Severe depression is a serious illnes

by Abdullah Arif · June 15, 2024

Severe depression should not be taken lightly, as it is a serious mental illness that severely limits the lives of those affected. People with a severe form of depression fail to carry out everyday tasks and may develop a desire to die, so medical treatment is essential.

Get professional treatment for severe depression

Severe depression can manifest itself in a variety of symptoms that can last for a long period of time. A severe loss of interest as well as persistent feelings of sadness, hopelessness and dejection characterize the mental illness. If left untreated, suicidal thoughts can arise, which make inpatient therapy advisable. To prevent the condition from becoming serious, outpatient psychotherapy should be used and drug treatment with antidepressants should be considered.

CHARACTERISTICS AND SYMPTOMS What characterizes severe depression?

Severe depression is a mental illness that can significantly affect a person’s general well-being and ability to function. According to the ICD-10 guideline, the three main symptoms of depression include a persistent sad, depressed mood, lack of motivation with increased fatigue, and loss of interest combined with joylessness. A person with severe depression experiences deep sadness that lasts for a long time and regardless of external circumstances. Depression, despair, and hopelessness spread. In addition, those affected lose interest in activities that actually give them pleasure. Hobbies and once-loved activities can now seem pointless or uninteresting.

Interest in social interaction and sexuality is also reduced. A predominant lack of motivation is also a typical sign of severe depression . Severely depressed people find it difficult to work and manage normal everyday tasks such as personal hygiene, shopping and housework. Increasing neglect can be the result. If the condition lasts for a few days, it does not necessarily indicate depression. If the symptoms persist for a period of two weeks, a mental illness is more likely and should be checked by a doctor.

SIGNSAdditional symptoms and other signs of severe depression

In addition to the three main symptoms that characterize severe depression , those affected may experience other symptoms. According to the ICD-10, these are classified as additional symptoms:

impaired ability to concentrate and reduced attention
reduced self-confidence and self-esteem
Feelings of guilt and worthlessness
negative thoughts about the future
Suicidal thoughts and actions as well as self-harm
sleep disorders
reduced appetite

Severe depression can impair cognitive function , which can manifest itself in problems with concentration, memory and decision-making. Depressed patients often find themselves unable to carry out everyday tasks because they cannot concentrate on the external demands of the situation. Affected people are usually inhibited in their thinking and plagued by self-doubt and fear. Ruminating over the same thing over and over again is also typical.

This is often accompanied by reduced self-esteem and self-confidence, as well as feelings of guilt and worthlessness. People who experience severe depression often blame themselves and lose faith in their abilities. Another additional symptom is a pessimistic attitude towards the future, which can be perceived as hopeless. Depressed patients can have very negative expectations of the future, which also relate to their recovery. Suicidal thoughts are not uncommon in severely depressed people. The thoughts can be very specific or vague.

Suicidality, previous suicide attempts and self-harm can be signs of severe depression and should be treated with professional inpatient psychotherapy. Sleep disorders are also additional symptoms. These can manifest themselves as difficulty falling asleep, waking up several times during the night and waking up early. Excessive sleeping behavior can also be a sign of depression . A reduced appetite, which can lead to weight loss, is also to be expected in people with severe depression .

In addition to these symptoms, psychomotor slowing or agitation can occur. Some people with severe depression experience a slowing of their movements, speech and thought processes. Others can feel agitated, restless and agitated. In addition to the emotional symptoms, physical complaints such as headaches and local or generalized muscle pain, gastrointestinal problems and tension can occur. Social withdrawal is also possible. Due to the symptoms of depression, those affected often stay away from social activities, generally avoid contact with other people and withdraw into their own world of thoughts and feelings.

Get help for severe depression

SEVERITYSeverity of depression

Depressions are differentiated based on their severity. There are mild, moderate and severe depressions. The illness is classified based on the occurrence of the various symptoms that last for at least two weeks. According to the ICD-10, mild depression is present when two of the main symptoms and two of the additional symptoms are present. Moderate depression has two main symptoms and three to four additional symptoms. Severe depression includes all three main symptoms in conjunction with at least four additional symptoms.

TO FORMSpecial forms of depression

As a mental disorder, depression can have different forms and degrees of severity:

Dysthymia: In this form of depression, depressive symptoms occur over a longer period of time. If the symptoms have been present for at least two years or more, this clinical picture can be diagnosed. The symptoms are chronic and affect daily functioning, but may be less severe than those of major depression.
Seasonal depression: Depression does not have to be generalized. The form, also known as winter depression, usually occurs in autumn and winter. It is associated with a lack of sunlight and the resulting reduced production of vitamin D and is manifested by symptoms such as increased fatigue.
Postpartum depression: This depression occurs in women after giving birth to a child. It is caused by hormonal changes, emotional adjustments to motherhood, and other factors. Symptoms can range from mood swings and irritability to strong feelings of hopelessness and self-guilt. Depression during pregnancy is also possible.
Bipolar disorder: Although not exclusively a form of depression, bipolar disorder is characterized by episodic mood swings that include depressive phases and manic phases. During the “low” phase, symptoms similar to those of major depression may occur.
Substance and medication-induced depressive disorder: Depression can also be caused by drugs and medications. Both taking and stopping drugs can lead to depression.

CAUSESCauses of severe depression

There are many different causes that can trigger severe depression . It is often a combination of different circumstances. The main causes include:

genetic predisposition
Disturbance of neurotransmitters in the brain
Pregnancy and postpartum
Medicines and drugs
personal factors such as generally negative thought patterns or perfectionism
excessive stress
physical illnesses such as thyroid disorders and chronic pain
serious life events such as traumatic childhood experiences

There is evidence that there is a familial predisposition to depression . People whose close relatives suffer from the mental disorder may have a higher risk of developing severe depression themselves. Chemical imbalances in the brain can also contribute to the development of depression. In particular, a disruption in the signal transmission through the neurotransmitters serotonin, noradrenaline and dopamine can promote depression and should be examined by neurologists. Women can develop depression during pregnancy and after childbirth, which can take a severe form. It can be triggered by hormonal changes and an adjustment disorder.

Taking and stopping certain medications and drugs is also considered to be a trigger for depression . Drugs that can be involved in a depressive disorder include cytostatics, anticonvulsants, retinoids and benzodiazepines. The use and withdrawal of psychotropic drugs and hallucinogens can also cause severe depression . Personal factors also play a role. For example, negative thought patterns and low self-esteem can lead to the development of depression.

Strong perfectionism can also be a trigger. People who suffer from a lot of stress have a higher risk of developing severe depression . The clinical picture must be distinguished from burnout syndrome. Illnesses can also cause depression. In particular, suffering that has a major impact on one’s life is among the possible triggers. In addition, traumatic experiences in childhood, the death of a loved one, relationship crises, financial problems and other negative life events can be the cause of severe depression .

FORMS OF THERAPYOvercoming severe depression

Various forms of treatment can be used to overcome severe depression . First and foremost, those affected should seek professional psychotherapy. Depending on the cause, severity and symptoms, neurological and psychosomatic measures can be helpful. In the case of suicidal thoughts, inpatient treatment may be advisable.

TREATMENTTreatment & therapy forms

There are now several successful forms of therapy available for those affected by mental depression . Despite this, the illness returns in around half of all cases or develops into a chronic disorder. In the case of mild or moderate depression, psychotherapy alone may be sufficient to treat the disorder. However, the situation is different with psychotic depression, which is one of the more severe forms of depression . According to the latest findings, a combined treatment of medication and psychotherapy is most successful for severe depression.

Just like classic depression, psychotic depression is also easy to treat. The sooner you start therapy, the greater the chances of success. First, the psychotic symptoms must be combated before you can deal with the actual causes of the depression. In therapy, those affected learn how to deal with their illness. They learn how to identify risk factors that can trigger a psychotic episode. It is particularly important that the specific characteristics of the affected person are taken into account. No two clinical pictures are the same, and the interaction of the causes is also individual. These circumstances are taken into account in individual discussions.

Get help for severe depression

Treating depression with psychotherapy and other therapeutic measures

Psychotherapeutic measures must be used to treat severe depression . It is important to build a stable, trusting relationship with the patient so that they can open up to the therapist and communicate their concerns. During the conversation, negative thought patterns and behaviors as well as psychosocial conflicts are analyzed in a solution-oriented manner in order to better understand the causes of the depression, defuse problems and implement positive and healthy thought patterns.

In the case of severe depression, the healing process is usually gradual and even the achievement of small goals represents a therapeutic success. Measures can include establishing a fixed daily structure and pursuing better sleep hygiene. Getting up in the morning, filling the day with manageable tasks and positive activities and only going back to bed at night can break through an existing lack of motivation and reduce sleep disorders. The following methods can be used to support this: