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Without evidence: Four tips for treatment of persons with depressive disorders

Journal: Die Psychiatrie - Grundlagen und Perspektiven
ISSN: 1614-4864
Topic:

Depression

Issue: 2017 (Vol. 14): Issue 3 2017
Pages: 184-187

Without evidence: Four tips for treatment of persons with depressive disorders

U. Hegerl (1, 2)

(1) Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig (Direktor: Prof. Dr. Ulrich Hegerl); (2) Stiftung Deutsche Depressionshilfe (Vorsitzender: Prof. Dr. Ulrich Hegerl)

Keywords

Depression, hidden bipolarity, arousal, pathogenetic concept

Summary

Four practical approaches that are helpful in the treatment of patients with depressive disorders are presented. First, to convey a concept of disorder where psychosocial and neurobiological aspects are used as complementary aspects, it is recommended to use the image of two sides of a coin. Second, the importance of the semantic distinction between fatigue in the sense of sleepiness (strong tendency to fall asleep) versus fatigue in the sense of exhaustion with long sleep onset latencies as well as between reduction versus inhibition of drive is explained. Third, the possible depressogenic effect of sleep and resulting consequences for patients’ self-management are discussed. Fourth, the speed of onset of a depressive episode as an important clinical indication of a possible previously undiscovered bipolarity is presented.

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