Has anyone gone through ECT because of depression

What is Depression?

Symptoms and Diagnosis

All people go through phases of good and bad mood. Often there are reasons for a bad mood, e.g. through drastic life events such as the loss of work, grief or through conflicts with other people. You will usually recover from such low moods in the foreseeable future. However, if the bad mood manifests itself over days and weeks and increasingly begins to influence daily activities, social relationships or performance at work or leisure, depression could develop.

Depression is an illness that affects people on a physical and psychological level and thus in all of their thinking and experience. The ability to work, family and social relationships and contacts are impaired. The behavior of those affected changes.

What are the signs of depression?

The World Health Organization WHO has compiled criteria on the basis of which depression can be determined (diagnosed). For that you need the depressive symptoms for at least two Weeks to be predominant.

The three main symptoms are:

  • Depressed mood: I suffer from a depressed, depressed mood most of the day and almost every day of the week. My mood is not influenced by any particular circumstances or events.
  • Loss of interest and joylessness: Activities that I used to enjoy doing no longer give me pleasure or interest me.
  • Lack of drive and increased fatigue: I tire much more easily than usual and / or my energy and my drive are significantly reduced.

Other symptoms:

  • Reduced concentration and attention: I have trouble concentrating, or having trouble making decisions, or feeling unsure how to act.
  • Decreased self-esteem and self-confidence: My usual self-confidence /
    Self-esteem is gone.
  • Feelings of guilt and worthlessness: I blame myself or have feelings of guilt that are exaggerated and unfounded.
  • Negative and pessimistic future prospects: I feel tense inside and behave restless and driven. I also feel the opposite of that: I am physically slowed down and see the future black.
  • Thoughts of suicide, suicidal acts took place: I am preoccupied with thoughts of death or suicide.
  • Sleep disorders: I can no longer fall asleep or wake up at night and lie awake for a long time or wake up early in the morning. I don't feel rested in the morning. Often the morning is the worst time of the day.
  • Loss of appetite and weight loss: I have no appetite and no desire to eat - it no longer tastes like it used to.
  • Loss of libido: I have largely lost interest in sexuality.
  • Inner restlessness or lack of drive: I feel driven, restless, and am
    nervous - or the opposite of it: without drive and as if paralyzed.

The more symptoms prevail and the more pronounced they are, the more severe the depression is assessed.
The composition and severity of symptoms can vary widely from person to person. The treatment must also be adjusted accordingly.

How common is depression?

Depressive illnesses are one of the most common mental illnesses. In one year approximately 7% of the population suffers from a depressive disorder.

The lifetime prevalence of depression is approximately 17%. This means that 17% of the population will experience a depressive disorder at least once in their lifetime. Women are affected more often with around 20% lifetime prevalence than men with around 13%.

The WHO estimates that in 2030, depression will be the disease with the greatest total burden, ahead of cardiovascular diseases.

How long does depression last?

Depression usually occurs in episodes, followed by depression-free periods with partial or complete freedom from symptoms. A depressive episode lasts on average between six months and a year for mood to spontaneously normalize. As a consequence, antidepressant treatment should last for up to a year, even after symptoms have improved well.

Most people experience multiple depressive episodes, which can occur at different intervals. The more depressive episodes someone has already experienced, the greater the risk of experiencing another episode. Despite this episodic course, depression is referred to as a chronic illness.

Manifestations

The type and severity of symptoms of depression can vary widely from person to person. There are forms of depression in which physical complaints are in the foreground (masked depression or masked depression) such as headaches, back and neck problems, abdominal pain, digestive disorders and even heart problems. Often the person concerned is searched for physical causes for a long time and unsuccessfully, until the suspicion of an associated depression is raised.

Another sub-form, melancholic depression, is characterized by a pronounced morning low, weight loss, joylessness, loss of libido and interest.

For some people, depression can show up very differently. Instead of feeling depressed or sad, they react with irritation, aggressiveness, anger or increased alcohol consumption. Under certain circumstances, you may do too much sport. Those affected feel stressed and burned out. Men are more likely to suffer from this type of symptom (see also “Male depression”).

Unipolar and bipolar courses

If only depressive episodes occur, one speaks of a unipolar depression. However, some patients experience not only depressive but also intermediate manic episodes or episodes in which both manic and depressive symptoms occur (mixed episodes). Manic episodes are characterized by an irrepressible thirst for action, a lofty mood, a lack of need for sleep, great ideas that often lead to a shopping spree or the start of over-ambitious business projects. In these cases one speaks of a bipolar affective disorder or bipolar depression.

Seasonal depression (winter depression)

Dark and foggy winter days can make your mood worse. In some people, this can lead to what is known as seasonal or winter depression. In addition to the depressed mood, the symptoms of "winter depression" are often atypical with a greater need for sleep, hunger for carbohydrates and weight gain. The cause is the seasonal decrease in the amount of light through the eye and possibly a shift in the circadian rhythm (various body functions such as temperature, heartbeat, mental alertness and others are subject to a daily rhythm that is controlled by daylight, among other things). Winter depression is more common in northern areas with shorter winter days than in southern countries. Light therapy with powerful lamps is a common treatment for winter depression.

Postpartum depression and baby blues

Depressive episodes after delivery (= postpartum depression) occur in around
10–15% of women and usually begin in the first or second week after giving birth. Often the course is gradual over weeks to months. The clinical picture cannot be distinguished from a typical depressive episode. The postpartum phase is characterized by pronounced and rapid hormonal changes. During the first 48 hours after delivery, there is a marked decrease in the hormones progesterone, estrogen, cortisol and thyroxine. However, it is still unclear why these hormonal changes lead to the disease in some women.

Of the postpartum depression are the much more common so-called "crying days"
(also called “Baby Blues”). They begin in the first week after delivery, but usually not before the third day and last only a few hours to days. They occur in around 50% of women who have recently given birth.

Dysthymia

Dysthymia is a chronic form of depression with the same symptoms as a depressive episode. The symptoms are less pronounced, however, they last a very long time. If this creeping depressive state lasts for more than two years, it is called dysthymia.

Male depression

Behind a male depression lies nothing other than a “normal depression” that simply expresses itself differently - just “male-aggressive” not “female-sad”. Such symptoms, which tend to occur in men, can be irritability, aggressiveness, increased risk behavior and addictive behavior such as increased alcohol consumption, excessive and dangerous sport or risky behavior in road traffic. Social withdrawal and a lack of use of help facilities or a failure to seek medical help are also more common among men.

Depression in old age

People who are diagnosed with age over 65 are generally referred to as “age depression”, although the great differences in the aging process from person to person would not justify such an age limit. Overall, depressive illnesses do not occur more frequently in old age. There is even increasing evidence that they occur somewhat less frequently between the ages of 65 and 75 years. It should be noted, however, that in elderly patients, depression is overlooked and can therefore often not be treated for a long time. Older patients tend to withhold depressive symptoms and complain more about physical illnesses. Unexplained pain can often reflect underlying depression. Depression of old age can also arise or be favored by malnutrition and malnutrition or by insufficient fluid intake. Radical life events, the loss of relatives or friends, serious illnesses or financial problems gain importance as the risks of depression in old age.

Especially with older people, an active lifestyle with regular physical activity, balanced food, enough fluids and a good social network is a protection against depressive disorders. Inadequately treated and permanent cognitive disorders are a risk factor for the later occurrence of dementia, especially in advanced age - therefore their therapy is particularly important. Cognitive disorders in the context of old age depression are often not easy for the doctor to distinguish from the onset of dementia.

Depression in children and adolescents

Depressive disorders are also widespread among children and adolescents. Depression affects between three and ten percent of adolescents between the ages of 12 and 17. In addition, various anxiety disorders such as social anxiety or obsessive-compulsive disorder often start in adolescence. If these anxiety disorders are not adequately treated, the risk of developing depression as a result increases. In children under 12 years of age, the frequency of depressive disorders is between 0.3 and 2.5%. As in all age groups, but especially in childhood and adolescence, depression is often not recognized in time and therefore not treated.

Is Burnout Depression?

Burnout syndrome was first described in the 1970s as a state of mental exhaustion in people who are chronically under heavy occupational stress. The symptoms are emotional exhaustion, depersonalization (indifference to cynical behavior) and reduced performance. The focus was on highly committed people in professions with many social contacts such as nurses, doctors, teachers, etc. Burnout is now a widely known and discussed phenomenon that is on everyone's lips in the increasingly stressful and short-lived professional world. It is not an actual medical diagnosis, but should be understood as an occupational stress concept. Burnout syndrome can develop into severe exhaustion depression.

Often there are diffuse physical complaints such as increased sweating, dizziness, headaches, gastrointestinal problems and muscle pain, and very often sleep problems. Rising expectations of employees, increasing pressure in the workplace and a lack of recognition have all led to an increase in burnout. The changed working conditions in the age of globalization, such as constant availability via e-mail, cell phone or smartphone, place new demands on mental health and the correct handling of workloads.