Depression – Depression leads to deep sadness, listlessness and inner emptiness.
Introduction
PantherMedia / Ganna Didora
Everyone is unhappy and listless from time to time. And every human being has probably been depressed or even despondent at one time or another. Such phases are part of life, and usually they pass after a while. It's different for people with depression. Sad feelings and negative thoughts last longer for them and overshadow all their actions and thoughts. Depression can also occur without a triggering event or identifiable reason. Sufferers often feel as if they are stuck in a deep hole. They experience themselves as joyless and lacking in drive, suffer from strong self-doubt and feel worthless. Everyday activities, work or learning become difficult; friends, family and hobbies are neglected. They sleep badly.
Depression can also cause worry, anxiety and helplessness among family and friends: One would very much like to help, but does not know how to. For relatives, it is often difficult to tell whether it is a temporary sadness or a serious illness.
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People with depression fall into an emotional low for several weeks or months, from which they often see no way out. Depression can be experienced differently:
– Some sufferers are mainly sad and depressed. Everything seems meaningless, nothing and no one can cheer them up. – Others feel instead of sadness only a strong inner emptiness and numbness, exhaustion and lack of drive. – Still others suffer primarily from agonizing worries, fears and anxieties .
Many sufferers have sleep disorders. Especially in older people, depression also manifests itself through physical symptoms such as weight loss or unexplained pain.
Depression can be associated not only with lassitude but also with increased excitability. Thus, in bipolar depression (manic-depressive illness), in addition to depressive phases, there are also euphoric phases in which the connection to reality can be lost.
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It is not yet known exactly how depression develops. It is based on the amption that biological processes, psychological factors, the personal situation and special events in life interact in this process. Here are some examples of what can promote depression and influence its course:
a hereditary increased risk: It can be seen from the fact that the disorder has also been more common in family members. stressful experiences: for example, abuse or neglect, but also a separation or the death of a loved one. Chronic anxiety disorders in childhood and adolescence, associated with a lack of self-confidence and insecurity. biochemical changesIt has been found that in depression, the metabolism in the brain is altered and nerve impulses are transmitted more slowly. Also certain neurotransmitters. Hormonal changes may play a role. physical illnesses Like a stroke , a heart attack , cancer or hypothyroidism . stressful life circumstances: for example, persistent stress and overwhelm or loneliness. Light deficiencySome people react to the lack of daylight in the dark autumn and winter months with depression .
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Depression is one of the most common mental illnesses: An estimated 16 to 20 out of every 100 people experience depression or chronic depressive disorder (dysthymia) at least once at some point in their lives. Women are affected more often than men, older people more often than young people.
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Depression takes different courses: for some people, a depressive episode subsides after a few weeks or months – sometimes without treatment – and does not return. After about 3 to 6 months, about half of the people who are treated for depression feel a significant improvement in their symptoms.
For many, depressive episodes alternate regularly with symptom-free periods. Others are depressed over a long period of time, sometimes more, sometimes less, and some have persistent symptoms. If symptoms persist for more than two years, they are referred to as chronic depression .
If depression recurs within six months after symptoms have subsided, this is called a relapse ( recurrence ). If another episode occurs more than six months or even years later, it is called a recurrent depression .
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Depression causes people to feel and behave differently than they did before they became ill. They often blame themselves for their condition. Are plagued by self-doubt. They report feelings that they can no longer control or manage. Thoughts of suicide may also arise. Mostly it remains with the thoughts, but unfortunately not always.
Many withdraw, avoid social contacts and hardly go out of the house anymore. Alcohol, medication or drug abuse can occur. All this can lead to the fact that the depression persists and the complaints become stronger and stronger. Breaking this vicious circle is often only possible with outside help.
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Many sufferers are so severely depressed that they no longer have the strength to seek help on their own. Then it is important that relatives offer their support and, for example, are present during an initial discussion with the doctor.
To find out whether someone is suffering from depression, medical or psychological psychotherapists proceed in two steps: First, they ask about complaints that may indicate depression. Second, they try to rule out other illnesses or problems that cause similar symptoms. This may also require physical examinations by the doctor.
The typical characteristics of depression are distinguished between main and secondary symptoms.
– depressed mood, sadness, dejection – disinterest and joylessness – lack of drive and rapid fatigue, often even after small efforts.
Consider secondary symptoms:
If several major and minor symptoms persist for two weeks or longer, depression is diagnosed. For the diagnosis often certain questionnaires are used, which ask for typical complaints. Depending on the number, type and severity of symptoms, experts distinguish between mild, moderate and severe depression. Treatment is based on this classification.
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Stressful experiences such as loss or chronic stress can contribute to the development of depression. Avoiding certain negative influences or learning to deal with them differently can reduce the risk of depression. This may be especially true for children. Adolescents to be important.
The social environment also plays a major role. People with stable attachments are less likely to suffer from depression. In order to prevent depression, early psychological help or counseling services may be appropriate. For people with an increased risk of recurrent depression, long-term protective treatment with medication may be considered in order to prevent relapses. Others undergo outpatient psychotherapy for a longer period of time.
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There are several treatment options available for depression. The most important are psychotherapy, such as cognitive behavioral therapy, and/or treatment with medication. Which form of therapy is the right one, where it can best take place and how long the treatment lasts depends, among other things, on the severity of the illness, the personal life situation and how the complaints develop. The advantages and disadvantages of possible treatments, as well as expectations and fears about therapy, can be discussed with the therapist.
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People with depression find it difficult to cope with everyday life. Meeting work demands, keeping up with personal obligations, and completing even small household tasks can become endlessly tedious. Often the contact with partners, relatives and friends changes. They are also usually very burdened by the depression. Emotional withdrawal and apathy can lead to arguments and further withdrawal.
Nevertheless, when faced with mental problems or illness, many people first turn to partners, relatives or friends for help. These notice depressive symptoms. Changes often first. Their comfort and support are especially important to people with depression. With severe depression, however, partners also need. Relative support. In addition to medical or psychological support, self-help groups can be an option.
Active help and support becomes especially important when there are signs that someone may take their own life. It is enormously important to take such signs seriously and talk about them with others. If this is not possible in an acute situation, there are services such as the social psychiatric service, crisis centers or the telephone counselling service, where you can get help – if necessary anonymously and around the clock.
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For most people seeking specialist advice and help with mental health problems or illness, the primary care physician is the first point of contact. However, people can also turn directly to a psychological counseling center, a psychotherapeutic or psychiatric practice. In emergencies, such as acute suicide risk, psychiatric-psychotherapeutic practices with emergency services or the emergency outpatient departments of psychiatric-psychotherapeutic hospitals are available.
German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy. Treatment of depressive disorders in children and adolescents . Evidence- and consensus-based guideline (S3). AWMF Register No.: 048-023. 07.2013.
German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN). S3 guideline and national health care guideline (NVL): Unipolar depression . AWMF Register No.: nvl-005. 03.2017.
National Institute for Health and Care Excellence (NICE). Depression in adults: recognition and management . 10.2009. (NICE Clinical Guidelines; Volume CG90).
Robert Koch Institute (RKI), Federal Statistical Office (Destatis). Depressive diseases . Berlin: RKI; 2010. (Federal health reporting; ie 51).