Four million people in Germany suffer from depression - and many sufferers perceive it as a blemish, which one would be ashamed of. But depression is neither a mental illness nor a sign of personal weakness. She can meet anyone. Depression is a disease with clear causes, symptoms and treatment options. It influences feelings, thoughts and behavior. But the body also reacts - for example with gastrointestinal complaints, back and headaches, weight fluctuations or insomnia. Experts predict that depression will continue to advance in the ranking of major diseases.
Causes of depression
Biologically, depression can be explained as a metabolic disorder in the brain. Messenger substances, which, as neurotransmitters, control the communication between the many billions of nerve cells are out of balance and trigger physical and psychological changes.
The causes are very diverse. Science is based on an interplay of genetic factors and mental stress. Significant experiences, constant overwork, difficult childhood conditions, but also drugs and diseases can trigger depression. Many physicians and psychologists interpret depression as a protective mechanism that intervenes from the unconscious into a life, when the person pursuing illusory goals and puts health and integrity on the line.
Symptoms and signs
Typical mental symptoms of depression are:
- Freedom and helplessness
- missing drive
- inner restlessness and emptiness
- difficulty concentrating
- a feeling of worthlessness, expressed in the extreme case in suicidal thoughts
The body responds to depression with marked deviations from normal: with unrestrained or little appetite, with a slowed or agitated speech, with an increased or decreased need for sleep. A basic fatigue as well as head, heart, abdominal or back pain can accompany a depression.
Depression: This is the diagnosis
Not every "gray" day in a person's life is the result of a major depressive disorder. Grief, inner restlessness or feelings of guilt can be normal, healthy reactions and should not be a cause for concern. However, if the symptoms appear over a period of at least two weeks each, or at least every other day, and reduce the long-term effectiveness, a doctor should be consulted.
Depression has many symptoms that are sometimes difficult for the doctor to interpret. It is crucial that the patients speak openly about physical and mental complaints, worries and fears. The diagnosis "depression" is only made if other diseases, medicines or drugs can be ruled out as the cause of the symptoms. A full physical examination by a general practitioner or internist, as well as laboratory tests are therefore essential.
Therapy for depression
For many affected people - after many years of suffering in uncertainty - the diagnosis of "depression" a relief. For some, but also a severe shock, because mental illnesses are socially less accepted and the possibilities of successful therapy are underestimated.
The chances of recovery are great today. However, recovery usually takes some time. The treatment is essentially based on two complementary therapeutic approaches: psychotherapy (talk therapy) and drug therapy. Which method of treatment is best for each patient or whether they are used in combination, the patient and doctor usually decide together.
Psychotherapy is a learning and cognitive process. It conducts research into causes and develops strategies that help the patient cope better with the problems of life. Talk therapy usually takes three to six months.
- Cognitive-behavioral therapy (CBT) helps the patient to recognize their own negative thought patterns and destructive behaviors and to replace them with life-affirming patterns that match personality and circumstances.
- Interpersonal Psychotherapy (IPT) focuses on the treatment of disturbed personal and social relationships. The depressed person learns to interact more effectively with others in order to reduce conflicts and gain the support of family and friends.
- Psychodynamic therapy allows the patient to look inside. It reveals emotional conflicts or unresolved childhood problems as the cause of depression.
Conversational therapy is often enough to effectively help people with mild forms of depression. In patients with moderate or severe depression, medication supplements psychotherapy. Antidepressants have the task to bring the disease symptoms under control and thus to create good conditions for effective talk therapy. Biologically, antidepressants correct the imbalance of certain messengers in the brain. The drugs should not be confused with sedatives, intoxicants, sedatives or addictive substances. Antidepressants usually have no stimulating effect on people who do not suffer from depression. Important: The therapeutic effect occurs only after regular use for a long time.
Today, over 20 different antidepressants are available for the treatment of depression, all of which are indicated for treatment. However, the treatment options have evolved significantly in recent years. Instead of the tricyclic antidepressants (TZAs), whose side effects restrict their use in clinical practice, today more modern SSRIs are used, ie antidepressants that only act on the serotonergic system. Another therapeutic option was achieved in which the researchers succeeded in developing a selective compound with dual effects on the serotonergic as well as the noradrenergic system (sSNRI).
Patients and physicians confirmed that drug therapy combined with talk therapy has produced better outcomes than therapy alone. The success of any therapy depends largely on the patient's willingness to cooperate. The support of relatives and friends can be very important. If they accept the difficult situation of the patient, as well as strengthen the initiative and self-responsibility without paternalism, they contribute significantly to the recovery.