07. April 2019
“You’re getting depressed,” “I’m feeling really depressed today,” “Monday depression”… The term depression is often used as a colloquial term for a low mood, a bad mood or a lack of motivation. We are well aware that life is not always the proverbial peace and joy. Ups and downs are part of being human. But what if the depressed mood lasts for weeks and months? When the beautiful sides of life can no longer be perceived? What are the unmistakable signs of depression and at what point is professional help really necessary?
Depression is one of the most common mental illnesses worldwide and represents an enormous burden for those affected and their relatives. Increasing rates of illness are being recorded in the health care system (Spießl et al., 2006). The risk for a German adult to develop depression once in a lifetime is estimated to be 20% (Wittchen & Hoyer, 2006). Because depression usually progresses in phases, it is also referred to as depressive episodes, which can be classified into different degrees of severity (mild/moderate/severe). The causes of the disease are manifold.
Genetic factors, metabolic disorders, stress, stressful life events and inadequate coping mechanisms all influence each other. It is an illness that is still often concealed and associated with a high degree of insecurity and shame. Yet depression is well researched and treatable! The prerequisite for this is the correct and early recognition of the signs of depression (Henkel et al., 2003).
Often the question arises: am I in a low mood or is there a real depression? However, depression is much more than just a brief period of low mood or listlessness. The time period plays a decisive role in the diagnosis. Thus, depression is only present when the symptoms occur longer than two weeks. The first sign of depression is depressed mood in general. Those who think only of sadness in this context are thinking too briefly. Negative feelings of all facets such as anger, resentment, dejection, shame, defiance, or pessimism may occur.
Feelings of worthlessness and guilt are particularly prominent. Thus, depressed persons are often convinced that they have failed as a person, are of no added value to friends and family, and only burden their environment. Even if the depressed person was previously an important support for his or her fellow human beings, or still is, he or she no longer recognizes this. Strong feelings of guilt can arise that they no longer have life “under control” and can no longer fulfill their obligations.
Important: A lack of feeling, inner emptiness or rigidity can also be an indication of depression. The whole facial expression can appear frozen and mask-like. Those affected sometimes feel as if they are isolated under a bell jar
The loss of all joy
In severe depression, interest and pleasure in almost all activities may be diminished. Even loved ones, children or beloved pets can no longer put a genuine smile on one’s face. Long cherished hobbies are put on hold. Those affected often report permanent brooding that makes it impossible to concentrate on any activity. Incessant, circling thoughts are among the frequent symptoms of depression. In addition, there is a feeling of tiredness and loss of energy almost every day of the week.
“My head was working like crazy, brooding until it hurt. At the same time, my body was empty: no emotions, no strength, no hope.”
Quotation from a sufferer
The thousand faces of depression
Some symptoms of depression are characteristic and occur in almost all patients, especially the depressed mood and loss of pleasure and interest discussed earlier. Nevertheless, depression can manifest itself quite differently from person to person. For example, some sufferers are very slowed down in their movements and appear paralyzed, while others tend to be more hectic, can hardly sit still, and feel driven by an inner restlessness. The sleep behavior can also be quite different: either sleep is increased and sufferers would prefer to spend the whole day in bed, or sleep is significantly reduced because they are agitated and nervous. Appetite may also be decreased or increased.
Therefore, in depression, there may be weight loss, or weight gain. It is important to remember, then, that depression is not necessarily associated with lethargy and slowing down, as many people stereotypically think, but can also manifest itself in sometimes opposite behaviors. The signs of depression can therefore vary greatly in some cases.
High level of suffering
In general, the suffering pressure of depressive persons is very high. They are severely restricted in their everyday life and may no longer be able to pursue their actual activities. Affected persons report sometimes extreme difficulties in concentration and decision-making, which hinder everyday life. Affected persons often withdraw as a result of the symptoms and avoid company. A devil’s circle of isolation and a further aggravation of the symptoms develops. In severe depressive episodes, recurrent suicidal ideation should never be taken lightly. If there is an acute threat, relatives or involved parties should not hesitate to notify the emergency services (112)!
Depression can affect anyone! It is therefore important to realize that many different factors have an influence. Depression therefore occurs independently of, for example, the following factors:
If you recognize the signs of depression in yourself or in people in your environment, a medical or psychotherapeutic clarification should be initiated. The first course can lead to the family doctor, who takes over the first examination and initiates all further steps. In most cases, a psychiatric specialist will then decide how to proceed with treatment. A psychotherapist can also be consulted.
Medical and psychotherapeutic research has shown that a combination of psychotherapy and medication is effective for severe depression, while psychotherapy is often sufficient for milder illnesses (Kirsch et al., 2008). The specialist also decides whether inpatient treatment is appropriate. As a family member, you too can heed a few things to help the sufferer!
Ruling out other causes
Medical causes for the symptoms of depression must be excluded by the specialist. For example, thyroid function is checked or the side effects of other medications are ruled out as a reason for the depressed mood. The normal grieving process following the loss of a loved one must also be considered as a cause. Depressive symptoms due to grief can persist for up to two months without a diagnosis of depression.
Don’t delay, seek help
Note: The longer depression requiring treatment becomes entrenched, the more difficult it can be to treat. But no matter how severe the illness, there is always hope for improvement, and the effectiveness of common treatment methods has been scientifically proven (Wittchen & Hoyer, 2006). Care for people with mental illness continues to evolve, and awareness among the general population is also growing. Take advantage of the help you deserve and declare war on depression. Life’s little and big joys are waiting around the corner, I promise!