Die Vorstellungen darüber, was unter der Krankheit „Depression“ zu verstehen hat, weichen je nach philosophischem bzw. schulenspezifischem Hintergrund bei verschiedenen Autoren voneinander ab.
Definition der Depression von Karl Jaspers
Der Begründer der sogenannten „Psychopathologie„, der Philosoph und Psychiater Karl Jaspers („Allgemeine Psychopathologie“, 9. Aufl. (1973)) definiert als „Kern“ der Depression v.a. „eine…motivlose Traurigkeit, zu der eine Hemmung alles seelischen Geschehens kommt, die sowohl subjektiv schmerzlich empfunden als auch objektiv festzustellen ist. Alle Triebregungen liegen darnieder; zu nichts hat der Kranke Lust. Der verminderte Bewegungs- und Betätigungsantrieb wird zur völligen Regungslosigkeit. Kein Entschluss kann gefasst, keine Tätigkeit in Angriff genommen werden. Die Assoziationen stehen nicht zur Verfügung. Den Kranken fällt gar nichts ein, sie klagen über ihr völlig zerrüttetes Gedächtnis, sie empfinden ihre Leistungsunfähigkeit und klagen über ihre Insuffizienz, ihre Gefühllosigkeit, ihre Leere.Sie fühlen die tiefe Verstimmung als Empfindung in Brust und Leib, als ob es da gleichsam zu fassen wäre. Ihre tiefe Traurigkeit lässt ihnen die Welt grau in grau erscheinen, gleichgültig und trostlos. Aus allem suchen sie das Ungünstige, Unglückliche heraus. In der Vergangenheit haben sie sich viel zuschulden kommen lassen (Selbstvorwürfe, Versündigungsideen), die Gegenwart bietet ihnen nur Übles (Kleinheitsideen), die Zukunft liegt entsetzlich vor ihnen (Verarmungsideen u. a.).“
Definition der Depression von Klaus Dörner
Für Klaus Dörner („Irren ist menschlich“ (1990)) ist der Depressive ganz allgemein „der sich und Andere niederschlagende Mensch“. Wesentliche Ursache für die Entstehung einer Depression ist seiner Meinung nach eine „depressions-freundliche“ Lebenswelt der Erwachsenen.
Definition der Depression von Volker Faust
Volker Faust („Psychiatrie“ (1995)) grenzt die Depression als „phänomenologisch (Erscheinungsbild) konkret beschreibbares Krankheitsbild“ v.a. von gewöhnlichen „Befindensschwankungen“ und der „Trauer“ ab. Er stellt aber zugleich fest, es handele sich um „ein Syndrom mit einer Vielzahl von Symptomen in variabler Kombination und Ausprägung.“ Seine Definition lautet:
„Eine Depression ist ein Gemütsleiden, mit unterschiedlichen Ursachen (reaktiv, endogen, körperlich begründbar usw.), das mit psychischen, psychomotorischen sowie vegetativ-somatischen Symptomen einhergeht.“
Definition der Depression von Rainer Tölle
Rainer Tölle („Psychiatrie“ (1999)) ist der Auffassung, dass die Bezeichnung „Depression“ einen Sammelbegriff für verschiedene Zustände und seelische Entwicklungen darstellt:
- Das „normale“, besser erlebnisadäquate Verstimmtsein bei betrüblichen oder entmutigenden Anlässen, was auch Traurigkeit oder Deprimiertsein genannt wird.
- Wenn der Betroffene über Zugefügtes oder häufiger über Verlorenes sehr stark und sehr lange deprimiert ist und diese Störung mit psychosomatischen Beschwerden einhergeht, spricht man von reaktiver Depression oder Anpassungsstörung.
- Wenn eine lang anhaltende depressive Störung nicht auf eine aktuelle Belastung oder einen aktuellen Konflikt allein zurückzuführen ist, sondern weit zurückreichende und langanhaltende Konfliktkonstellationen erkennbar sind, nennt man das eine neurotische Depression.
- Mit depressiver Persönlichkeitsstörung ist im wesentlichen das gleiche gemeint wie mit neurotischer Depression.
- Als eine sehr schwere Krankheit kommt Depression bei den affektiven Psychosen vor (hier als depressive Episode, major depressive disorder, Melancholie bezeichnet) und auch bei Schizophrenien und bei organischen Psychosen.
Definition der Depression von G. Laux
In dem aktuellen Referenzlehrbuch von Möller, Laux und Kapfhammer (Psychiatrie und Psychotherapie, 2000) definiert G. Laux die Depression deskriptiv in Ausrichtung auf die kriteriengeleitete, theoriebereinigte Klassifikation wie folgt:
„Hauptcharakteristikum einer depressiven Episode ist eine depressive Verstimmung einhergehend mit Verlust von Interesse und Freude. Veränderungen der Psychomotorik zeigen sich entweder in Form einer Antriebshemmung oder einer ängstlichen Agitiertheit sowie einem reduzierten Energieniveau. Neben verschiedenen körperlichen Funktionsbeeinträchtigungen wie z.B. Schlafstörungen und Appetitlosigkeit prägen Gefühle von Wertlosigkeit oder Schuld, Konzentrationsstörungen sowie Suizidgedanken das klinische Bild. Beim Auftreten mehrerer Krankheitsphasen wird von einer rezidivierenden depressiven Störung („unipolare Depression“) gesprochen. Weitere Charakterisierungen umfassen die Ausprägung des Schweregrades, das Vorhandensein „somatisch-melancholisch-endogener Symptome“, psychotische Merkmale und den Remissionsgrad.“ (S.1104)
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