I feel lost without my depression
Depressive symptoms can be very diverse. Very often physical and psychological symptoms occur together. The feeling of dejection and helplessness is often in the foreground. In many cases, those affected feel endless sadness and are constantly crying. Others feel nothing but a feeling of emptiness. (...)
Depressed people are extremely pessimistic about the future (...). They often see themselves as flawed, inadequate, or sick. They also interpret positive experiences negatively. (...) Everyday problems turn into huge, insurmountable mountains and probable disasters.
Thinking is slowed down, concentration impaired by brooding. Ideas of hopelessness and futility in one's own life often culminate in thoughts of suicide. Those affected often feel restless, tense and irritable. You feel exhausted, tired and lacking in energy. (...)
In addition, vegetative complaints can sometimes occur (...). (...) Then it can be difficult to recognize the depression as such. (...)
Those affected (...) withdraw, avoid any confrontation with life and feel overwhelmed. Everyday tasks (...) are being postponed more and more. (...)
According to ICD-10, depressive episodes are divided into mild, moderate and severe forms. In the case of severe episodes, those with additional psychotic symptoms are again considered separately. With all forms, symptoms should last at least two weeks. (...) According to ICD-10, at least two of the following symptoms are present in mild and moderate depression, and all three in severe episodes:
- unusually depressed mood for most of the day and almost every day, regardless of external circumstances;
- Loss of enjoyment or interest in enjoyable activities;
- Reduced drive or increased fatigue.
In addition, one to four symptoms for a mild episode, up to six for a moderate episode, and all of the following symptoms for a severe episode must occur:
- Loss of self-confidence and self-esteem;
- unfounded self-blame and inappropriate feelings of guilt;
- repeated thoughts of death or suicide;
- Difficulty thinking and concentrating, or indecision;
- psychomotor restlessness or inhibition;
- Sleep disorders;
- Loss or increase in appetite, which leads to weight changes.
Globally, between 5 and 7 percent of the population develop depression every year. (...) On average, 16 percent of all people experience a depressive episode at one point in their life. Depression is about two to three times more common in women than in men. (...)
Most people get sick for the first time between the ages of 25 and 30. About 80 percent of those affected do not just have a single depressive episode, they get sick repeatedly. (...) About 5 to 20 percent of diseases take a chronic course. (...)
Depressive phases are often triggered by stressful life events (e.g. separation, loss, death of a relative) or by stress and excessive demands at work or in the family. (...)
For some people, even a small amount of external exposure is enough to cause depressive symptoms. That is, the combination of a specific vulnerability and stress leads to depressive symptoms.
Those affected often see no prospects. (...) You have to rediscover life first. As long as this is not possible, they need people by their side who have hope on their behalf. (...)
Depressed people have (...) "forgotten how to want". Access to one's own will is blocked. (...) The inability to want is difficult for outsiders to understand (...) That is why employees need a lot of patience and a high level of sensitivity for what is possible and what is not possible for those affected at any given time. (...)
Direct your attention to the concrete in the conversation
(...) People who are depressed often find it easier to concentrate on specific tasks or to report on a specific activity than to talk about their general state of health. (...) These can be tasks for coping with everyday life or for spending free time. (...)
Discuss goals and obstacles
(...) Depressed people are on the one hand good at anticipating difficulties, on the other hand they often only see hurdles. (...) It is therefore particularly important to find access to the goals and then to relate the goals to possible difficulties. (...) The goals can be in the areas of health, work, living, leisure, social contacts (...).
Bring attention to the here and now
In conversations and encounters, what is done or talked is often not decisive. The decisive factor is how the person concerned is involved. (...) It's about encouraging people to participate. (...)
Dealing with lawsuits
It can be helpful for professionals to remember that lawsuits can be an expression of desperation. It can be necessary, relieving, and a real need to talk about the desperation, worry, and negative feelings. (...)
Antidepressants have been used to treat depressive disorders for decades. (...) They not only help to lighten the mood, but can also influence all of the (...) mentioned symptoms. (...)
Antidepressants are not equally effective for everyone. The use of antidepressants should be supplemented by psychosocial support measures or psychotherapy. For those affected it can be useful to note that no antidepressant is addictive. If you start taking antidepressants again, it is also important to know that they take a few weeks to work.
Helping people help themselves
Psychoeducation: knowledge about one's own illness
Information about how depressive disorders arise and how to counter them can help affected people to free themselves from their feeling of hopelessness and helplessness and to break the depressive vicious circle. (...) In addition to self-help, symptoms, explanatory models, medicamentous and other forms of therapy are contents of psychoeducation.
Promote positive experience
Almost all therapeutic approaches to coping with depressive symptoms focus on conveying positive experiences and feelings. To influence feelings directly and then also depressive feelings is quite difficult. On the other hand, it is easier to give thought or behavior a new direction and to indirectly change feelings. Affected people can learn to influence their feelings. (...)
A great way is to make a list of positive activities to help you become aware of what is good for you. (...) As part of inpatient measures, work or movement therapy offers are important ways to give depressed people access to resources, experiences of success and positive feelings. (...)
Dealing with negative thoughts
Brooding thinking is often the entry point into a depression spiral. It can have a self-deprecating, fear-inducing or stressful effect. Negative thinking prevents new and above all positive experiences. (...) Affected people tend to close themselves up and withdraw into their snail shell. (...) The first step is to even notice negative thinking in yourself. (...) The second step can be to find positive alternatives or another point of view.
People with depression often have difficulties with free, that is, unstructured time. (...) To prevent this feeling of emptiness, it can be helpful to create a daily or weekly plan. The plan should be a mix of everyday coping activities (...), social activities (...) and positive, enjoyable activities (...).
According to Pitschel-Walz (2003), there are such things as golden rules, with the help of which a person affected can prevent further depression (...):
- plan pleasant activities in everyday life;
- to keep moving;
- do something good for yourself;
- Learn relaxation techniques and incorporate them into everyday life;
- challenge yourself, but not overwhelm yourself;
- pay attention to one's own feelings;
- Maintain friendships;
- gain positive attitude towards life;
- Problem solving instead of brooding;
- pay attention to warning signs and seek help in good time;
- Take medication regularly;
- keep hope.
- S3 guideline / National Care Guideline for Unipolar Depression (short version)
- S3 guideline / National Care Guideline Unipolar Depression (patient guideline)
- Bischkopf, J. (2015): So close and yet so far - Living with people suffering from depression. BALANCE book + media publisher. [To the book review]
- Giger-Bütler, J. (2011): Free at last. Steps out of depression. Beltz Publishing House.
- Görlitz, G. (2015): Self-help with depression. Klett-Cotta publishing house.
- Hammer, M. (2015): The enemy in my head: Stop the inner critic! Gräfe and Unzer Verlag.
- Hammer, (2012): Finding your inner balance - mindful ways out of the stress spiral. 2nd edition, BALANCE buch + medien verlag.
- Hautzinger, M. (2006): Counselor Depression. Information for those affected and their relatives. Hogrefe Publishing House.
- Hegerl, U .; Niescken, S. (2013): Overcoming depression, rediscovering the joy of life. TRIAS Verlag, 3rd edition.
[To the book review]
- Johnston, M. (2008): My Black Dog. How I put my depression on a leash Publisher Antje Kunstmann.
- Jurk, C. 2008): The downcast person - Depression - History and social significance of a diagnosis. Publishing house Westphalian steam boat.
[To the book review]
- Pitschel-Walz, G. (2003): Regaining the joy of life. Advice for people with depression and their relatives. Urban & Fischer Verlag.
- Teismann, T. (2016): Brooding - How thought loops arise and how to solve them. BALANCE buch + medien verlag, 2nd edition.
[To the book review]
- Wolfersdorf, M. (2011): Depression. Coping with the disease. BALANCE book + media publisher. [To the book review]
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