DEPRESSION BY CORONA The new risk factor

DEPRESSION BY CORONA The new risk factor

Depression is already the most common mental illness - and now the stresses of the pandemic are being added to the mix. What exactly does that mean?
Is the depression epidemic coming after the virus?
Corona stresses us all. Many are afraid for their health, are annoyed by the restrictions of everyday life, work in jobs that are now particularly demanding, or are worried about their professional future. "Quite a few have depressive symptoms because of this, but just not automatically a depressive illness," says Dr. Ulrich Hegerl, professor at the University of Frankfurt and chairman of the board of the Stiftung Deutsche Depressionshilfe.

The fact that the two are still mixed up is probably one of the reasons that depression is still underestimated. "Many people think 'I'm in a bad mood right now, too,' but don't know how serious the illness is," Hegerl said. Depression is the main cause of suicides and is always accompanied by a high level of suffering. And it is an illness in its own right, not merely a reaction to severe life circumstances.

"The decisive factor is whether there is a predisposition. Those who have it slip into depression, even if their life circumstances are wonderful. Conversely, people without this depressive tendency get through the greatest bitterness without falling ill," says Hegerl. "So external factors play a much smaller role than most think." Current stresses are more likely to be a trigger for a depressive illness phase if one already has a predisposition to it. The psychiatrist, therefore, does not assume that we are facing a wave of new depressive illnesses.

What about people who already have depression?
For them, the consequences of the pandemic can be dramatic. The virus itself is not the problem. Depressives are no more concerned about the risk of infection than healthy people, but they suffer far more from the Corona measures. This is shown by the "Deutschland-Barometer Depression," a representative survey of more than 5,000 people conducted regularly by the German Depression Aid Foundation with the support of the German Railway Foundation: People with depression experienced the lockdown as significantly more stressful.

The lack of daily structure was a problem for 75 percent; in the general population, this was only true for a good third. "Almost every* second sufferer stayed in bed completely more often during the day," says Hegerl. "And although people with depression are exhausted, it is counterproductive for them to lie down a lot and for a long time." Not only because the danger then increases of sinking further and further into musings: "More sleep tends to have a worsening effect on the majority of those affected. In the clinic, sleep deprivation is even a treatment for depression."

Also negative: the lack of physical activity. Four out of five depressives said they exercised less, almost twice as many as in the healthy population. "Yet exercise is, after all, something that is supportive in depression," Hegerl said. While the survey refers to the first lockdown last spring, the expert suspects the second one had similar effects.

What about supplies during the pandemic?
"Here lies the most important cause for concern, because care has unfortunately deteriorated significantly for more than half of those suffering from depression," says Ulrich Hegerl. Outpatient treatment appointments have been canceled or not attended for fear of infection, planned hospital stays have been canceled, and even group offerings such as self-help groups have not taken place or have been limited.

Even when infection rates were low for a long time over the summer, a third of those affected still reported poorer medical care. "That's a disaster, of course, with this serious disease," Hegerl says. "Extrapolated to the total population, this means that more than two million people received worse care - with all the expected negative consequences. Worsening of symptoms, more relapses, more suicide attempts."

The expert criticizes that health side effects of infection control are not sufficiently considered: "The measures against Corona are supposed to prevent suffering and death, but they also cause suffering and death in other places. Where the right balance lies here needs to be discussed much more intensively. Narrowing the view only to the infectious event would be irresponsible."

What is the importance of online therapies?
Their importance has definitely increased in the last year. Even if they are not accessible to many sufferers, such as the elderly, due to a lack of technical requirements. According to the "Depression Barometer," 14 percent of patients with acute depression have used telephone or video consultations. The vast majority rate this positively. "If you have a diagnosis and also already have a relationship of trust with the doctor or psychotherapist, a lot can actually be absorbed in this way," says Ulrich Hegerl.

Digital therapy services have also been used more since then. "The programs work well, however, especially when there is professional support." In the meantime, there are programs such as "ifightdepression," for example, to which one not only gains access via the*treater, but is also supported in the implementation. The expert warns, "The message 'If you have depression, go online and treat yourself' is fatal."

Where to find help?
The right people to contact are specialists in psychiatry, psychological psychotherapists or the family doctor. In fact, the latter treat the majority of patients who are not in clinics. For Ulrich Hegerl, the most important thing is to communicate to those affected: "People with depression are entitled to good medical care, even in corona times. They don't have to take a back seat, but should seek professional help, as always."

What can and should relatives do?
First of all, get informed. After all, those who understand the disease can also better categorize the behavior of the person affected. "Otherwise, you may experience it as letting yourself go or as unkindness or even develop feelings of guilt," says Ulrich Hegerl. "It is also important to understand that as a relative, you are not responsible for the treatment. Or simply put, you can't cure depression with love, any more than you can cure diabetes."

Nevertheless, some things can be done to support those affected. Many lack the energy and hope to care for and persevere through treatment. "That's where relatives definitely have an important role and can make appointments, accompany and motivate the depressed person," says Hegerl. Partners, circle of friends and family are also helpful in everyday life when it comes to maintaining a daily structure. "A weekly schedule, which of course contains duties, but also just consciously something nice that you've perhaps always wanted to do, can also be set up together." And last but not least, this focus on the positive has also been proven to help people who are simply "in a bad mood" at the moment.


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