Feeling bad and down sometimes is normal and will pass. For a person with depression, this is not the case. Sad feelings and negative thoughts persist for a longer period of time and control their entire life. Read more here about causes, symptoms, and treatment.
At a glance
- Depression is a common mental illness.
- Deep sadness, listlessness, and a feeling of emptiness are common. But many other symptoms can occur.
- Life circumstances and hereditary predisposition can make a person more susceptible to depression.
- Symptoms of depression last for at least 2 weeks and can remain for many months.
- Medication and psychotherapy can alleviate symptoms and help shorten a depressive phase.
Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.
What is depression?
Phases in which a person feels down or low are normal and pass. For a person with depression, this is not the case. Sad feelings and negative thoughts persist for a longer period of time and control their entire life. Everyday activities, work, or studying become difficult. The person withdraws from friends, family, and hobbies.
What is depression?
The video below explains the signs of depression. What triggers it and what treatment options are there?
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What are the symptoms of depression?
People with depression experience a phase of deep sadness that can last for many weeks. Often, they do not see a way out. Depression can manifest itself in very different ways. The following indications are common:
- continuous despondency and a depressed mood
- exhaustion and lethargy
- apathy and indifference
- low sense of self-esteem
- guilty feelings and continuous rumination
- difficulty concentrating and making decisions
- withdrawal from family members and friends
- hopelessness and anxiety about the future
- suicidal thoughts
Physical symptoms that can occur with depression:
- loss of appetite
- weight loss or weight gain
- loss of sex drive
- gastrointestinal problems such as constipation
- increased sensitivity to pain
In older people, in particular, symptoms of depression manifest themselves frequently also as physical disorders, for example, as unexplainable pain.
Visit gesundheitsinformation.de to read about how people with depression have experienced the disease.
What causes depression?
The cause of depression is still unclear. Specialists believe that there are many factors: biological processes, physical factors, life circumstances, and certain events. For example, the following factors can foster depression and impact its progression:
- increased genetic risk: other family members have suffered from the disease.
- stressful experiences, such as abuse and neglect, but also the death of a loved one or a separation
- chronic anxiety disorders in childhood and adolescence.
- metabolism of the brain: research shows that neural stimuli are transmitted more slowly in the brain of people with depression. Neurotransmitters and hormones can play a role.
- physical illnesses such as a stroke, heart attack, cancer, or an underactive thyroid.
- continuous stress and overload, but also a lack of challenge in one’s life.
- insufficient light: some people experience depression in the dark months of fall and winter due to a lack of sunlight.
How many people have depression?
Depression is a common mental illness. Experts believe that 16 to 20 percent of people experience depression at least once in their lives or suffer from a chronic depressive mood (dysthymia). Women become ill more often than men, and older people more often than younger ones.
How does depression develop?
Depression causes a person to feel and act differently. Many blame themselves for their condition. They avoid social contact, withdraw, and rarely leave their home. This behavior can intensify symptoms. Help is often necessary at this point.
Depression can manifest itself in very different ways:
- For some people, the symptoms disappear after some time without treatment and do not return.
- Many other people regularly alternate between depressive phases and phases without symptoms.
- And some have sometimes more, sometimes less severe symptoms of depression over longer periods of time.
- Other people develop chronic depression. This is the case when the depressive episode lasts longer than 2 years.
In the case of depression, typical symptoms persist for at least 2 weeks and can last for several months. The end of a depressive episode ends when the symptoms subside after a period of time. About half of the people who are treated for depression feel a significant improvement in their symptoms after about 3 to 6 months.
If depression recurs within 6 months after the symptoms have subsided, it is referred to as a relapse (recurrence). If the symptoms reappear after more than 6 months or even years later, this is referred to as recurrent depression.
You can find more detailed information about depression and its various forms at gesundheitsinformation.de.
How can depression be prevented?
Stressful events, such as the loss of a partner or chronic stress, are likely partially responsible for depression. Some types of stress can be reduced. Learning how to deal with crises can also lower the risk of depression. A person’s social environment also plays an important role. People with stable bonds experience depression less often.
Long-term treatment with medication helps to prevent relapses in people with an increased risk for recurrent depression. Another option is long-term psychotherapy.
How is depression diagnosed?
Some people view their depression as a personal failure or temporary phase linked to stress and not a disease. In contrast, many others are so seriously ill that they cannot see a doctor or ask for help on their own. In both cases, family members should offer their support and, for example, accompany the affected person to an initial doctor visit.
In order to diagnose depression, doctors ask, on the one hand, questions about typical symptoms of depression. However, it is important to rule out diseases or problems that can cause similar symptoms. Therefore, it may be necessary to conduct a physical examination.
When checking for typical indications of depression, a differentiation is made between primary and secondary symptoms.
The primary symptoms are:
- depressed mood, sadness, despondency
- disinterest and apathy
- lethargy and a tendency to quickly become fatigued
Secondary symptoms are often:
- loss of appetite
- inability to concentrate or make decisions
- low self-esteem
- feelings of guilt
- negative and pessimistic thoughts about the future
- suicidal thoughts or attempts at suicide
Certain questionnaires are often used to diagnose depression. If they indicate that multiple primary and secondary symptoms have lasted for 2 or more weeks, a diagnosis of depression is made. Depending on the number, type, and intensity of symptoms, trained professionals differentiate between mild, moderate, and severe depression. A treatment plan is developed accordingly.
How is depression treated?
There are a variety of treatments available for depression. The most important are:
- psychotherapy, such as cognitive behavioral therapy, and
- treatment with medication.
The most suitable therapy is determined by the patient’s life circumstances, the severity of the disease and how the symptoms develop over time. The advantages and disadvantages of possible treatments, as well as the expected results, can be discussed with the therapist.
For more information about the treatment of depression, visit gesundheitsinformation.de.
What can family members do?
Often partners, friends, or family members of the person are the first to notice or learn about the symptoms of depression and changes because they are the first point of contact. For people suffering from depression, their support is particularly important. People who are close to someone suffering from depression can also reach their limits, and often need to seek help themselves in severe cases. Support groups are one option, but medical or psychological support can also be helpful.
In the event of indications of suicidal thoughts, help and active support is particularly important. For the most part, these remain just thoughts. However, they must be taken seriously. Those with such thoughts should confide in others.
There are various support options for these types of situations, for example social psychiatric services, crisis centers, or telephone helplines. In emergency situations, support services often maintain anonymity and are available day and night.
For suggestions and tips on how to effectively speak to someone suspected of suffering from depression, visit gesundheitsinformation.de.
Where can I find support?
For most people, family doctors are the first point of contact even for psychological issues. However, it is also possible to receive help from psychological counseling centers, psychotherapists or psychologists. A doctor’s referral is not necessary for an initial consultation in a psychotherapeutic practice.
Important: In emergencies, such as acute suicide risk, psychiatric-psychotherapeutic practices with emergency services or the emergency outpatient departments of psychiatric-psychotherapeutic hospitals can help.
Further information on psychotherapy and tips on how to find appointments quickly or learn which services are covered by statutory health insurance can be found at gesundheitsinformation.de.
- Deutsche Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie. Behandlung von depressiven Störungen bei Kindern und Jugendlichen. Evidenz- und konsensbasierte Leitlinie (S3). AWMF-Registernummer 048-023. 07.2013.
- Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN). Unipolare Depression. S3-Leitlinie und Nationale Versorgungsleitlinie (NVL). AWMF-Registernummer nvl-005. 03.2017.
- Depression in adults: recognition and management. London: National Institute for Health and Care Excellence (UK); 2009 Oct 28. PMID: 31990491.
- Robert Koch-Institut (RKI). Statistisches Bundesamt (Destatis). Depressive Erkrankungen. Gesundheitsberichterstattung des Bundes. Heft 51. RKI: Berlin 2010.
In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) (IQWiG). As at: