Endogenous DepressionMajor Depression

Nowadays outdated, a distinction was once made between endogenous depression triggered from within and reactive depression and neurotic depression caused by external events. This subdivision has been changed because it is assumed that all depressions result from the interaction of various internal and external factors (multifactorial genesis). The term “major depression” is English and describes a severe depressive episode (major = major, significant).

Here, the patient exhibits all three main symptoms of depression: Depressed, sad mood, loss of joy and interest, and strong listlessness. In addition there are at least five secondary symptoms. These include, for example, loss of self-esteem, feelings of guilt, reduced appetite and weight loss, sleep disorders with early awakening and morning depression, suicidal thoughts, concentration problems and a negative future outlook. A severe depressive episode is an illness in urgent need of treatment which is extremely stressful for the person affected and his or her relatives. The remedy of choice here is often drug therapy in combination with psychotherapy.

Manic-depressive disorder

Manic-depressive disorder is one of the bipolar disorders. Bipolar describes that there are two mood poles between which the affected person swings back and forth. In contrast, unipolar depression has only one mood pole.Bipolar disorders belong to the upper group of affective disorders.

To be diagnosed, the patient must have experienced at least one manic episode and one depressive episode. In most cases, this does not mean that the mood of the affected person will fluctuate within one day. Rather, it means that the affected persons have longer lasting episodes that are characterized by one of these two mood extremes.

For example, patients with bipolar disorder can be depressed for months, but they can also have manic episodes that last for weeks or months. The exception to this is patients with so-called ultra-rapid cycling. Here, within a few days there are fluctuations between one extreme and the other.

The symptoms of a depressive episode are already mentioned above. The main symptoms include sadness, loss of joy and interest and loss of drive, and there are other secondary symptoms. In a manic phase, the symptoms turn into the opposite.

For at least one week, the affected persons have a permanently elevated, exuberant or irritable mood. Further symptoms are: Delusions of grandeur and clearly elevated self-confidence. A significantly reduced need for sleep, often for weeks only 2-3 hours per night.

In addition there is a strong urge to talk. The subjective feeling that your thoughts are racing. The listener notices this as so-called flight of ideas.

Here the manic patient jumps from one topic to the next seemingly without sense or reason, the listener has difficulties to follow the context. Excessive spending, gambling or sexual activity are also possible “side effects” of mania. It is not uncommon for patients to get into debt because they can no longer judge their actions objectively.

Bipolar disorder occurs on average at a younger age than pure depression. The mean age of onset of the first episode is between 17 and 21 years of age. Men and women fall ill about equally frequently.