Internal unrest, nagging self-doubt, hardly any energy: Almost two percent of the students in Germany, according to a study by the health insurance DAK a diagnosed depression. For their current children and youth report, the health insurance fund has evaluated the billing data of more than 800,000 minors for the years 2016 and 2017.
Accordingly, doctors diagnosed in about two percent of students a mostly moderate depressive episode and in as many an anxiety disorder. Extrapolated to all children and adolescents in Germany, a total of about 238,000 children between the ages of ten and 17 are so severely affected that they consult a doctor. Compared to the previous year, the frequency of depression in 2017 increased by five percent.
Since health insurance companies have different insured structures, such projections are disputed among experts. At the DAK, according to the health insurance funds, a total of around six percent of all children and adolescents aged between 0 and 17 are insured in Germany. She describes her study as "approximately representative" in terms of age and gender distribution. By contrast, the data are not representative of the socio-economic situation of families.
According to the cash register data, girls were significantly more likely to suffer from depression in the doctor than boys. The development in the sexes is therefore at the latest from the age of 14 significantly apart.
Almost one in six young patients (17 percent) was prescribed antidepressants in 2017, mostly by specialists. Up to eight percent of affected children and teens came to a clinic for depression, averaging more than one month (39 days).
"In the report, we only see the tip of the iceberg," said Thomas Fischbach, president of the Professional Association of Paediatricians. "We assume a high number of unreported cases." There are many children who suffered from depression and came to the medical practice late.
more on the subject
In the transition from the clinic to outpatient care, the DAK sees large gaps: About a quarter of the young patients come later to the hospital again. "We need an open discussion on the taboo topic of depression in children," demanded DAK chief executive Andreas Storm. "Children often suffer from silent dysfunctions before they get a proper diagnosis, and we all need to be more attentive - in the family, at school or at the sports club." The stigmatization caused by a long stay in adolescent psychiatry was an additional burden for those affected. The DAK therefore calls for better care for those affected, especially with outpatient treatment offers.
German Depression Aid estimates two affected schoolchildren per class
That depression is not just an issue for adults is well known. The psychiatrist Ulrich Hegerl, chairman of the Foundation German Depressionshilfe estimates the numbers of the cash register as realistic. Depression can be genetic as well as acquired through traumatization or abuse experiences. According to Hegerl, experts agree that the propensity for depression does not increase in Germany. Rather, there are more diagnoses, because doctors recognize the suffering better and more people than before are willing to seek help.
For Germany, there are studies, according to which around eight percent of adults between 18 and 79 years in the course of a year to suffer from a persistent depressive disorder. That's about five million people.
depressions
Illness and spread
Depression is widespread in the population. According to epidemiological studies , about 5 to 12 percent of men and 10 to 25 percent of women develop depression during their lifetime. This does not mean slight moods, but psychological problems that need to be addressed.
If this does not happen, the consequences can be dramatic: depression is one of the most common causes of disability in Germany and is blamed for much of the approximately ten thousand annual suicides.
Causes and triggers
The causes of depression are manifold and remain unknown in many patients . Mostly they can not be traced back to a specific trigger, fate blows, however, can cause a depression favorable. But there are also depressions that come from an unresolved, early childhood conflict that is carried into adulthood. Furthermore, there are people with predisposition, so a genetic risk of becoming depressed. Medications can sometimes trigger depression: it is called as a side effect in many medicines. Also, diseases such as Parkinson's, tumors, hypothyroidism and hormonal imbalances can cause depression.
symptoms
The depressed person experiences a persistently depressed and sad mood , although the symptoms in the morning are often worse than in the evening. An important symptom is sleep disorders . The patients withdraw and lose interest in social contacts and many other things in life. Often, anxiety and unfounded feelings of guilt are added, as well as the feeling of complete worthlessness.
therapy
Depression is generally considered treatable. Often a combination of modern psychotropic drugs and psychotherapy helps. In some cases, targeted sleep deprivation or light therapy is useful. After the symptoms have resolved, treatment usually has to be continued for months as there is a high risk of relapse.
What can affected people do?
To find out from depression, the most important thing is to seek help from, for example, a doctor, psychiatrist, psychologist or another point of contact.
It helps many patients to structure their daily routine , says Angelika Schlarb of the Department of Clinical Psychology and Psychotherapy of Child and Adolescence of the University of Bielefeld. "It's important to get up in the morning and engage in physical or athletic activities, and a 30-minute walk will help as well as an antidepressant."
In addition, one should look for tasks that have to be mastered and deal with the negative. Relatives should ignore negative expressions of the depressive and try to talk about possible positive events of the day.
The German Depressionshilfe Foundation offers further information about the disease on its website. To find out if you yourself are prone to depression, the foundation's first self-test can help.
With material from dpa
Signs of depression in students
Signs of depression often include depression, listlessness, inner emptiness, loss of appetite and loss of interest. Concentration disorders often lead to less efficiency. In severe episodes, sufferers withdraw heavily. Children and teenagers then hardly manage to go to school. The duration, intensity and symptoms of depression can be very different. Left untreated, severe episodes can lead to suicidal thoughts.
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For teenagers, it may be difficult for laymen to distinguish signs of depression from normal "puberty" with violent mood swings. For experts, however, it is quite possible to recognize, for example, feelings of inner fossilization, so Hegerl.
The Foundation German Depressionshilfe assumes that in preschool age one percent of children and in primary school age about two percent are affected. In the case of adolescents, the rates then rose: Between 12 and 17, between three and ten percent were affected. According to Ulrich Hegerl, untreated depressive illness in young people is associated with a high risk of not successfully ending school or education.
Children of depressive parents more at risk
The numbers in the health insurance fund show similarities that have already been proven in other studies. According to the report, the risk of depression in children and teenagers increases threefold if parents are mentally or otherwise chronically ill (read here about the effects of depression) Parents can have on children).
Your own chronic illness, obesity, diabetes, asthma and pain can increase the risk of depression in young people, according to report. For boys, the DAK assumes that depression is underdiagnosed: Like adult men, they often trivialized psychological problems.
Conversely, one's own family seems to be able to protect children against depression on the condition that this is particularly pronounced in the cash register data of academic families. It is believed that they could offer their children education, a good network and social security.
Overall, the report included respiratory diseases, infections, eye and skin problems among the most common diseases among 10- to 17-year-olds. Mental illness followed with 24 percent in fifth place. Depression was only a small part of it - the most commonly diagnosed are developmental and behavioral disorders.