Not every period of sadness signifies a medical condition. The decisive factors are the duration, depth, and total number of symptoms experienced. If a near-total loss of joy or a deeply depressed mood persists for at least two weeks, accompanied by additional symptoms, a formal evaluation is highly recommended. This approach makes it possible to distinguish ordinary daily worries from a depressive phase that requires professional treatment.

Emotions and thoughts fall heavily out of balance. Common symptoms include persistent sadness, a total lack of interest, a sense of inner emptiness, constant rumination, difficulty concentrating, intense feelings of guilt, hopelessness, and low self-worth. Many people withdraw socially, put off decisions, and find daily tasks nearly impossible to manage. If thoughts of death or suicide become strong or frequent, this is a critical alarm signal—please seek professional help immediately.

The body sends clear warning signs as well. Frequently, individuals experience trouble falling or staying asleep, waking up too early, severe fatigue, and changes in appetite or weight. Unexplained physical pain, such as headaches, stomach cramps, or backaches, can also occur. What matters most is the combination of mood, thought patterns, and overall daily functioning.

Depression does not always manifest through tears. When experiencing depression, men are more frequently irritable, impatient, or aggressive. In many cases, risk-taking, addictive behaviors, or social withdrawal take center stage. These outward behaviors easily mask the underlying situation and delay crucial medical help. An open conversation and early counseling provide vital protection.

Most of the time, depression is caused by a combination of factors coming together: stressful life events, chronic stress, exhaustion, loneliness, physical illnesses, and a certain genetic predisposition. Nobody is to "blame" for this condition. The most helpful approach is to recognize these stressors and actively work to reduce them. Engaging in regular physical exercise, maintaining a structured daily routine, keeping up social contacts, and setting small, achievable goals can make a noticeable difference.

If the symptoms are more severe, Cognitive Behavioral Therapy (CBT), other forms of talk therapy, and—if necessary—medication can be added to the treatment plan. The right choice depends entirely on the severity of your symptoms and your personal recovery goals.

The "Patient Health Questionnaire-9" (PHQ-9) is a brief self-assessment tool. It evaluates how frequently nine typical symptoms have occurred over the past two weeks. You can easily complete it at home. While the score provides an initial assessment of your situation, it does not replace a professional medical diagnosis.

How to Prepare for the Self-Test

• Set aside ten minutes in a quiet space where you won't be interrupted.
• Have a pen and paper ready, or open a fresh note on your phone.
• Read each statement carefully. Answer honestly based on your actual experience.

The Nine Statements

Please reflect on how you have been feeling over the past two weeks. For each statement, choose one of the following four answers and note down the corresponding points:

• Not at all = 0 points
• Several days = 1 point
• More than half the days = 2 points
• Nearly every day = 3 points

1. Little interest or pleasure in doing things.
2. Feeling down, depressed, or hopeless.
3. Trouble falling or staying asleep, or sleeping too much.
4. Feeling tired or having little energy.
5. Poor appetite or overeating.
6. Feeling bad about yourself, a sense of failure, or feeling worthless.
7. Trouble concentrating on things, such as reading the newspaper or watching television.
8. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual.
9. Thoughts that you would be better off dead, or of hurting yourself in some way.

Calculate Your Result

Calculate your total score. It will be between 0 and 27. Match your total score to the ranges below:

• 0–4: Minimal or no symptoms
• 5–9: Mild symptoms
• 10–14: Moderate symptoms
• 15–19: Moderately severe symptoms
• 20–27: Severe symptoms

This classification helps you plan your next steps. However, any definitive decisions regarding treatment must be made during a medical or psychotherapeutic consultation.

Those who seek help will find a clear and structured process. During a detailed consultation, specialists will evaluate the severity of your symptoms and how much they impact your daily life. This includes questions about your mood, energy levels, sleep patterns, appetite, physical pain, and current life circumstances. In addition, possible physical causes—such as a thyroid disorder or specific vitamin deficiencies—will be thoroughly checked.

The evaluation is based on recognized clinical criteria that clearly define what qualifies as a depressive episode. A depressive episode is a time-limited phase with clearly defined signs that go far beyond normal grief or temporary stress reactions. These diagnostic criteria are outlined in the international disease registry, the ICD-11, compiled by the World Health Organization (WHO).

The choice of treatment depends entirely on the severity of the condition. For mild cases, short and effective consultations, guidance on staying active, and a consistent daily routine are often highly successful. For moderate to severe depression, medical guidelines recommend psychotherapy—such as Cognitive Behavioral Therapy (CBT)—and, depending on the situation, antidepressants. Together with your professional, you will create a personalized treatment plan that fits you and your daily life.

Good preparation saves time and reduces stress. Before your appointment, take a moment to note down the following details:

• Duration of symptoms: How long have you been feeling this way, and what triggers or eases your symptoms?
• Physical changes: Note changes in your sleep patterns, appetite, energy levels, and any physical pain.
• Daily life impact: How are your work, family responsibilities, household chores, and social contacts being affected?
• Medical history: List your current medications, any pre-existing health conditions, and your family history.
• Your goals: What specific improvements would you like to see over the next four weeks?

During your consultation, feel free to ask these specific questions:

• "Which treatment approach best fits my current situation, and how exactly does it work?"
• "What potential side effects should I expect, and how should I manage them if they occur?"
• "What self-help strategies or steps do you recommend I try before our next appointment?"
• "Is there a suitable Digital Health Application (DiGA / "app on prescription") that could help support my recovery?" (National Association of Statutory Health Insurance Physicians / 2025; Federal Institute for Drugs and Medical Devices / 2025)

Finding quick relief starts with small steps. It is highly beneficial to maintain consistent sleep schedules, get daily physical exercise, spend brief moments outside in the fresh air, and follow a simple daily schedule filled with achievable tasks. Please don't hesitate to lean on trusted people in your life for support. If talking feels too difficult right now, starting with a simple text message is a great first step. During an emotional crisis, speaking directly with mental health professionals provides vital guidance and safety.

If you find yourself temporarily unable to work or continue your education, a doctor's certificate for sick leave may be necessary. Your primary care doctor or a specialist clinic can advise you on this process. When it comes to securing a therapy placement, scheduling an initial psychotherapeutic consultation is the best way to get started.

Additionally, ask your GP or healthcare provider about Digital Health Applications (DiGA in German) to help bridge the waiting time. Several of these digital programs are officially approved specifically for treating depression. A DiGA, such as deprexis, is a certified and thoroughly tested health app that doctors and psychotherapists can prescribe. Your health insurance company covers the full cost of these applications. There are apps available that offer targeted exercises, educational psychological insights, and daily guidance for dealing with depression. Ask at your clinic about a suitable app and current options available to you.

Sleep and mood are deeply interconnected and heavily influence one another. People experiencing depression frequently face difficulties falling or staying asleep, waking up too early, or dealing with severe daytime fatigue. Establishing a consistent sleep schedule, reducing screen light in the evening, staying active during the day, and keeping your bedroom cool and dark can provide significant relief. If nightmares, late-night rumination, or an overwhelming urge to sleep during the day persist, be sure to bring this up at your next medical appointment. Addressing sleep disturbances is typically planned in tandem with your overall depression treatment.

Certain phases of life come with unique emotional and physical challenges. Following childbirth, postpartum depression can develop. During adolescence and puberty, sleep patterns and emotional regulation undergo massive shifts. In older age, loneliness and physical illnesses often play a significant role. Across all of these diverse life stages, the same rule applies: seeking early intervention greatly improves your recovery outlook. Please make sure to explicitly inform your healthcare provider if you are pregnant, breastfeeding, or starting any new medications.