Depression is already the most common mental illness – and now comes the stresses of the pandemic to. What exactly does that mean?
Will the epidemic of depression come after the virus?
Corona stresses us all. Many fear for their health, are annoyed by the restrictions of everyday life, work in professions that are particularly demanding now, or worry about their professional future. "Quite a few have depressive symptoms because of this, but not automatically also a depressive illness," says Dr. Ulrich Hegerl, Professor at the University of Frankfurt and Chairman of the Board of the German Depression Aid Foundation.
The fact that the two are still mixed is probably one of the reasons that depression is still underestimated. "A lot of people think 'I'm in a bad mood too right now'" but don't know how serious the disease is, "says Hegerl. Depression is the main cause of suicides and is always associated with high levels of suffering. And it is a disease in its own right and not just a reaction to difficult living conditions.
"The decisive factor is whether there is a predisposition. Anyone who has it slips into depression, even if the living conditions are wonderful. Conversely, people without this depressive tendency get through the greatest bitterness without falling ill," says Hegerl. "So external factors play a much smaller role than most people think." The current stress can be a trigger for a depressive phase of illness if you already have a predisposition for it. The psychiatrist therefore does not assume that a wave of new forms of depression is imminent.
What about people who already have depression?
For them, the consequences of the pandemic can be dramatic. The virus itself is not the problem. Depressed people no longer worry about the risk of infection than healthy people, but they suffer far more from the Corona measures. This is shown by the "Germany Depression Barometer", a representative survey of over 5000 people that is regularly carried out by the German Depression Aid Foundation with the support of the Deutsche Bahnstiftung: People with depression experienced the lockdown as significantly more stressful.
75 percent made the lack of daily structure to create; in the general population this was only true for a third. "Almost every second patient stayed in bed more often during the day," says Hegerl. "And although people with depression are exhausted, it is counterproductive for them to lie down a lot and for long." Not only because then the risk of getting deeper and deeper into brooding increases: "More sleep tends to make the majority of those affected worse. In the clinic, sleep deprivation is even a treatment for depression."
Another negative: the lack of physical activity. Four out of five depressed people said they had exercised less, almost twice as many as in the healthy population. "Sport is something that has a supportive effect on depression," says Hegerl. The survey refers to the first lockdown last spring, but the expert suspects that the second had similar effects.
How is the supply during the pandemic?
"This is the most important reason for concern, because unfortunately the care has deteriorated significantly in more than half of the depressed sufferers," said Ulrich Hegerl. Outpatient treatment appointments were canceled or were not attended for fear of infection, planned hospital stays were canceled, and group offers such as self-help groups did not take place or only to a limited extent.
Even when the number of infections was low over the summer, a third of those affected reported poor medical care. "With this serious illness, that is of course a disaster," says Hegerl. "Extrapolated to the total population, this means that more than two million people received poorer care – with all the expected negative consequences: worsening of symptoms, more relapses, more suicide attempts."
The expert criticizes the fact that the health side effects of infection protection are not sufficiently taken into account: "The measures against corona are intended to prevent suffering and death, but also cause suffering and death in other places. Where the right balance is here must be discussed much more intensively. A narrowing the view only of the infection process would be irresponsible. "
How important are online therapies?
Their importance has definitely increased in the past year. Even if they are not accessible to many affected people, such as the elderly, because the technical requirements are lacking. According to the "Depression Barometer", 14 percent of patients with acute depression used the telephone or video consultation hours. Most of them rate this positively. "If you have a diagnosis and already have a relationship of trust with a doctor or psychotherapist, a lot can actually be absorbed," says Ulrich Hegerl.
Since then, digital therapy offers have also been used more. "However, the programs work particularly well when there is professional support." In the meantime there are programs such as "ifightdepression", to which one not only receives access through the practitioner, but is also supported in implementation. The expert warns: "The message 'If you have a depression, go online and treat yourself' is fatal."
Where can I find help?
The right contact persons are specialists in psychiatry, psychological psychotherapists or the family doctor. In fact, the latter treat the majority of those who are not in clinics. Ulrich Hegerl is above all important to convey to those affected: "People with depression are entitled to good medical care even in times of the Corona. They don't have to back off, but should get professional help as always."
What can and should relatives do?
First of all, find out more. Because whoever understands the disease can better classify the behavior of the person affected. "Otherwise you may experience it as letting go or as lovelessness or even develop feelings of guilt," says Ulrich Hegerl. "It is also important to understand that as a relative you are not responsible for the treatment. Or, to put it simply: You cannot cure depression with love, just as you cannot cure diabetes."
Nevertheless, there is a lot that can be done to support those affected. Many lack the energy and hope to take care of the treatment and to endure it. "Relatives definitely have an important role here and can make appointments, accompany and motivate the depressed person", says Hegerl. Partners, friends and family are also helpful in everyday life when it comes to maintaining a daily structure. "You can also set up a weekly plan together, which of course includes duties, but also deliberately something beautiful that you may have always wanted to do." And last but not least, this focus on the positive also demonstrably helps people who are currently "just" in a bad mood.
You can find help and information here
On the phone: The telephone counseling can be reached around the clock on 0800/111 0 111 or 222. It is also possible to contact us by email or chat (online.telefonseelsorge.de). The Depression info telephone offers information on illness, treatment and contact points throughout Germany: 0800/334 45 33
In the web: The German Depression Aid Foundation has extensive information on its website, including self-tests, tips and addresses: deutsche-depressionshilfe.de
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