Symptoms and course

 

 

 

 

 

 

 

 

 

 

 

 

 

Symptoms and course

If you notice an acute mental health crisis (e.g. suicidal tendencies, psychosis, panic attack) in another person or yourself and you need urgent help, do not hesitate to call the following numbers:

Medical on-call service:116 117

Telephone helpline: 0800 1110111 or 0800 1110222

Emergency number: 112

You can findmore informationhere

    As already mentioned at the beginning, depression, which is one of the affective (emotional) disorders, is one of the most common mental illnesses in which those affected can feel depressed, joyless, sad and without drive, among other things. In addition, there are often problems with concentration and attention, loss of energy, low self-esteem, as well as difficulty falling asleep and sleeping through the night and changes in appetite (DSM-5). Also characteristic are pessimistic future prospects, diffuse somatic complaints (e.g. headaches, abdominal or back pain), reduced sexual interest, feelings of guilt, thoughts about one's own worthlessness, as well as suicidal thoughts or actions.

    Testimonials

    Depending on its severity, depressive symptoms can have different effects on social relationships, everyday life and therefore also on everyday university life.

    To get a better understanding of what depression feels like and how it can affect your lifestyle, you can findtestimonialsfrom people affected.

    Course and forms of depressive disorders

    The variation and severity of the symptoms can be very different and individual. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the symptoms must persist over a period of at least 2 weeks, every morning and evening, and have a negative impact on several areas of life (e.g. social or professional). If this is the case, it is referred to as major depression (according to DSM-5) or a depressive episode (according to ICD-10).

    As this is of course not complicated enough, a distinction can be made between a mild, moderate and severe depressive episode, depending on the number and severity of the symptoms. Some people experience a single episode in their lifetime, while for others they recur at irregular intervals (= recurrent depressive disorder). Around 40-60% of those affected experience a recurrence (relapse) after the first occurrence of a depressive episode, i.e. experience more than one depressive episode. Other people experience persistent depressive symptoms which, however, do not fulfill the full picture of a depressive episode in terms of their severity and severity, but occur in a weakened form but have a chronic course (= dysthymia). Nevertheless, dysthymia can in turn develop into a depressive episode.

    Depending on the course and trigger, there are other forms, such as cycle-associated depressive disorders (e.g. postpartum depression) or seasonal depressive disorders (e.g. depression that occurs mainly in winter and spring). Explaining these further here would probably go beyond the scope of this article. If you would like to find out more about this, you can find recommended reading on the homepage for depression.

    How are the symptoms related to each other?

    Every depression manifests itself differently in terms of the type and severity of the symptoms, which is why it is not always easy to recognize it. A person may subjectively feel down and depressed, but may try to maintain a positive facade on the outside, which in turn can cost a lot of energy, of which the person in question already has very little. The loss of energy and reduced drive must be distinguished from normal exhaustion. If a healthy person is exhausted, rest or sleep usually helps them to feel better. This is not the case with depression. Excessive passivity and too much sleep can even be counterproductive and exacerbate the symptoms. One symptom that is mutually reinforcing with the lack of drive is the loss of interest and pleasure in (almost) all activities, even those that used to be a lot of fun. The reduction in activities leads to increasing social withdrawal and positive experiences, including those that provide energy (e.g. regular meals, a healthy sleep-wake cycle, social relationships), are lost.

    Another typical symptom, as already described, concerns the person's mood and thoughts, which often color their experience black. The view of oneself, the environment and the future is strongly negatively distorted by the depressive symptoms. Perception and attention are selectively shifted towards negative information and stimuli.

    Source: National Care Guideline Unipolar Depression (2022)

    APA [American Psychiatric Association] (2015). Diagnostic and Statistical Manual of Mental Disorders DSM-5® (2nd corrected edition). Göttingen: Hogrefe.

    German Medical Association (BÄK), National Association of Statutory Health Insurance Physicians (KBV), Association of the Scientific Medical Societies in Germany (AWMF). National Care Guideline Unipolar Depression - Guideline Report, Version 3.0. 2022 [cited: 2023-09-13]. DOI: 10.6101/AZQ/000494.

    Hautzinger, M. (2010). Acute depression. Place: Hogrefe Verlag.

    Hautzinger, M. (2018). Depression. In Margraf, J. & Schneider, S. (Eds.). Textbook of behavior therapy (4th edition). Place: Springer Verlag. https://doi.org/10.1007/978-3-662-54909-4

    ICD -10- GM Version 2021, Systematic Index, International Statistical Classification of Diseases and Related Health Problems, 10th Revision, as of September 18, 2020. Place of publication: Cologne.

    Relf-Leonhard, C. & Reif, A. (2021). Affective disorders. In Bauer, M., Meyer-Lindenberg, A., Kiefer, F., Philipsen, A. (Eds.), Reference Mental Disorders. Place: Georg Thieme Verlag.