How do you recognize depression? The following three main symptoms are typical of the disease:

1. Depressed Mood : Those affected suffer greatly from a deep depression. The depressed mood is almost continuous, severe, and lasts for at least two weeks.
2. Inner emptiness and loss of interests : It is also characteristic that those affected feel neither joy nor other feelings. Inside they feel empty and dead of feeling. Interest in social contacts, work and hobbies disappears. Attempts at encouragement by fellow human beings have no effect. Positive experiences do not improve mood.
3. Restlessness and tiredness : Depressed people have difficulty or are unable to cope with everyday tasks. You feel constantly mentally and physically exhausted. Even getting up in the morning becomes difficult, so that some do not even get out of bed because of their depression. Fatigue becomes the norm.

The following secondary symptoms are also typical of depression:

• Strong self-doubt
• feelings of guilt and self-reproach
• Concentration and attention disorders
• Extreme need for sleep or difficulty sleeping
• Strong restlessness and inner agitation
• loss of sexual interest

Depression Symptoms in Men

Men are less likely to be diagnosed with depression. Part of the reason is that the condition often manifests differently in men than in women. Aggression, severe irritability, poor impulse control and low stress tolerance are common side effects here.

Many affected men also take more risks than usual, for example driving a car much too fast. They often drink more alcohol than usual or smoke more. They blame their fellow human beings and are dissatisfied with themselves and the world. One reason for this may be that they feel weak and unmanly because of the depressive feelings and therefore act out their feelings differently.

Attention, risk of suicide!: In severe depression, the negative thoughts sometimes become so strong that suicidal thoughts arise. There is a risk of suicide!

Physical symptoms of depression

Depression is often accompanied by physical complaints that have no recognizable organic cause. Such symptoms are called somatic. Typical physical symptoms include:

• cardiovascular problems
• headache and back pain
• stomach and bowel problems
• sleep disorders
• Loss of appetite, more rarely: increased appetite
• morning low
• sexual reluctance

Somatization disorder

Sometimes the physical complaints are so much in the foreground that the depression is not recognized immediately. Doctors then speak of a somatic syndrome. The physical symptoms appear in phases and subside as the depression is treated.

If the doctor cannot find an organic cause for the symptoms, he will uncover the hidden depression as the actual cause by asking specific questions. If this is the case, he will diagnose a so-called somatization disorder. This does not mean that the patients only imagine the symptoms, but only that the depression manifests itself in physical form.

Delusions and hallucinations in depression

A major depressive episode is sometimes accompanied by delusions and hallucinations . The patients then suffer, for example, from delusions of persecution or obsessive thoughts . Such delusional depression is particularly difficult to treat. In addition to antidepressants, antipsychotic medications are also used.

Endogenous and exogenous depression

A few years ago, depression was divided into endogenous and exogenous depression, depending on the suspected causes. These terms are no longer common in the professional world, but are otherwise still widespread.

An endogenous depression was a depression without a recognizable external trigger or organic cause. This form of the disease was attributed to altered metabolic processes in the brain, for example due to a corresponding genetic predisposition.

If, on the other hand, a specific trigger for a depression seemed to be recognizable, one spoke of an exogenous depression . The terms “reactive depression” or “depressive reaction” were also frequently used. When mental stress was assumed to be the cause of reactive depression, this was referred to as ” psychogenic depression” .

Depression is generally considered to be curable. However, this does not mean that all patiens will get rid of their depression or not have a recurrence (recurrent depression). Since the suffering of those affected is often great, it is important that depression is treated promptly and professionally. In addition, the therapy becomes more difficult after a longer period of time. The risk of the disease becoming chronic is increasing.

Depending on the severity of the illness, depression is usually treated with psychotherapy, antidepressant medication, or a combination of both. Combination therapy is particularly indicated for chronic and recurrent depression. Experts also recommend a combination of both treatment approaches for severe depression.

Psychotherapy for depression

Psychotherapy requires months of patience and commitment on the part of the patient. However, those who get involved often overcome their depression in the long term and improve their overall mental stability.

There are many psychotherapeutic options for people with depression. The health insurers cover the costs for psychotherapy based on depth psychology , analytical psychotherapy ( psychoanalysis ) and systemic therapy.

Classical psychoanalysis and psychotherapy based on depth psychology belong to the group of psychodynamic psychotherapies. They are based on the idea that depression is often triggered by experiences of loss and hurt that have not been properly processed. These are processed during the course of therapy.

Cognitive behavioral therapy – an extension of classic behavioral therapy – is also used to treat depression. With the help of the therapist, the patient looks for ways to get out of the depression. Among other things, negative thoughts, patterns and beliefs are uncovered, checked for accuracy and, if necessary, replaced by new, more positive ways of thinking.

Other forms of psychotherapy for depression

Interpersonal therapy (IPT) is a short-term therapy method that was specially developed for the treatment of depressive disorders. It combines therapeutic concepts from behavioral therapy and psychodynamic therapy. An important goal of therapy is to learn skills and strategies for dealing with conflicts that contribute to the development or maintenance of depression.

Depression treatment: therapy with drugs

Antidepressants are usually prescribed for more severe depression or when the patient refuses psychotherapy. It can be used to successfully treat the symptoms of depression. However, the effect of the medication often only sets in after a few weeks.

Examples of medications used to treat depression include:

Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) : They increase the level of the “happiness hormone” serotonin in the brain and thus have a mood-enhancing effect.
Tricyclic antidepressants: They inhibit the reuptake of serotonin and norepinephrine.
Monoamine oxidase inhibitor (MAO): This active ingredient blocks the enzyme monoamine oxidase, which breaks down the messenger substances norepinephrine and serotonin.
Although lithium is not a classic antidepressant, it is often used as a mood stabilizer in depression.
St. John’s wort preparations have a mood-enhancing effect and are mainly used for mild to moderate depression.

Electroconvulsive therapy

In many cases, electroconvulsive therapy can be used to treat depression where medication and psychotherapy fail. A short “epileptic seizure” is triggered under short-term anesthesia by electrical impulses. This idea may be frightening at first. In fact, however, the patient is not aware of the procedure and the risks are low.

Awake therapy

For awake therapy, patients must remain awake the second half of the night or all of the night. This method does not cure the depression, but the symptoms are relieved in the short term. Patients are feeling well for the first time in a long time, albeit for a short time. Not only is this a tremendous relief, it gives them renewed hope that they may actually be able to overcome their depression. And a hopeful attitude contributes to the success of the therapy.

Repetitive transcranial magnetic stimulation

Repetitive transcranial magnetic stimulation is a new technique that can be considered when depression cannot be treated with medication. Various areas in the front right or left hemisphere of the brain are stimulated by magnetic fields. This painless treatment is carried out in a clinic for ten to 30 minutes a day for three to six weeks.

Self-help assistance with depression

Recent studies come to the conclusion that offers of help without direct contact with the therapist are also helpful. One option is self-help guides. Those affected read a lot of the information themselves and only occasionally have contact with an expert who supports them. This helps, for example, to bridge the waiting time until therapy.

Internet-based therapies and apps

Another option for people with depression is professional counseling via the Internet. The therapy is carried out using a special computer program. There are now also so-called depression apps and chatbots that make it easier to deal with depression. They are based on elements of cognitive behavioral therapy.

Exercise as an antidepressant

Get out of the house, get out of depression: experts recommend regular physical training for depression. This can significantly reduce depressive symptoms – both in the short term and in the longer term. In fact, regular exercise works as well as an antidepressant for some patients. Because it reduces stress and may have a positive effect on the levels of messenger substances in the brain (e.g. serotonin and noradrenaline).

The psychological effect of sport may have an even greater effect: through physical activity, patients break out of the spiral of listlessness and withdrawal. Self-esteem is strengthened, hopelessness suppressed. Anyone who does sport in a group also benefits from the sense of community and social contact, which is otherwise becoming increasingly rare in the case of depression.

Inpatient or outpatient therapy for depression?

A mild or moderately severe depressive phase can often be treated with outpatient psychotherapy. A stay in a clinic is necessary, especially in the case of severe depression. The combination of drug treatment, a wide range of psychotherapeutic therapies and intensive care in the clinic helps patients to return to a structured daily routine.

If you are concerned that you are suffering from depression, you should urgently contact your family doctor or a psychiatrist or psychotherapist directly. The doctor will first talk to you in detail in order to take your medical history ( anamnesis ).

The following questions, aimed at typical symptoms of depression, are often part of this initial consultation:

• Has your mood often been depressed or depressed in the past few weeks?
• Have you often felt unhappy lately?
• Have you often been listless and tired lately?
• 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?
• How long have these symptoms lasted?

The diagnosis is more difficult when physical symptoms are the main focus. Many patients complain of headaches, backaches, abdominal pains and cardiovascular problems. Describe all symptoms to the doctor in as much detail as possible.

Physical exams for diagnosis of depression

Various examinations make it possible to rule out physical causes of depression symptoms. This includes a blood test , possibly also a computed tomography (CT) of the brain. Because sometimes depressive symptoms can be traced back to, for example, low blood sugar levels, a lack of vitamin B12 , substance abuse, dementia , hypothyroidism or changes in the brain.

If the suspicion of depression is confirmed, the doctor will refer you to a specialized clinic or an outpatient psychiatrist or psychotherapist.

There are different forms of depression. They differ, among other things, in the type and frequency of the symptoms, the cause and personality-specific characteristics:

Unipolar Depression

Unipolar depression is considered the “classic version”: Typical depression symptoms such as sadness and listlessness occur over a period of several weeks or months. Such a depressive episode often passes, especially thanks to therapy. However, after a period without symptoms, there is a risk that another depressive episode will occur.

Bipolar depression

In bipolar depression or bipolar disorder, depressive episodes alternate with manic phases. Typical features of mania are an excessive feeling of high, overexcited behavior and excess.

Dysthymia

In dysthymia, the depressive symptoms are less pronounced but are present for a long time. Therefore, this form is also referred to as “chronic depression”. Symptoms must have been present for at least two years to make a diagnosis.

Depression in children and adolescents

Depression also affects children and young people. It often manifests itself in them through symptoms such as sadness, withdrawal, but also tantrums. In particular, puberty as a time of upheaval with hormonal turbulence and stress makes young people particularly susceptible to depression.

Old age depression

For many people, growing old is a process that entails losses above all: Retiring from professional life and the feeling of no longer being needed plunges many into a void. This sets the stage for depression for some people.

Postnatal depression

Some women develop depression after childbirth . Doctors then speak of postnatal depression or postpartum depression. Colloquially it is also called postpartum depression . In some cases, depression also occurs for the first time during pregnancy.

Depression is a serious mental illness that occurs at any age . The patients feel very depressed, lose their interests and are exhausted and listless. The disease is long-standing and rarely gets better on its own without treatment. How do you recognize depression, which forms of depression are there and which therapies help? Read everything you need to know about it here!

Quick overview of depression

Symptoms : Main symptoms are deep depression, loss of interest and listlessness; Side symptoms include insomnia, self-doubt, feelings of guilt, difficulty concentrating
Causes and risk factors : partly genetic predisposition, mental injuries, disturbed messenger metabolism in the brain , stress
Diagnostics: anamnesis interview, physical examinations
Treatment : Various forms of psychotherapy , medication (antidepressants)
Course and prognosis: Depression is curable. The probability of recurrence after a depressive episode without prevention is about 50 to 75 percent.
Prevention: stress reduction, sport, maintaining social contacts.

What is depression?

Depression is a mental disorder that makes people feel depressed and lacking in motivation. In addition, there are often symptoms such as low self-esteem, feelings of guilt, sleeping disorders and poor concentration . Depression usually severely impacts those affected, restricts their everyday life, puts a strain on romantic relationships and, in some patients, leads to incapacity to work – in the worst case even to suicide.

Incidence of depression in Africa

According to NIH.gov, it is estimated that 29.19 million people, which forms 9% of 322 million in Africa, suffer from depression. Over 7 million of these are in Nigeria (3.9% of 322 million).

The WHO reports that about 5% of adults in the world suffer from depression.

What causes depression?

How depression develops has not yet been fully elucidated. Doctors assume that several factors always play together. These include biological, genetic and psychosocial triggers. The extent of the influence of the various factors varies from case to case.

Genetic Influences

Twin and adoption studies have shown that depression also has a genetic root. The risk of developing depression is 50 percent higher if other first-degree relatives already have the disease. For example, if a mother has a depressive disorder, this is a risk factor for the child, especially if the disorder started at an early age.

Vulnerability: Susceptibility to depression

Vulnerability describes how susceptible a person is to a mental disorder. For people with high vulnerability, even a little stress can lead to depression. If, on the other hand, vulnerability is low, people manage to cope well with even very stressful events. Such people are called resilient . Not only the objective severity of the stress decides whether a person suffers from depression, but the ability to deal with it.

The experiences that a person has made in his life have a significant influence on this. For example, people who have experienced traumatic experiences such as abuse or neglect in childhood have a particularly high risk of developing depression. But it is also crucial which skills a person has acquired in order to cope with stressful situations.

Disturbed messenger metabolism in the brain

Nerve cells in the brain communicate with each other via electrical impulses and messenger substances, so-called neurotransmitters. There are indications that this so-called cerebral metabolism is altered during depression.

A disturbed norepinephrine or serotonin level in the brain tissue may be partly responsible for depression. If these messenger substances are not in balance, this disrupts the exchange between the nerve cells. And that in turn affects feelings and thoughts negatively.

Irregulated stress hormones

Other approaches to explaining the cause of depression focus on a dysregulation of the stress hormones adrenaline , noradrenaline and cortisol . In particular, depressed people have been found to have elevated cortisol levels. Such a condition can be considered as a trigger for depression, but also as its consequence.

Stress as a trigger

Stress plays a crucial role in the development of depression. Conversely, depression itself also causes stress – for example, because the illness reduces a lot of quality of life. Some phases of life are inherently associated with increased stress. These include, for example, puberty or retirement. In such phases, the risk of depression increases.

Significant life events are also stressful. This includes negative experiences such as job loss, separation or a serious illness. However, positive events also cause stress: For example, a promotion, the birth of a child or a wedding also increases the likelihood of developing depression.

In fact, people with depression often report difficult events before the onset of the illness. In many other cases, however, depression appears to appear out of nowhere.

Negative thought patterns

It’s not always fate or genes: personal attitudes towards life also have an impact on the risk of depression. People who think badly of themselves and the world and see pessimism about the future are more likely to become depressed. Good self-esteem and optimism, on the other hand, protect against depression.

Risk factor female gender

Women are about twice as likely to suffer from depression as men. One possible explanation is that women are more at risk due to hormonal fluctuations. Such hormone fluctuations occur, for example, in the course of the menstrual cycle and during and after pregnancy.

In addition, depression in men is discovered less frequently. Some are reluctant to show weakness and seek help. However, they also sometimes have atypical symptoms such as aggressive and excessive behavior, which makes diagnosis difficult.

Physical illnesses and depression

Some physical illnesses promote depression. Diseases of the brain and hormonal imbalances in particular affect the emotional world. The latter include hypothyroidism and hyperthyroidism or what is known as Cushing’s syndrome , in which the adrenal glands release excessive amounts of cortisol – the result is often a depressive phase.

Serious and chronic illnesses are also a constant burden on the psyche. People who suffer from cancer, severe cardiovascular diseases or diabetes often develop depression. It is also possible that the drugs used for treatment or the physiological processes associated with the disease increase the risk of depression.

Conversely, depression has an unfavorable influence on the course of such diseases or even promotes their development. With such a combination of physical and mental illnesses, it is always important to treat the mental and physical suffering equally.

Medicines and drugs

Taking certain medications also occasionally affects mood. These include cardiovascular drugs such as beta blockers, cortisone and related substances, hormonal contraceptives and some neurological drugs such as antiepileptics and anti-Parkinson drugs.

Drugs such as alcohol, cannabis and other substances that influence the psyche also promote the onset of depression.

How does depression progress?

Depression progresses very differently from person to person. Consistent treatment helps most people who suffer from depression. The therapy makes it possible to break through depressive episodes or to let them subside completely. Depression is considered curable.

If left untreated, however, there is a high probability that depression will persist for months or years. This is especially true for major depression. The earlier treatment begins, the better the outlook.

About half of people who have had a depressive episode will relapse. For people with severe depression, the figure is 75 percent. With each relapse, the likelihood of further depressive phases occurring increases. Chronic depression is particularly difficult to cure. They often become lifelong companions and require constant treatment.

How can depression be prevented?

There are many factors that contribute to depression. Not all can be turned off. In order to strengthen your own mental health and thus possibly reduce the risk of depression, it is advisable to reduce stress.

A stable social network also has a protective effect. Therefore, maintain regular contact with friends and exchange ideas about worries and problems.

Sport and regular exercise have proven themselves in the therapy of depression and make a contribution to preventing the development of depression.