Complaints & connections · borters.ch
Neither weakness nor a matter of will, but a treatable illness — and help works better the earlier it starts.
Also known as: depressive episode · depression
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Depression is not a sadness one can talk oneself out of but an illness with physical and mental signs. Two things stand at the centre: a lowered mood and the loss of interest and pleasure in what used to give pleasure. Added to that are lack of drive, difficulty concentrating and deciding, sleep problems — classically waking in the early hours with a low that eases towards evening — changes in appetite and weight, guilt and a sense of worthlessness. For the diagnosis these signs must be present most of the time for at least two weeks and get in the way of daily life. Very often it shows itself physically first: as back pain, headache, stomach trouble or exhaustion — which is why it is often recognised late. The laboratory does not make the diagnosis but serves to rule out: an underactive thyroid, iron and B12 deficiency and vitamin D can produce a very similar picture and are correctable. Psychotherapy and medication work, singly and combined; in milder forms regular exercise demonstrably contributes. Worth knowing: under treatment the drive often returns before the mood — the time in between is the most delicate.
For severe depression that has not responded to several treatments over years, there is a method using an electrode on the vagus nerve. It is not an early step and no alternative to therapy and medicines, but a possibility once the long road has been exhausted.
Morning light and regular sleep stabilise mood.
Psychotherapy and, if needed, medication work – not a sign of weakness.
Psychotherapy works, medication works, together often best. The hardest step is the first — and it is one of the things others are allowed to take on.
Getting up, getting dressed, a walk outside, one arrangement a week. In depression the wanting does not come before the doing but after it — that is the core of behavioural activation.
Antidepressants need two to six weeks and then often act on drive first. After recovery they are continued for at least six months — and never stopped abruptly.
Advice and cheering up increase the pressure. What helps: listening, taking concrete tasks away, coming along to appointments, and staying, even when nothing comes back.
Antidepressants change how long messengers stay in the gap between nerve cells. The effect sets in after two to six weeks, because only then does receptor sensitivity adjust. They do not make you happy, they raise the floor — psychotherapy works alongside and by a different route.
About one person in five goes through a depression in their lifetime. An untreated episode lasts six to eight months on average; with treatment considerably less. Several years pass on average before the first help.
The loss of joy and interest is the most characteristic sign — even more than the sadness. Things that used to feel good leave you cold.
Lying awake from three or four in the morning, the hardest part of the day in the morning, easier towards evening. This pattern speaks particularly for depression.
Back, head, stomach, exhaustion without a finding. In men and older people this is often the only way it appears.
Concentration, memory, simple decisions. In older people this can look like the start of dementia and recedes with treatment.
Such thoughts belong to the illness and are a reason not to wait but to get help today — from the family doctor, an emergency practice or a crisis service. Talking about it does not make it worse, it makes it lighter.
An underactive thyroid, iron or B12 deficiency, sleep apnoea, some medicines, and grief after a loss. Grief comes in waves and allows joy in between — depression does not.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
In pregnancy clearly established against neural-tube defects, otherwise mainly with deficiency. Can mask a B12 deficiency — watch both.
In the SMILES trial switching to a Mediterranean pattern over 12 weeks improved symptoms markedly more than support alone. It does not replace treatment, it comes on top.
All three can cause a lack of drive that feels like depression. Measure before supplementing — a deficiency is treatable, a normal value needs nothing.
Alcohol brings sleep on faster and disturbs the second half of the night. Over weeks that measurably worsens mood — a circle easily overlooked.
Studied in mild to moderate forms. Important: it speeds up the breakdown of many medicines, including the pill.
Regular movement is among the best-documented non-drug measures there are.
A deficiency is common and is measured before supplementing — the value says more than the guess.
Studied in mild to moderate forms — and the plant with the most medicine interactions there are.
Studied in small trials on mood, with favourable but short effects. With moderate and severe depression no scent replaces a treatment — and St John’s wort has far better data here.
Traditionally used for restlessness and grief. The scent works through memory and breathing — both are real and neither treats the cause.
Low mood with irritability and tension is assigned to “Liver Qi stagnation” — the image of something that does not flow. A description, not a cause.
On the crown, assigned to lifting. In studies of acupuncture for depression the effects are small and the comparison groups difficult.