapist Anna Schmied, "but we do know that the structure and functionality of the brains of men and women differ."
Various social, psychological and biological reasons are discussed for the differences. For example, women deal with problems and mental instability differently and are more likely than men to seek outside help for difficulties. In addition, women are often socioeconomically worse off, which is definitely a risk factor for mental illnesses.
Is the number of people affected increasing in Germany??
Burnout, panic attacks, depression – it is felt that more and more people suffer from a mental illness. Health insurance companies also report more frequent diagnoses of mental illnesses, increased sick leave and rising treatment figures. "Scientific studies, on the other hand, do not show rising numbers," ares Anna Schmied. In her opinion, the fact that mental illnesses have increased is due to the fact that depressions are recognized, diagnosed and treated more frequently nowadays. "This means that the number of diagnoses is increasingly approaching the number of actual illnesses," explains the expert. "So all in all, we simply talk about this topic more openly and more often, and those affected are more likely today to have the courage to seek professional help."
Treatment: Depression, what to do?
If a depression is diagnosed, it is important to treat it quickly, because those affected suffer greatly from their unstable condition. Depending on the severity of the illness, depression is usually treated with psychotherapy, antidepressants, or a combination of both. Combination therapy is particularly effective for chronic. Recurrent depression for use.
In addition, there are numerous psychotherapeutic services for people with depression that can help improve symptoms, everyday coping and quality of life. However, health insurers only cover the costs of cognitive behavioral therapy. For so-called psychodynamic psychotherapies.
Medication for depression
Drug treatment does not simply make the causes of depression, such as stress, a painful breakup, or a difficult life situation, disappear. However, psychotropic drugs influence the way the neurotransmitters serotonin and norepinephrine work in the brain and can correct existing dysfunctions. Consequently, antidepressants cause symptoms such as listlessness, hopelessness and dejection to subside and existing problems to appear solvable again. Pharmacotherapy is therefore considered an indispensable component in the treatment of depressive disorders.
Sport as an antidepressant
Sport against depression and anxiety? Yes, this can actually work. Regular exercise and sports act like a natural antidepressant, so to speak. This is why experts recommend regular exercise for depression sufferers. This can significantly reduce depressive symptoms in both the short and long term. Sport reduces stress and has a positive effect on the neurotransmitters serotonin and norepinephrine. Those who physically exercise will also find it easier to get out of the negative spiral of listlessness and listlessness.
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Help for self-help without therapists
Recent studies have shown that offers of help without regular contact with a therapist can also contribute positively to the treatment of depression. One option is self-help instructions, with which those affected can read up on the subject themselves and only have occasional contact with an expert.
Another option is professional therapy via the Internet. Online psychotherapy, such as via the Minddoc online platform, is a good alternative, especially if you don't feel comfortable sitting directly opposite a stranger and talking openly about your problems, says Schmied. Since the sessions take place via videocall, you can stay in your familiar environment and talk more easily about your state of mind. It is important to always make sure that the therapy sessions are conducted by a qualified psychotherapist.
Exchange with fellow sufferers
Online forums can also be helpful to approach the topic of mental illness and to find out for yourself that you are not alone with the problem. "This can already help many sufferers a great deal," reports the Berlin psychotherapist. Nevertheless, one should be cautious, since not only technically correct information circulates in Internet forums. In addition, one should think carefully about what private information one wants to share in a forum despite the supposed anonymity.
Depression test
Questions like "Am I depressed??" or "Do I have depression??" are not easy to answer, because depression is often not clearly recognizable. For this reason, so-called depression tests have been developed to help detect depressive states. Various main and secondary symptoms of depression are queried, based on the diagnostic criteria commonly used in Germany according to the so-called ICD-10. However, this self-test cannot and should not replace a professional diagnosis and only serves as an orientation. For a professional diagnosis, an appropriate specialist or psychotherapist must be consulted.
Depression diagnosis via smartphone app
In the meantime, there are medical apps that should be able to help with diagnosis. "A scientifically based app can indeed provide orientation and help to better understand the first feeling of 'there's something wrong with me,'" explains Anna Schmied.
Scientific studies have shown that the Moodpath app, for example, can detect depression almost as reliably as the regular questionnaire of a therapist. The medical app requires users to answer questions about their well-being three times a day over a two-week period. The answers are then statistically evaluated and the user receives a recommendation as to whether professional help is needed. In addition, it is possible to create an overview for the attending physician, which provides information about the symptoms and findings.
However, apps like Moodpath can only provide an initial overview and assess which symptoms may be part of depression. In order to make an accurate diagnosis and plan subsequent treatment, a personal consultation with an expert is always necessary. Particularly in the case of long-term illnesses, it becomes clear that personal contact with a therapist is essential and cannot be replaced by an app or other tools.