Depression or chronic sadness (Latin deprimere “to depress”) is a state of psychological dejection. In psychiatry, depression is assigned to the affective disorders. However, depression can also occur in the course of other diseases.
What is depression?
Depressed people lose interest in activities, have a very dim experience of their experiences, and often tend to lose their appetite or overeat. Depression is a mental condition characterized by seriously negative and depressed moods and aversion to any type of activity. Depressed people feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless. In depression, many of these signs usually occur simultaneously and are so stressful for those affected that they feel ill and very restricted in their ability to act. Depressed people lose interest in activities, experience their experiences only very weakly and often tend to lose their appetite or to overeat, focus strongly on their real or perceived problems and often have difficulty making decisions. In extreme cases, depression can lead to a suicide attempt and a successful suicide. Authorized to professionally diagnose depression in Germany are specialists in psychiatry, who usually follow the international classification system of mental and other disorders ICD. In order to diagnose depression, certain characteristics must be present to a certain degree. Mood swings must exceed a certain level of severity, and specific indicators must be present for the physician to diagnose major depression or bipolar disorder (in the past, the term “manic-depressive episode” was commonly used here).
Causes
At the present time, not all causes in depression are understood by science, as they are very complex. Nevertheless, it can be assumed that there is an interaction of various causes. The main role here is played by biological factors, developmental history factors, cognitive processing mechanisms, and current events. It is still controversial whether depression in many cases can be clearly traced back to a metabolic disorder in the brain. It is assumed that messenger substances for the exchange of information between brain regions are not sufficiently active. Physicians who come more from the field of depth psychology or cognitive behavioral therapy assume that depression in many cases is related to life upheavals or has been learned over long periods. According to this approach, depression is a sign from the mental system that life coping can only become effective again after a certain period of rest. In this approach of therapy of depressions, they are interpreted as a necessary step to come to a new way of life.
Diseases with this symptom
- Cardiovascular disease
- Cancer
- Dysthymia
- Irritable bowel
- Borderline Syndrome
- Anxiety disorder
- Bipolar disorder
- Stroke
- Burnout syndrome
- Affective disorders
- Cushing’s syndrome
- Eating disorders
- Menopause
- Bulimia
- Ulcerative colitis
Complications
Depression can be associated with suicidality. The spectrum ranges from general thoughts of death to suicidal fantasies, planning, preparing, and attempting suicide. When suicidality is present, inpatient admission is indicated. The length of stay is highly variable and depends on the individual case. People with depression often suffer from concentration problems that hinder them in everyday life. Activities such as reading or watching television also sometimes prove problematic. Motivational and volitional difficulties also contribute to impairments at work, school or in training. Social complications related to friends and family occur frequently; depressive thought patterns can promote the emergence of conflicts. Even independently, people with depression often withdraw socially. Cognitive disorders such as memory problems are also a possible complication of depression. These can take on the appearance of so-called pseudodementia.Patients show symptoms that are very similar to those of Alzheimer’s disease and other dementias. Short-term memory is often more affected than long-term memory. The effect of antidepressants can vary from person to person. Some patients experience only slow improvement in symptoms or notice no improvement. Some sufferers may also experience a worsening of their condition despite antidepressants. In response to depression, some sufferers develop other mental disorders, such as eating disorders.
When should you see a doctor?
Depression can affect people of any age and is independent of social status, occupation, or gender. The symptoms of depression can often be very nonspecific, and so the person or persons often do not realize that they are already in a depressive phase. In many cases, patients suffer from unexplained symptoms such as sadness, lack of drive, and so on. Usually it is then family members or friends who notice the change in behavior and personality. If these complaints do not disappear after a few days or weeks, going to the family doctor is initially the best method. The family doctor can then initiate further steps for treatment. Especially when the person concerned is no longer able to cope with everyday life, a visit to the family doctor or specialist is unavoidable. However, patients are often ashamed to tell anyone about their mental problems for fear of being stigmatized by society. Permanent depression can also have a very strong impact on social life and then make it impossible to cope normally with household duties and work. The existence is then also endangered, because there is the threat of losing one’s job or even the breakup of a partnership or marriage. A stay in a clinic can mean salvation from the difficult situation.
Treatment and therapy
Self-treatment must be discouraged, because the processes of depression are too diverse. Important treatment options are psychotherapy, behavioral therapy and the use of antidepressant medications. With these, depression can be treated quite successfully nowadays. Depending on the approach, psychotropic drugs (antidepressants) or psychotherapy are used to treat depression. However, there are also experts of depression who implement a combination therapy of medication with psychotherapy, depending on the situation. The psychotropic drugs can induce a change in the production of neurotransmitters in the brain in depression. However, psychotropic drugs are not successful in all patients with depression, whereupon electroconvulsive therapy (ECT) can be used as a further therapy. Psychotherapy for depression tends to help patients learn new ways of dealing with life upheavals. This therapy is more prolonged but in many cases more stable in the long term because new behaviors are learned that can build a protective wall for future depression.
Psychotherapy
Here the conversation between and therapist is decisive. Psychotherapists, child and adolescent psychotherapists or medical psychotherapists are particularly suitable.
Outlook and prognosis
In depression, the further course of the disease with possible complications always depends on the severity of the depression. If they are in a very low stage relatively at the beginning, they can also disappear on their own if they were triggered in life by negative events. If these events turn to the positive side, depression can be fought relatively easily. In the case of more severe problems and severe depression, it is usually necessary to visit a doctor or a psychologist. In most cases, conversations and therapies with the psychologist help here. In the case of severe depression, medication must be used to contain it and help the patient, especially in the early stages. For the further course of the disease, the relationship with the patient’s friends and relatives is also a very strong variable. They can provide a lot of help here to help the sufferer and free him from the negative thoughts that lead to depression. If the depression is not treated, it can also have a negative impact on life circumstances. This includes loss of work, antisocial behavior, and possibly even drug or alcohol addiction.In the worst cases, depression ends with suicidal thoughts or suicide itself.
Prevention
It has long been known that the risk of depression is partly inherited. So prevention of depression can be useful if there has been a history of suicide or serious physical illness in the family. In these cases, cognitive behavioral therapy would be used as a preventive measure. Here, those susceptible to depression learn to take a more comprehensive view of their work and life situation. Depression can be prevented by giving those affected more options for action. Situations that often lead to depression are re-evaluated, making them more manageable.
Here’s what you can do yourself
For many people with depression, it helps to have a clearly structured daily routine. Sensible times for getting up and going to bed form the framework of the daily schedule. Activity schedules can help prevent too much idle time. The activities should be realistic and should not be too demanding. In addition, it is beneficial to alternate more strenuous and pleasant activities. Vitamin D can help improve symptoms. Therefore, sufficient daylight is of great importance for people suffering from depression. Getting up in the morning on time, as well as taking walks (for example, half an hour a day), can help improve vitamin D levels. Everyday exercise and sports are other ways to combat depression in everyday life. Exercise promotes the release of dopamine and serotonin, which are neurotransmitters that play a central role in depression. Furthermore, regular meals are useful. If necessary, sufferers can also set an alarm on their cell phone so that they never miss a meal. A balanced diet tends to have a positive effect on the improvement of psychological symptoms. The extent to which friends, family members or others should be informed about the depression is individual. However, especially in cases of suicidality, self-harm, or self-injury, it is a good idea to involve at least one trusted person and develop an emergency plan.
