First aid against depression Self-sabotage and fears [+ self-test]


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Text comes from: Das 10 Schitte Programm gegen Depression. Ein verhaltenstherapeutischer Ansatz (2019) from Simon Rego & Sarah Fader, published by Münchener Verlagsgruppe (MVG), Reprints by friendly permission of the publisher.
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There are several possible causes of depression. Maybe it's because of the messenger substances in the brain, but there can be other reasons as well. An overview.

First aid against depression Self-sabotage and fears [+ self-test]

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Who is at particularly high risk for depression?

You may have heard that depression can result from an imbalance in chemical messengers in the brain. This is a common but controversial belief. In contrast, Harvard Medical School emphasizes on its website that this disease is too complex to be ascribed to a single cause. Depression can arise from a variety of different factors.

Possible causes include: genetic predisposition, serious medical conditions, certain medications, problems with mood regulation, and stressful life events. People with a family history of death, divorce or a traumatic event (such as physical or emotional abuse, or sexual abuse) are at a significantly higher risk of developing depression.

Depression with and without clear causes

Traumatized people often not only suffer from depression, but also from post-traumatic stress disorder (PTSD). Both clinical pictures are sometimes expressed in similar symptoms: for example, concentration disorders, a feeling of distance from other people, sleep disorders and the difficulty of feeling positive emotions. Depression or PTSD also leads to an increase in negative beliefs or expectations about themselves and less interest or pleasure in activities that they previously enjoyed.

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Sometimes depression occurs for no apparent cause. If that's the case with you, you know how frustrating it can be. But your depression is real even if you don't know what caused it. Depression is based on an illness that is just as specific as any other illness; Unfortunately, sometimes you don't know what caused it. But there is also good news: even if we don't know what causes depression, it can still be treated very well.

How Does a Depression Questionnaire Help You?

In the 1960s, the psychiatrist was Dr. Aaron T. Beck pioneered cognitive behavioral therapy (CBT). CBT wants to help people who suffer from negative thoughts (for example: "I'm a total failure!") And maladaptive behavior (for example sleeping too much, isolating themselves from friends and family) - typical side effects of clinical depression. CBT can help such people by teaching them new skills that will help them feel better. Knowing that depression can cause a wide variety of symptoms and vary in severity (from mild to very severe) Dr. Beck published the Beck Depression Inventory (BDI), which is designed to help people assess the severity of the various symptoms of depression (and the depression itself).

Many other inventories and questionnaires for assessing depression have been developed since then. Some of them (for example the questionnaire printed below) correspond to the nine main criteria for depression from the DSM-5. This questionnaire will give you an idea of ​​the symptoms on which the diagnosis "depression" is based. It also makes you aware of how severe these symptoms are in you and how severe your depression is. The questionnaire can also help you decide whether or not to seek professional help. The self-test below is the patient questionnaire (PHQ-9). Take this test right now to get a better idea of ​​the severity of your depression. You can tick one of four answers for each question. Write the numbers that correspond to your answers in the blank lines next to the questions. You can repeat this test at any time - either periodically while reading this book, or at least when you have finished reading it and done all the exercises - to see if anything has changed in the severity of your depression.

Patient Questionnaire (PHQ-9)

You can evaluate this depression test yourself. You will find the result at the end of the test. Over the past two weeks, how often have you felt affected by the following symptoms?

1. Little interest or pleasure in your work? ____

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  • 0 Not at all
  • 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

2. Despondency, melancholy, or hopelessness? ____

  • 0 Not at all 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

3. Difficulty falling asleep or staying asleep, or increased sleep? ____

  • 0 Not at all
  • 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

4. Tired of feeling or having no energy? ____

  • 0 Not at all
  • 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

5. Decreased appetite or excessive need to eat? ____

  • 0 Not at all
  • 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

6. Bad opinion of yourself; Feeling like a failure or abandoned the family? ____

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  • 0 Not at all
  • 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

7. Difficulty concentrating on something, such as reading the newspaper or watching TV? ____

  • 0 Not at all
  • 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

8. Were your movements or speech slowed enough that others noticed? Or, on the contrary, were you "fidgety" or restless and therefore had a stronger urge to move than usual? ____

  • 0 Not at all
  • 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

9. Thoughts that you would rather be dead or hurt yourself? ____

  • 0 Not at all
  • 1 On individual days
  • 2 More than half of the days
  • 3 Almost every day

The evaluation of the self-test

Add up all the points in the blank lines and write the total in the line below. (The highest possible score is 27, the lowest possible score is 0.)

My score: ____ / 27

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What does your PHQ-9 score mean? 0–4 points: healthy 5–9 points: normal 10–14 points: mild depression 15–19 points: moderate depression 20–27 points: severe depression

If you get more than zero points in question 9, please seek professional help immediately. A score between 15 and 27 usually requires active treatment with psychotherapy, medication, or a combination of both. Spiegelt your current mood in your score? Why or why not? Have some of your answers to these questions surprised you? Why or why not? Please write your ideas or comments on your answers in the blank lines below:

What types of depression are there? Be clear about your problems

Depression can manifest itself in many different ways and with different degrees of severity. It can also be associated with other mental illnesses such as anxiety or panic disorder, ADHD, or substance abuse. These are all comorbidities of depression, which we will discuss in more detail later in this chapter.

For now, let's take a look at the diseases that people generally think of when they hear the word depression. These include: major depression (also known as clinical depression), dysthymia (persistent depressive disorder), bipolar disorder, and postpartum depression. Regardless of the type of depression you're suffering from, this workbook can help you see light again at the end of the tunnel.

Major Depression / Clinical Depression

Major depressive disorder (also known as clinical depression or sometimes simply depression) is depressed and / or motivated to deal with everyday tasks has diminished. To be called clinical depression, this change in mood and / or motivation must last for at least two weeks and be accompanied by several other symptoms (see page 12). The depressed or moody mood and the resulting behavior are very different from how you behave when you are in the best of moods.

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In order to meet the criteria of clinical depression, this illness must also cause problems in working life, in social interactions with friends, in coping with domestic tasks and / or in the patient's studies or training. He suffers from a severe change in mood that clearly affects his behavior. A student with major depression may suddenly get very much worse grades. He may also isolate himself from his friends by declining invitations to social events.

Persistent Depressive Disorder (Dysthymia)

The symptoms of persistent depressive disorder (dysthymia) are similar to those of major depression, but usually last for months. Symptoms are usually milder, but keep coming back for years, while major depressive episodes are shorter. The severity of the depressive symptoms in dysthymia can vary significantly over the years; but the typical characteristics - low self-esteem, sleep disorders, lack of energy or exhaustion (fatigue), changes in appetite, concentration problems and feelings of hopelessness - never go away for more than a period of two months.

In addition to dysthymia, depressive episodes can also occur; this means that this mild depression can coexist with an episode of major depression. This phenomenon is usually referred to as double depression.

Bipolar disorder

Bipolar disorder (formerly known as manic depression) is associated with considerable mood swings and corresponding behavior: from exuberant euphoria to complete hopelessness. "Bipolar" means nothing other than two poles, in other words: two opposing moods. The elevated mood phase is referred to as a manic (bipolar disorder type I) or hypomanic (bipolar disorder type II) episode, the depressed mood phase as a depressive episode. People with bipolar disorder also go through phases of "normal" or "stable" mood from time to time - especially when they are treated with medication and psychotherapy.

Contrary to popular belief, not all people with bipolar disorder have severe manic episodes. Patients with type II bipolar disorder experience hypomania (mild mania) during periods of high spirits that does not affect them in their social or professional life and does not require hospitalization. Sometimes it just feels good, and maybe you are particularly productive in those phases. Unfortunately, the hypomanic "light switch" can flip in a flash, and then the patient falls into depression.

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Postpartum depression

Postpartum depression is an astonishingly common form of depression: every ninth woman suffers from it after having a child. Women with postpartum depression experience overwhelming feelings, ranging from sadness to severe anxiety. Sometimes they are totally exhausted physically and emotionally; this makes it difficult for them to take good care of themselves and their baby. It is not the young mother's fault if she becomes ill with postpartum depression: depression is just as serious a mental illness and requires the same care and attention as any other form of depression.

Depression and comorbidities

People with depression may also have one or more of the comorbidities described below. For example, depression is often associated with an anxiety disorder. How is it with you? Have you ever suffered from the symptoms below? Or do you fear that you might experience such symptoms at some point?

anxiety disorder

Symptoms of an anxiety disorder include worrying thoughts, nervousness, and a feeling of internal discomfort. We all get scared now and then; that is part of life. But when fear dominates your thoughts and actions every day, it becomes an anxiety disorder.

If you have such a disorder, you may also feel extremely anxious now and then. We'll come to this problem, which is known as an anxiety attack or panic attack, in a moment. Regarding her anxiety disorder, Sarah's psychotherapist once explained to her that depression and anxiety are two sides of the same coin; and that seemed quite plausible to her, because after a depressive phase she usually fell into a state of anxiety.

Attention deficit hyperactivity disorder (ADHD)

We all know the age-old stereotype of someone with ADHD: the kid running around the classroom unable to sit still and focus on class. Today we know that adolescents and adults can also suffer from ADHD. Symptoms of this disorder include inattention (difficulty concentrating, poor performance in school or at work, poor time management), hyperactivity and impulsiveness (fidgeting, talking, falling into words). Such symptoms can contribute to a depressed mood because they often cause other people to withdraw from you. As a result, patients with ADHD often feel misunderstood, lonely, and even depressed.

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(Please note: Major depressions are rare in people with ADHD. This form of depression is more common in the general population.)

Panic disorder

This disorder is characterized by recurring panic attacks: those affected suddenly fall into severe fear or panic. Symptoms include shortness of breath, sweating, tremors; sometimes the patient even feels that death is imminent. If persistent panic disorder is not treated by a psychotherapist or psychiatrist, it can affect the patient's quality of life. Those who suffer from panic disorder sometimes isolate themselves from those around them,

because he feels misunderstood, is afraid of negative judgment, or is afraid to do something embarrassing if he has a panic attack in the presence of other people. This isolation can contribute to feelings of depression. When Sarah had her panic attacks, she felt misunderstood and even felt like she was acting weird; but there are many things that can be done today to help people with panic disorder. Please seek advice from a doctor, psychotherapist or psychiatrist. You no longer have to live with the fear of being attacked by a panic attack when you least expect it!

Seasonal Affective Disorder (SAD)

This disorder with the aptly named (sad is the English word for "sad"), like postpartum depression, belongs to the class of depression. (That is, it is not listed as a separate mood disorder in DSM-5.) In SAD, the depressive episodes always occur at a specific time of the year. If you have SAD, you may be fine in the spring and summer; but in autumn and winter you fall into a very depressed mood. (This is why this disease is also known as winter depression.) In rare cases, however, patients with SAD also experience depressive episodes in summer. If you only have the typical symptoms of depression during the winter months, you may have SAD.

Bottom line: watch yourself

Do the symptoms of some of the comorbidities of depression described here sound familiar? Write down (if applicable) your experience with these conditions for yourself personally.

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If you suspect you may have any of these disorders that you have not yet been diagnosed, speak to your doctor, psychotherapist, or psychiatrist about your symptoms.


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