So depressed and hopeless about what to do

Depression - more than just sad

Signs of depression

Certain signs suggest that you have depressive illness, rather than just temporary depression. The three main signs are:

  • depressed, depressed mood

  • Loss of interest and joylessness

  • Lack of drive and fatigue

If you have had two of these three signs for more than 2 weeks, it could be a sign of depression.

Other complaints can also occur:

  • decreased focus and attention

  • decreased self-esteem and self-confidence

  • Feelings of guilt and worthlessness

  • exaggerated fear of the future and "black eyesight"

  • Thoughts or attempts to kill yourself

  • sleep disorders

  • decreased appetite

Physical complaints can also be an expression of depression. These are, for example, gastrointestinal problems, pain, dizziness or shortness of breath. Depending on how many signs there are, experts differentiate between three degrees of severity of depression: mild, moderate and severe.

The two-question test

A simple test can provide the first signs of depression: the Two-question test.

  • In the past month, have you often felt down, sad, depressed, or hopeless?

  • In the last month, have you had significantly less desire and enjoyment in things that you normally enjoy doing?

If you answered "yes" to both questions, it is advisable to contact a doctor or psychotherapist.


A doctor or psychotherapist will ask you in detail about the symptoms. He may also ask you to fill out questionnaires. Talking openly is essential to find out if you have depression and how severe it is. Questions about further complaints and physical examinations can be added to rule out other illnesses.


Depression can usually be treated well with psychotherapy or antidepressants. Both can also be combined with each other. In addition, other methods can be considered, such as waking therapy or light therapy. Exercise and physical training complement the treatment.

Which treatment is right for you depends on the severity of the condition. Your needs and living conditions are also important:

  • Mild Depression: You can wait and see together with your doctor or therapist. If the symptoms do not improve, he should offer you psychotherapy. Antidepressants should not be used generally.

  • Moderate Depression: They should be offered either psychotherapy or treatment with antidepressants.

  • Major depression:

    Medicines and psychotherapy together are most effective here.

There are also easily accessible offers such as self-help manuals, DVDs or online programs with exercises and suggestions. These can help if you have not yet started personal therapy or if you have mild depression. Even without treatment, depression often subsides after a certain period of time. However, if the disease is left untreated, it may return and last longer.

More information on treatment can be found in the patient guidelines (see "Explained in detail" below).

What you can do yourself

  • The most important step is to see a doctor or psychotherapist. Don't be ashamed. Depression, like physical illness, is not a question of guilt: Nobody would hesitate to see a doctor about back pain.

  • It can help to take someone you trust with you to see a doctor or psychotherapist. She can support you and describe your mood “from the outside”.

  • By seeking treatment, you have already taken an important step. Be prepared for such a treatment to take time. For many of those affected, the first improvement occurs after 2 to 4 weeks.

  • Sport and exercise are important. You don't have to perform at a high level. Try to set yourself small achievable goals: a walk in the fresh air, a little tour on a bike. Choose what you enjoy doing.

  • Other small activities can also help: a phone call to a friend, an appointment, a trip to the hairdresser's or a home-cooked meal can all be small successes.

  • Crises can be overcome more easily with support. Accept the offers of conversation and help from your family and friends.

  • Perhaps it will help you to exchange ideas with other people affected. Then you can turn to a support group.

October 2016, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians