Depression symptoms causes treatment zava dred

Germans suffer from depression at least once in their lives. Depression, however, is
Often not recognized, why sufferers often have to endure their symptoms alone and do not receive any treatment. The Consequences can be dramatic: a long, tough course of illness without improvement, loss of job and social environment as well as financial worries or even suicide. On this information page you can learn more about the occurrence, symptoms and treatment of depression.

Brief overview

Definition& Frequency: Depression is a mental illness that can be experienced by those affected over a period of time
more than 2 weeks to continuous low mood and joylessness Leads. Almost every 5. Germans experience depression at least once in their lives. Women are affected more often than men.

Symptoms: The
Main symptoms of a depression are Low mood, lack of drive and Lack of interest/joy.

Common Secondary symptoms are:

– circling thoughts – inner restlessness and tension – concentration and memory problems – hopelessness – loss of self-esteem – decreased libido – loss of appetite

Causes: Depression often occurs in connection with difficult life circumstances:

– Separation – Loss of a loved one – Job loss or change, increased workload – Birth or moving out of a child – Conflicts

Biographical experiences and the presence of depression in the family influence the risk of developing depression.

Treatment: Depressions are
well treatable. About half of those affected recover within 6 months. The type of treatment depends on the severity of the illness. Psychotherapy and medication are usually the means of choice. If the treatment is not successful, other antidepressant therapy options are available.

About depression

Every year, about 6 million people in Germany suffer from depression, with women suffering from it significantly more often than men. People living alone without committed relationships, those with lower incomes and education levels, and those living in urban areas are also more likely to be affected.

Depression is likely when low mood, lack of joy or drive almost continuous for more than 14 days The following symptoms may exist and cannot be alleviated by appointments, visits to the cinema or the like.

In contrast to a temporary "low mood," depressive symptoms last for a long time. Low mood, joylessness, inner restlessness and brooding change little or not at all, even if the sufferer seeks out situations that would normally provide pleasure and distraction.

What are symptoms of depression?

Depression is an illness that varies greatly from person to person Different complaints can show. The diagnosis is therefore not always easy.

A distinction is made between Main and secondary symptoms, over at least 2 weeks Must be present almost all the time. Depressed patients often report:

depressed mood
– Loss of interest in things that used to give pleasure – a feeling that every single task in the day takes a lot of effort and overcoming

The three main symptoms

The main symptoms of depression are:

Depressed, gloomy mood: One feels depressed and can neither courage nor confidence grasp. loss of driveEverything is "hard to do", you feel as if you have to fight against you tenacious inner resistance work. The loss of drive can be so pronounced that the Daily structure can no longer be maintained. sufferers then lie in bed for days, do not attend to personal hygiene and eat and drink very irregularly. Loss of interest and joylessnessYou lose interest and enjoyment in activities, topics, or tasks that used to give you pleasure. In addition, many affected people do significantly less than before.

Accompanying symptoms show up on a psychological and physical level

The following accompanying symptoms may occur:

difficulty concentrating and paying attention: reading, following a conversation, or completing a task (z.B. cooking or answering mail) are hardly possible. Deterioration of memory / memory impairment: A lot of information "seems to fly by". circling of thoughts: frequently recurring, negative thoughts and brooding (e.g.B. "How should all this continue?", "How will I ever manage XY?"). Inner (psychomotor) restlessness and tension, constant feeling of a "running inner motor" that can lead to a high urge to move (nervous pacing, impatience). Hopelessness, excessive demands, leading to thoughts such as "I can't be helped".", "It will never get better.", "I don't know how I will ever manage all this." lead. Inability to make decisions.
Irritability ("I get upset much more quickly than I used to."). Feelings of guilt and Loss of self-esteem to feelings of worthlessness.
Life-threatening thoughts, Death wishes, suicidal thoughts, development of suicide plans up to attempts to take one's own life. Difficulty falling asleep and staying asleep, Early waking in the middle of the night ("I lie in bed from half past two in the night and can no longer fall asleep."). Morning low with evening improvement; some affected persons experience themselves almost normally in the evening. Loss of appetite, sometimes also Increase in appetite; corresponding weight loss or gain. Loss of sexual desire.

Severe depression can furthermore be accompanied by symptoms in which the affected person perceives things which, however, are not present in reality. Similarly, the person affected can be rock-solidly convinced of something, even though these conviction does not correspond with reality. Such symptoms are psychotic symptoms called. Examples include:

Depressive delusionThis can take various forms, for example Impoverishment mania (uncorrectable conviction of having high debts, not being able to pay bills), Delusions of guilt ("I need to atone. I am guilty. The police are looking for me because I have made so many mistakes."), hypochondriacal delusion (conviction of suffering from a serious and as yet undiscovered illness). Crucially, the sufferer thinks they are poor/guilty/sick, although there is evidence to the contrary (such as a bank statement from a savings account; confirmation from the police that the sufferer is not wanted by the police; a statement of any examination findings showing physical health). hallucinations In the form of voices that speak derogatorily about the person with depression.

Suicide risk

Suicidality is a serious symptom in depression:

– The risk of suicide is 30 times higher in depressed persons compared to the normal population. – 60 to 70 % of all people suffering from depression know suicidal thoughts. – 7.000 of the 10.000 suicides recorded annually in Germany are associated with depression.

The following Risk factors for suicide are known so far:

– Male gender and age over 70 years – Single living situation without resilient, firm ties – Unemployment – Chronic physical illness – Previous own suicide attempts, suicides in the family history – Current suicides in the circle of acquaintances or in the vicinity – Depression with psychotic symptoms (z.B. depressive delusions, hallucinations)

For the assessment of the acute suicide risk the following aspects are considered:

– Are there concrete suicidal thoughts / a suicide plan? – How strong are the suicidal thoughts? Can the affected person always distract himself from the thoughts or do his thoughts constantly circle around the topic of suicide, although he actually does not want to do so? – Has the patient already attempted suicide?? – Have preparations been made for suicide and for the time after one's own death (obtaining materials, suicide notes, estate arrangements, or the like)? – If the affected person suddenly seems relatively calm and composed, almost cheerful?

The more of these points apply and the more risk factors are present, the more cautiously and critically the suicidal risk is assessed. The assessment of self-harm due to suicidality is a difficult subject, involving a lot of responsibility, and is therefore carried out by experienced doctors.

Important: If you are concerned that someone close to you may harm themselves, accompany the person to the doctor or emergency room. Rescue service and/or police can and should be called in if necessary.

Who gets depressions?

Depression is caused by an interaction of external (external; affecting the environment) as well as inner (concerning the own person) Factors. Thus, every depression has its Individual history of development. The individual factors that contribute to the development of depression are described in more detail below:

Depression symptoms causes treatment zava dred

Disturbed neurotransmitter metabolism in the brain

Nerve cells in the brain communicate with each other through various messengers. Two messenger substances in particular play a role in the development of depression, serotonin and norepinephrine, an important role. When serotonin and norepinephrine are released in certain areas of the brain not in sufficient quantity negative mood, joylessness and other depressive symptoms can develop.

Physical illnesses

Physical illnesses can cause depression. Therefore, a physical examination is very important in any depressive illness. In particular

– hormonal disorders (hypothyroidism, disorders of the adrenal glands u.A.inflammation of the brain, – brain tumors, – severe, physically debilitating illnesses

lead to depressive symptoms. A Treatment of the underlying physical illness can also lead to a comprehensive improvement of depressive symptoms in these cases.

In addition, any physical illness that can lead to a Long-term impairment leads to the development of depression. An accumulation of depression and physical illness has been observed, among others, after

– heart attacks, – strokes, – cancer, – other neurological diseases such as Parkinson's disease, – rheumatic diseases, and – after severe infections

observed. It often remains unclear whether the physical illness causes the depression or whether the depression develops as a reaction to the limitations imposed by the physical illness.

stress

Stress leads in the body to the release of the stress hormone cortisol. In the short term, cortisol helps the organism with stress management, it increases alertness, raises blood prere and pulse, decreases pain sensation and dampens inflammatory reactions.

If a person is under Constant stress, is the Cortisol levels in the body permanently increased. The consequences are

– lack of regeneration and relaxation, – sleep disturbances, – constant inner tension and restlessness, – fatigue and lack of strength over time, and – an increased susceptibility to infections.

Such a permanent stress reaction leads to the development of depressive symptoms over time, due to lack of positive experiences, sufficient rest and inner relaxation.

Genetic predisposition

The risk of developing depression is higher if there are other family members suffering from depression. A depressed family member means an increased risk of up to 50% for first-degree relatives (siblings, children, parents) of also suffering from depression compared to the normal population.

However, a "depression gene" has not yet been discovered. Instead, it is amed that Interaction of several genetic factors gone out.

In addition, it is difficult to determine genetic and learned factors to distinguish: For example, children of depressed mothers are significantly more likely to develop depression than children of non-depressed mothers. This may be due to genetic factors on the one hand, or the child's reaction to the depressive behavior of the mother, who is unable to care for the child sufficiently. Medicine ames that both play a role.

Life circumstances

A distinction is made here between changes in life circumstances and the general life situation.

Changes in life, which can be both positive and negative, require a Adaptation of the person adaptation to a new situation and can thus lead to depression. Examples include:

– Loss of a loved one – Relocation – Completion of school/training/studies, entry into professional life – Birth of a child – Separation – Changes at work

These tasks can be better managed the more secure a person feels and the more support they receive. If Lack of security and support, also increases the risk of depression. Examples include:

– lack of close contacts and relationships, social isolation (childlessness, living alone, lack of friendships) – unemployment, financial worries – persistent conflict situations

Lack of light

Sunlight can have a positive effect on mood, while darkness often promotes negative feelings and thoughts:

– In the seasonal depression occur during the Winter months to negative thoughts, sad mood and lack of energy, which improve again in the course of spring. – In the Spring are the Suicide rates higher than in the rest of the year. This is associated with increased depression over the winter months. sleep disorders increase the susceptibility to depression. Studies have shown that the more time a person spends during the day without a roof over their head in the Daylight spent.

Individual vulnerability

It explains why some people have after a very stressful event (such as the death of a close relative or the loss of a job) develop a depressive illness, but others do not.

Dysregulated stress hormones

For many depressives the Proportion of cortisol (stress hormone) levels in the blood are higher than in healthy individuals. This makes sufferers More susceptible to stress, which in turn increases the risk of developing depression.

Physical causes (without underlying disease)

Chronic physical complaints such as pain, prere in the head, digestive problems, nausea or stomach pain mean a immense stress for the affected person. If no physical cause for the complaints can be found, those affected experience great Helplessness. This stress can promote the development of depression.

Conversely, such chronic physical complaints are also an expression of a depressive disorder its. When the depression improves, the physical complaints also decrease.

Medication

Some medications may have as a side effect to depressed mood, lack of energy and further depressive symptoms lead. These include:

– medications for chronic inflammatory diseases such as cortisone, special antibody therapies and immunosuppressants, – medications for cancer, – certain blood prere medications (beta blockers), – tranquilizers (benzodiazepines) and strong painkillers (opioids) when used regularly, – hormone preparations, including the contraceptive pill.

Negative thinking patterns

The way a person processes experiences in his or her mind influences the psychological stability. People who blame themselves for negative experiences the blame, the experiences generalize ("With me everything always goes wrong.") and also for the future Negative expectation ("It will never get better.") have a higher risk of becoming depressed than people who perceive defeats as a consequence of negative external factors ("The saleswoman probably had a bad day today and that's why she was so rude to me.").) and as a one-time event ("Tomorrow she will surely give me a smile again").").

Personal experience and current psychological condition

Experiences of violence and abuse, a life marked by difficulties and hardships Childhood as well as other stressful experiences increase the likelihood of developing depression.

The presence of a mental illness such as a Anxiety, obsessive-compulsive, eating or personality disorder or a dependence disease (alcohol addiction, drug addiction) also leads to a significantly increased susceptibility to depression.

Gender

Women suffer from depression more often than men. The exact cause for this is so far not known. Theories that men are more likely to keep depression to themselves and women are more likely to open up and seek help have not been confirmed. Currently, the influence of sex hormones is being discussed as a cause of the gender difference.

How is the diagnosis of depression made?

The earlier depression is recognized, the earlier treatment can be initiated. If you are not feeling well, are brooding and experiencing cloudy moods, it is Important to seek help early. On the Internet many different Self-tests offered for depression, which additionally provide guidance.

The two-question test is the shortest test variant, the 96 % of all depressions and is therefore well suited as a screening instrument:

1. In the past month, have you often felt down, sadly depressed, or hopeless? 2. In the past month, have you had significantly less pleasure and enjoyment from things you usually like to do?

If both questions are answered "yes," depression could be associated with a Probability of about 50 present. A doctor should be consulted to clarify whether depression is present.

family doctor or specialist?

In the case of unclear, possibly depressive complaints, the family doctor the right contact person. Family physicians can recognize depression, perform the necessary physical examinations and initiate treatment. Your primary care physician will provide a referral to a mental health specialist if needed and/or recommend seeing a psychotherapist.

The suspected diagnosis of depression can only in personal conversation are put. Questionnaires or chat histories are not sufficient for this purpose and would not do justice to the person affected. Progress monitoring or psychotherapy sessions can also be done via video telephony, if both the patient and the practitioner agree to it.

Patient interview

In the conversation, the doctor will ask you about:

– asking about your current complaints, – your life situation, – medical history, – stressful events in the past.

Subsequently, a comprehensive psychopathological findings raised. It means that the doctor will get a comprehensive picture of your current mental state, asking about very many different symptoms. This is important in order to be able to detect depression and not overlook other illnesses. The doctor will also ask you if there are any suicidal thoughts, attempts or plans.

It can be helpful to also Relatives or friends of the affected person to be questioned. However, such an "external history" will only be taken with your consent, unless there is an acute emergency in the sense of a danger to yourself or others.

Diagnoses must be made consistently and should not vary from doctor to doctor. Therefore, there is an internationally recognized Diagnostic catalog, in which it is written down exactly which Criteria The tests that must be performed in order to diagnose a disease such as depression are.

Physical examination

The main purpose of the physical examination is to check whether there is evidence of a possible physical cause of the depression. Possible examinations are:

– An orienting neurological examination, in which concentration and memory, coordination, strength and gait, as well as the functioning of some important nerves, z.B. means of eye movements, can be tested. In this way, damage caused, for example, by a past stroke or dementia can be detected. In addition, certain head movements can rule out meningitis. – In most cases, the physician will also Heart and the Lungs tapping as well as the Abdomen palpation to find evidence of existing diseases such as inflammation in these areas. – A Blood sampling serves to clarify common hormonal disorders such as hypothyroidism. In addition, the physician palpates the Thyroid on the neck to rule out a possible enlargement. If drug therapy is started, the kidney and liver values are also checked when blood is taken. – Depending on the individual history, further examinations such as a imaging from the head by means of MRI or special blood tests be necessary. However, your doctor will decide this on the basis of the available findings in each individual case.

Treatment

Depressions are in many cases well treatable. Various treatment options are available for the therapy of depression. The choice of one or more treatment paths is always made together with your treating physician and therapist.

Drug treatment

Several different groups of medications are available for the treatment of depression with medication. A medicamentous treatment is mainly for moderate and severe depressive episodes used. The most important groups of medications are:

SSRIs (Selective Serotonin Reuptake Inhibitors) work by changing the metabolism of the neurotransmitter serotonin in the brain. Serotonin has, among other things, an activating effect antidepressant function, which is exacerbated by SSRIs. SSRIs are among the most commonly prescribed antidepressants and are considered to be well efficacious as well as well tolerated. The most common agents in the SSRI group are citalopram, escitalopram, sertraline, paroxetine, and fluoxetine. SSNRIs (Selective Serotonin-Norepinephrine Reuptake Inhibitors) affect not only serotonin metabolism, but also norepinephrine metabolism. They are similar to SSRIs in their effects in that, on the one hand stimulating and, on the other hand, counteract the depressive mood. Active substances from the group of SNRIs are venlafaxine and duloxetine. MAO inhibitors inhibit an enyzm that normally degrades the neurotransmitter serotonin in the brain. This gives the brain more serotonin available, which counteracts the depressive symptoms. Important representatives of the MAO inhibitors are moclobemide and tranylcypromine. Tranylcypromine, however, is more difficult to dose and manage than other antidepressants; and requires a special diet. NaSSAs (noradrenergic and specific serotonergic antidepressants) affect not only serotonin and norepinephrine metabolism, but also the autonomic nervous system, which controls vital functions such as breathing, digestion and metabolism. Thus it has an antidepressant effect and is additionally slightly fatiguing, which is particularly important for patients suffering from depression with concomitant Restlessness or anxiety suffering, beneficial is. The active ingredients in this group are mirtazapine and mianserin. TCAs (tricyclic antidepressants) have been used since the 1950s. They ensure that, similar to SSRIs and SSNRIs, the amount of serotonin and norepinephrine, respectively, in the brain is increased. The antidepressant effects of TCAs have been widely documented in studies; however, TCAs should not be used in certain pre-existing conditions due to their Side effects should only be used with caution. Bupropion is an active ingredient that reduces the effect of the two neurotransmitters Norepinephrine and dopamine supports. It can be used as a stand-alone agent or in combination with other antidepressants. Lithium is not an antidepressant in the true sense of the word, but rather a Mood stabilizer. It is nevertheless used as an additional medication (augmentation) together with other antidepressants for depressions that otherwise could not be sufficiently improved. In addition, lithium has been shown to reduce the risk of suicide.

How quickly do antidepressant drugs work?

Taking antidepressant medication improves the symptoms of depression Not immediately. In particular, the normalization of mood usually requires at least 2-4 weeks, until a clear effect is noticeable. Recent studies suggest that even in the first 2 weeks of taking medication, up to 20 percent improvement in depressive symptoms can occur. However, care should be taken that already in the first days the performance of increased drive may occur before the mood improves.

Important: If suicidal ideation occurs during this time, there is an increased risk of suicide. In this case, contact a doctor immediately.

Herbal medicines

In addition to classic medicines, many patients ask themselves whether herbal remedies are also helpful against depression. However, the use of herbal preparations can also cause side effects.

Are herbal medicines always harmless?

No, herbal medicines can be just as Side effects lead to the same effects as synthetically produced drugs. For example, known side effects of St. John's wort include gastrointestinal distress and increased skin sensitivity to sunlight.

Which herbal remedies are approved for the treatment of depression?

The only relevant herbal remedies for depression are St. John's wort-preparations, which are usually available as an extract in capsules. There are a large number of preparations that do not have a comparable composition and are therefore only comparable to a limited extent.

Can interactions with other medications also occur when taking herbal medications?

St. John's wort can be used in conjunction with a variety of medications undesirable interactions enter. It can reduce the effectiveness of Antidepressants influence as well as the effect of Birth control pills or of Medications for chronic diseases. An unauthorized intake of St. John's wort preparations without prior consultation with the treating physician is therefore not recommended.

Is the effectiveness for herbal remedies as proven as for the classical drugs?

Herbal remedies have a significantly worse against depression than synthetic medications such as SSRIs. St. John's wort has been shown to have some efficacy in mild and moderate depression. In severe depression, however, no effect of St. John's wort has been proven.

What are the advantages or disadvantages of herbal medicines?

A frequently cited advantage is the low rate of side effects With herbal remedies. However, it should be borne in mind that herbal remedies also have not completely free of side effects and can be used in the same way as conventional medicines interactions with other medications can lead. In addition, the low efficacy of herbal remedies is a disadvantage. Nevertheless, St. John's wort preparations can be an alternative to other medications for patients with mild depression, as in these cases a some efficacy has been proven.

Psychotherapeutic treatment

In psychotherapeutic treatment, discussions with the therapist are Development of depression, the management of the disease and possible thinking or behavioral strategies discussed for overcoming depression. There are different so-called schools of psychotherapy, in particular the Behavioral therapy as well as depth psychological and analytical therapies.

Which therapies are covered by health insurance?

At present, 3 recognized forms of therapy are covered by the statutory health insurances. These include:

In a behavioral therapy the focus is on learning behavioral or thinking methods, to be able to overcome the depression.

A depth psychological therapy aims rather to provide the patient with Conflicts or problems, which may have contributed to the development of depression, to be made aware of and to dissolve. There are two subtypes here, both of which are reimbursed by the statutory health insurance: Depth psychological talk therapy, which involves going to therapy about once a week, and psychoanalysis, which involves very intensive work with 2-3 appointments a week for more than a year.

The 3. reimbursable procedures has only recently been the systemic therapy. With this form of therapy, the social environment and the Relationships as well as their role for the depression analyzed and processed.

For mild and moderate depression, psychotherapy alone can lead to a cure, but for severe depression it is strongly recommended that drug therapy be started at the same time.

Please note: Health insurance companies only cover the costs if a mental disorder has been diagnosed in advance by a doctor or psychological psychotherapist and an application for reimbursement has been made and approved.

Other treatment approaches

In addition to the established therapies with medication and/or psychotherapy, other therapies are also available as a supplement:

Occupational therapy Helps patients practice concentration skills or activities related to everyday life, such as professional work routines, if these have been partially lost due to the depression. Patients can also express themselves through art projects, for example, and thus come to terms with their illness. Relaxation techniques such as autogenic training are one way to reduce stress and agitation associated with depression. – The Sociotherapy is aimed primarily at chronically ill patients and is intended to help them to find their way again in their social environment and to make use of support services. electroconvulsive therapy is a highly effective treatment method that can be used to treat patients for whom previous attempts at therapy have failed. An electrical impulse is triggered in the head up to three times a week under short anesthesia. In studies, depression could be improved in 60-90% of patients. – At therapeutic sleep deprivation the patient is specifically prevented from sleeping for one night. In about 60 % of the patients an immediate improvement of the symptoms can be achieved, but the effect usually lasts only until the next sleep phase. – A Light therapy, i.e., daily irradiation with white light from special therapy lamps, is particularly useful for seasonal depression (Winter depression) a possible treatment option.

Self-help

Depression can also be treated with some remedies that can be used at home. Whether these methods are feasible, however, always depends on the severity of the depression and the drive associated with it. Set yourself therefore not under prere, if you do not manage.

sports/exercise

Several studies have shown that physical activity has a positive effect on symptoms of depression. Both Endurance as well as strength training Seems to be effective against depression. Even taking a walk can lead to an improvement in symptoms. There is no firm data yet on how often you should ideally be physically active, however regular activity seems to be about 2-3 times a week for 30-60 minutes to be a good guideline.

Apps

There are an increasing number of health apps on the topic of depression. While such apps do not replace psychotherapeutic or drug therapy, they can supportive useful can be used to bridge the waiting time for a therapy place, for example, or Relaxation techniques to exercise. Whether an app is helpful depends heavily on the individual's condition and aspirations, so it's difficult to make a general recommendation for specific apps. Certain paid apps can also be prescribed, although this offer differs between health insurance companies. Further information can be obtained from your health insurance company.

Routine

A Regular daily routine with a fixed structure can help to cope better with the depression and last coping better with everyday life despite the lack of drive. It is important to not under prere to Set. There is no reason to feel bad if you cannot follow the daily structure you have made because of depression. Do not set your goals too high, but have realistic expectations. For example, take a shower the next day rather than cleaning up the entire apartment.

Pets

Pets are an important support for many people with depression. For one thing, this gives you an obligation to take care of the pet and a certain Structure in the daily routine respectively physical activity to be included. In addition, the pet donates comfort and prevents one from feeling completely alone.

Inpatient vs outpatient therapy

The first option in the treatment of depression is usually a outpatient therapy. For this, for example, the family doctor can ie a referral to a psychologist or psychiatrist. In the case of severe depression or depression that does not improve sufficiently under outpatient therapy, an inpatient therapy are considered. The decision as to whether outpatient or inpatient therapy is more appropriate depends on many individual factors and must always be decided on a case-by-case basis together with the treating physician or psychotherapist. In the case of acute suicidal danger, immediate inpatient admission is usually necessary.

Selfapy – Psychological support on prescription

Depression symptoms causes treatment zava dred

Are you suffering from depressive symptoms or have you been diagnosed with depression? The Selfapy app includes a Online course for psychological support – on prescription. Selfapy can in fact be prescribed by a doctor. The 12-week course was developed by psychologists and is based on the cognitive behavioral therapy. The aim is to Reduction of symptoms and the Better management of the disease. Selfapy can be used before, during or even after therapy for supportive guidance. Talk to one of our partner doctors now about whether Selfapy is right for you.

Progressions

Not all depressions run the same course; in fact, there are several different typical courses of depression. Treatment of the various forms differs, at least to some extent, so a exact diagnosis is important.

Unipolar depression

In the case of unipolar depression, the typical features of depression (depressed mood, listlessness and lack of interest/pleasure) over a period of at least 2 weeks at. Unipolar depression occurs in around 6 million people per year in Germany. On average lasts Unipolar depression untreated 6-8 months, during professional treatment shortens the duration to an average of 16 weeks. Around 50-70% of patients experience at least one further depressive episode in their lifetime after the first depression (depressive episode); this is known as a recurrent depressive episode. The time between two episodes is very variable and cannot be predicted.

Bipolar depression

Bipolar depression is also referred to as Bipolar affective disorder or popularly known as manic-depressive illness Designates. Both depressive episodes as in unipolar depression and episodes with an exaggerated good mood and a completely exaggerated drive occur (manic episodes). There may be years between episodes, but in some patients the mood may change within a few days. The duration of an episode can also vary significantly from patient to patient. Bipolar depression is much rarer than unipolar depression and occurs about five times less frequently, i.e. in Germany in about 1 to 1.5 million people per year.

Dysthymia

In dysthymia, patients suffer over At least 2 years in a depressive mood. However, this mood is not pronounced enough to be diagnosed as a depressive episode. Most often, dysthymia begins in early adulthood and lasts for many years. It is estimated that dysthymia occurs in 2% of the general population within one year. Dysthymia can be overlaid by an additional depressive episode and is then Double depression called.

Tips for relatives and friends

Depression usually affects not only the patient, but also his or her environment. Relatives and friends often want to help, but feel themselves helpless or desperate. However, there are good ways to deal with this situation as a relative.

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