Symptoms of depression can come and go
Recognize depression and treat it in good time
Every year five million people in Germany fall ill with depression. In the course of their lives, 23 percent of Germans are directly affected by depression, 37 percent are affected by sick relatives. But errors and ignorance about the serious illness are still widespread. Many believe that depression is mainly caused by strokes of fate, stress at work or a wrong lifestyle. Advice like "go on vacation" or even "pull yourself together" is completely unsuitable for depressed people. And: Depression is dangerously underestimated as a potentially fatal disease.
Widespread mental illness
Depression can affect people at any age - from childhood to old age. Women are about twice as likely to be affected by depression as men. It is believed that women are more prone to the condition because of hormonal fluctuations. However, depression is less likely to be discovered in men. They often shy away from showing weakness and seeking help. They also show different symptoms than women, such as aggressive or excessive behavior.
Depression in the elderly often has age-specific triggers. The entry into retirement age with the termination of the employment relationship goes hand in hand with many changes in the area of the daily structure, employment and, above all, personal appreciation. The increasing loss of physical and social independence can also have a negative impact on mood. If, for example, long-standing hobbies can no longer be pursued and the reduced mobility increasingly restricts the range of motion, the social isolation of those affected threatens.
Traumas can be triggers
The loss of a partner or relatives of the same age, friends and acquaintances is also associated with severe emotional stress. In many cases, the losses leave behind a pronounced feeling of sadness and desolation. It is not uncommon for wounds and trauma such as war experiences or other physical and mental injuries to be reactivated.
Causes and Risk Factors
The causes of depression are not yet fully understood. Depression can come suddenly - almost overnight. It can affect anyone, just like any other disease. Apparently internal and external factors play together in the development, for example biological, genetic and psychosocial factors.
- Genetic disposition: The risk of developing depression is higher if the illness has already occurred in the family.
- Disturbed brain metabolism: Some experts believe that low levels of norepinephrine or serotonin are partly responsible for depression. The disturbed exchange between nerve cells can lead to listlessness, poor appetite and insomnia.
- stress: Psychosocial stress plays a decisive role in the development of depression. Negative life events are often accompanied by stress, for example the death of a loved one, separation, loss of a job or a serious illness. However, positive events such as the birth of a child, wedding or a promotion also create stress and increase the likelihood of developing depression. The risk of depression generally increases in phases of life with major, far-reaching changes, for example puberty or the start of retirement.
- vulnerability: People who have suffered traumatic experiences such as abuse or neglect in childhood have a particularly high risk of depression. You may find it difficult to deal with stressful situations.
- Attitude to life: People who think badly of themselves, about the world and the future are at higher risk. A positive self-esteem and optimism, on the other hand, can protect against depression.
- Physical illnesses and hormone dysregulation: Brain diseases and hormonal disorders such as hyperthyroidism or hyperthyroidism affect the emotional world. Many depressed people have high levels of the stress hormone cortisol, which is produced in the adrenal cortex. From a physiological point of view, they are therefore under constant stress. There is also evidence that inflammatory hormones from abdominal fat (visceral adipose tissue) fuel depression. There is a striking correlation between depressive illnesses and obesity: people who are very overweight are more likely to develop depression. The same goes for people with diabetes, cardiovascular disease, or cancer. Type 2 diabetics are twice as likely to be depressed as healthy people.
- Medication: Cardiovascular drugs (beta blockers), cortisone, hormonal contraceptives, and some neurological drugs such as anti-epileptic and anti-Parkinson drugs can make depression more likely.
Symptoms of depression
According to the ICD-10 classification system, the following symptoms indicate depression:
- Almost uninterrupted, strongly depressed mood that cannot be influenced from the outside and lasts for at least two weeks
- Loss of joy and interests
- Loss of drive or fatigue
Affected people feel uninterruptedly depressed for many days. Even positive experiences cannot improve their mood.
Examinations and diagnosis
If depression is suspected, those affected should consult a doctor, psychiatrist or psychotherapist. The earlier a depression is recognized, the better the chances of recovery. The doctor could ask the following questions:
- Have you been down or down a lot in the past few weeks?
- Have you been listless and tired a lot recently?
- Have you had a lot of self-doubt, guilt, or negative thoughts lately?
- Do you suffer from insomnia?
- Have you had trouble concentrating lately?
- Has your appetite changed recently?
Physical exams are also important for diagnosis. This includes a blood test and possibly a computed tomography (CT) scan of the brain. A low blood sugar level, vitamin B12 deficiency, dementia, thyroid problems (mostly underactive) and changes in the brain can also be the cause of depressive symptoms.
Different forms of depression
Depending on the severity and course, doctors differentiate between different forms of depression:
- A depressive episode is when symptoms persist for at least two weeks. Rarely does it come to a single depressive episode in a lifetime. 75 percent of those affected will relapse within ten years. The earlier a depressive episode is treated, the lower the risk of relapse.
- At a recurrent depressive disorder Those affected repeatedly experience depressive episodes. It is the most common type of depression. Life is severely restricted. Many of those affected can no longer work in their profession, and social relationships can break down.
- At a chronic depression (Dysthymia) sufferers continuously from depressive symptoms. However, these are usually less pronounced. This form is often not recognized. Many people consider their depressed mood to be normal. But chronic depression also affects quality of life, productivity and social relationships.
- From one bipolar disorder Doctors speak when depression and listlessness alternate with overconfidence, extreme euphoria and exaggerated actionism. This form used to be called manic depressive disorder.
Side diseases of depression
Depression often occurs together with other mental disorders: for example anxiety or panic disorders, personality disorders, addictions, eating disorders or dementia. Therapy can only be successful if the other mental problems are also treated.
Therapy for depression
If the suspicion of depression is confirmed, the person affected is referred to a specialized clinic or an outpatient psychiatrist or psychotherapist. They can create a customized treatment plan for the patient.
Important: Treat depression early
The prerequisite for being able to treat depression effectively and possibly cure it is that it is recognized as a serious illness. Most of those affected can then be helped well with consistent treatment. Therapy breaks through depressive episodes or allows them to subside completely. If left untreated, there is a high chance that depression will last for months or years. The earlier treatment begins, the easier it is to cure depression.
- In mild to moderate cases, a cognitive behavioral therapy help.
- Often will Medication (Antidepressants) are used, especially serotonin reuptake inhibitors (SSRIs). They make serotonin levels rise and can improve symptoms. However, it usually takes weeks for the medication to work.
- For the treatment of chronic and recurring depression, the Combination of medication and psychotherapy proven.
- An at least supportive approach is an anti-inflammatory, low-sugar diet, if you are overweight, in combination with mindfulness training and, if necessary, weight reduction. It should be noted that the Antidepressants often have an impact on weight. Some substances can increase weight: including lithium (effect partly dose-dependent), valproate, the tetracyclic mirtazapine and sedating tricyclic antidepressants such as amitriptyline. Among the selective serotonin reuptake inhibitors (SSRI), paroxetine is most likely to lead to unwanted weight gain. The active ingredients agomelatine, sertraline and fluoxetine do not increase weight according to studies. Fluoxetine even inhibits appetite so much that those affected can become underweight.
- If you have severe depression, a inpatient stay in a clinic. Treatment with medication, psychotherapeutic therapy offers and intensive care help those affected to return to a structured daily routine. If there is a high risk of suicide, depressed people can be admitted to a clinic against their will.
- If psychotherapy and medication do not have the desired effect and those affected increasingly lose the will to live, electroconvulsive therapy can be helpful.
Exercise and stress relief
Because of the often increased stress hormone levels in depression, those affected should learn techniques for coping with stress where possible: for example yoga, meditation, qigong or autogenic training. Often, fees for such courses are reimbursed by the health insurance companies. These exercises have a positive effect on controlling eating habits as well as on mood. Sport is also mood-enhancing. Especially running in nature, in the fresh air - but also dancing, gymnastics or whatever else corresponds to the inclination: Every movement helps to reduce stress and to a better body feeling.
Help for those affected
If you are currently in a mental crisis, you can:
- go to or call your doctor
- Contact a clinic with a psychiatric department
- Contact the medical (psychiatric) on-call service (nationwide tel .: 116 117)
- turn to an offer of help or advice for acute crisis situations.
The following offices offer help:
- Telephone counseling, anonymous, free advice at any time of the day or night on the nationwide telephone numbers (0800) 111 0 111 or (0800) 111 0 222
- Telephone for children and young people, "Number against Kummer", free advice from Monday to Saturday from 2 pm to 8 pm on 116 111 (telephone number for children and young people) or Monday to Friday from 9 am to 11 am and Tuesday and Thursday from 5 pm to 7 p.m. on the telephone number (0800) 111 05 50 (parents' telephone)
- You can reach the Germany-wide Depression information hotline from Deutsche Depressionshilfe on Mondays, Tuesdays and Thursdays from 1 p.m. to 5 p.m. and Wednesdays and Fridays from 8.30 a.m. to 12.30 p.m. by calling (0800) 33 44 533. Deutsche Depressionshilfe also offers a self-test and knowledge and addresses on the subject of depression.
- The German Alliance against Depression offers concrete on-site help in over 80 cities and regions
- The Depression discussion forum offers an exchange of experiences for those affected and their relatives
- The psychiatric network BApK offers advice and self-help groups especially for relatives
- You can find out where you can find a self-help group in your area at the NAKOS (National Contact and Information Center for the Suggestion and Support of Self-Help Groups), Tel. (030) 3101 8960
- In every German city there are psychological counseling centers, counseling centers for marriage, family and life issues, psychosocial counseling centers, and social psychiatric services. However, these facilities are not available around the clock, and consultation appointments may have to be made - so they are only of limited help in acute crises.
Chat Log: Depression
As a potentially fatal disease, depression is often underestimated. Psychiatrist and psychotherapist Claas-Hinrich Lammers answered questions on the subject in the visit chat. more
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The Nutritional Docs | 01/27/2020 | 9:00 p.m.
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