Depression

"Depression affects everyone, it stops at nobody."

What is depression?

Today, many prominent people deal with cancer in a direct manner. This is different in diagnosing depression. Few like the soccer player Sebastian Deisler Dare speak openly about their depression. Perhaps this is because many people think that depression does not fit into a positive, performance-oriented way of life. The disease does not stop at anyone. Many well-known personalities suffered from depression, including creative artists such as Jackson Pollock, Mark Rothko, Catherine Zeta-Jones, Truman Capote or Albert Camus, as well as industrialists, sportsmen and statesmen.

Today, we assume that about 20 percent of women and 10 percent of men in the course of their lives suffer from depression, the actual number of men probably being significantly higher. Being depressed is often an even more tabooed subject and issue for men than for women.

The term depression refers to a state of psychic dejection that may occur occasionally or persistently. Depression is counted among affective disorders (mood disorders).

No depression is like the other. In individual cases, there are large differences in the picture of the symptoms, depending on whether you are a man or a woman, whether you are in puberty or menopause, whether you are fully in professional life or if you live as a pensioner.

How do you recognize that you may be suffering from depression?

In addition to feelings of dejection and sadness, depression is accompanied by a number of other symptoms such as

• Unhappiness, lack of energy and drive
• Sleep problems
• Brooding and worrying, often associated with strong fears of the future
• Irritability and inner agitation
• Despair and hopelessness to world weariness and suicidal thoughts
• Physical discomfort

The latter can even be in the foreground in the experience of those affected. If sadness and other symptoms last for more than two weeks almost continuously and lead to significant impairments in everyday life, this is an indication of a disease and should be clarified medically.

How does depression develop?

The development process of depression has not been completely clarified to this day.
However, there are a number of risk factors:

• prostrained negative Stress
• Stressful life situations, be it at the workplace (e.g. occupational overclaiming, lack of recognition, job loss) or familial (e.g. separation, divorce or loss of nahestender people due to illness or death)
• Traumatic childhood experiences

 Many experts suspect that depression is also responsible for a malfunction of certain messengers in the brain (so-called neurotransmitters). In therapy, therefore, drugs are used which restore this imbalance.

Depression is treatable. Sufferers are not losers. Relatives must know that this is a disease in need of treatment in the medical sense. This is particularly important because people often lack the power to help themselves.

It is important that you talk to a doctor about your symptoms and develop a treatment plan adapted to your individual needs.

How is the depression treated?

In no other mental disorder, treatment options are as numerous as in depression. And nowhere else are so many different therapy methods redeveloped. It is important to find the appropriate therapy as quickly as possible under the available possibilities.

• Pharmacological psychotherapeutic Combination Treatment
• Cognitive behavioral therapy
• Interpersonal psychotherapy
• Non-invasive brain stimulation methods
• CBASP - currently not offered

 Despite numerous therapeutic developments, up to 30% of those affected continue to suffer from a chronification of the depressive symptoms for more than two years.

Pharmacological psychotherapeutic Combination Treatment

The therapy of a longer-lasting depressive disorder should be done on a biological as well as on a psychological-cognitive level. Only in this way the result can be efficient and successful.

Consequently, the therapy is a combination of biological and psychotherapeutic components in order to counteract the recurrent (recurring) nature of affective diseases.

It is also advisable to create long-term therapy. In addition to the remission (temporary or permanent weakening of the disease symptoms), the prevention of new depressive episodes is at the forefront of treatment.

Pharmacologically, newly developed antidepressants are used, which allow a syndromspezifische indication, e.g.:

• Norepinephrine-Aufnahmehemmer for drive increase
• Serotonin reuptake inhibitors in associated anxiety symptoms

 The decisive factor is the adaptation of plasma mirrors in the context of therapeutic drug monitoring (TDM, see here D1).

Depending on the conditions of the Depression, its severity and progression, specific psychotherapy programs are used according to the first national S3 guideline for unipolar affective disorders and the current national S3 guideline  "unipolar depression " of the 16.11.2015 (long version).

Cognitive behavioral Therapy

The permanent presence of the depressive symptoms often contributes to physical inactivity and the loss of positive social contacts. Negative cognitive schemes, i.e. automatic thinking habits that affect self-assessment, the view of the environment and the future prospects, can be consolidated. Through cognitive behavioral therapy there is the possibility of modifying individual thinking, perceiving, learning and remembering.

The goal of therapy is to become aware of these negative patterns and at the same time to draw your attention to positive experiences. The therapy aims to promote increasing activities in order to create the psychological conditions for a way out of depression.

Cognitive behavioral therapy is performed in individual and group sessions. This psychotherapeutic approach has been proven to be extraordinarily effective in many studies.

Interpersonal psychotherapy

The depressed symptoms often involve insufficient social and interpersonal support, as well as communication deficits. The reduction of these deficiencies and the development of a positive self-perception contribute to the way out of the depression.

Our therapy program is conducted in group sessions and has proven to be extremely successful in numerous studies.

In the case of a small number of patients, treatment can be continued in outpatient therapy groups (individual and group), under the continuation of antidepressants therapy (parallel to the care provided by the established physician).

Non-invasive brain stimulation methods

The TMS is an important therapeutic development with a new active principle. It is based on the non-invasive stimulation of the brain with a solenoid that is held to the head from the outside. The process is characterized by the fact that it is gentle and few side effects. In contrast to the Elektrokonvulsionstherapie (ECT), no anesthesia is required.

Psychodynamic psychotherapy

The psychodynamic psychotherapy can be displayed if the current complaints can be explained to a good extent psychologically against the background of conflicts and problematic relationships. The therapy concept is in principle suitable for various diagnoses (depression, fears or, for example, burn-out).

A systematic diagnosis takes place beforehand (so-called functionalised psycho-dynamic diagnosis, OPD). Among other things, the life story and important relationships are asked to understand how the current problem could come about. Psychotherapy aims to ensure that patients themselves have an understanding of their conflicts, relationship patterns and vulnerabilities. In the course of the therapy, internal changes can take place, which will resolve the current problem or make reoccurrences less likely.