Depressed people suffer from a
severe low mood or a feeling of inner emptiness from which they can no longer
free themselves. Even sleep and non-specific physical complaints are typical.
In a depression, various factors act - physical, psychological, and psychosocial
nature - together. From a neurobiological perspective, changes in the
regulation of stress hormones and imbalances of certain messenger substances in
brain metabolism play a role.
How does depression develop?
In addition to genetic
predisposition and neurobiological explanations, certain developmental and
personality factors (psychosocial factors), and their combination with external
stresses form the basis of the models of explanation for depression. For
example, a high level of perfectionism connected with internal psychological
conflictual issues can promote the development of depression. On the other
hand, internal resources, that is, internal sources of strength, can provide certain
protection or counterbalance against depression.
1. Crises can lead to a depressive adjustment
disorders or exacerbate them
In some patients, depression can
be triggered or intensified by external stressors such as illness, loss, or
crises. One also speaks of a depressive adjustment disorder. A crisis like the
current COVID-19 pandemic presents patients who have had depressive episodes in
the past or who suffer from manifest depression with special and new challenges
that require individual solutions.
Often patients go to the doctor
at the beginning of a depressive phase with uncharacteristic symptoms such as
tiredness, physical exhaustion, or even concentration disorders. Some sufferers
describe their mood as despair or hopelessness, others feel a general lack of
drive and listlessness.
2. Isolation can promote mental health problems
The COVID-19 pandemic is
radically challenging the often unconscious assumption of being in control of
life. Enduring the imponderables and the necessary regulations, restrictions,
and changes in the social and personal environment is new and unfamiliar to
many people. In addition to fear for their health - or that of their relatives,
many also face existential economic fears faced. People with depression are
much more aware of negative things and focus on them. Current protective
measures can paradoxically reinforce this. Because isolation, home office, and
the lack of contacts take important external stimuli and impulses from the
everyday life of those affected, which can have a positive effect on the world
of thoughts and mood. But there are ways and means how those affected can try,
even in today's situation, to prevent an inner passivity or depressive state
and get a realistic picture of the situation.
3. Measures against slight depressive moods
"Fixed times for work,
leisure, and meals give the daily routine and structure. Telephone or video
telephony appointments with friends and family or online forums offer a
communicative exchange, and a jogging session or a walk in the afternoon
provides exercise and fresh air. All of this can have a positive effect on the
psyche even in times of crisis," explains Dr. Christian Koch, senior
physician and specialist in psychosomatic medicine at the BetaGenese Clinic in
Bonn. You can find more tips on the website of the German Depression Aid
Foundation at deutsche-depressionshilfe.de/corona
Mental illness as a result of the crisis
Medical professionals assume that
diseases such as depression and anxiety disorders will increase during the
COVID-19 pandemic. They are the body's reaction to increased psychological
stress. Dr. Christian Koch: "In addition to the essential medical care of
corona sufferers, one of the challenges facing our health system will be acute
psychotherapeutic treatmentbe. In addition to a consultation, it will be about
assessing the severity and further observation: Can a patient develop
sufficient access to his internal resources again in the context of outpatient
discussions, i.e., find an active contact? For which patients is it not about
more active coping, but rather about a certain tolerance for the current
uncertainty? Is there a prospect that the complaints will go away again when
the crisis ends? And because of the severity of the symptoms and because
outpatient treatment is not sufficient, is there a medical need for more
extensive multimodal inpatient treatment? "
Treating depression
Patients with severe depression
and other mental illnesses can be treated as inpatients by outpatient
psychiatrists or psychotherapists after appropriate instruction. A purely
day-patient treatment is currently not carried out by us with a social
responsibility to reduce the infection rate but will be possible again in the
foreseeable future.
Each therapy plan is developed
from an individual compilation of various therapy modules from psychotherapy,
body therapy, and various creative therapies and medical and, where
appropriate, pharmacological approaches close to the needs of the patient. An
approach that has proven itself. For this purpose, the experts also work
closely with treating outpatient colleagues to achieve and maintain long-term
treatment success.
You will find out more about Telehealth psychiatry services.
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