Depression - exhausted soul

The sky is grey; the soul is grey, and the unfinished work has been piling up on the desk for days. They feel tired, lacking in energy and listless. They are depressed. But is this a real depression or just a seasonal mood? This is not the same, but has things in common.

Seasonal depression occurs in low light seasons. Without light, the body produces fewer mood-lightening endorphins and emits fewer serotonins, so-called happiness hormones. More melatonin is produced, which helps control sleep during the night and therefore makes you tired. Typical signs of seasonal depression are severe fatigue and a craving for sweets, which often leads to a significant increase in weight. The best thing to do is to exercise a lot in daylight. A special light therapy can also be very helpful. A therapy with high-dose St. John's wort extract (prescription-only) is also often successful.

A real depression is a metabolic disorder in the brain. The brain cells send serotonin and norepinephrine as messenger substances through the synaptic cleft on their way to the neighbouring nerve cell, but in the state of depression the messenger substances cannot migrate in this way. This affects the mind in the form of lack of drive, listlessness, discouragement, lack of energy and disinterestedness. In contrast to seasonal depression, appetite and insomnia are added.

It is estimated that in some years depression will occur more than cardiovascular diseases. Why, this is not yet known. When factors such as great sorrow, a car accident, a shocking event, losing a person or unemployment cause depression, we speak of a reactive depression.

In addition, there is the depression from the inside out, the endogenous depression. Here, the cause is largely unknown; genetic factors are assumed to be inherited. Third, we are still talking about the somatogenic depression. Somatogen means body-related. This form can be caused by a severe physical illness such as rheumatism and cancer. One realizes that life will never be the same because one has to deal with a physical limitation. That's depressing. According to international standards, depression is nowadays classified differently for doctors, but this division into three is still clear.

However, no matter for what reasons a depression has arisen, it can be treated with antidepressants, i.e. special medication for depression. The modern drugs are called selective serotonin-noradrenaline reuptake inhibitors (medical abbreviation derived from the English name: SSNRI). This means that the nerve cells are prevented from re-integrating the messenger substances that are important for happiness and well-being. Of this type of medication, there are several active ingredients. However, it is very important that you take the tablets always at the same time. A carelessness endangers the therapeutic success.

Benzodiazepines and neuroleptics are also used in the short term. Psychotherapy is also important, but at the beginning it only has a supportive effect, i.e. the doctor only gives the patients and their relatives the feeling they are not alone. The so-called MAO inhibitors are used in cases difficult to treat. However, these drugs were banned for a long time because of the danger of high blood pressure peaks developing. With an MAO inhibitor diet you can avoid this side effect: Remove fermented or preserved foods such as old cheese, red wine or salami from the menu, and meat and fish that are not fresh, such as hung game, rollmops or smoked salmon.

But it is also important to have your own mental support. Depression gives rise to recurring thoughts such is "I'm just not lovable, I'm stupid, I'm clumsy". These sentences have often been internalized since childhood. Such a devastating self-image is the engine for many depressive disorders. Negative thoughts only flash up, however, so they rarely become conscious. If you notice them, write them down. When you feel better, take the note out and question it. This will help you in the next depressive phase.

Besides these forms of depression, there is also exhaustion depression, also known as burnout. It is also characterized by depressive listlessness, lack of energy and senselessness. It is typical that those affected wake up early in the morning at three, four or five o'clock in the morning, are still dead tired but cannot fall asleep again. This burnout is often caused by excessive demands. The exact processes in the brain are not yet known, but it is assumed that they are caused by a metabolic disorder similar to depression. As with normal depression, alcohol is an intensifying and triggering factor that becomes clear about three weeks later.

In the initial phase, an extensive recovery, such as a cure, can help. Later on, targeted psychotherapy is required, supported by medications such as high-dose St. John's wort. If this doesn´t help, the doctor will prescribe specific antidepressants.

Copyright: Landeszentrale fuer Gesundheitsfoerderung in Rheinland-Pfalz e.V. (LZG) Germany

Text: Dr. Beatrice Wagner, Editor: Marielle Becker