Lesson 1 Mood Disorders

The most common mental health disorder is depression.

Almost every 6th woman is affected (men 15%).

  • The treatment of depression is effective.
  • If not treated 10-15% of people suffering from major depression  end their lives.

Depression includes psychological and physical symptoms. Various degrees of severity, courses and clinical pictures are distinguished in the diagnosis, each of which requires special treatment. This is why an accurate diagnosis is so important.

Degree of severityMild depressive disorder
Moderate depressive disorder
Major depressive disorder
Forms of depressive disorderTypical depression / major depression
Bipolar disorder / manic depressive disorder
Reactive depression

The severity of depression depends on the number of different individual depressive symptoms that patients are diagnosed with. Another decisive factor in the diagnosis is whether the patient can still participate in everyday life and whether they are able to interact with others in their depressive thinking. 

Mild depressive disorder

  • Affected people already suffer from symptoms and have difficulties to continue their work and social activities in the usual way, but are still able to maintain their usual home, family and work routine.

Moderate depressive disorder

  • Here the above is only possible with significant difficulties.

Major depressive disorder

  • Affected persons are completely unable to continue their activities. There is often a high risk of suicide. Those affected suffer greatly from the physical symptoms of depression. A reduction in self-esteem and inhibition of drive or even drivability and inner tension are almost always present.

Symptoms of Depression

Depressive symptoms in medical terms (According to ICD 10 p. 68)

  • depressed mood
  • lack of interest/joy
  • drive dysfunction, energy loss
  • lack of concentration 
  • decrease in self-esteem
  • feeling of guilt
  • inhibition/restlessness
  • self-harm
  • sleep disturbance
  • decrease in appetite
  • somatic syndromes
  • lack of emotional involvement
  • early awakening, morning low
  • psychomotor inhibition or agitation
  • weight loss
  • loss of libido

According to diagnose criteria depressing episodes are characterized if the patient report the symptomes for at least more than 2 weeks.

  • Mild depression: patients need to report 2/3 core symptomes + 2 addinional symptomes
  • Moderade depression is diagnosed by 2/3 main symptomes + 4 additional symptomes
  • Major depression includes 3/3 core symptomes + 3 additional symptomes

1. Depressive experience

  • „I can do nothing, I am nothing“
  • „I can´t breath, I am afraid!“
  • „Nothing can make me happy“
  • „I feel nothing“
  • „every movement is too hard“

2, Depressive thinking

  • „It´s my fault, I am worthless, I lose everything I have“
  • „I am stupid“
  • „I can´t decide“
  • „all is meaningless, why don´t i die?“

3. Physical symptoms

  • „I can´t eat anymore“
  • „If only i could sleep“
  • „I can no longer“

If you find yourself in this don´t hesitate to get professional help! Untreated Depression can lead to suicide.
Check also Chapter 5, Lesson4: Risk Assessment.

An additional search criterion for the classification of depressive disorders is their past and (probable) future course.

A distinction is made between:

  • single episodes of depressive disorders
  • recurrent episodes of depression
  • depressive states which may also be present in varying intensity over longer periods of a life history, and which have almost become deeply interwoven with the personality of the person concerned
Major depressionClassic type of severe depression. We speak of severe depression when the depressive symptoms last for a longer period of time (at least 2 weeks). Often, patients are no longer able to keep up with everyday life. A phasic course is possible, which means that depressive phases can occur again and again, but there are also phases without symptoms in between.
Bipolar disorderIn bipolar disorder, or manic depressive illness, the person affected goes through both phases, i.e. manic or depressive states. The affected person experiences manic phases as a high and not as suffering. Nevertheless, it is mainly relatives who are affected: When people are manic, they lose control of their actions and, above all, the ability to see the consequences of their actions. Wrong decisions and dangerous situations are frequent, and financial risks are also taken with negative consequences.
CyclothymiaOne speaks of a cyclothyme disorder when patients complain of mood swings without a comprehensible connection to corresponding life events. These mood changes are comparable to the poles of a bipolar disorder, but neither in high mood nor in depressive outburst with a mania or major depressive episode to be equated. Often patients with cyclothyme disorder remain undiagnosed and or untreated, because they do not suffer so severely.
DysthymiaDysthymia means a pathological tendency to sad moods. It is not as severe as a depressive episode, but it lasts longer. According to the diagnosis, it lasts at least 2 years.
Reactive depressionAn adjustment disorder or reactive depression develops as a direct response to a stressful life event. The triggering situation is experienced as a loss, separation or insult. This depression can be over after a few weeks, but longer courses and transitions into other forms of depression are also possible.


Positive activites, or activities that you used to like in the past, can help you to motivate yourself and get more active again. For a list of positive activities, you will find a large selection online, where you can choose suitable activities for you and get inspired to try new things.

A daily schedule will help you to structure and manage your daily life again and gives you motivation, in case you are in a depressive mood.

  • First enter the activities that are scheduled (breakfast, start of work, lunch/meal, end of work and dinner).
  • Fill the daily schedule with as many enjoyable activities as possible (make a list of enjoyable activities in advance).
  • If the day contains many unpleasant tasks, plan a pleasant activity as a reward after each of these tasks has been completed.
  • Plan times of resting and enough breaks.
  • Plan your day in such a way that it does not overwhelm you. It is important to specify the individual tasks. (for example, don’t write “phone call” but “phone call with mom”, or instead of watching TV on sunday: crime movie, 20:15.