Depression – when the soul carries “mourning”.

Four million people in Germany suffer from depression – and many of those affected see it as a flaw to be ashamed of. But depression is neither a mental illness nor a sign of personal weakness. She can meet anyone. Depression is an illness with clear causes, symptoms and treatment options. It influences feelings, thoughts and behaviour. But the body also reacts to gastrointestinal complaints, back pain and headaches, weight fluctuations, and insomnia. Experts assume that depression will continue to rise in the ranking of the most critical diseases.

causes of depression

Biologically, depression can be explained as a metabolic disorder in the brain. Messenger substances, neurotransmitters that control communication between the many billions of nerve cells, are out of balance and trigger physical and psychological changes.

The causes are very diverse. Science assumes an interaction of genetic factors and psychological stress. Incisive experiences, constant excessive demands, difficult childhood circumstances, and medication and illnesses can trigger depression. Many physicians and psychologists interpret depression as a protective mechanism that intervenes in life from the unconscious when the person concerned is pursuing illusionary goals and jeopardizing health and integrity.

 

symptoms and signs

Typical mental symptoms of depression are:

• joylessness and helplessness
• lack of drive
• inner restlessness and emptiness
• guilt
• difficulty concentrating
• a feeling of worthlessness, which in extreme cases expresses itself in suicidal thoughts

The body reacts to depression with noticeable deviations from normal conditions: with rampant or little appetite, with slow or excited speech, and with an increased or reduced need for sleep. A general tiredness, as well as headache, heart, stomach or back pain, can accompany depression.

Depression: How to diagnose it

Not every “grey” day in a person’s life is the result of a major depressive disorder. Sadness, inner turmoil, or guilt can be completely normal, healthy reactions that need not be a cause for concern. However, if the symptoms occur every day or at least every other day over at least two weeks and permanently reduce performance, a doctor should be consulted.

Depression has many symptoms that are sometimes difficult for the doctor to interpret. The patients must speak openly about physical and mental complaints, worries and fears . The diagnosis of “depression” is only made when other illnesses, medications or drugs can be ruled out as the cause of the symptoms. Therefore, a complete physical examination by a general practitioner or internist and laboratory tests are essential.

 

therapy for depression

For many affected people – after often a long period of suffering in uncertainty – the diagnosis of “depression” is a relief. For some, however, it was also a severe shock because mental illnesses are less socially accepted, and the possibilities of successful therapy are underestimated.

The chances of healing are great today. However, recovery usually takes some time. The treatment is based on two complementary therapeutic approaches: psychotherapy (talk therapy) and drug therapy. Patients and doctors typically decide which treatment method is best for the respective patient or whether they should be combined.

The psychotherapy

Psychotherapy is a learning and knowledge process. She researches the causes and develops strategies to help the patient cope better with life’s problems. Talk therapy usually lasts three to six months.

• Cognitive behavioural therapy (CBT) supports the patient in recognizing their negative thought patterns and destructive behaviour and replacing them with life-affirming patterns that fit their personality and living conditions.
• Interpersonal Psychotherapy (IPT) focuses on the processing of disturbed personal and social relationships. The depressed person learns to relate to others more effectively to reduce conflict and gain the support of family and friends.
• Psychodynamic therapy enables the patient to look into his innermost being. It uncovers emotional conflicts or unresolved childhood problems as the cause of depression.

The drug therapy

Talk therapy is often enough to help people with milder forms of depression effectively. Drugs supplement psychotherapy in patients with moderate or severe depression. Antidepressants have the task of bringing the symptoms of the disease under control and thus creating good conditions for effective talk therapy. From a biological point of view, antidepressants correct the imbalance of certain neurotransmitters in the brain. However, the drugs must not be confused with sedatives, intoxicants, tranquillizers or addictive substances. Antidepressants usually do not have a stimulating effect on people who do not suffer from depression. Important: The therapeutic effect only occurs after regular use over an extended period.

There are now over 20 different antidepressants available for the medical treatment of depression, all of which are, in principle, indicated for treatment. However, the treatment options have developed significantly in recent years. Instead of the tricyclic antidepressants (TCAs ), whose side effects limit their use in clinical practice, the more modern SSRIs are now increasingly being used, i.e. antidepressants that only act on the serotonergic system. Another therapeutic option was achieved when research developed a selective substance with dual effects on the serotonergic and noradrenergic systems ( sSNRI ).

Patients and doctors confirmed that drug therapy combined with talk therapy led to better results than therapy alone. The success of any treatment largely depends on the patient’s willingness to cooperate. The support of family and friends can be of great importance. If they accept the problematic situation of the sick person and if they strengthen their initiative and personal responsibility without being patronizing, they make a significant contribution to recovery.