In psychiatric terms, depression is an illness that is classified into certain subtypes based on criteria, such as depressive episode, dysthymia, etc., depending on the number, type and severity, and duration of symptoms. Since the International Classification of Mental Disorders ICD-10 version chapter F, a distinction is no longer made between endogenous (disease) and exogenous (triggered by problems) depression. The cause is always seen as an interaction of genetic disposition and environmental stress. Depression is certainly the most common psychiatric disorder and also the disorder with the most impact on disruption of social function and quality of life. Treatment of depression has improved significantly in the decades since the first antidepressant was developed. On the other hand, new chronic forms of depression have either emerged or have been recognized for the first time with so-called comorbidity, i.e., additional diagnoses such as anxiety, trauma, compulsion, pain, physical mood disorder.
Considered as a social phenomenon, depression has a meaning that goes far beyond the diagnosis of an illness. It is a kind of access key to achieve something: it brings affection, help in partnership, job, finances and physical illness. It is often the only currency at the end of a long descent that can finally recruit help via therapies, rehab, hospital, social services. It is also a permanent red alert when someone feels offended, insulted, humiliated and wants redress from the environment or society and its institutions.
Here, depressed patients speculate without being sufficiently aware of the risks. They often surrender to the disease for too long before fighting back. And sometimes long-lasting consequences for health have already arisen and a lot of social china has been broken. It is getting harder and harder to expand the radius of activity again. The disease of depression and social problems complement and complicate each other at every stage of the disease. Without improvement of social circumstances, psychopharmacological therapy is often ineffective; without psychopharmacological therapy, the ability to cope with problems does not improve.
Loneliness is often a consequence of depression, often it is also at the beginning. The structures of the big city allow anonymity as a retreat when one is “in a bad mood” and as a predicament when one is unable to mobilize contacts. It’s easier to spend hours on the phone with a girlfriend hundreds of miles away than to ring the neighbor’s doorbell. In the final state, therapists and artificial entities such as recreational clubs, patient day care centers must replace the social environment like a simulation. The gravity of life pulls down if you don’t constantly fight it, so the hard landing on the ground is inevitable.