Important! Severe depressive episodes correlate with psychotic symptoms. Are therefore called delusional depression. In such cases, the person suffers from delusions and hallucinations.
Excursus: Somatic syndrome
By the term somatic syndrome, doctors mean the occurrence of a series of symptoms related to the body (this is called 'somatic'). If at least four of these symptoms occur, the affected person has a somatic syndrome in addition to depression. These symptoms are:
– Joylessness (sog. 'anhedonia') – positive events have no influence on mood (sog. 'lack of responsiveness') – Early waking – Morning low – Psychomotor inhibition or agitation – Loss of appetite – Loss of weight – Loss of libido
Since the symptoms just mentioned are part of a severe depression anyway, the additional diagnosis of somatic syndrome exists for people suffering from mild or moderate depression. The main ones just mentioned-. Additional symptoms can be supplemented by others. The Wide of which and the Flexibility Make this disorder highly individually. This means that those affected should not be lumped together. Everyone has his or her own hurdles to overcome not generalized can be. Other symptoms include:
Emotions and moods (so-called. 'affect'): Appearance of numbness, inner restlessness Formal thought disorder: Inhibition of thinking Content thinking disorder: delusion of guilt, delusion of impoverishment, conviction of being incurably ill (sog. 'Hypochondriacal delusion'), conviction of not existing (sog. 'Nihilistic delusion') Pseudodementia: Apparent intelligence reduction that feels like dementia
Attention! Acting on suicidal tendencies!
10.000 people end their lives by suicide each year in Germany alone, slightly less than 50 percent of them because they suffer from depression. If you have an affective disorder, you may feel a strong sense of hopelessness. This is what makes depression so dangerous. Specific triggers for suicidal thoughts can be external events, among other things. The best prevention is the treatment of depression. There are behaviors in suicidal individuals that family members should take seriously. These include threats of suicide, great hopelessness, and the ordering of affairs; sufferers often appear calmer and more settled. Very important for relatives: If you notice such behavior, be sure to address it! In addition, seek help from your doctor or health care professional. Therapists.
Who is affected by depression?
Affective disorder can affect people of any age, although it is considered the most common mental illness in adulthood. Most people suffer a first episode after the age of 30. The age of onset. Several studies across Europe have shown that up to a quarter of all adults have experienced a clinically depressive episode at least once in their lives. Two-thirds of all sufferers are diagnosed with unipolar depression. In Germany, about 800 people suffer from depression.000 people, on the other hand, suffer from a bipolar variant of the disorder. In general, the disease occurs much more often in industrialized countries.
Good to know!
Not only adults are affected by depression. Children and adolescents can also suffer from the disorder. However, the symptoms are usually less pronounced than in adults. The most common are depressive symptoms such as depressed mood, sleep disturbances as well as listlessness, cognitive impairments such as concentration and memory problems, loss of motivation, performance and attention as well as paradoxical behavior such as restlessness or aggression.
Is depression hereditary?
The development of depression is also influenced by the genetic predisposition suffer a role. However, it is not a single gene that is decisive. Only a constellation that favors depression can increase the risk of an affective disorder. Twin studies have shown that such a predisposition does not necessarily lead to depression. However, the probability of falling ill, three times as high as in people whose close family members have not had a depressive episode. Earlier approaches to research amed that women would be twice as likely as men to experience depression. According to Will (2008), this is not true, since women "only" have a higher risk of relapse than men. In addition, diagnostic habits have changed as men are now more open about their own emotions.
Risk group pregnant women
Pregnant women are a special group of patients. Due to the enormous changes women experience before, during and after childbirth, the risk of depression increases. A distinction must be made between pregnancy depression (known as depression during pregnancy) and pregnancy depression. peripartum depression) and puerperal depression (so-called "postpartum depression"). 'postpartum depression'). The latter is about ten times more common. Mostly occurs within the first two weeks after child birth. Since the use of antidepressants must be carefully considered due to the side effects, psychotherapeutic discussions and support from relatives are particularly helpful.
The number of depressions in our society is increasing?
Are there more people suffering from depression in postmodern society? As early as 1982, the Swedish psychiatrist Olle Hagnell therefore asked himself whether an era of melancholy was dawning. Medical experts doubt that the increase in the number of sufferers is related to a greater spread of the disease. The reason for the high number of new cases is rather that the number of diagnoses is higher. Especially men now more often make the necessary step to the doctor.
Occupational disability due to depression
Depending on the individual situation, depression can be so severe that it is no longer possible for those affected to carry out their profession for some time or even permanently. Such an occupational disability due to depression or even other mental illnesses entails considerable financial losses, which are then no longer covered by pension insurance. In addition to the already heavy burdens of a mental illness, existential fears may even be added in the worst case.
An occupational disability insurance can be a remedy, which – depending on the insurance conditions – will cover such cases. In principle, it is still possible to take out insurance even if you are undergoing or have undergone psychotherapy. However, you have to take. U. Expect risk surcharges, but some providers also reject the insurance application due to the pre-existing condition. It is therefore recommended to take out such insurance as early as possible. When taking out an insurance policy, it is crucial that you have provided correct information about your state of health. If the health check reveals that you have given false information, you will not receive any benefits.
What does the doctor? Part 1: The diagnosis
Every visit to the doctor begins with a Medical history, the patient interview. In the course of this, your doctor will ask you in detail about any symptoms you may be experiencing. Life circumstances, previous illnesses as well as cases within the family are also points which are important for a diagnosis. Your doctor will use the already mentioned diagnostic criteria orient you to the underlying symptoms.
In addition, in order to be able to exclude organic causes, your doctor will perform a physical examination initiate. This consists, among other things, of a blood test and an EEG (so-called 'electroencephalography'). 'Electroencephalography').
Since a further characteristic of depression is sleep problems, your doctor can, in the sense of an additional diagnosis, perform an Polysomnography carry out with you. This takes place in sleep laboratories and is the measurement of certain values while you sleep. Include a long-term ECG, measuring eye movements and breathing, among other things.
Depression disease usually around the age of 30. The symptoms (main and secondary symptoms) are now an integral part of a multisymptom therapy
– Depressed mood – Lack of interest – Lack of drive – Lack of concentration and attention – Lack of self-esteem – Feelings of worthlessness and guilt – Negative and pessimistic outlook on the future – Thoughts of self-harm and suicide – Decreased appetite
What the doctor does? The therapy of depression is just as varied. Individual as the disease itself. The most important pillars are the Administration of medication and a Psychotherapy dar. In this way, the neurobiological. Psychosocial causes can be countered in equal measure. Administration of antidepressants. These are now an integral part of multimodal therapy. Among other things, interfere with the release of neurotransmitters in the brain. These are now an integral part of a multimodal therapy. Among other things, interfere with the release of neurotransmitters in the brain. Antidepressants are taken regularly and over a long period of time. Contrary to general concerns that many patients have at the beginning of medication, they are neither addictive nor "high" and also do not act as stimulants or sedatives.
Antidepressants work delayedUsually you will not notice that your symptoms are getting weaker until one to two weeks after you have been taking them daily. Even if they have completely subsided, you should not simply stop the medication. Otherwise a relapse is likely. Therefore, six months after symptoms end, continue to take. Discuss discontinuation with your doctor! Depending on the severity and number of phases, the medication may take years to complete. Pharmacy has now produced a wide range of antidepressants. It is always important to consult with your treating physician in order to ensure an individual and well-tolerated solution.
Antidepressants can have some side effects. That is why your doctor is aiming for monotherapy. This means that you will be treated with one medication – and not several at the same time.
The second pillar is psychotherapy, which serves to overcome the psychosocial causes. As part of this treatment, you will have discussions with your therapist. Masters exercises led by it. Specific goals can be formulated for you to achieve during the sessions. In many cases, outpatient treatment is sufficient.
In addition to the therapy options already mentioned, there are other services that help sufferers cope with affective disorder. These fall under the somatic therapies. They are related to the body. Are usually carried out as an inpatient.
Light therapyDuring this therapy you will be exposed to a strong light source for a maximum of 40 minutes per day. Light therapy is mainly used for patients suffering from winter depression. Sleep deprivation therapy (sog. 'awake therapy'): As part of inpatient treatment, you undergo a therapeutically supervised sleep deprivation with. They then stay awake for half or the whole night, but also do not sleep the following day. The therapy leads to an improvement in mood. ECT (sog. 'Electroconvulsive therapy'): This type of therapy is particularly suitable for patients with severe or chronic depression. It is a method that works with electricity: epileptic seizures are triggered with short electrical stimuli. The patient is under general anesthesia. This is done up to 12 times in three weeks. Patients experience an improvement in their depression. Rehabilitation sports: Exercise as part of a clinic-supported sports plan can complement multimodal therapy.
Finding a therapist – not so easy at all
Finding a suitable therapist is not so easy. The waiting times for a therapy place are sometimes very long. Once you have received an appointment – usually during telephone consultation hours – you will be given five trial sessions (sog. 'Probationary sessions') the opportunity to get to know each other and determine whether you can imagine a long-term collaboration. Health insurance companies cover the costs if the therapist is licensed by a health insurance company. You can get more information about cost coverage directly from your health insurance company.
Depression as a symptom
Affective disorders can also occur as a consequence or concomitant disease, but also as a side effect of certain medications. In the following we have compiled a selection for you.
Anemia, dementias, Parkinson's disease and malignancies
AnemiaAnemia initially refers to anemia. In medicine, pernicious anemia is anemia caused by a vitamin B12 deficiency. Again, there are different causes for this, common ones are medications as well as alcohol dependence. In addition to depression, symptoms such as fatigue, reduced performance and an increased heart rate may occur. DementiasDementia is a term used to describe neurological diseases that impair brain functions such as thinking or memory. Depressive symptoms are part of a vascular dementia. However, an affective disorder can also be a cause of secondary dementia. Parkinson's disease: In the course of this disease there is a death of nerve cells in the central nervous system. These are among other things for movements. Their processes responsible. Known are symptoms like trembling, but also lack of movement and muscle rigidity. In addition, there are other symptoms, including concentration and sleep disorders as well as depression. The cause of the disease is unknown, so treatment is only symptomatic. Malignancies: malignancies are tumors that are malignant. This means that there is uncontrolled growth due to unnecessary cell divisions and breaking through of the tie, but also settlement of the cells in other parts of the body (so-called. 'Metastasis') comes. Malignancies are symptomatically grouped under cancer. As a consequence, sufferers can develop depressive symptoms.
Anxiety disorders, addictions, burnout and borderline
Anxiety and panic disordersThese clinical pictures are based on anxiety, which can be triggered by various factors. There can be chronic as well as acute attacks. Anxiety disorders also include various phobias. Basically, doctors distinguish between generalized anxiety disorder, which is chronic, and panic disorder and phobic disorder. The latter manifest themselves in acute panic attacks. Depression may appear as a concomitant symptom. Alcohol, medication and drug addiction: An addiction describes the craving for a certain substance. The physician speaks of an addiction if three of the following points apply: Substance cravings (sog. 'Craving'), difficult control of consumption, physical withdrawal syndrome, development of tolerance, neglect of everyday life, use of the substance despite knowledge of harmful consequences. The symptoms of addiction also depend on the stage of the disease and the substance used. However, depression is a common psychological symptom. Burnout: Burnout results from prolonged overwork. This is an emotional. Physical exhaustion. Concrete causes are often individual. Cannot be generalized. As with borderline, burnout often occurs in combination with depression. Borderline: Borderline is a personality disorder that affects self-perception. Characteristic are unstable as well as impulsive behavior in the context of interpersonal relationships. Depressive symptoms can be part of the clinical picture.
Eating disorders, ear correction, tinnitus and side effects
Eating disordersThe group of eating disorders includes anorexia, bulimia, binge-eating syndrome and obesity. What they all have in common is that they have a disturbed relationship with food and their own self-image. These diseases are often accompanied by affective disorders. This can contribute to sufferers of obesity, for example, becoming even more involved in food or. their denial escape. Ear correction (so-called. 'otopexy'): Affected individuals suffer from the psychological consequences of siglopharyngitis. How sufferers develop depression. To relieve the psychological prere at an early stage, otopexy is recommended. The symptom tinnitus manifests itself as an unpleasant noise in the ear. Can occur both acutely and chronically. There are various causes of ringing in the ears. It is also not fully understood where tinnitus originates. Tinnitus can trigger further accompanying symptoms such as irritability, concentration and sleep disorders and also depression. MedicationSome medications, such as the painkilling opioid tapentadol, can cause a number of side effects. Its causes include interactions with other medications. In addition to an increased risk of dependence, depressive moods can occur so frequently.
Frequent patient questions
What are the symptoms of depression?
Dr. T. Weigl: Type and course of depression are individual. Nevertheless, the disease can be broken down to three main symptoms, which are complemented by a number of secondary symptoms. The three main symptoms are depressed mood, lack of interest and drive.
Do I have to take medication??
Dr. T. Weigl: Medications are not the sole pillar of a therapy, but work in addition to psychotherapy. Together, medication and psychotherapy cover neurobiological and psychosocial factors and causes. In principle, so-called antidepressants are used as part of such therapy, which among other things intervene in the regulation of neurotransmitters in the brain. It is important not to mix several substances. In addition, the drugs used in the case of depression have a delayed effect. This means that you will not notice a change in your symptoms until one to two weeks later. Even after the symptoms have subsided, you must continue to take the medication to prevent relapses.
Your doctor will discuss with you whether and which antidepressants you should take.
Is depression treatable??
Dr. T. Weigl: Depression can actually be treated with the help of multimodal therapy. In addition to psychotherapy and medication, there are a number of other services that can help you manage depressive episodes. These include, for example, sleep deprivation therapy or electroconvulsive therapy. Somatic therapies such as sports can also be supportive!
My friend has depression – what do I do??
If relatives have depression, they need the support of the people who are close to them. This is not easy for many, as many do not know how they can help in concrete terms. In addition to targeted information about the disease, it is especially important that relatives remain patient and accept the disease and the accompanying changes for themselves. This also includes not overloading the affected person with tips that are actually well-intentioned or persuading them to engage in well-intentioned activities. Often those affected can't help the situation. React negatively or with excessive demands. Therefore, rather encourage when the affected person shows own initiative and be there.
Good to know!
It can quickly happen that relatives become overwhelmed in the course of providing support. So negative feelings come up, they feel overloaded. Therefore: Be honest with yourself. You may admit to yourself if you feel overwhelmed in the situation. Gently drawing attention to this can help. In addition to contacting the doctor treating the patient, there are other possibilities. You can, for example, talk about your situation and experiences in self-help groups. It is also important to talk openly about this with those affected if you take advantage of such offers!
"Thank you!", says Lieke and smiles at Jonas. They stroll through the park, hand in hand. Six months have now passed since Jonas correctly interpreted the signs and they saw a doctor together. He has diagnosed Lieke with unipolar affective disorder. Lieke is now in therapeutic treatment; she just had her fourth session. She does not yet know whether medication will additionally come into play. She will talk about this with her therapist. Jonas is relieved that things are moving forward for Lieke. He is sure that she is on a good path – even if he knows by now that there is still a long way to go and that it will not always be easy.
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The points described here (disease, symptoms, diagnosis, therapy, complications, etc.) are not clear.) do not claim to be complete. It is called what the author considers important and worth mentioning. A visit to the doctor is in no way replaced by the information given here.