Depression is more common during the holidays

Depression: causes, symptoms, help

Depression is a widespread disease. According to the Robert Koch Institute, 11.6 percent of the population in Germany will be affected once in their life. Even so, many people don't know very well about the condition. A recent survey by Deutsche Depressionshilfe has shown how big the information gaps are.

According to this, almost a fifth said it would help depressed people to pull themselves together. Just as many of those surveyed believed that chocolate could alleviate their suffering, and just under 80 percent believed that a vacation would solve the problem. None of this is true. Depression aid emphasizes that no sick person can pull themselves together.

Stress is overestimated

"Depression is a serious illness," says Professor Ulrich Hegerl, head of the Clinic for Psychiatry and Psychotherapy at Leipzig University Hospital. A bundle of causes causes it to break out. But there is also a lot of misinformation about this.

95 percent of those surveyed believe that strokes of fate or stress at work trigger depression. This would overestimate stressful life events for the development of the disease, says Hegerl. Biological causes play an at least as important role. However, many people do not know that the metabolism in the brain is disturbed during depression and that the risk for the disease is inherited. "Even with a lot of stress you don't get depression if you don't have a predisposition to it," says Hegerl.

Because psychological suffering is still stigmatized and taboo, many of those affected do not receive any help. The World Health Organization estimates that over half of major depressions are not diagnosed as such. Experts in Germany repeatedly emphasize that most suicides in this country can be traced back to untreated depression.

Sadness and inner emptiness for several weeks

So when should you get help? When should relatives and friends sit up and take notice? The main symptoms of the disease include the basic feeling of deep sadness and inner emptiness. If you can't be happy about anything for at least 14 days or feel constantly exhausted, you could suffer from depression.

"Personally, I think two weeks are a bit short," says Professor Tom Bschor, head of the psychiatry department at the Schlosspark Clinic in Berlin. After all, a period of mourning, for example, can sometimes take longer. "But if the condition lasts for four, six or eight weeks, that speaks for something pathological." Then you should see your family doctor - also to rule out other diseases. If necessary, he will refer you to a psychotherapist or psychiatrist.

People who are depressed can suffer from a variety of symptoms

Depression has many faces. Some people suffer from self-doubt, fears, or feelings of guilt. Others find it difficult to concentrate and become aggressive and irritable. Sleep disorders are now a common sign. Typically, people with depression find it difficult to sleep, often lie awake at night and get up very early.

Ultimately, only a specialist can make a reliable diagnosis. "I ask older people whether they think of their grandchildren with good feelings," reports Bschor. "The little ones are generally positive." People who are depressed, however, often report that they no longer feel anything, that they feel cut off, like numb, dull and numb.

Severe Depression: Delusions are also possible

A special form of severe depression is the depressive madness. Affected people hold on to an immovable belief that is not true. Typical topics: I will become impoverished and end up under the bridge. I took the blame on me. I have a serious illness, AIDS or cancer. "Even if all medical examinations prove the opposite," says Bschor.

One of his patients could not let go of the thought that she would soon be standing naked and ashamed, that she did not have enough clothes. "It doesn't help to show the full wardrobe," says Bschor. Further maximum forms are the depressive stupor, in which the patient lies frozen. Or strong and pressing thoughts of suicide.

"Most depression is mild to moderate," says expert Bschor. But these manifestations can also cause great suffering. Many of those affected have to pull themselves up to every day-to-day task, force them downright. Get up, get dressed, do your hair - everything is difficult. "You are no longer able to think outside the box of the negative," says Dr. Gabriele Schleuning, psychiatrist and chief physician at the clinics in the Upper Bavaria district, including the Munich Atrium House, a psychiatric emergency clinic for crises.

Depression can go away, but relapses are possible

But how do you get out of there? The good news: Depression can go away, sometimes without therapy. However, it takes time. "On average, an untreated depression passes after a few weeks to several months," says Schleuning. Around 40 percent of people who have been caught once remain there - at least for a period of five years after the illness, as a large Swiss observational study from the 1980s has shown.

Conversely, this also means that most patients will relapse at some point. Depression comes on in flares. A phase without symptoms can be followed by another phase of illness. Experts advise anyone who has been diagnosed with depression to watch out for possible signs of a new flare-up - and, if necessary, to see a doctor.

Behavior therapy and antidepressants

Depression should always be treated, the sooner the better. "Because of the high level of suffering and constant hopelessness, the risk of suicide is a frequent companion of depression," warns expert Hegerl from the Leipzig University Hospital. The best evidence of effectiveness is for cognitive behavioral therapy. It is intended to train resilience and teach strategies to cope better with difficult situations and to relax more. Aids can be yoga, qigong, mindfulness exercises and sports.

In general, treatment is based on two pillars: psychotherapy and medication, so-called antidepressants. The agents intervene in the brain metabolism and influence the concentration of certain messenger substances. Contrary to popular belief, the drugs do not change personality. However, side effects such as insomnia or decreased libido can occur.

The risk of suicide may also be increased in the first few weeks of use. That is why close supervision is necessary, especially in the initial phase. "Sometimes you have to switch if a patient does not tolerate a drug or it doesn't work," says psychiatrist Hegerl. For some people, antidepressants work well and quickly, for others it takes several weeks to show an effect. And with still others, the drugs do not help at all.

Depression has nothing to do with guilt or weakness

Especially in the case of severe depression, the remedies are an integral part of the therapy. According to the National Health Care Guideline, a guide for doctors, antidepressants are not necessarily recommended for mild forms. In moderate forms, they should be offered alongside psychotherapy. St. John's wort is also an option here. "In the case of moderate grades, it also depends on the patient," explains Schleuning. Some people have great hopes for medication, others would rather be suspicious.

Regardless of whether you are treated with antidepressants or without - one thing is certain: Depression has nothing to do with weakness, guilt or even personal failure. And chocolate doesn't help here.

Maybe depressed? What relatives can do:

Who a partner, a partner, sibling or parents who suffer from depression must be very sensitive. And be patient. At the same time, it is difficult for relatives to live with the illness of the loved one and to keep realizing that it is an illness. That there is no point in pulling yourself together or traveling.

Meanwhile there are many offers for relatives where they can find help and advice or exchange ideas with others. Information can be found, for example, at You can also contact the Social Psychiatric Service or the Federal Association of Relatives of Mentally Ill People.

Also seek the conversation with the patient - especially when the sick person has not yet recognized what is wrong with him. "Ask questions," says expert Bschor. For example: Have you noticed that you've been feeling bad for a while? Do you want to talk? Did you notice changes in yourself? Have you ever thought about depression?

Do not devalue the other, try to keep in touch. "Don't say I can't take you anymore, do something, or I'll let you down," says Schleuning. It would be better to put the offer of help in the foreground. Like saying: You may be depressed. You can treat them. You should get examined.

Don't be shycontact the doctor on your own and inform the patient about it. Especially when depressed people are to blame for their condition, they will not necessarily go to a practice on their own initiative. Take care of the patient, especially in a crisis situation. Take him to the clinic or to the doctor, for example.

But also set yourself apart. Try not to exceed the threshold of your own resilience. Do something for yourself too.

Do you have the feeling that there is no way out of your situation?

You can get immediate help around the clock, also anonymously, from the telephone counseling: 08 00/111 0 111 or 08 00/111 0 222

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