Psychiatry-Online

Recognizing Depression

introduction

Depression is a disease with a thousand faces. Therefore, it is not always easy to recognize depression, especially if you are the one who is affected. It is widely known that depression has something to do with unhappiness, a bad mood, and in the worst case, suicide. The illness depression is much broader and deeper and can express itself in many different ways.

Many of those affected have been suffering from an impaired quality of life for a long time and notice that they are no longer as productive as they were before. After a while, physical symptoms such as pain, sleep disorders, chronic exhaustion or loss of appetite often appear.

In simplified terms, some main and additional symptoms of depression can be recorded.

Main symptoms

depressed, sad mood
Loss of interest and joylessness
Listlessness

Quite often, depression and burnout syndrome have similar symptoms. Read more about this at: Depression or Burnout - What Do I Have?

Additional symptoms

Collapse in concentration and performance
Decreased self-esteem and confidence
Feelings of guilt and worthlessness
pessimistic view of the future
Self-harming behavior up to suicide
sleep disorders
Loss of appetite

Physical symptoms that may be associated with depression:

insomnia
Fatigue and rapid exhaustion
Loss of libido
physical pain (usually head, back, joint, or muscle pain)
Heart and circulatory problems
Indigestion
Shortness of breath

Changed experience

Many patients report that Feelings of hopelessness and helplessness dominate. They feel empty inside, feel guilt and fear, sadness and despair, but often they also feel that they are unable to feel “right feelings” at all, they feel “petrified” inside. General rule negative thought patterns in front.

Depressed people often have one pessimistic attitude towards themselves and their own future and tend to brood and worry a lot. This results in a highly self-critical attitude and severe concentration and performance problems. Sometimes the patients also suffer from so-called delusions, for example, they are firmly convinced that they are bringing shame to the family, driving them financially into bankruptcy or being terminally ill and having to die. These ideas are so real for those affected that it is difficult or even impossible as a relative to convince them of the opposite. This requires professional help.

Changed behavior

Often there is a social withdrawal from there depression To watch the sick. Hobbies that used to be pursued with pleasure and extensively are now more and more neglected or completely given up. The chores are put off and those affected spend a lot of time in bed. The voice of some also becomes quieter and monotonous, Facial expressions and gestures are very limited. However, some patients also feel a strong one internal tension and run restlessly up and down the room as if driven (so-called agitated depression).

Physical changes

The most striking are probably the much observed sleep problems. The depressed have difficulty falling asleep, wake up again and again at night and find it very difficult to return to sleep and are already awake very early in the morning, but feel tired, broken and as if exhausted. This results in tiredness and rapid exhaustion throughout the day.

The drop in performance intensifies the symptoms of guilt. When the patients are told why they cannot sleep, they often reply that they would brood a lot, their minds keep having the same worries and fears over and over again, a spiral of the devil that they cannot avoid with rational considerations . In addition, there is often a loss of libido, multiple physical pain and loss of appetite (combined with unwanted weight loss).

To learn about the types of depression, please click here.

diagnosis

In order to be able to diagnose depression, a period of at least two weeks is required several main and additional symptoms occur:

mild depression: at least two main symptoms + at least two additional symptoms
Moderate depression: at least two main symptoms + at least three or four additional symptoms
severe depression: all three main symptoms + at least four additional symptoms

So you can see that depression is both physical changes, as well as Changes in behavior and Experience can bring with it.

Detect

From these manifold symptoms and complaints, some questions can be created with which people who fear that they are suffering from depression can provide some clarity and then perhaps seek help from their family doctor or a psychologist.

Can you still feel joy? Or are you often joyless, can no longer even react positively to a pleasant event?
Do you feel broken, miserable, battered, like seriously ill, but can't find a real reason?
Have you recently found it difficult to make decisions, even if it is only about everyday things such as "what should I wear today?"
Have you lost interest in things that you used to love?
Have you had a tendency to brood over problems lately, even on totally irrelevant things?
Do you feel almost permanently dejected, resigned, hopeless, so depressed by a melancholy that you can almost physically feel it?
Do you feel tired, listless and without initiative, without vigor or strength - even though you haven't exhausted yourself beforehand?
Are you suddenly completely insecure, without any self-confidence, full of feelings of inferiority?
Are you blaming yourself exaggerated or completely unfounded? Feeling kind of worthless and guilty without being able to give a specific reason?
Have you been thinking, speaking or moving lately like slowed down, sluggish, are indecisive, fickle in your decisions, have become anxiously weighty and can no longer even cope with your everyday tasks?
Is it very difficult for you to concentrate, you often forget things, are dismayed about your "emptiness in your head" and perhaps even fear the beginning of a mental weakness?
Can you no longer sleep: it is difficult to fall asleep, fragmented sleep, grueling early waking with great fear of the day to come?
Doesn't everything taste the same as it used to?
Have you lost your appetite and, with it, weight?
Have you had sexual problems for some time now?
Do you keep feeling persistent, difficult to describe feelings of pressure, paresthesia, pain, especially in the head, chest, back, etc.?
Do you increasingly feel that your life has become meaningless?
Do you sometimes think about your death, or have you even imagined how you might end your life?

Also read our article: What can be signs of suicide?

If you can clearly answer “yes” to several of these questions, it is a sign that you should seek help. For example, you can go to your family doctor or another doctor you trust and tell them about your problems and suspected depression. Do not be ashamed and calmly tell everything - the doctor is subject to confidentiality and so nobody will find out about your intimate complaints. Because if you do not tell the doctor about your problems, it will be very difficult for him to provide you with adequate help.

Over half of all depression remains undetected despite a doctor's visit, precisely because it is still a shame-ridden topic for those affected.

However, if depression is not recognized and professionally treated, there is a quick risk that the depression will become chronic and it is not uncommon for those affected to end up with suicide as the only way out.

What tests are there that can reveal depression?

Since this is a mental illness, there are no clear tests or laboratory values that would reveal depression. Diagnostics are carried out with the help of questionnaires and psychological / psychotherapeutic sessions. Above all there are questionnaires in abundance, from simple online self-tests to valid, standardized scales that are used by doctors. This also includes simple symptom checklists such as the SCL-90 (“symptom checklist” with 90 questions) or the HSCL-25 (“Hopkins symptom checklist” with 25 questions), which are intended to determine general psychological stress.

More specific results are provided by the tests specially developed for depression, such as the Hamilton scale, which among others shows the severity of depression. Other questionnaires help differentiate a depressive disorder from other diseases, such as anxiety or personality disorders. There is therefore a plethora of tests that can be used in suspected depression and that can be combined at the therapist's discretion. While this procedure complicates identifying and defining depression, it is more reliable than self-tests, which can only raise suspicions of depression.

How do you recognize pregnancy depression?

Depending on the study, around 10% of all pregnant women experience a more or less pronounced depressive episode, especially at the end of pregnancy. This cannot always be clearly distinguished from the typical mood swings and those affected often feel guilty when they are actually expected to look forward to the coming baby. It is therefore not very easy to recognize pregnancy depression.

Typical symptoms would be listlessness, listlessness, excessive irritability and a feeling of helplessness. Physical complaints such as sleeping problems, massive or no appetite at all, difficulty concentrating and the like also occur. If you consider the enormous burdens and the possible fears and worries that affect the expectant mothers, pregnancy depression is understandable. Since they can have a long-term effect on the health of mother and child, the first signs should still be taken seriously.

Read more on the topic: Homeopathy Pregnancy Psyche

How do you recognize a winter depression?

Winter depression is referred to by doctors as a seasonal affective disorder and occurs in the fall and winter months when the days get shorter and temperatures drop. Typical symptoms include (as is generally the case with depression) pronounced joylessness and listlessness, fatigue, difficulty concentrating, fatigue and the like. In contrast to seasonal depression, the patients suffer less from loss of appetite and shortened sleep, but more from an increased appetite and an increase in the need for sleep. A real cravings for sweets and carbohydrates in general is not uncommon for winter depression.

People who are susceptible to this suffer more or less from these symptoms every year. The most likely trigger is the lack of light and the resulting disruption of the day-night rhythm and hormonal balance of the body. If the symptoms mentioned above occur around the same time as the sunshine hours are shortened, winter depression is likely.

Read more on the topic: Homeopathy for winter depression, light therapy for depression

Can you see depression on an MRI?

No, an MRI is not a suitable method for diagnosing depression, as the structure of the brain usually remains in tact, even with depression. Occasionally there are abnormalities such as a reduced cerebral cortex or inflammatory processes in patients with severe and / or long-standing depression, but these appear late and can also be caused by concomitant diseases (e.g. dementia). An MRI is therefore more likely to be used when other causes of the symptoms are to be ruled out.