Forms of depression

Depression can have many causes, but it can also have no apparent cause; it can manifest itself in many different symptoms and sometimes even be hidden behind busyness and actionism. 

Depression is a mental disorder that usually manifests itself in the form of markedly depressed mood, lack of interest, and decreased drive. In addition, physical complaints often occur, and more rarely they are associated with delusional ideation.

Depression can develop as an "overreaction" to triggers that are actually present (exogenous, reactive depression).

A special form of depression is winter depression winter depression or seasonal affective disorder (SAD), which affects about 800,000 Germans every year. It is triggered by a lack of daylight during the "dreary season". It differs from seasonally independent depression, which is usually present all year round, in that it is characterized by severe fatigue / prolonged sleeping (year-round depressives tend to lie awake and brood) and by ravenous appetite for carbohydrates (year-round depressives tend to lack appetite) and associated weight gain (arising from the body's formerly vital need to build up a fat cushion for the barren season). Again, melancholy and fatigue are normal to a certain extent as relics of prehistoric times, when winter was a period of reduced activity for humans - comparable to a quasi-hibernation. 

In rare cases drugs can also trigger depressive symptoms; these include antihypertensives (ACE inhibitors, beta blockers), glucocorticoids ("cortisone"), thyroid hormones, hormonal contraceptives such as "the pill," opiates2

Not only hormones taken as drugs can have a significant impact on mood;"natural" changes in hormone levels can also cause depressive feelings, even full-blown depression. In this context, Hyperthyroidism and hypothyroidism (hyperthyroidism and hypothyroidism) should be mentioned, as well as menopause mainly in women, but men are not immune to it either; or postpartum depressionwhich differs in its manifestation from the so-called crying days or baby blues shortly after delivery, just as the winter blues differs from winter depression.4 Both postpartum and winter depression are severe mental illnesses that require medical, drug, and, if possible, psychotherapeutic treatment. 

In addition, there are severe depressive moods that arise without a recognizable trigger, "out of themselves", so to speak. This is known as endogenous depression.2

Physical symptoms such as headache or backache, fatigue, dizziness and sleep disturbances are frequent side effects of depression; unclear gastrointestinal complaints with loss of appetite can also accompany all forms of depression.

Sometimes, however, these physical symptoms are even in the foreground as the main complaint, so that the underlying depressed mood hardly appears at all. This is known as a larvated (masked, hidden) depression with somatization (i.e. with a shift of the mental complaints to the physical = somatic level). This form of depression is often found in older people.2

In most cases, depressive moodiness or depression Antriebslosigkeit is accompanied by a lack of drive. However, a depressive mood can also be hidden behind increased nervousness and irritability, overactivity, work or sports addiction, which is then referred to as agitated  depression.3 This can lead to a state of permanent overstrain and exhaustion; the transition to burn-out (being burned out) is fluid.

In rare cases, depressions are accompanied by obsessive thoughts such as persecutory delusions or even delusions (hallucinations). This form is then called psychotic depression.4 Here, too, one finds fluid transitions, because this form of depression can also occur as a concomitant of schizophrenia, in which the psychotic perception of non-real events is a characteristic of the illness.


Depression is one of the most common and underestimated illnesses in terms of its severity. About one in four women and one in eight men is affected by affected by depression in the course of their lives. Women are therefore two to two to three times as often as men.1