What made you wake up today

Depression: When you don't have the strength to get up in the morning

This interview with Christa Roth-Sackenheim, specialist in psychiatry and psychotherapy, was first published in August 2016 by WirtschaftsWoche.

WirtschaftsWoche: Everyone gets out of bed badly and feels bad. Is depression more than just a mood disorder?
Christa Roth-Sackenheim: Depression is a serious and serious illness that plays out in the brain, but also affects the psyche, mind, concentration and body. If, for example, there is a physical illness in addition to depression - such as diabetes, high blood pressure, asthma or cancer - the course of the physical illness is worse.

Why is that?
This is on the one hand because people are less able to take care of their physical illness due to depression, on the other hand, an untreated depression seems to have a worsening influence on the physical illness. Researchers suspect that this has to do with immune processes in the body that we do not yet fully understand.

Can illnesses also be the trigger?
Certain physical illnesses, such as an underactive thyroid or adrenal gland, or the use of certain medications such as beta blockers or antibiotics can trigger depression. The reasons for depression, however, are usually very complex - or cannot be identified as a single trigger at all.

Experts mostly speak of the four pillars of depression. According to this, the diseases already mentioned, heredity, neglect in childhood and serious experiences in adulthood are common reasons for people to become chronically depressed.

Symptoms of depression

... poor concentration, insomnia, loss of appetite or increased appetite.

(Source: Ursula Nuber, "Who am I without you?", Campus-Verlag)

When do sufferers become chronically depressed?
There are one-time depressive episodes after a serious biographical event, which, however, fade away again due to compensatory factors or self-healing powers. In this case, the person has had depression once in a lifetime - but they are not chronically depressed.

We differentiate from this the so-called recurrent depression, in which those affected repeatedly experience depressive phases between which they are healthy again. With chronic depression there are also depressive episodes - but in between the sick person is never in the normal state of health.

How do depressed people perceive their environment then?

My patients often describe it to me like this: “I live as if I had to live through a tough gel. Every movement and every thought is incredibly exhausting and tiring. I have no strength to get up in the morning, even though I really want to. I think that is why I am the worst person on earth and I do not deserve that anyone wants to have anything to do with me. "

Burnout can have different causes and symptoms. Therefore, there is no generally applicable way out, says Nico Rose. He explains the three points to keep in mind in the recovery process.

How many people in Germany have such thoughts?
It is assumed that in industrialized countries the lifetime prevalence, i.e. the probability of developing depression once in a lifetime, is around 15 percent. In Germany, the Robert Koch Institute assumes that five to six million people will become depressed within twelve months.

This does not include the depressive episodes that occur as part of a bipolar disorder - a disease that fluctuates between severe depression and very strong, pathological elation.

Is that more than a few years ago?
There are numerous studies that show that the number of depression has not increased in recent years. However, doctors are always better able to diagnose the disease, it is less taboo and accordingly more people are undergoing therapy. That is why we often have the subjective impression that the number of those affected is constantly increasing.

Burnout diseases have numerous causes. A specialist in psychiatry explains what distinguishes burnout from depression, why stress alone is not a problem and why optimized time management does not help.

Are there jobs in which a particularly large number of employees are depressed?
People who do helping jobs fall ill more often than other occupational groups. For example health care workers, geriatric nurses, doctors, firefighters or even police officers.

Does work generally make you depressed?
No. Work per se is a meaningful factor that even prevents depression. Bad working conditions can, however, trigger states of exhaustion and depressive illnesses - but one cannot generally say that work makes you depressed.

Can you give examples of poor working conditions?
These can be repetitive activities, poor working hours, little involvement in the team, little perspective and opportunities to identify with the work environment, little involvement in work-related decisions, as is often the case in temporary work, for example. On the other hand, temporary work is often an entry into a professional activity that later makes sense again.

What can depression lead to in the worst case?
Depression is a potentially fatal condition. We assume that over 80 percent of the approximately 11,000 suicides per year in Germany are caused by depression. Between four and five percent of all depressed people commit suicide. If you only look at major depression, it is up to 15 percent. Men are twice as likely to suicide as women.

What helps against depression?
Basically, depression can be treated well. Treatment will depend on the type and severity of the depression. The general practitioner can wait and see for mild depression. The more severe the depression becomes and the more common it occurs, the more complex the need for treatment becomes. Good psychotherapeutic and drug treatments are available. In the case of moderate and severe depression, these are usually combined. For very severe and therapy-resistant depression, there are also so-called biological treatment methods such as neurostimulation.

More on the subject: Not because of the zeitgeist: As early as the 19th century, people were struggling to find a balance between work, leisure and family. The historian Eva Ochs has researched how the men of the bourgeoisie achieved this.

© Handelsblatt GmbH - All rights reserved. Acquire usage rights?