Duration

Depression can last for different lengths of time depending on its severity and it is difficult to give an exact time. Depressive episodes do not simply start overnight, but develop over weeks and months. Likewise, they often do not just subside suddenly, but get better all the time.

One speaks of a severe depression only after the symptoms have lasted for 2 weeks. Most depressions subside within 6 months, and it is not unusual for symptoms to subside within a year. Nevertheless, a depression can also last for several years.

The high probability of a relapse for years after the episode has ended is a cause for concern. Although the main symptoms of depression may also disappear completely, reduced performance and resilience and a tendency to depressive moods may remain. If depression has been diagnosed, pharmacotherapy, i.e. treatment with medication, is the quickest way to help.

Various antidepressants are intended to lighten the patient’s mood and reduce the immediate pressure of suffering. Afterwards, the causes of depression can be effectively tackled, provided that some can be found. Psychotherapy plays an important role here.

If the trigger cannot be found or removed, the patient learns in therapy to deal with the negative feelings and to regain his or her self-esteem. The phased nature of depression must also be taken into account. The depressive mood usually lasts for a few weeks, then passes by itself, but then returns.

Thus, it must be made clear to the patient that the immediate pressure of suffering will pass again and that he should not despair of it, but that in the long term, however, active work against relapses must be carried out. As described above, depressions are phased, recurring episodes that should be prevented by medication after successful treatment in order to avoid relapses. In some cases, if the depression was particularly severe and persisted for a long time, lifelong treatment is necessary.

In most patients, however, the medication can be discontinued after some time and a cure can be assumed if the psychotherapy was successful. Ideally, those affected have learned to deal with stress and their very individual demons. Patients who are firmly integrated into a social network and who are supported by family and friends have a particularly good prognosis.

Thus, a depression can be overcome permanently. However, the risks associated with depression are problematic, as they can have long-term consequences, such as an unhealthy lifestyle, other concomitant diseases or a suicide risk. For example, patients with depression are more likely than average to suffer from coronary heart disease and have an increased risk of heart attack.

Classification

Depression is first classified as either a one-off (monophasic) or recurrent (recurrent) depression. Further classification is made into the following categories: monophasic depression recurrent depression Depression and burnout syndrome usually exhibit similar symptoms. Would you like to find out whether burnout has already reached the next stage

Mild depressive episode without somatic symptoms with somatic symptoms
Moderate depressive episode without somatic symptoms with somatic symptoms
Severe depressive episode without psychotic symptoms
Severe depressive episode with psychotic symptoms
Other /not specified
Currently mild depressive episode without somatic symptoms with somatic symptoms
Currently moderate depressive episode without somatic symptoms with somatic symptoms
Currently severe depressive episode without psychotic symptoms
Currently severe depressive episode with psychotic symptoms
Currently remitted
Other /not specified

Special forms of depression are those: Pregnancy depression is a variant of depression that occurs after pregnancy and can have different forms.

Winter depression is found during the winter months and is caused by a lack of light. You can find help and information on this topic under Winter depression. Winter depression is found during the winter months and is caused by a lack of light.

You can find help and information on this topic under Winter depression. – Pregnancy depression

Winter Depression

The drugs that can be used for depression are divided into different groups. They often act by influencing the control and messenger substances in the brain and intervene more strongly in the serotonin, norepinephrine and dopamine balance.

Serotonin is particularly responsible for our good mood, while noradrenalin can increase our motivation and dopamine is released as a reward reaction. Tricyclic antidepressants act by increasing the messenger substances (especially serotonin, dopamine and norepinephrine) at the switching cells between nerve cells. This leads to an increase in the signal and a brightening of the mood.

However, only after a few weeks, which in conjunction with the earlier increase in activity can lead to an increased risk of suicide. Side effects are mainly their dampening effect on the circulatory system. Drugs that largely block the docking site of a messenger substance (e.g. selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors) have fewer side effects.

Care should be taken not to combine the mood enhancer lithium (which can also be given for depression) with these agents. Another group of agents are MAO inhibitors, which inhibit the breakdown of messenger substances, or more precisely of amines such as serotonin and dopamine etc., and thus increase their effect. These can inhibit the degradation completely or only for a certain period of time and belong to the 2nd choice of agents.

Tricyclic antidepressants are named after their chemical structure. They increase the concentration of messenger substances, especially serotonin and norepinephrine, and thus improve signal transmission in the brain. This reduces, for example, the patient’s lack of drive/motivation and joie de vivre.

The effect only occurs after 1-2 weeks. Typical side effects are tiredness, dry mouth, constipation, headaches and many more. For this reason they are not always the first choice of therapy for depression.

So-called SSRIs (“selective serotonin reuptake inhibitors”) also increase the concentration of messenger substances, but only of serotonin. They are most commonly used today, but they also have a delayed effect and typical side effects, especially on the gastrointestinal tract (e.g. nausea, diarrhoea). Compared to tricyclic antidepressants, many SSRIs have a stimulating rather than a dampening effect, so they should only be given under observation in patients at risk of suicide.

Lithium salts are a long established drug for the treatment of depression and have a proven suicide prevention effect. Unfortunately, the therapeutic range of lithium is very narrow, which means that the concentration of the drug in the patient’s blood must be closely monitored, as even a slight increase in lithium levels is harmful. Nowadays, the drug is mainly used to prevent a relapse of depression.

St. John’s wort preparations are made from “genuine St. John’s wort” (Hypericum perforatum). Their mechanism of action has not yet been clarified with certainty, but it is believed that their effect is based on an increase in the brain‘s serotonin messenger substance responsible for mood. Even though St. John’s wort has been shown to be more effective than a placebo in studies, no definitive statement on its effectiveness can be made from a scientific perspective.

Neither the therapeutically most sensible dose (i.e. the dose with the best ratio of desired to undesired effect) nor which component of St. John’s wort is responsible for the mood-lifting effect have been conclusively clarified. Nevertheless, St. John’s wort has proven to be as effective as the commonly used drugs, but only in mild and moderate depression. St. John’s wort should also be given not only for a short time when needed, but over a longer period of time, as it does not work immediately and it also has to reach a certain amount in the body in order to work. A disadvantage of St. John’s wort is that it is freely available for sale, as it lacks medical supervision. This is particularly dangerous, as St. John’s wort, in combination with other medicines, can influence their effect and thus cause considerable harm to the patient.