Depressions - still a taboo subject?
Depres­si­ons – still a taboo subject?

At the moment, it is estima­ted that around 5 % of the popula­tion are suffe­ring from depres­sion. The risk of becom­ing depres­sed during one’s lifetime is as high as a third. And yet, this subject is rarely discus­sed, as many of those affec­ted by it never confide in anyone, for fear of stigma­ti­sa­tion. There are also frequent errors in judge­ment on the part of doctors. A lot of psych­iatric exper­tise is requi­red in order to correctly catego­rize symptoms. The profes­sio­nally accredi­ted Online Self-Assess­ment develo­ped by the psych­ia­trist Ivan K. Goldberg can offer a first point of reference for deter­mi­ning how you are affec­ted by depres­sion. However, this is not a substi­tute for a profes­sio­nal, medical diagno­sis. As a general rule: waiting will not lead to impro­ve­ment, depres­sion generally does not get better on its own.

Fact #1 – Definition

Depres­sion is a severe mental illness which absolutely must be treated. Depres­sion is descri­bed as a long-term, unipo­lar mood disor­der, with constant feelings of dejec­tion, which do not go away even after positive experi­en­ces. In contrast to this, bipolar disor­der is when manic episo­des occur along­side depres­sive episo­des, with power­ful feelings of eupho­ria, a tendency to be overcon­fi­dent, and heigh­te­ned restless­ness. This pheno­me­non has been the subject of world­wide discus­sions, following the rapper Kanye West’s candi­dacy for Presi­dent of the US.

Fact #2 – Causes

In addition to genetic predis­po­si­tion, there are many possi­ble causes for depres­sion: hormone imbalan­ces, a severe illness, taking certain medica­tion (like corti­sone), trauma­tic experi­en­ces, perso­nal outlook on life, and perso­na­lity struc­ture. Some people are parti­cu­larly vulnerable, while others can cope with many of the afore­men­tio­ned risk factors much better. Last but not least, stress is a signi­fi­cant trigger of depres­sion. It influ­en­ces our body clock and can inter­fere with neuro­trans­mit­ter activity in the brain.

Fact #3 – Forms and Symptoms

„I feel empty and worn out. Everything hurts,“ Herbert Gröne­meyer sings in his song ‘Flugzeuge im Bauch‘ (Aeropla­nes in my stomach), and indeed, these words also describe the mental state of people with depres­sion. Dejec­tion, lack of motiva­tion and disin­te­res­ted­ness are the key symptoms of depres­sion. Someti­mes symptoms also include self doubt and feelings of guilt, diffi­culty concen­tra­ting and sleeping, inner restless­ness and lack of interest in sex. For some patients, symptoms of depres­sion are predo­mi­nantly physi­cal, which is refer­red to as a somatic syndrome.

Nowadays, we refer to a mild depres­sive episode when at least two key symptoms and two additio­nal symptoms have been occur­ring for at least 14 days. A depres­sion is consi­de­red to be chronic, when the symptoms persist for two years or longer.

Incident­ally, men only suffer from depres­sion half as often as women do. They also someti­mes have other symptoms like aggres­si­ve­ness, irrita­bi­lity, and a desire to take risks.

Fact #4 – Treatment

Depres­sion is now very treat­a­ble. Depen­ding on the severity, either medical treat­ment or psycho­the­rapy would be advis­able. However, the latter is not always covered by health insurance. Today, the most frequently prescri­bed Selec­tive Seroto­nin Reupt­ake Inhibi­tors (SSRI) have signi­fi­cantly fewer side effects than previous approa­ches to treat­ment. They incre­ase the amount of seroto­nin, the so-called ‚happi­ness hormone‘, in the brain, thus creating an uplif­ting effect. More than half of patients experi­ence a clear impro­ve­ment of their symptoms after 6–8 weeks.

In severe cases, it can also be useful to treat patients in hospital.

As an alter­na­tive to conven­tio­nal medicine, regular exercise can also help with depres­sion, and the consump­tion of St John’s wort is also consi­de­red helpful. However, the latter has numerous side effects, and parti­cu­larly women should consume it with caution.

Fact #5 – Suicide risk

Depres­sion is one of many undere­sti­ma­ted illnes­ses, that often lead to suici­dal thoughts. Around 10–15 % of people suffe­ring from depres­sion die as a result of suicide. This is the case especially with people who take energy-enhan­cing medica­tion, in order to remain profes­sio­nally capable.

First aid is avail­able in Germany from the natio­nal crisis line at 0800 – 1110111 and 0800 – 1110222. The service is anony­mous, free, and avail­able around the clock. Related self-help groups can be found at