Depression

Why do people develop depression?

Approximately three to five per cent of men and eight to ten per cent of women suffer from depression that requires treatment. According to the World Health Organisation (WHO), depression is the most common cause of health impairment worldwide. Depression is the most common and severe mental illness. It can lead to death as a result of suicide.

Depression can have different causes. An interplay of different factors is assumed to be the trigger.

1. Material causes
Depression can occur as a side effect of medication or as a result of drug and alcohol use.

2. Biological causes
Depression can be constitutionally predisposed. Hereditary (genetic) factors play a role. This means that certain genetic factors can increase the risk of developing depression under stress. Often depression can be found in the family history of parents, grandparents or other relatives.

In all depressions, changes in the neurotransmitter system and in the regulatory system of hormones in the brain can be detected. These can also be made visible with imaging techniques. The therapeutic successes of both medicinal and other therapies can thus be rendered visible.

3. Mental causes
Depression can be the result of severe mental stress (e.g. existential changes in life circumstances, strokes of bad luck such as the death of a close person, serious illness, persistent stressful situations due to conflicts in the family, partnership or at work). Negative thinking patterns can increase the risk (fragility = vulnerability) of depression. The social environment can also play a role in the development of depression (e.g. loneliness).

4. Physical causes
Chronic physical illness increases the likelihood of developing depression.

What symptoms can occur with depression?

Physical symptoms

  • Exhaustion
  • Fatigue
  • Sleep disorders
  • Early waking
  • Low mood in the morning
  • Loss of appetite
  • Weight loss
  • Libido loss
  • Various physical complaints


Psychological symptoms

  • Concentration and memory disorders
  • Tendency to brood
  • Inner restlessness
  • Feeling of dejection
  • Depressed mood to the point of despair
  • Joylessness
  • Lack of interest
  • Fears
  • Impairment of self-esteem and self-confidence
  • Guilt
  • Thoughts about one's own worthlessness
  • Feelings of hopelessness/meaninglessness up to death wishes and suicidal thoughts

If the mood and other symptoms persist for more than two weeks, depression that requires treatment should be considered.

How is depression diagnosed?

The diagnosis of depression is made through a consultation. The description of the symptoms usually provides enough clues as to the cause of the depression. Psychological tests complement the diagnosis. We always use additional test procedures.

Classification of depression

In the ICD-10 classification system, depressive disorders are described on the basis of symptoms, severity, duration, course and frequency of recurrent episodes of illness:

  1. Depressive, first-ever episodes in which a minimum number of the characteristic symptoms are present almost continuously for at least two weeks
  2. Recurrent depressive disorder in which a depressive episode has occurred repeatedly
  3. Dysthymia (dysthymia = melancholy): Disorder in which depressive symptoms are very frequent in smaller numbers and milder manifestations over a period of more than two years
  4. Adjustment disorder, in which depressive symptoms occur after a decisive life change, but are not as numerous or as long-lasting as in depressive episodes or dysthymic disorders

How is depression treated?

Why inpatient treatment? Depression can often be treated on an outpatient basis. Hospital treatment may be necessary due to the severity of the illness. Often, even leaving the everyday/overwhelming situation results in a helpful distancing from tasks and conflicts.

Our depression treatment includes therapies that take into account the physical, psychological and spiritual dimensions.

Physical dimension: Anthroposophic medicines, external applications, compresses, rubs, oil dispersion baths, sports and physiotherapy

Psychological dimension: Imparting knowledge (psycho-education), patient education, therapeutic painting, music therapy, therapeutic eurythmy, therapeutic modelling and sculpting

Spiritual dimension: Psychotherapy (Schema therapy according to J. Young, behavioural therapy, depth psychology-based psychotherapy, anthroposophic psychotherapy), meditation

Aim of the treatment: Improvement of mood and other symptoms of depression, improvement of quality of life

Drug treatment

The antidepressant drugs (belonging to the group of psychotropic drugs) are intended to normalise the brain metabolism. This usually leads to an improvement in depressive symptoms. There are different substances with different starting points. With anthroposophic antidepressant medicines, the patient's self-healing powers are stimulated to return to a health-promoting balance. External applications, compresses, rubs and oil dispersion baths support the healing process.


Music therapy

Music therapy improves the ability of the soul to vibrate and move. It leads it to a strengthening of its own creative capacity in order to be able to counter dominant influences from the outside world. Engaging with musical processes is a path and an aid away from inertia, despair and lack of perspective towards inner movement, courage to face life and new perspectives.


Therapeutic painting

We mostly work in the wet-on-wet painting technique and with watercolours, as this technique is very mobile and lively, stimulating the imagination. Thus, through the effect of colour, the mood of the soul is taken up and positively influenced, the rigidity of the soul is set in motion and dissolved, and the inner emptiness is filled by enriching and meaningful pictorial content. Depending on the individual needs of the patient, other techniques such as shape drawing can also be used.


Therapeutic modelling and sculpture

Modelling and sculpting stimulate the creative strengths. Patients can engage with the clay by creating something they love and using their hands to express their thoughts.

Psychotherapeutic treatment

Cognitive behavioural therapy (CBT)

Development of an individual disorder model. Establishing a regular daily structure, incorporating pleasant activities but also duties into the day. Regular physical activity. Goal: less withdrawal. Have positive experiences again. Reduction of negative thought patterns about oneself and the environment. Review of one-sided views. Replace with more appropriate, realistic ways of thinking. Goal: Findings: "Some things I can't manage. But a lot is already succeeding". Social skills training: communication exercises, role plays (e.g.: establishing contact with others, confidently expressing one's own wishes and opinions). Goal: stabilisation of therapy success, prevention of relapses, dealing with relapses.


Depth psychology-based psychotherapy

The focus here is on examining (analysing) the unconscious inner conflicts that have arisen from negative experiences in the past. It is about raising awareness of the unconscious conflicts, living through the feelings associated with them. The repeated experience in therapy leads to resolution (catharsis = mental cleansing).


Schema therapy according to Jeffrey Young

Schema therapy expands the methods of cognitive behavioural therapy with elements of depth psychological treatment concepts and other proven therapy methods, such as transactional analysis, hypnotherapy and Gestalt therapy. Patients can quickly start working independently and benefit sustainably and in a short time. Schema therapy is based on the assumption that schemas, i.e. behavioural patterns, are acquired in childhood and throughout life, which include memories, emotions, cognitions and bodily sensations and can influence behaviour in a pathogenic way. These behavioural patterns - e.g. through the overemphasis on performance, perfection and reliability - can have such a pathogenic effect that depressive symptoms develop. By recognising and changing the patterns, the depressive symptoms can often be resolved.


Anthroposophic psychotherapy

Anthroposophic psychotherapy extends the various psychotherapeutic directions to include the idea of destiny. In visualisation of past and future – in actual presence of mind – an inner attitude can be found and formed to cope with, change and/or endure difficult life and illness situations. The biographical concept of development in physical, mental and spiritual terms in relation to the individual's life as well as the psychosocial relationship life of a person is crucial here.

Prospects: living with the depression

Depression usually runs in phases. These usually subside again spontaneously. In most patients, the depression is completely cured.

However, depression can also reoccur in the course of life. Even if there is repeated (recurrent) depression, there are effective treatments (exercise, medication, art and psychotherapy). Usually, treatment methods are then combined.