There can be various causes for depression. Maybe it's because of the messenger substances in the Brain, but there may be other reasons as well. An overview.

First aid against depression Self-sabotage & fears [+ self-test]

Who is at particularly high risk for depression?

You may have heard that depression can result from an imbalance in chemical messengers in the brain. This is a common but controversial belief. In contrast, the Harvard Medical School emphasizes on its website that this disease is too complex to be ascribed to a single cause. Depression can arise from a variety of different factors.

Possible causes include: genetic predisposition, serious medical conditions, certain medications, Problems with mood regulation and stressful life events. People, in whose Family a death has occurred, who has experienced a divorce or a traumatic event (e.g., physical, emotional, or sexual abuse) enter clear higher Risksto develop depression.

Depression with and without clear causes

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Traumatized people often not only suffer from depression, but also from post-traumatic stress disorder (PTSD). Both clinical pictures are sometimes expressed in similar symptoms: for example, difficulty concentrating, a feeling of Distance to other people, sleep disorders and the difficulty positive emotions to feel. Depression, or PTSD, also leads to an increase in negative beliefs or expectations about themselves and to people showing less interest or pleasure in activities that they used to have Fun have made.

Sometimes depression occurs for no apparent cause. If that's the case for you, you know how frustrating it can be. But your depression is real even if you don't know what caused it. Depression is based on just as concrete a disease process as any other disease; Unfortunately, sometimes you don't know what caused it. But there is also good news: even if we don't know what causes depression, it can still be treated very well.

How Does a Depression Questionnaire Help You?

In the 1960s, the psychiatrist was Dr. Aaron T. Beck a pioneer of cognitive behavioral therapy (CBT). CBT aims to help people suffering from negative thoughts (e.g., "I'm a total failure!") and maladaptive Behavior (e.g. sleeping too much, isolating oneself from friends and family members) - typical side effects of clinical depression. CBT can help such people by teaching them new skills that will make them feel better. In which Backgroundthat depression causes a wide variety of symptoms and in different degrees of severity (from light to very severe) can occur Dr. Beck's Beck Depression Inventory (BDI), which is designed to help people assess the severity of the various symptoms of depression (and the depression itself).

Since then, many other inventories and questionnaires have been developed to assess depression. Some of these (for example the questionnaire printed below) correspond to the nine main criteria for depression from the DSM-5. This questionnaire gives you an idea of ​​the symptoms on which the diagnosis »depression« is based. It also makes you aware of how severe these symptoms are in you and how severe your depression is. The questionnaire can also be obtained from the decision whether or not you should seek professional help. The self-assessment below is the Patient Questionnaire (PHQ-9). Take this test right now to get a better idea of ​​the current severity of your depression. You can tick one of four answers for each question. Write the numbers that correspond to your answers in the blank lines next to the Ask. You can repeat this test at any time—either periodically as you read this book, or at least after you have finished reading and doing all the exercises—to see if there has been any change in the severity of your depression.

Patient Questionnaire (PHQ-9)

You can evaluate this depression test yourself. You will find the result at the end of the test. Over the past two weeks, how often have you felt affected by the following symptoms?

1. Little interest or pleasure in your work? ____

2. Despondency, melancholy, or hopelessness? ____

3. Difficulty falling asleep or staying asleep, or increased sleep? ____

4. Fatigue or feeling none Energy to have? ____

5. Decreased appetite or excessive need to eat? ____

6. Bad Opinions of itself; Feeling like a failure or let down family? ____

7. Difficulty concentrating on something, such as reading the newspaper or watching TV? ____

8. Were your movements or speech slowed enough that others noticed? Or, on the contrary, were you "fidgety" or restless and therefore had a stronger urge to move than usual? ____

9. Thoughts that you would rather be dead or hurt yourself? ____

The evaluation of the self-test

Add up all the points in the blank lines and write the total in the line below. (The highest possible score is 27, the lowest possible score is 0.)

My score: ____ / 27

What does your PHQ-9 score mean? 0–4 points: healthy 5–9 points: normal 10–14 points: mild depression 15–19 points: moderate depression 20–27 points: severe depression

If you scored more than zero on question 9, please seek professional help immediately. A score between 15 and 27 usually requires active treatment with psychotherapy, medication or a Combination from both. SpiegelDoes your score reflect your current mood? Why or why not? Did some of your answers to these questions surprise you? Why or why not? Write yours ideas or comments on your answers in the blank lines below:

What types of depression are there? Be clear about your problems

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Depression can manifest itself in many different ways and with varying degrees of severity. In addition, it can be associated with other mental illnesses such as a Anxiety– or associated with panic disorder, ADHD, or substance abuse. All of these are comorbidities of depression, which we'll discuss in more detail later in this chapter.

For now, let's take a look at the diseases that people generally think of when they hear the word depression. These include: major depression (also known as clinical depression), dysthymia (persistent depressive disorder), bipolar disorder, and postpartum depression. Regardless of the type of depression you're suffering from, this workbook can help you see light again at the end of the tunnel.

Major Depression / Clinical Depression

Major depressive disorder (also known as clinical depression or sometimes simply depression) is depressed and / or his or her Motivationto deal with his everyday tasks has subsided. To be called clinical depression, this change in mood and / or motivation must persist for at least two weeks and be accompanied by several other symptoms (see page 12). The dejected or moody mood and the resulting behavior are vastly different from how you behave when you are in the best of moods.

In order to meet the criteria for clinical depression, this disorder must also have problems in the work life, in social interactions with friends, in coping with the domestic Tasks and / or the Study or the Vocational Training cause of the patient. He suffers from a severe mood swing that is clearly affecting his behavior. A student suffering from major depression may suddenly get much worse grades. He may also isolate himself from his friends by turning down invitations to social events.

Persistent Depressive Disorder (Dysthymia)

The symptoms of persistent depressive disorder (dysthymia) are similar to those of major depression, but usually last for months. Symptoms are usually milder, but keep recurring for years, while major depressive episodes are shorter. The severity of the depressive symptoms in dysthymia can vary significantly over the years; but the typical characteristics - low self-esteem, sleep disorders, lack of energy or exhaustion (fatigue), changes in appetite, difficulty concentrating and feelings of hopelessness - never go away for more than two months.

In addition to dysthymia, depressive episodes can also occur; this means that this mild depression can coexist with a major depressive episode. This phenomenon is usually referred to as double depression.

Bipolar disorder

Bipolar disorder (formerly known as manic depression) is associated with significant mood swings and corresponding behavior: from exuberant euphoria to complete hopelessness. "Bipolar" means nothing more than two poles, in other words: two opposing moods. The elevated mood phase is referred to as a manic (bipolar disorder type I) or hypomanic (bipolar disorder type II) episode, the depressed mood phase as a depressive episode. People with bipolar disorder go through phases of "normal" or "stable" mood from time to time - especially when they are treated with medication and psychotherapy.

Contrary to popular belief, not all people with bipolar disorder have severe manic episodes. Patients with type II bipolar disorder experience hypomania (mild mania) during periods of high spirits that does not interfere with their social or professional life and does not require hospitalization. Sometimes it just feels good, and maybe you are particularly productive in those phases. Unfortunately, however, the hypomanic "light switch" can flip in a flash, and then the patient falls into depression.

Postpartum depression

Postpartum depression is a surprisingly common form of depression: one in nine Ms. suffers from it after having a child. Women with postpartum depression experience overwhelming emotions ranging from sadness to intense anxiety. Sometimes they are totally exhausted physically and emotionally; this makes it difficult for them to take good care of themselves and their baby. It's not her Debt the young Mother, if she develops postpartum depression: This depression is just as serious a mental illness and requires the same attention and care as any other form of depression.

Depression and comorbidities

People with depression may also have one or more of the comorbidities described below. For example, depression is often associated with an anxiety disorder. How is it with you? Have you ever suffered from any of the comorbidities listed below? Or do you fear that you might experience such symptoms at some point?

anxiety disorder

Symptoms of an anxiety disorder include worrying thoughts, nervousness, and a feeling of internal discomfort. We all get scared now and then; that's part of life. But when fear dominates your thoughts and actions every day, it becomes an anxiety disorder.

If you have such a disorder, you may also feel extremely anxious now and then. We will come to this problem, which is known as an anxiety or panic attack, in a moment. Regarding her anxiety disorder, Sarah's psychotherapist once told her that depression and anxiety are two sides of the same coin; and that seemed quite plausible to her, because after a depressive phase she usually fell into a state of anxiety.

Attention deficit hyperactivity disorder (ADHD)

We all know the age-old stereotype of someone with ADHD: the kid who runs around the classroom, can't sit still, and can't concentrate on class. Today we know that adolescents and adults can also suffer from ADHD. Symptoms of this disorder include inattention (difficulty concentrating, poor performance at school or work, poor Time management), hyperactivity and impulsiveness (fidgeting, constant talking, interrupting others). Such symptoms can contribute to a depressed mood because they often cause people to withdraw from you. For this reason feel Patients with ADHD often misunderstood each other, lonely, even depressed.

(Please note: Major depressions are rare in people with ADHD. This form of depression is more common in the general population.)

Panic disorder

This disorder is characterized by recurring panic attacks: those affected suddenly experience intense fear or panic. Symptoms include shortness of breath, sweating, tremors; sometimes the patient even feels that his death is imminent. If persistent panic disorder is not treated by a psychotherapist or psychiatrist, it can Quality of life affect the patient. Those who suffer from panic disorder sometimes isolate themselves from those around them,

because he feels misunderstood, is afraid of negative assessments, or is afraid of doing something embarrassing if he has a panic attack in the presence of other people. This isolation can contribute to feelings of depression. When Sarah had her panic attacks she felt misunderstood and even felt she was acting weird in some way; but there are many things that can be done today to help people with panic disorder. Please seek advice from a doctor, psychotherapist or psychiatrist. You no longer have to live with the fear of being attacked by a panic attack when you least expect it!

Seasonal Affective Disorder (SAD)

This disorder with the aptly named (sad is the English word for "sad"), like postpartum depression, belongs to the class of depression. (That is, it is not listed as a separate affective disorder in DSM-5.) In SAD, the depressive episodes always occur at a certain time of the year. If you have SAD, you may be fine in the spring and summer; but in autumn and winter you fall into a very depressed mood. (This is why this disease is also known as winter depression.) In rare cases, however, patients with SAD also experience depressive episodes in summer. If you only have the typical symptoms of depression during the winter months, you may have SAD.

Bottom line: watch yourself

Do the symptoms of some of the comorbidities of depression described here sound familiar? Write down (if applicable) your experience with these conditions for yourself personally.

If you suspect you may have any of these disorders that you have not yet been diagnosed with, speak to your doctor, psychotherapist, or psychiatrist about your symptoms.

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