Psychological distress is a part of daily life for many students. While figures vary depending on the study due to different measurement tools being used, they still paint a clear picture: 21% of students show depressive symptoms. During the pandemic phases, the pooled rates were around 31%. Higher values are reported among female students than male students (PMC).

Across Germany, a very large number of people are enrolled: in the winter semester 2024/25, the number of students stood at 2,871,600. Applied to this baseline, the 21% estimate corresponds to approximately 606,000 students experiencing depressive symptoms (Destatis).

Surveys such as the "Student Survey in Germany" additionally show that a relevant proportion of students report an impairment that makes studying difficult. Psychological impairments are the most frequently cited. These findings align with health insurance analyses and university reports, which have been documenting an upward trend for several years: more and more young people are seeking help due to depressive complaints, exhaustion, or anxiety.

It is important to distinguish between "depressive symptoms" in questionnaires and a clinical diagnosis of depression. Screenings capture how students feel and function. Diagnoses require a structured clinical evaluation—including duration, severity, and level of impairment. Both perspectives complement each other and show that these are not isolated cases, but rather a widespread issue that requires attention, clear information, and reliable access to support.

A depression is a serious, treatable illness. It affects…

• Feelings: such as persistent sadness.
• Thinking: in the form of rumination and self-deprecation.
• The body: through changes in sleep and appetite, as well as exhaustion.
• Behavior: through withdrawal and procrastination.

Crucial for the diagnosis are duration (at least two weeks), frequency (almost daily), and a noticeable impairment in university, work, and relationships. The international classification (ICD-11) and the German guideline describe how symptoms are classified and how they are effectively treated—ensuring that those affected receive reliable help regardless of their location or university.

Depression occurs in different forms. An accurate classification helps in choosing appropriate treatment steps—ranging from psychotherapy (e.g., Cognitive Behavioral Therapy, CBT) and medication to supplementary services like group programs or digital applications. For university students, it is additionally important to note that daily and weekly structure, sleep routine, and social integration are key factors that noticeably support the treatment.

A distinction is made between four types:

What it is: Unipolar depression is the most common form and occurs in episodes that can be mild, moderate, or severe. The number and weight of symptoms, as well as the level of impairment in daily life, are decisive. Mild episodes often manifest through fatigue, loss of interest, and withdrawal. People experiencing moderate episodes feel a distinct lack of drive, concentration problems, and feelings of guilt. In severe episodes, the daily routine can be massively blocked, extending even to suicidal thoughts.

How it is treated: Psychotherapeutic methods such as CBT are effective; they identify negative thought and behavior patterns, evaluate them realistically, and replace them step by step with helpful activities. For moderate and severe cases, antidepressants are often recommended. Combining them with psychotherapy can accelerate the onset of action and reduce relapses. For university students, close coordination between the family doctor, therapist, and university facilitates implementation during the semester.

What it is: Seasonal affective disorder occurs predominantly during the dark winter months. Typical symptoms include daytime fatigue, an increased need for sleep, carbohydrate cravings, lack of drive, and withdrawal. The underlying cause is, among other factors, a disrupted circadian rhythm: less daylight, a shifted internal clock, and changes in melatonin and serotonin regulation.

How it is treated: Alongside CBT, light therapy with appropriate illuminance and session duration shows positive effects. Consistent sleep and waking times, regular outdoor exercise, exposure to morning daylight, and structured semester and exam planning are also effective. A medical check-up determines whether the criteria for a depressive episode are met and which combination of measures is appropriate.

What it is: Dysthymia is a long-lasting, usually milder, but persistent form of depressive complaints. For years, those affected feel "down," exhausted, and poorly motivated—without reaching the depth of a severe episode. During university, this often leads to chronic procrastination, reduced enjoyment of course content, and a discrepancy between effort and perceived success. Precisely because the symptoms feel so familiar, they are easily underestimated or misinterpreted as a "personality trait."

How it is treated: CBT helps identify negative core beliefs, establish new behavioral routines, and systematically reactivate social contacts. If necessary, medication support can lift the baseline mood and facilitate the implementation of therapeutic steps. (Bundesärztekammer/KBV/AWMF, 2023)

What it is: In bipolar disorder, depressive phases alternate with (hypo)manic episodes, during which mood, activity, and self-confidence rise to an atypically high degree.

How it is treated: This has consequences for treatment: without specialist medical supervision, antidepressants can carry a risk of triggering mood swings. Therefore, mood stabilizers, psychoeducational programs, and relapse prevention are the primary focus. For university students, a stable daily and sleep routine, early warning sign management, a reliable emergency plan, and the involvement of their social network are important. Coordination with the examination office and student counseling can help make peak workload periods (exams, deadlines) manageable and plannable.

Most students are familiar with stressful phases: too much material, too little sleep, a disappointing grade. A depression goes beyond that. It manifests through persistent changes in mood, thinking, physical sensation, and behavior that noticeably impair daily life. Crucial factors are duration (at least two weeks), frequency (almost daily), and the extent of the impairment—for instance, when attending lectures, studying, social contacts, or self-care can barely be managed. Online self-tests can provide guidance; however, a diagnosis is made by a medical or psychotherapeutic professional based on established criteria. (WHO/ICD-11, 2023; Bundesärztekammer/KBV/AWMF, 2023)

Three main symptoms are at the core: a persistently depressed mood, a loss of interest and joy (anhedonia), and a pronounced lack of drive accompanied by rapid fatigue. These core signs indicate that something fundamental has fallen out of balance. Frequently, accompanying symptoms also occur: changes in sleep and appetite, concentration problems, agonizing rumination, feelings of guilt or worthlessness, inner restlessness or slowing down, as well as physical complaints without a sufficient medical finding. If suicidal thoughts occur, it is an emergency—call 112 immediately or contact the TelefonSeelsorge, a crisis helpline, which is available around the clock (0800 1110111, 0800 1110222, 116 123). The earlier you seek help, the better the chances of overcoming the depression. (TelefonSeelsorge, 2025)

Depression has multiple causes that interact with one another: genetic and biological vulnerability, learning experiences, social factors, and current stressors. University life often consolidates these factors within a short period: a new phase of life, a relocation, performance demands, financial issues, as well as questions regarding identity and the future. At the same time, protective factors such as a stable daily routine, regular sleep, reliable relationships, or sufficient physical activity are sometimes lacking. Important: A depression is not a weakness, and nobody is "at fault" for it.

Typical triggers and intensifiers in daily student life include:

• Performance and time pressure: leading to chronic stress and preventing recovery.
• Financial worries: restricting choices and opportunities for relaxation.
• Social isolation: due to moving away or intensive periods of studying alone.
• Perfectionism and comparisons: which set unrealistic standards.
• Mismatches with the chosen field of study: eroding motivation and purpose.
• Lifestyle factors: such as a lack of sleep, a lack of exercise, or increased alcohol consumption.
• Biographical/biological influences: such as a family history of depression or previous episodes.

The interaction of these factors explains why similar events affect people differently—depending on resources, environment, and support.

In short: Depression arises from a combination of factors and is highly treatable. There are many areas where adjustments can be made—individually (sleep, structure, exercise), socially (peers, family), academically (counseling, academic accommodations), and therapeutically (CBT, medication if necessary). The earlier you begin, the easier the path becomes.

The most important step is the initial contact. Many students wait out of uncertainty, because they dismiss their symptoms ("it is not that bad"), or because they do not know where to start. You do not have to manage this alone: support services, treatment pathways, and emergency help are available. Often, a combination of approaches is most effective—short-term relief, medium-term structure, and a therapy that changes thinking and behavior step by step.

• General practitioner: Here you receive an initial medical assessment, a sick leave note if needed, and a referral. The consultation clarifies symptoms, duration, pre-existing conditions, and next steps, such as contacting a psychotherapist or arranging lab tests/sleep evaluations. This lowers barriers and makes the treatment path plannable.
• Psychotherapeutic consultation hours: You can obtain a prompt appointment for a diagnostic assessment by calling 116117. During the consultation, you will discuss symptoms, prior experiences, risk factors, and options—such as acute treatment, waiting lists, group therapy, or digital applications. You will receive a written recommendation that facilitates further planning.
• Psychological counseling services of the student unions (Studierendenwerke): This counseling is free of charge, confidential, and frequently available at short notice—including online. You receive a structured assessment, concrete coping strategies (e.g., study and learning routines, sleep habits), and support with applications such as those for academic accommodations.
• Crises & suicidal thoughts: In the event of acute danger, call 112. The TelefonSeelsorge (Crisis Helpline) is available around the clock and offers stabilization, relief, and information regarding local support services.

• Psychotherapy: In Cognitive Behavioral Therapy (CBT), you learn to recognize negative patterns, evaluate them realistically, and replace them with helpful activities. This improves mood, sleep, concentration, and daily functioning—including in the lecture hall and at your desk. The goal is to prevent relapses, recognize warning signs early, and strengthen self-efficacy.
• Medication: For moderate and severe episodes, antidepressants can be beneficial. They stabilize mood and drive, enabling you to benefit from therapy and daily life again. Selection and dosage are tailored individually; effects and side effects are monitored closely. Combined with CBT, the chances of success are often higher.
• Group offers and training: Universities, outpatient clinics, and practices offer groups—ranging from stress and sleep courses to depression or mindfulness groups. Groups combine professional input with social support and reduce the feeling of being "alone." Ask about available spots during your counseling session or via 116117.

Digital Health Applications (DiGA) are prescription apps approved by the Federal Institute for Drugs and Medical Devices (BfArM) that fulfill a medical purpose and have a proven benefit. Doctors and psychotherapists can prescribe them, and health insurance funds generally cover the costs.

DiGAs are frequently based on CBT components and guide you through structured modules—ranging from psychoeducation and thought or activity logs to relapse prevention. They do not replace in-person treatment, but they can bridge waiting times, boost motivation, and stabilize therapeutic success. Example: deprexis is listed in the DiGA directory for unipolar depression and can be used to accompany treatment. Ask during your consultation whether a DiGA is right for you, and schedule fixed times for it in your daily university routine.

As a student with a health impairment—which includes depression requiring treatment—you are entitled to fair conditions. The academic performance goals remain the same, but the path to achieving them is adapted to your situation. This protects equal opportunities and academic success. (DSW, 2024)

Academic accommodations allow examination and study conditions to be adapted without lowering the performance standards. Examples include extended deadlines, scheduled breaks, alternative examination formats (oral instead of written or vice versa), separate rooms, or assistive tools. The process is generally similar:

• Counseling: Consult with the responsible office (student union, representative for students with disabilities/chronic illnesses) to identify suitable measures for your specific case.
• Medical certificate: Obtain a certificate from a doctor or psychotherapist that describes the nature and expected duration of the impairment and justifies the requested measures.
• Application: Submit an application to the examination office/examination committee—as early as possible before the exam, ensuring that decisions are issued in a timely manner.

Carefully document your paperwork (medical certificates, emails, official notices). If your application is rejected, an appeal is possible; counseling centers can support you through this process. (DSW, 2024)

If a break is necessary, you can apply for a leave of absence (Urlaubssemester). Requirements and deadlines vary depending on the university and state legislation. Generally, you will need proof of the health impairment. Clarify in advance which academic achievements are permitted during the leave of absence (e.g., individual exams, internships) and how it affects your enrollment status, health insurance, and part-time job. Use this time specifically for stabilization, treatment, and a structured return to your studies.

Funding extension: In the case of serious reasons such as illness or chronic conditions, an extension of funding beyond the standard period of study is possible (§ 15 para. 3 BAföG). Key steps include contacting the BAföG office in a timely manner, providing complete evidence (e.g., medical certificates, therapy reports), and creating a realistic study plan. In cases of inability to take exams due to illness, withdrawals and retakes can often be arranged in compliance with regulations—speak to the examination office and student counseling early on.

• Documentation: Document your phases of illness and all communication with the university.
• Review options: Evaluate options such as retaking exams, deadline extensions, or a change of module or university. Changing your field of study or university is not a failure, but rather a decision in favor of your health and a better fit.
• Seek support: Obtain assistance—including legal support if necessary—from counseling centers and student unions.

Self-help complements treatment but does not replace it. Choose a few points and start small—consistency is what matters.

Set micro-goals: Aim for one to two prioritized tasks per day, combined with fixed study and break times. Stabilize your sleep routine with a consistent wake-up time, exposure to daylight in the morning, and reduced screen time in the evening. Sleep hygiene is a fundamental pillar of treatment—even during semester stress.

Stay active: Engage in moderate exercise two to three times a week—such as a walk, cycling, taking the stairs, or bodyweight exercises. Even 10 minutes can have a noticeable effect and boost motivation. Pay attention to regular meals and sufficient hydration; consume caffeine and alcohol mindfully.

Plan joint sessions: Schedule binding study dates (in the library or a study group). Make use of peer offers, university sports, cultural events, and groups provided by the student unions (Studierendenwerke). Social integration has an antidepressant effect and increases the likelihood of staying on track with your therapy and daily goals.