Dossier: Strong mind

The many faces of depression

Cases of depression are on the rise. Various studies show that cases skyrocketed during the coronavirus lockdown. but feeling sad or low doesn’t automatically equate to depression.

Text: Robert Wildi; photo: Unsplash

Clinical depression involves more than just periods of sadness, low spirits and listlessness. Zurich-based psychoanalyst Martin Brezina explains the difference: “A runny nose is one symptom of the flu, but it doesn’t mean you’ve got it. You need to have several symptoms at the same time before you can be diagnosed with the flu.” The same applies to depression.

Symptoms of depression

Symptoms  may include lack of energy and interest, but also listlessness, inner restlessness , tension, joylessness and fatigue. ​ Problems concentrating, forgetfulness, loss of self-confidence, feelings of guilt, sleep disorders, changes in appetite and suicidal thoughts can occur – and in a wide range of combinations. Depression also manifests itself externally in very individual ways: some people withdraw, others seem restless and become loud and quarrelsome. Some cry frequently, while others seem frozen and emotionless. “Symptoms of depression vary. It is not always easy to recognise,” says Brezina.

Depending on the frequency and severity of the symptoms, experts differentiate between mild, moderate and severe depression.

Depression triggers

Brezina explains that depression is “usually triggered by longer phases of overwork and excessive demands, family problems, stressful relationships, sustained stress at work, disappointment, loss, crises or bullying.” Depression has nothing to do with laziness or a bad attitude. In fact, people suffering from depression are “often very committed, conscientious and looking for solutions”. As their stress levels increase, their constant search for solutions mean they can no longer “switch off”, and their “body tries to protect itself by shutting down.” 

“Depression totally changes the personality of the person affected”, says Brezina. People with depression suffer, but it also takes a toll on their friends, family and children. Shame and a guilty conscience can exacerbate the problem.

What can help with depression?

Family doctors often prescribe medication for depression. If this doesn’t work, patients can be referred for psychiatric or psychological treatment designed to help them make crucial changes. “This takes time”, says Martin Brezina, “not only because treating depression is complicated, but above all because one of the most common features of the history of the illness is that sufferers do not allow themselves space and time to deal with it.”

However, once depression has been diagnosed, this is exactly what patients need – and the right experts  for help and support. Rapid assistance and psychological as well as physical relief are  key. Well-meant advice to “pull yourself together” is contra-productive. What is needed now is a lot of patience and goodwill from everyone involved. But Brezina also has encouragement for anyone suffering from depression: “Depression is usually only temporary. It only becomes chronic in vary rare cases.”