Expert questions: Depression or just depressed?

Expert questions: Depression or just depressed?

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Depressed or just out of sorts? Ten important questions about melancholy
Experts estimate that around four million people in Germany are depressed. But how can I actually tell whether I'm just out of tune or already suffering from “melancholy”? And what are the benefits of Mediterranean food, sleep deprivation, light showers or magnetic stimulation in the event of illness? Answers to these and other questions about Dr. Friedrich Straub, chief physician of the Schlossparkklinik Dirmstein.

Depression is a common disease: 20 percent of us develop it once in a lifetime. Hopelessness, sadness and despair are spreading. Here, mental lows are fundamentally a natural part of our life - just as natural as mood highs. “If we are rejected by close friends, if we suffer professional failures or if we separate from our life partner, the psyche can get out of balance. We feel bad and depressed, ”explains Dr. Friedrich Straub, chief physician of the Schlossparkklinik Dirmstein.

But what distinguishes moods from depression?
"Depression is much more than just a mood depression," explains the specialist in psychiatry, psychotherapy and neurology. Gloominess, lack of drive and despair determine everyday life - and that for a long time: In contrast to moods, from which many people suffer, especially in mourning phases or in the cloudy season, depression (lat. Depressive = depress) can last months and years. In addition, there are often other complaints such as fears, stomach or intestinal problems, headaches or sleep disorders. “Coping with (everyday) work is becoming a problem for those affected. They hardly manage to overcome the low on their own, ”says Dr. Straub. Another typical sign of depression is sudden loss of interest. "Whether it's a job, hobbies or friends - everything loses importance," reports the expert. Those affected can hardly get excited about anything. Empathy, joy and ability to concentrate decrease noticeably.

How does depression come about?
Medical causes are disorders of the brain metabolism. Triggers can be lack of sleep and light, stress, loneliness or grief, for example. But the genetic predisposition is also important. As a rule, various biological, social and psychological moments play a role. Anxiety can also hide anxiety disorders or psychoses. It is not uncommon for diabetes, dementia, medication or thyroid problems to be behind this. Therefore, medical clarification is necessary and always the first important step to efficient treatment.

What helps with depressive moods?
"People with depression generally withdraw strongly from other people," says Dr. Straub from his daily practice. "You avoid meeting friends and family celebrations, but of course that is not a good thing," warns the specialist. Even if it is very difficult, it is extremely important to maintain social contacts: to go out among people and to participate in life. Sports and relaxation as well as herbal ingredients such as St. John's wort can be helpful for mild mood disorders.

When should I go to the doctor or clinic?
If I suffer from depressive moods for more than 14 days, the general practitioner should be consulted. He can assess whether further specialists should be consulted or whether psychological help is appropriate. The rule of thumb is that the earlier treatment begins, the shorter and easier it is. In the case of severe depression, a visit to a specialist clinic may be recommended. On the basis of a detailed medical history and diagnosis, an individual treatment plan is created for each patient, which should take into account the personality and complaints of each individual.

Does healthy food reduce the risk of depression?
Studies indicate that Mediterranean diets are not only good for your heart and circulation, but may also help to combat depression. Melancholy can not be cured by Mediterranean food with a lot of omega-3 fatty acids. What is certain, on the other hand, is that chocolate, for example, can raise the mood for a short time by increasing the serotonin level in the brain.

With sleep deprivation from deep soul?
Many therapists recommend waking therapy for severe depression. Controlled sleep deprivation changes the messenger substances in the brain and thus improves the mood in more than half of the patients. But sleep deprivation is anything but a permanent solution: Often another phase of deep melancholy follows after the next night's sleep. Nevertheless, the positive experience remains that even with severe depression, an improvement is possible and there is reason for hope.

In which cases does magnetic stimulation help?
Studies have shown that magnetic stimulation can be a safe, gentle and tolerable treatment for severe depression. "This treatment method is an alternative especially for patients for whom psychotropic drugs and psychotherapies have no effect," says Dr. Magnetic stimulation activates nerve cells in certain areas of the brain. There is an increased release of brain messenger substances (neurotransmitters) and, as a result, an antidepressant effect. Some patients may experience headaches and dizziness as possible “side effects”. Usually at least ten treatments are required. These are not paid by the statutory health insurance companies.

How does light therapy work?
As is well known, the dark season depresses the mind of many people. Many doctors therefore recommend light therapy to lighten the mood, especially in mild to moderate winter depression. Patients sit relaxed in front of a lamp with up to 10,000 lux for half an hour each day. Artificial light (without harmful UV content) promotes the release of the happiness hormone serotonin. The majority of patients feel an improvement in the symptoms after two to three weeks of treatment with the “light shower”.

Can Depression Be Cured?
While psychotherapy is usually sufficient for mild depression, psychopharmaceuticals (antidepressants) are usually added to severe forms. The mood-enhancing medications help to bring the metabolism in the brain back to normal. But people who are depressed are always prone to relapse. They often experience depressive phases several times in their lives. There are no preventive measures. However, a lot of exercise in the fresh air is beneficial for the psyche and mood - so cycling, running or walking as often as possible.

What can relatives do?
Relatives can help those affected by possibly accompanying them to the doctor and helping them with treatment. It often helps to simply signal that you are there for the sick at all times and that you face the challenges together. Instead of reproach, patience and understanding are required to support the treatment constructively. Despite all the well-intentioned help, it doesn't work without professional therapeutic support. (pm)

Author and source information

Video: Functional Medicine for Depressive Disorder: Advances in the Treatment Paradigm -- Robert Hedaya, MD (May 2022).