According to the chairman of the German Depression Aid Foundation, depression is easier to treat than is often believed. The majority of those affected consider psychotherapy and medication to be very or rather helpful options, said Ulrich Hegerl on Tuesday at the presentation of the new Germany Depression Barometer with survey results on attitudes and the treatment situation. Opinions about antidepressants are worse in the general population than among those affected, said Hegerl, looking at the results.
It takes an average of 20 months for people with depression to seek professional help. For the survey, annual attitudes and experiences of depression in the adult population were examined with a focus on the respective treatment situation. In September 2022, a representative cross-section of the population consisting of 5,050 people aged between 18 and 69 was surveyed.
“Depression is a serious, often life-threatening illness,” explains Hegerl, who is chairman of the German Depression Aid and Suicide Prevention Foundation. It is worrying that a large proportion of those affected need months or even years to seek help. “The reasons for this are the hopelessness and lack of drive typical of depression, but also supply bottlenecks and the still existing stigmatization of mental illnesses,” Hegerl continues.
Across all those affected surveyed, it took an average of 20 months for people with depression to seek help. There are big differences: A third of all those affected seek help immediately. In contrast, 65 percent took longer before they sought professional support – an average of 30 months.
When those affected seek help, the majority of them first turn to their general practitioner (51 percent). Every fourth patient (25 percent) goes directly to a specialist and 19 percent to a psychotherapist first. Naturopaths give only 0.7 percent of those surveyed with depression as a point of contact. In the survey, however, those affected reported in retrospect that they had to wait weeks before treatment could even begin.
Those affected stated that they had waited an average of ten weeks for an initial consultation with a psychotherapist, and for specialists it was an average of eight weeks. According to their own memories, those affected had to contact an average of five therapists before they were given an appointment. “With such a painful illness as depression, which is also associated with a high risk of suicide, such long waiting times are unacceptable,” says Hegerl.
According to Depression Aid, there is usually no single cause for the development of the disease. According to Hegerl, the predisposition plays a major role, but the genes alone do not explain it. Factors such as early trauma experiences also influenced the risk. The processes in the brain are not yet fully understood.
According to the National Health Care Guideline, medication or psychotherapy are the two most important treatment pillars for depression. Of those surveyed who are currently ill, 62 percent received medication such as psychotropic drugs and 48 percent received psychotherapy.
Around a third (35 percent) receive a combination of both. Those affected experience both as effective: 85 percent of the depression patients surveyed feel that psychotherapy is helpful or rather helpful, and 80 percent of medication.
As advice for those affected, the German Depression Aid and Suicide Prevention Foundation pointed out other strategies that could help those affected acutely, but are still not used enough. Online offers for self-help groups are currently visited by eight percent of those affected. Digital health services are also only used by seven percent of people suffering from depression, while a quarter had not heard of digital health applications (DiGA). These include health apps that can help record symptoms on a daily basis, but also meditation and mindfulness apps.
In addition, many of those surveyed struggled with bureaucratic hurdles: more than two-thirds of the people surveyed felt that the many alternative treatment options were a “jungle” in which it was difficult to get an overview. The choice of alternative medicine is also rarely used by depression patients (nine percent), who spend an average of 227 euros a year on non-evidence-based procedures such as homeopathy, healing stones or colon cleansing.
The main reason given was wanting to contribute something to the treatment (57 percent), but long waiting times for a place in psychotherapy or doubts about conventional medicine also play a role (19 percent each). Overall, it is important to those surveyed that there is scientific proof of effectiveness (evidence) for the chosen treatment path. 78 percent of those surveyed with depression stated that scientific evidence of effectiveness was important to them when choosing treatment.
“There’s a big market for procedures that make big promises of recovery and cost a lot of money. I can only recommend patients to inform themselves in the national care guidelines for depression. All methods that have sufficient scientific evidence of effectiveness are listed there. In most cases, treatment with these procedures is covered by health insurance,” says Ulrich Hegerl.
Depression is a common mental illness that affects around one fifth of all people – at least once in their lives. The chances of recovery are usually good and the better the earlier treatment begins. For many of those affected, going to the doctor is a major hurdle, but the first step in overcoming the disease.
The main symptoms of depression, according to experts, are depressed mood and/or loss of interest and joy for more than two weeks – plus secondary criteria such as sleep disturbances, exhaustion and suicidal thoughts. Susceptibility to depression is, among other things, hereditary. It is often stressful experiences that trigger the illness, such as the death of a loved one, lovesickness, failure at school or at work, excessive demands or burnout.
Preventing depression is difficult. It is also difficult to self-diagnose whether it is a temporary “depressed mood” or whether it is depression that requires treatment. The number of suicides in Germany has decreased significantly since the early 1980s.
Do you feel depressed or suicidal?
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