What is an irritable mood

depression

Causes & Symptoms

International classification system of the ICD-10

In the globally recognized WHO diagnostic system ICD-10, depressive disorders are differentiated on the basis of severity, duration, course and frequency of symptoms:
  • Depressive, first-time episodes in which a minimum number of characteristic symptoms have been present almost continuously for at least two weeks
  • Recurrent depressive disorder in which a repeated episode of depression has occurred
  • dysthymic disorders in which fewer and less severe symptoms of depression are present over a period of more than two years
  • Adjustment disorders, in which depressive symptoms appear after a crucial life change, but which are not as long-lasting as in depressive episodes or dysthymic disorders
  • Bipolar disorders, in which, in addition to depressive moods, episodes with so-called manic or hypomanic episodes can be delimited. These are characterized by an abnormally elated, euphoric or irritable mood, which among other things. go hand in hand with increased drive, increased activity, increased spending, increased self-confidence and decreased need for sleep.

Causes: how does depression develop?

Depressive disorders can have different causes. This includes drastic changes in living conditions and strokes of fate, such as the death of a loved one or a serious illness. Long-term stress, such as conflicts in partnership and family or chronic tension in the workplace, can also trigger a depressive episode. Postnatal depression after the birth of a child is a special case. Sometimes there are also no directly recognizable external reasons. Possible causes are then:
  • Biological causes
    Certain genetic traits increase the risk of reacting to external influences with depression.
  • Changes in the systems of messenger substances and hormones
    Regardless of the trigger, changes in the complex neurotransmitter systems of the brain are found in all forms of depression. Changes in the regulating system of the hormones of the hypothalamus, pituitary gland (pituitary gland) and adrenal gland were also detected.
  • psyche
    Distorted, one-sided negative thought patterns can contribute to depression.
  • social environment
    Relationships with other people, early or current loss experiences, family and social factors such as loneliness also play an important role.
  • Physical illness
    In old age, physical impairments in particular increase the likelihood of developing depression. Conversely, depression in old age is also a risk factor for physical impairment.

Signs of depression in old age

  • Emotional level:
    Depression, helplessness, hopelessness, abandonment, loneliness, inner emptiness, dissatisfaction, fear and worry, feelings of guilt, numbness and distance from the environment
  • Behavioral level:
    Posture (powerless, bent over, tension-free), slowing of movements, nervousness, (fidgety) restlessness, facial expression (sad, tearful, worried, drawn down corners of the mouth, frozen like a mask, nervous, alternately tense facial expressions), language (quiet, monotonous, slow), general reduction in activity, problems in coping with everyday life, withdrawal and avoidance behavior
  • Physical level:
    inner restlessness, excitement, tension, irritability, crying, fatigue, weakness, sleep disorders, loss of appetite, headache, stomach and digestive problems, memory problems
  • Thought level:
    negative attitudes towards oneself, towards others and towards the future, pessimism, self-criticism, self-insecurity, hypochondria, laborious thinking, concentration problems, brooding, suicidal thoughts
  • Motivational level:
    failure-oriented, loss of interest, listlessness, inability to make decisions, feeling overwhelmed, experiencing non-control

Symptoms: What are the signs of a disease?

In addition to depression, sadness, listlessness or reduced drive, depression is associated with a number of other symptoms:
  • sleep disorders
  • Loss of appetite
  • Concentration and memory disorders
  • decreased self-esteem
  • Feelings of guilt
  • fears
  • inner unrest
  • frequent brooding
  • Fatigue
  • exhaustion
  • hopelessness
  • Suicidal ideation
Physical complaints can also occur, sometimes these are even in the foreground. If the symptoms persist almost continuously for more than two weeks and lead to significant impairment in everyday life, you should urgently seek treatment.

Diagnosis

Diagnosis: This is how we diagnose depression

The symptoms above can be an indication that you have depression. But only an experienced doctor or therapist can make a diagnosis after a detailed discussion with you. After a spontaneous description of your symptoms, we clarify with specific questions whether you have depression and, if so, which form. Psychological tests can complement the diagnosis. Laboratory tests or imaging tests are not suitable for assessing whether depression is present. Under certain circumstances, however, they are used to rule out organic diseases that are associated with the same or similar symptoms.

Diagnosis of depression in old age

When they retire, many people fall into a deep hole. If there are other negative experiences, it can develop into depression.
Here, too, the diagnosis is based on a detailed interview and psychological tests. However, physical and psychological symptoms are often present at the same time in old age. A clear separation is therefore hardly possible. It has been estimated that 30 to 40% of elderly patients who are treated by a general practitioner have unrecognized depression. Often these patients tend to downplay their feelings and thoughts of depression and focus on their physical symptoms. The reasons for this are educational principles (“You shouldn't cry!”) And the stigmatization of mental illnesses in the past. That is why we carry out a thorough medical evaluation with older patients.