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Most common types of Depression: Symptoms, Treatments

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Depression is a serious mental illness. The patients feel very depressed, lose their interests and are exhausted and impotent. The disease persists for a long time and usually does not improve on its own without treatment. How do you recognize depression, how does it develop and what therapies help? Read everything important here!

Depression – Symptoms

The serious mental illness should be treated professionally. Unlike sadness and listlessness, which are part of life, depression does not disappear after a while and does not improve by distraction or encouragement.

Who suffers from depression?

People can get depressed at any age. According to the Federal Health Survey, around 16.2 million people in United States currently suffer from depression. Depression signs are so common – and they can affect anyone.

Three main symptoms of depression

How to recognize depression? The following three main symptoms are typical:

Depressed mood: Those affected suffer very much from a profound depression. The depressive mood is almost uninterrupted, severe and lasting for at least two weeks.

Inner emptiness and loss of interests: A characteristic of depression is also that the affected person feels neither joy nor other feelings. Inwardly, he feels empty and emotional.

The interest in social contacts, work and hobbies expires. Encouragement attempts by the fellow humans have no effect. Even positive experiences do not improve the mood. Everything seems hopeless to them, so some lose the will to live.

Listlessness and tiredness: coping with everyday tasks is difficult or even impossible for depressed people. They constantly feel mentally and physically exhausted.

Even getting up in the morning becomes a show of strength, so that some do not leave the bed because of their depression. Fatigue becomes normal.

Side symptoms of depression

Typical of depression are the following secondary symptoms:

  • strong self-doubt
  • guilt and self-reproaches
  • Concentration and attention disorders
  • extreme need for sleep or insomnia
  • severe restlessness and inner agitation
  • loss of sexual interest

Depression symptoms in men

In men, depressions are less frequently diagnosed. In part, it is because they often express themselves differently than women with depression.

Aggression, severe irritability, low impulse control and low stress tolerance are common side effects. They take more risks than usual, for example driving cars way too fast.

Often they also consume more alcohol than usual or smoke more. They reproach their fellow human beings and are dissatisfied with themselves and the world.

One reason could be that they feel the depressive feelings as weak and unmanly and therefore live out differently.

Female gender

Women are twice as likely to develop depression as men. One possible explanation is that women are more vulnerable to hormonal fluctuations, such as menstruation.

Strong hormonal changes also bring with it a pregnancy that leads to a pregnancy depression in some women. The so-called postpartum depression or postpartum depression also meet a lot of women.

Low socioeconomic status is also a risk factor for depression – and more women live in poverty than men.

In addition, depression is more rarely detected in men. Some are reluctant to show weakness and seek help. But they also have atypical symptoms such as aggressive and excessive behavior.

Depression in children and adolescents

Depression also affects young people: about one to two percent of pre-primary and primary school children and between three and ten percent of adolescents suffer from it.

In rare cases, even very young children get sick. In children, however, depression is often not recognized.

How do depression express themselves in children? Symptoms such as sadness and withdrawal are quickly classified as hypersensitivity in children, which is self-evident.

Depression is also often different in children than in adults. Some get tantrums, others are extremely affectionate.

Even smaller children are often difficult to describe their feelings. They then complain, for example, about stomachache or headaches, although actually the soul suffers.

For teenagers, melancholy and moodiness are also considered to be common side effects of this developmental phase. This may indeed be the case, but the cause is not infrequently also a depression requiring treatment.

Because puberty as a time of upheaval with hormonal turbulence and stress makes young people particularly vulnerable to depression.

The relapse rate is particularly high in children and adolescents with depression


. Because the mental disorder can permanently change the functions of the brain that is still developing.

That’s why fast and effective therapy is particularly important for young people. Help can be provided to children and adolescents specialized psychotherapists.

In addition to a cognitive behavioral therapy, a family therapy, which includes the family environment, may be useful. For small children there is the offer of a game therapy.

Attention, danger of suicide!

The negative thoughts can become so strong in severe depression that suicidal thoughts arise. In some depressive people, the risk of suicide is very high.

About ten to fifteen percent of patients with depression die from suicide.

Searching for help! If you think of suicide yourself, or believe it could be the case with a relative, seek help without hesitation. The seemingly hopeless situation is a symptom of depression that can be overcome with the right support.

Self-test for depression

Do you have the impression that you may be suffering from depression? Important hints are provided by online self-tests. Important: Such a self-test can not replace the diagnosis by a doctor or therapist. Be sure to seek help if the test gives this recommendation.

Physical symptoms in depression

Depression is often associated with physical ailments that have no apparent organic cause. Such symptoms are called somatic. Typical physical symptoms are, for example:

  • Cardiovascular complaints
  • Head and back pain
  • Gastric and intestinal problems,
  • sleep disorders
  • Loss of appetite
  • rare also stronger appetite
  • a morning low mood
  • sexual aversion

Somatization or somatoform disorder

Sometimes the physical symptoms are so prominent that the depression is not immediately recognized. Physicians speak of a somatic syndrome. The physical symptoms appear in phases and resolve with the treatment of depression again.

If the doctor does not find any organic cause for the ailments, he can reveal hidden depression as the actual cause by asking questions.

If so, 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 . For example, the patients suffer from persecutory delusions or obsessional thoughts.

Such delusional depressions are particularly difficult to treat. In addition to antidepressants, antipsychotic drugs are also used.

Mourning or depression?antidepressant_medicine_drugsjpg

Depression symptoms may be similar to those of deep mourning. But there are crucial differences.

This includes that in contrast to depression in a bereavement, the depressed mood does not always remain the same.

Most mourners, despite their loss, are able to laugh and feel joy in between. People can not do that with depression.

In addition, the mood of mourners usually improves with time. Grief can recur abruptly with the thought of loss. But gradually a mourning person will increasingly enjoy beautiful experiences again.

The support of friends and family can be a comfort to him. In some cases, however, a mourning reaction turns into depression.

Depression Side effects

Medications can have not only physical but also mental side effects – for example, depression or even thoughts of suicide.

And that affects many patients: for example, every third person takes remedies that have the potential to darken the mind.

The dementia risk is particularly high if someone takes several of these medicines at the same time – and that is often the case.

“Many will be surprised that their medications can affect their moods and promote depression,” says study author Dima Qato from the University of Chicago.

Among them are many common drugs such as proton pump inhibitors for heartburn, beta-blockers for high blood pressure, corticosteroids for rheumatism or asthma and even the painkiller ibuprofen, for which one does not need a prescription.

200 drugs linked to depression

Overall, the list of depression-related drugs includes around 200 drugs. “It was both surprising and worrying how many drugs have depression as a possible side effect,” explains Qato.

Doubling the rate of depression

The researcher and her team had analyzed the medications of 26,000 adults and compared them with the mental health of the individuals.

For those who took one of these drugs, the depression rate rose from 7 to 10 percent. Those taking two of these drugs had a nine percent risk. Of those who swallowed three or more, even 15 percent developed depression.

The influence of other factors that favor depression, they calculated the researchers out. These include poverty, unemployment but also health factors such as chronic pain.

“It is important that patients, doctors and pharmacists are aware of the possibility that taking some medications is associated with a higher risk of depression,” says Qato.

Open questions

The researchers emphasize that there are still many open questions on the subject and further research is needed. The study merely shows a link between taking medication and depression – but it does not provide definitive evidence that they actually promote depression.

Mixture of drugs is always problematicantidepressant_depression

When people take several medications at the same time, this can be problematic. A combination may exacerbate adverse side effects, or the various preparations may mutually block each other’s effects.

In Europe, every third person between the ages of 65 and 79 even takes five or more medicines prescribed by the doctor.

Depression: Causes and Risk Factors

How depression develops is still not fully understood. However, it is assumed that there are always several factors interacting – internal and external.

These include biological, genetic and psychosocial triggers. The size of the influence of the different factors varies from case to case.

There are many factors that cause depression:

Genetic Influences

Twin and adoption studies have shown that depression also has a genetic root. The risk of developing depression is higher when other blood relatives are already ill. This is especially true when they became ill at an early age.

If, for example, a monozygotic twin suffers from depression, the other develops depression in about 40 percent of the cases.

In dizygotic twins that happens about half as often, so in 20 percent of cases. To a certain extent, depression is inheritable.

Vulnerability – susceptibility to depression

Vulnerability describes how susceptible a person is to a mental disorder.

In people with high vulnerability, little stress can cause depression. But if the vulnerability is low, people can cope well with very stressful events.

Such people are called resilient, so resilient. It is not just the objective severity of the strain that determines whether a person suffers from depression.

Significant influence also has the experience that a person has made in his life. For example, people who have had traumatic experiences such as abuse or neglect in their childhood are at particular risk of developing depression.

However, it is also decisive what skills a person has acquired 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 is evidence that this so-called brain metabolism is altered during depression.

For example, a disturbed level of norepinephrine or serotonin in the brain tissue could be responsible for depression. If these are not in balance, it interferes with the exchange between the nerve cells.

And that in turn affects feelings and thoughts negatively.

Disturbed brain metabolismmetabolism:

Cause for depression could be a disturbed messengerin the brain.

The fact that neurotransmitters in the brain actually play a role in depression is supported by the effects of antidepressant drugs such as serotonin reuptake inhibitors. However, this hypothesis does not explain why it usually takes weeks for the drugs to work.

Misregulated stress hormones

Other explanations suggest a dysregulation of the stress hormones epinephrine, norepinephrine, and cortisol for depression.

In particular, it has been found in depressed people an increased cortisol levels. This can be the trigger for, but also the result of depression.

Stress as a trigger

Actually, it is known that stress plays a decisive role in the onset of depression. Conversely, depression also causes stress itself.

For example, by the loss of quality of life, but also when the profession can no longer be exercised or tensions with the social environment occur.

Some stages of life are per se associated with increased stress. These include, for example, the puberty or the entry into the pension. In such phases, the risk of depression increases.

Even drastic life events are stressful. These include negative experiences such as job loss, separation or a serious illness.

However, even positive events cause stress: Even with a promotion, the birth of a child or a wedding, the likelihood of developing depression increases.

In fact, people with depression often report difficult events before the onset of the disease. In many cases, however, depression also appears from nowhere.

Negative thought patterns

Fate or genes are not always the same: personal attitudes to life also have an influence on the risk of depression.

People who think badly about themselves and about the world and see black for the future are more likely to get sick. However, good self-esteem and optimism protect against depression.

You can do something about it: Negative thinking patterns and ideas can be positively changed through appropriate exercises.

Physical disorders and depression

Some physical illnesses can also contribute to depression. Especially diseases of the brain and hormonal disorders such as hyperthyroidism or hyperthyroidism affect the emotional world.

In Cushing’s syndrome , for example, excessive amounts of cortisol are released into the adrenal cortex . The consequence is often a depressive phase.

Heavy and chronic diseases are also a constant burden on the psyche. Thus, people who suffer from cancer, severe cardiovascular disease but also diabetes, often develop depression.

It is also possible that the drugs used for treatment or associated with the disease physiological processes increase the risk of depression.

Conversely, depression can adversely affect the course of such diseases or, in some cases, even promote their development.

With such a combination of physical and mental illnesses, it is always important to treat mental and physical suffering equally.

Additional mental illness

People with depression often suffer from other mental disorders. Again, it is important to recognize both diseases and treat them accordingly. These include:

  • anxiety disorders
  • obsessive-compulsive disorder
  • alcoholism
  • personality
  • disorders eating disorders

winter depression: lack of light as a trigger

Some people are depressed only in the dark season – but every year again. Depression in winter is one of the seasonal affective disorders (SAD = seasonal affective disorders).

Symptoms such as lack of drive, loss of interest and depression are largely consistent with those of a classic depression, but are usually milder.

Typical of a winter depression are also a pronounced need for sleep and cravings for sweets. That’s why people with winter depression usually gain weight in the winter months.

The cause of the disorder is believed to be the lack of daylight, to which some people are particularly sensitive.

In the dark, the body releases larger quantities of the sleep hormone melatonin . Not only does this hormone make you tired, it also depresses your mood.

Medication and Drugs

Certain medications can also affect mood. These include cardiovascular drugs such as beta-blockers, but also cortisone and related substances, hormonal contraceptives and some neurological medications such as antiepileptic drugs and Parkinson’s drugs.

Even drugs such as alcohol, cannabis and other substances that affect the psyche, can promote the onset of depression.


Depression – Treatment

Every third person develops depression in the course of his life, says the statistics. A speedy treatment is then important, because those affected suffer greatly from their condition.

In addition, the therapy becomes more difficult and the risk that the disease becomes chronic, grows.

Depending on the severity of the disease, depression is usually treated with psychotherapy, antidepressant medication, or a combination of both.

The combination therapy is especially indicated for chronic and recurrent depression. Even with severe depression, experts recommend a combination of both treatment approaches.

Psychotherapy for depression

There are many psychotherapeutic options for people with depression. At present, however, the coffers only cover the costs of cognitive behavior therapy and so-called psychodynamic psychotherapies.

Psychotherapy Psychotherapy

Psychotherapy requires patient patience and commitment over a period of months. However, those who get involved can often overcome their depression in the long term and improve their overall psychological stability.

Cognitive Behavioral Therapy

In a cognitive-behavioral therapy, the patient, assisted by the therapist, seeks ways to find out from the depression. Among other things, negative thoughts, patterns and beliefs are uncovered, checked for their correctness and, if necessary, replaced by new, more positive ways of thinking.

Psychodynamic Psychotherapy

Psychodynamic psychotherapy is based on the idea that depression is often triggered by loss and injury experiences that could not be properly processed. These should be processed in the course of therapy. Psychodynamic psychotherapies include classical psychoanalysis as well as deep psychological psychotherapy.

Other types of psychotherapy for depression

Interpersonal therapy (IPT) is a short-term therapy that has been developed specifically for the treatment of depressive illness.

She combines therapeutic concepts from behavior therapy and psychodynamic therapy. An important therapeutic goal is to learn skills and strategies for dealing with conflicts that contribute to the onset or maintenance of depression.

However, the costs for the ITP are not yet covered by health insurance. This also applies to various other forms of therapy such as systemic therapy, family-therapy,figure therapy.

However, they are often offered as supportive therapies for inpatient treatment.

This also applies to complementary therapeutic measures such as psychoeducation, occupational therapy, groups of relatives, the learning of relaxation techniques as well as body and movement-related therapies.

Light therapy for depression


Light therapy can improve the mood during winter depression.

The most important therapy for the prevention and treatment of winter depression is light therapy. It reduces depressive phases, especially during winter depression.

To do this, the patient sits in front of a device that emits strong artificial daylight daily for 30 to 60 minutes before sunrise and after sunset for two weeks.

If this is not enough, additional medication and psychotherapy can help.

Depression Therapy with medications

Antidepressants can treat the symptoms of depression successfully. However, the effect often sets in only after weeks. The drugs are usually prescribed for more severe depression, or if the patient is opposed to psychotherapy.

However, there is no guarantee that the drugs will produce their desired effect. Everybody reacts differently to the active ingredients: some benefit greatly, in others they hardly work or in particular the patients get the side effects.

If the medication is discontinued, there is a risk of relapse – especially if this happens abruptly. Therefore, do not stop taking antidepressants yourself, but discuss the procedure with your doctor!

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) are currently being used to treat depression. They increase the level of “happiness hormone” serotonin in the brain and have a mood-enhancing effect.

The drugs have significantly fewer side effects than older drugs. Typical side effects include nausea, inner restlessness and sexual dysfunction.

SSRI action in depression

SSRIs block the reuptake of serotonin into the nerve cell. As a result, the content of the messenger substance in the brain fluid increases. The free serotonin can thus bind more to suitable receptors and positively influence the mood.

Tricyclic Antidepressants

Tricyclic antidepressants are among the oldest drugs used for depression. However, they have strong side effects such as dry mouth, tremors, tiredness and constipation.

Especially in older people can also heart arrhythmia and increased heart rate occur. Tricyclic antidepressants are therefore almost only prescribed if newer drugs do not work.

Monoamine oxidase inhibitors

The monoamine oxidase inhibitors (MAO) have been used for a long time for depression. They have similar side effects as the tricyclic antidepressants.

Special care should be taken with tranylcypromine. This ingredient requires a strict low tyramine diet.

Tyramine is included in dairy products, wine and sausages, for example.

If the patient does not avoid tyramine-rich foods, serious side effects such as hypertension may occur.

Electroconvulsive Therapy

With the help of electroconvulsive therapy a depression, in many cases, can be treated in which medication and psychotherapy fail.

Under short anesthesia current impulses can trigger a short “epileptic seizure”. This idea may be frightening for now. In fact, the patient is unaware of the procedure and the risks are low.


For the Awake therapy, patients must stay awake for the second half of the night or the entire night. Although this method can not cure the depression, it can temporarily relieve the symptoms.

Primarily, Patients feel longago good, if only for a short time. Not only is this a tremendous relief, it also gives them the hope to actually overcome their depression.

Helping people help themselves

Recent studies have come to the conclusion that also offers of help without direct therapist contact can be helpful. One possibility is instructions for self-help.

Those affected can read themselves a lot of information and have only occasional contact with an expert who supports them. This can help, for example, to bridge the waiting period until therapy.

Internet-based therapies and apps

Another alternative is professional advice via the Internet. Therapy is performed using a special computer program.

Meanwhile, there are also so-called depression apps and chatbots, which facilitate the management of depression. They are based on elements of cognitive behavioral therapy.

Sport as an antidepressant

Out of the house, out of the depression! In depression, experts also recommend regular physical training. This can significantly reduce depressive symptoms – both in the short term and in the longer term.

In fact, regular exercise can work just as well as an antidepressant. Explanations for this are the reduction of stress and possibly a change of messenger substances such as serotonin and norepinephrine.

However, the psychological effect of sport could have even greater impact: Patients come from the spiral of listlessness and withdrawal.

They experience that they can do something for their own emotional well-being. Self-esteem is strengthened and hopelessness repressed.

Those who do sports in a group also benefit from the sense of community and social contact, which usually gets less and less in depression.

Dealing with depressed relatives

Do you have the impression that a person close to you suffers from depression? Then you should encourage him to talk to a doctor about it.

If the person concerned is lacking motivation, you may be able to take over the organization and possibly even accompany him.

It is important to act fast! Because a depression usually does not disappear by itself. It tends to get worse if left untreated.

But also take care of yourself: supporting a depressed relative is extremely exhausting. The gloomy mood, lack of motivation and the loss of interest – even compared to partners, family and friends – can affect your own zest for life very much.

Usually, a relationship is based on mutual give and take. But now you have to give patience, attention and support without getting back much. And maybe without the situation getting better quickly.

This is stressful and frustrating. It is therefore normal for relatives to feel helpless, angry and at the same time feel guilty.

Admit these feelings. Not only is your relative affected by the disease, but you too!

As family members, they should therefore seek help. First, find out about the clinical picture of depression.

A deeper understanding of the disease’s backgrounds and mechanisms is very important for proper management of the disease. Only then can you understand that a depressed person is unable to pull himself together, and that encouragement attempts can not help.

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