When the joie de vivre disappears

Tablets or car? Should she take the children with her to death, or should she bring them to her parents first? When Sibylle Mark (name changed by the editors) talks about the low point of her life, over the weeks and months when she was only thinking about dying, her bright voice gets a leaden sound. Sober, just as other people write a shopping list, she then thought: whether her husband would probably find a new wife? What would it be like to race against a tree? Or would it be better to fall asleep with tablets, never to wake up?

She had collected a deposit, hid the pills in the drawer, under the underwear. She knew a lot about medicines, as a doctor. "The bad thing about depression is that it robs you of all the courage to live," says Sibylle Mark, 51, general practitioner in Saarland. It's no longer about shaping everyday life. Not even making rational decisions. It's just about somehow survive the day. For 19 years, the dark-haired petite woman lives with this disease. She has not wanted to die for five years.

Flashback: The first time the black mourning sneaked into Sibylle Mark's life in 1989. At that time she was in the wedding preparations. "Strange that this coincided with such positive events," she says and smiles briefly. Every normal bride is looking forward to the day. She did not even enjoy choosing a white dress, let alone thinking about seating arrangements or flower arrangements.

But just the joy of life was lost to her

At first she believed that the constant depression had something to do with the stroke of fate that had struck her a few years earlier: in 1986, her longtime friend - the two of them wanted to marry - died of a serious heart disease. A year after his death, she met her future husband. "Of course, I was still struggling with grief," she recalls. "But I was young, I wanted to live, suddenly everything was possible: family, drive away, love of life."

But just the joy of life was lost to her. At first there were days when not everything appeared gray in gray. But even those became rarer. Finally, she went to the doctor three months before the wedding date. The psychiatrist prescribed antidepressants for the first time. Confirmed: No more than six months - then everything is over. That was in the spring of 1989.

In fact, she soon felt better. She calmed down: an episode, nothing more. Maybe necessary to finally get over the death of the loved one. "After a few weeks, I was the same again," she recalls. When she put down the pills, the sun was still shining. Almost eight years.

A normal, happy, successful life for eight years. She scarcely thought of the dark companion of her soul. In 1991, her first daughter was born. 1993 the son. She continued to work part-time as an employed doctor in a group practice. In 1996 her brother fell ill with leukemia. Shortly thereafter, she was pregnant with the third child. Again this closeness of death and joy. "That took me a lot," she says.

At first there were days when not everything appeared gray in gray

It started again: On a Sunday - her husband was working as often - the children quarreled. Quite ordinary, nothing special. Except that Sibylle Mark did not have the strength to respond to it this time. She lay down on the sofa and cried.

A new boost, she knew it immediately. With one big difference: the first time she was alone. Now she was the mother of two children and the third pregnant. You do not have to be a doctor to know that the pills that saved her life eight years ago were out of the question now if she did not want to endanger her unborn child.

So the Depression pushed back into her life, a little more every day. A household of four people - and she could not even clear the dishwasher. Two hungry kids - and she could not even give them a slice of bread. Let alone clean up toys, read aloud, cuddle. Sibylle Mark felt like a failure, a raven mother. She could not even look forward to the baby. The depression is "the disease of the Lotigkeit" in the book "shadow existence". For suffering makes us "callous, hopeless, sleepless, impotent, helpless."

Two hungry kids - and she could not even give them a slice of bread.

She was numb. Especially that, she says, sticking the black gucci glasses from the funky snub nose into the half-length dark hair. Unleashed from all emotions, from the desire to live, from the need to do something for oneself and others. It went like this until the last third of the pregnancy. Then she had to decide: medication or sinking. Your health or that of your baby.

As she tells, she knocks her right hand on the clasp of her watch, opens and closes it, again and again. Very low dose the doctor antidepressants, for fear of harming the unborn baby. Fortunately, her daughter was born completely healthy. Only she could not breastfeed her. After all, the pills helped her to work again. But while she had eight years earlier the feeling of having the disease under control, this time snapped the impression: "I miss something fundamental, something healthy people have." Not even the fact that her brother had overcome his illness helped her. Although she did not feel really sick. But she was also out of line.

The voice was right. Sibylle Mark noticed it immediately when she had to give up the antidepressants for a few days on the inner ear for a few days - they would not have tolerated the general anesthetic. After the operation, she lay like a heap of misery in the hospital bed. She began to take the pills again against the grief. But suddenly everything was different: Suddenly she suffered from massive side effects, extreme dry mouth, severe constipation, leaden fatigue. Not a rare phenomenon, the doctor told her: The effect of an antidepressant can change at any time, if it is discontinued for a short time.

Although she did not feel really sick. But she was also out of line.

From now on it went steeply downhill. She tried 15 different drugs over the next few months. Some helped too little. Others worked, but they tormented with side effects. With each further attempt, her hope of ever recovering, as in the past, faded. The deep blackness enveloped her again, soon every day. "Of course, I was a regular psychiatrist," she says. But even the talks did not help her.

The only thing that gave her life structure there was the work: Half-day she dragged herself into the office. Then the day came when the psychiatrist said, "It can not continue like that, I have to get you sick." He did not think her responsible anymore. Finally, she was responsible. "That was for me, as if the last bastion had fallen," she says.

At home: hell. The children who overwhelmed her. A husband who had long since lost his understanding and worn her down and desperately jumped over with his advice: "Please pull yourself together, you have everything you need." - "A 500 percent top offender," she says of him. And: "That was probably his way of coping with the situation, meanwhile I forgave him."

The clinic brought the turn

What moved her sister to finally take her to the emergency room at the local hospital is something she no longer knows. Maybe she had been listening because Sibylle Mark had been talking loudly about death. In any case, the doctors there sent her to a longer stay in a psychiatric clinic - with group and occupational therapy, especially with a lot of rest. "Silk painting at the expense of the taxpayer," her husband said cynically. She stayed there for 16 weeks. At the weekend, her husband visited her with the children. "It was not funny for her to constantly see her mother down," she says.

The clinic brought the turn. "I got to know people with depression, realized I was not the only one with this problem." Finally it went up. At home, she chatted on the Internet with other stakeholders, shared her experiences. It was as if someone had opened the door to their inner dungeon.

This helped her accept her illness, not just seeing herself as a "hypersensitive" who can not cope in life. She started a behavioral therapy, got to know her inner patterns that made her constantly doing something, being a "good girl". So well-behaved and adapted that her only escape was the disease. Finally, the shadows cleared. Finally, the doctor had found a medicine that helped her. She went back to work.

She has changed her life one way or another - also for the better

The tablets she takes today. Of course she wants to get rid of her, someday. A remedy that not only affects the head: in the evening, they attack true food cravings that she can not control. And sometimes she suffers from extreme sweats. But do not take psychotropic drugs? The price could be too high. That sounds like a muted feeling of life, without highs and no bottomless depths, maybe after a little luck? "I'm not asking myself that question," she says.

But at least she is no longer hopeless. And also the fear is gone, to completely fail and to sink, at least mostly. Only sometimes does she bother her, when she thinks about it, how it will be when her children leave home or their old parents die. "That's what I'm afraid of, maybe depression has been anchored in me as a response to bad events," she says.

She has changed her life one way or the other - also for the better: "Maybe it sounds weird, but the disease has something positive for me, I'll never go through life with ease.But that's a certain quality for me. My life has more depth, less superficiality. And thats me."

Only sad or already ill - where is the line to depression?

Everyone has a bad day. But what if the dark feeling of life becomes dominant? The line between depression and depression is difficult to define. So it is normal for psychotherapists to respond to severe blows with depressive symptoms without being immediately sick. Basically, however: If the depressed mood lasts longer than two weeks, those concerned should seriously worry.

Is the upset stronger than usual, does it last most of the day and almost every day?
Is the interest in everyday activities that were otherwise fun in general lost?
Is there even a lack of energy to leave the bed? Do tiredness and lack of power become the predominant feeling of life?
Are self-esteem and self-confidence seriously affected?
Do baseless self-reproaches or pronounced and totally inappropriate guilt feelings get out of hand?
Is it harder than usual to concentrate, remember or make decisions?
Are there more restlessness and nervousness? Is it hard to sit still? Or vice versa, to move?
Are there any problems falling asleep? Is sleep disturbed?
Is the appetite lost, or is it getting bigger?
Do thoughts always revolve around death or suicide?

Two of the first three symptoms, or at least four symptoms altogether, are suspected to be mildly depressed. Then it is advisable to see a doctor. If the first three and at least five other questions are approved, there is a serious depression.

Read on

David Althaus, Ulrich Hegerl and Holger Reiners: "Depressed - two experts and one affected person answer the 111 most important questions", Kösel. Ulrich Hegerl and Svenja Niescken: "Coping with depression, rediscovering the joie de vivre", Trias. Thomas Müller-Rörich u. a .: "Shadow existence. The misunderstood suffering depression", Springer.

Anselm Grün: "Paths through Depression - Spiritual Impulses," Herder.

Matthew Johnstone: "My black dog, how I put my depression on a leash", Kunstmann.

More info: The Competence Network Depression provides affected people and relatives with tips on the subject, addresses of clinics, crisis services and self-help groups.