Many people link depression solely to feeling sad. In reality, however, it is a complex mental health condition that affects how a person thinks, feels, and behaves.

Depression can make everyday tasks suddenly require an overwhelming amount of energy. Activities that used to bring joy lose their appeal. Even simple decisions or social interactions can feel exhausting and burdensome.

Depression can occur at any age. However, adults often face additional pressure from work, family, or financial responsibilities, which can make the condition impact daily life particularly hard.

Depression does not present the exact same way in every adult. Some individuals mainly report sadness, while others experience inner emptiness, irritability, or physical complaints. According to the international classification system (ICD), the core symptoms include:

• Persistently depressed mood
• Loss of interest and pleasure
• Decreased drive or rapid fatigability

These symptoms typically persist for at least two weeks.

• Concentration problems
• Feelings of guilt
• Low self-esteem
• Sleep disturbances
• Changes in appetite
• Changes in weight
• Feelings of hopelessness
• Social withdrawal
• Physical complaints without an apparent cause
• Thoughts of death or suicide

Not everyone displays all of these symptoms. The type and intensity of symptoms can vary significantly from person to person.

When experiencing a depressive episode, many people wonder whether their symptoms are "severe enough." However, a diagnosis should always be made by a doctor or psychotherapist. You deserve to seek professional support at any time, especially if you notice that your ability to manage daily life is suffering because of your symptoms.

Healthcare professionals base the diagnosis of depression on:

• A detailed clinical consultation
• Standardized questionnaires
• Diagnostic criteria from the ICD
• Physical examinations to rule out underlying medical causes

Depending on the number and severity of symptoms, depression is classified as mild, moderate, or severe.

Googling your own symptoms is often a first step toward finding answers. In this context, scientifically sound self-tests can help you better understand your complaints, recognize typical symptoms, and make it easier to take the next step toward getting professional help.

Most evidence-based depression tests consist of questions about typical symptoms experienced over the past two weeks. For example, they may ask:

• How often you have felt down, depressed, or hopeless
• Whether you have lost interest or pleasure in doing things
• Whether you suffer from sleep disturbances
• Whether you frequently feel exhausted or lack energy
• Whether you have trouble concentrating
• Whether your appetite or weight has changed
• Whether you feel worthless or experience strong feelings of guilt

Points are assigned based on your answers. The final score can offer insights into whether depressive symptoms may be present and how severe they might be.

Interested in trying out a test for yourself?

However, it is important to note: An online test cannot diagnose depression. It replaces neither a medical examination nor a psychotherapeutic diagnosis. If a test indicates signs of depression or if your symptoms persist for longer than two weeks, you should seek professional support.

Depression rarely stems from a single trigger; rather, it typically develops through the interplay of various biological, psychological, and social factors. Experts therefore refer to this as a multifactorial model of origin. Why some people develop depression while others do not—despite facing similar stressors—often cannot be answered definitively.

The most common contributing factors include:

Biological Factors

In the brain, various neurotransmitters such as serotonin, norepinephrine, and dopamine play a crucial role in regulating mood, motivation, and emotions. If this delicate balance gets disrupted, it can contribute to the onset of depression. Genetic factors also appear to play a role: individuals with a family history of depression face a higher risk of developing the condition themselves. Additionally, hormonal changes or certain physical illnesses can amplify depressive symptoms.

Psychological Factors

Personal traits and past life experiences also influence individual risk. People with pronounced perfectionism, low self-esteem, or high self-expectations often react more sensitively to prolonged stress. Similarly, distressing childhood experiences, traumatic events, or a lack of coping strategies for managing stress can foster the development of depression.

Daily Life Stressors

Depression frequently emerges during or after challenging life phases. These include:

• Prolonged professional or personal stress
• Conflicts in relationships or family life
• Separation or divorce
• The loss of a loved one
• Financial worries
• Loneliness or social isolation
• Chronic physical conditions or pain

Not every difficult situation or phase automatically leads to depression. However, when multiple risk factors coincide and stress persists over an extended period, the risk increases significantly.

Lifestyle and Physical Health

Factors such as a lack of physical activity, chronic sleep deprivation, excessive alcohol consumption, or other substance use disorders can also intensify depressive complaints or contribute to their onset. Conversely, regular exercise, adequate sleep, and social connections can support mental well-being, even if they cannot prevent or treat depression on their own.

The current S3 clinical practice guideline for depression in adults synthesizes the latest scientific evidence for treatment. Depending on severity, it recommends options including:

• Psychotherapy
• Antidepressant medication
• A combination of both approaches
• Exercise therapy
• Psychoeducation
• Relapse prevention
• Involving family members or loved ones

Treatment is always tailored to the individual patient's needs.

In Germany, a care level is not awarded based on a specific diagnosis, but rather on how much support an individual requires in their daily life. Mental health conditions, including depression, are fully taken into account during this assessment.

As a general rule, a diagnosis of depression alone does not automatically guarantee a care level. What matters is the actual level of support needed in everyday activities. A care level for depression may be considered if the condition leads to a long-term need for assistance with tasks such as:

• Self-care
• Daily structure and routine
• Managing the household
• Spatial or temporal orientation
• Maintaining social contacts

Whether an entitlement exists is evaluated by the Medical Service through an individual assessment.

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