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SANIMA Klinik am Mayenberg
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Indication

Depressive Disorders.

Depressive disorders are common mental health conditions. The probability of experiencing depression at some point in one's life (lifetime prevalence) is 23–26 % for women and 12–16 % for men. In industrialised countries, approximately 10 % of the population are affected by a depressive disorder each year (annual prevalence).

Medically reviewed by
Vivien Müller-Prasse, Specialist in Psychiatry and Psychotherapy
Last updated
Reading time
approx. 6 minutes
Mandala
The soul in darkness
Lifetime Prevalence · Women23–26%

Probability of suffering from a depressive disorder during one's lifetime.

Lifetime Prevalence · Men12–16%

Probability of suffering from a depressive disorder during one's lifetime.

Annual Prevalence · Industrialised Countriesca. 10%

Proportion of the population in industrialised countries affected in any given year.

Symptoms
Abstract illustration: depression manifests on multiple levels.

In depression, a person's emotional experience, thinking, behaviour, physical wellbeing, and social relationships are impaired.

Depending on the type and severity of depression, individual or multiple symptoms appear on the following four levels:

Four Dimensions

How depression manifests.

The following symptom complexes are characteristic — rarely do all appear simultaneously. Depending on severity and course, the emphasis shifts between the different levels.

i.

The emotional level

Low mood, despondency, depressed spirits, sadness, loss of joy and pleasure, feelings of worthlessness, anxiety, bitterness, hopelessness, emotional blunting or affective irritability, a sense of being "walled in", inner emptiness or inner agitation, loss of drive, feelings of meaninglessness through to weariness of life, among others.

ii.

The cognitive level

Narrowed pessimistic thinking, rumination, negatively distorted view of oneself and the world, concentration difficulties, reduced concentration capacity, memory problems, ambivalence or inability to make decisions, among others.

iii.

The physical level

Fatigue, exhaustion, disturbance of vital feelings, difficulty falling and staying asleep, muscle tension, headaches, back pain, gastrointestinal problems, loss of appetite, weight loss (depressive eating inhibition) or weight gain (comfort eating), reduction or loss of sexual interest, among others.

iv.

The social and relational level

Social withdrawal, abandonment of interests and hobbies, family conflicts, incapacity for work, suicidal acts, among others.

Causes
Abstract illustration: interplay of multiple causes.

The causes of depressive disorders are manifold. According to current knowledge, we assume a multifactorial model of causation for depression. This may involve genetic factors (biological vulnerability), neurobiological factors (changes in neurotransmitters), somatogenic factors (physical conditions), psychosocial stressors (professional or personal stress, significant life changes, conflicts, traumas, experiences of loss, including societal changes), and personality factors (psychological vulnerability shaped by biographical influences, early relationship experiences, inner conflicts, structural deficits, limited available coping mechanisms, learned helplessness, and much else).

Treatment

Treatment approach at Sanima Klinik.

Depressions are serious conditions that require professional treatment. Those affected who suffer from depressive symptoms, or relatives who observe depressive symptoms and are concerned, should always contact a physician in order to initiate appropriate treatment with a psychiatrist/neurologist and/or psychotherapist, and to prevent an escalation of the depressive symptoms or even suicidality.

At Sanima Klinik, depression is the most common indication for inpatient admission. Depending on the type and severity of the depressive symptoms, we plan the inpatient treatment — tailored individually. Removal from the domestic or professional environment and reduction of external stressors often provide initial relief and initiate the diagnostic and stabilisation phase.

Particularly effective in the treatment of depression has proven to be "the combination of antidepressant medication and psychotherapy." Antidepressants are indicated from a certain level of symptom severity or in recurrent courses of illness. The appropriate medication for each individual is discussed thoroughly. We also provide information on how long the medication should continue to be taken at what dosage, and what follow-up examinations should be carried out during this period.

Stabilisation of mood, drive, and affect is an important prerequisite for engaging more deeply in psychotherapeutic work with existing problems, one's own role in them, and biographical influences, for mustering sufficient strength for change and problem-solving, and for connecting with inner resources.

Course

Course and prognosis.

Depressive episodes are fundamentally amenable to treatment. With guideline-based therapy, many episodes improve considerably; however, the individual duration and course depend on severity, history, and accompanying factors.

A relevant proportion of those affected experience further episodes during their lifetime. Early treatment, a stable therapeutic relationship, and targeted relapse prevention can reduce the risk of recurrence.

In the inpatient setting, diagnostics, therapy, and daily structure can be closely integrated — with the aim not only of alleviating the acute symptoms but also of working through underlying patterns. Outpatient follow-up treatment is generally advisable afterwards to consolidate the progress achieved and support the transition back to everyday life.

Facts & Data

Depressive Disorders at a glance.

A structured overview of classification, prevalence, and treatment framework — as a quick reference for patients, relatives, and referring clinicians.

ICD-10 Classification F32 Depressive Episode · F33 Recurrent Depressive Disorder
Lifetime prevalence Women 23–26 % · Men 12–16 %
Annual prevalence In industrialised countries approx. 10 % of the population
Frequency at Sanima Klinik Most common indication for inpatient admission
Average length of stay 6–8 weeks, individually agreed with the treatment team
Therapy components Antidepressant medication (where indicated) · Psychodynamic psychotherapy · Cognitive-behavioural therapy · Systemic therapy · Body and creative therapy · Internal medicine support
Service region Bad Herrenalb, Northern Black Forest · Baden-Württemberg · approx. 35 km south of Karlsruhe
Access & funding Privately insured · Entitled to supplementary benefits · Self-paying
Waiting time (standard) Typically 7–14 days until admission · shorter in acute cases
Getting here Bad Herrenalb station (S1 from Karlsruhe Hbf) · 8 minutes on foot to the clinic
Contact +49 7083 748-0 · info@sanima-klinik.de · Mon–Fri 8:00–16:30

Severity grades according to ICD‑10 / S3 guideline.

ClassificationDiagnosis & typical treatment recommendation
F32.0 Mild depressive episode 2 core + 2 additional symptoms for at least 2 weeks. Recommendation: outpatient psychotherapy (watchful waiting possible); antidepressants generally not indicated.
F32.1 Moderate depressive episode 2 core + 3–4 additional symptoms. Recommendation: psychotherapy and/or antidepressant; consider inpatient treatment in case of significant psychosocial burden.
F32.2 Severe depressive episode 3 core + ≥ 4 additional symptoms, marked functional impairment. Recommendation: combination of antidepressant and psychotherapy; inpatient treatment frequently indicated.
F32.3 Severe with psychotic symptoms Severe depressive episode with psychotic features (delusions, hallucinations). Recommendation: inpatient psychiatric treatment; antidepressant + antipsychotic.
F33 Recurrent depressive disorder Recurring depressive episodes without mania. Recommendation: pharmacological relapse prevention (at least 2 years with repeated episodes), psychotherapy for relapse prevention.
Glossary

Key terms briefly explained.

The most important medical terms relating to depression — concise, precise, and in the order in which they appear on this page.

Depressive Episode F32
First or single phase of a depressive disorder; lasting at least two weeks with core and additional symptoms.
Recurrent Depressive Disorder F33
Repeated depressive episodes without manic phases — classified as a recurrent course from the second episode onwards.
Lifetime prevalence
Proportion of the population that suffers from a condition at least once during their lifetime. For depression: women 23–26 %, men 12–16 %.
Annual prevalence
Proportion of the population affected by a condition within a given year. In industrialised countries approx. 10 % for depressive disorders.
Suicidality
Weariness of life, suicidal thoughts, or acts of self-harm. Acute suicidality is an indication for immediate specialist psychiatric treatment.
Antidepressant
Medication for the treatment of depressive symptoms. Indicated from moderate severity upwards or in recurrent episodes — acts synergistically with psychotherapy.
Psychotherapy
Structured therapeutic methods — at Sanima Klinik psychodynamically based, cognitive-behavioural, or systemic, supplemented by body and creative therapy elements.
Stimulus reduction
Deliberate reduction of external stressors (occupational, domestic, social) through inpatient admission — initiates the diagnostic and stabilisation phase of treatment.
Comorbidity
Simultaneous occurrence of two or more conditions (e.g. depression with anxiety disorder, substance use disorder, or chronic physical complaints).
Relapse prevention
Long-term treatment (primarily antidepressant medication) to prevent further depressive episodes — recommended from the second episode onwards for at least two years.
Frequently Asked Questions

Answers to frequently asked questions about depression.

Patients, relatives and referring physicians regularly ask us recurring questions about the treatment of depressive disorders. Here you will find the most important answers.

01.What are depressive disorders?

Depressive disorders are frequently occurring mental health conditions. In depression, a person's emotional experience, thinking, behaviour, physical wellbeing, and social relationships are impaired. The lifetime prevalence is 23–26 % in women and 12–16 % in men.

02.What symptoms are typical of depression?

Symptoms manifest on four levels: the emotional level (depressed mood, loss of drive, hopelessness), the cognitive level (rumination, concentration difficulties), the physical level (exhaustion, sleep disturbances, pain), and the social level (withdrawal, family conflicts, incapacity for work).

03.When is inpatient treatment appropriate?

Inpatient treatment is particularly appropriate in moderate to severe depressive episodes, recurrent courses, existing suicidality, or insufficient stabilisation in outpatient care. Removal from the domestic or professional environment and reduction of external stressors often provide initial relief.

04.How long does inpatient treatment at Sanima Klinik last?

The average inpatient stay is six to eight weeks. The exact duration is agreed individually with the treatment team and is guided by the severity and course of symptoms.

05.What forms of therapy are used for depression?

We combine evidence-based psychotherapy (psychodynamic therapy, cognitive-behavioural therapy, systemic therapy) with body-oriented and creative-therapeutic approaches. Where indicated, antidepressant medication is added — the combination of antidepressant medication and psychotherapy has proven particularly effective in the treatment of depression.

06.Are antidepressants always necessary?

Antidepressants are indicated from a certain level of symptom severity or in recurrent courses of illness. The appropriate medication for each individual is discussed thoroughly. We provide transparent information regarding dosage, duration of use, and follow-up examinations.

07.Who covers the cost of treatment?

Admission is open to privately insured patients, those entitled to government allowance (Beihilfe), and self-pay patients. Some statutory health insurers (e.g. Techniker Krankenkasse and DAK) stipulate in their statutes that, under certain conditions, they may cover the costs of treatment at a purely private clinic up to the level of comparable rates at a hospital approved under Section 108 SGB V. We are happy to advise you during the initial telephone consultation.

08.How long is the waiting time for an admission appointment?

As a rule, we can offer an admission appointment within 7 to 14 days. In acute cases, sooner.

09.Where is Sanima Klinik am Mayenberg located?

Sanima Klinik am Mayenberg is situated in Bad Herrenalb in the Northern Black Forest, approximately 35 kilometres south of Karlsruhe in Baden-Württemberg. Bad Herrenalb station (S1 from Karlsruhe Hauptbahnhof) is approximately 8 minutes on foot from the clinic.

10.How can I arrange an admission appointment?

By telephone on +49 7083 748-0 (Mon–Fri 8:00–16:30) or by email at info@sanima-klinik.de. Our admissions office will respond within 24 hours with a proposed appointment for a detailed, no-obligation telephone consultation.

Sources

The evidence base for our content.

  1. [1] S3 Guideline / National Clinical Practice Guideline: Unipolar Depression DGPPN, BÄK, KBV, AWMF (ed.), 3rd edition, Version 1.0, 2022. leitlinien.de/themen/depression
  2. [2] ICD-10-GM Version 2025 — Chapter V: Mental and behavioural disorders (F00–F99) Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM). bfarm.de · ICD-10-GM
  3. [3] Federal Health Reporting — Depression Robert Koch-Institut, Berlin. Data on the prevalence and care of depressive disorders in Germany. rki.de · Health Monitoring
  4. [4] Depression — World Health Organization WHO Fact Sheets, updated 2023. who.int · Depression
  5. [5] Stiftung Deutsche Depressionshilfe Evidence-based information, self-tests and support resources for those affected and their relatives. deutsche-depressionshilfe.de
  6. [6] DGPPN — Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde Professional medical society with patient guidelines on depressive disorders. dgppn.de
Further reading
II. Anxiety & Panic Disorders → III. Psychosomatic Medicine → IV. Personality →
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Patients of some statutory health insurance providers (e.g. Techniker Krankenkasse and DAK) may in certain cases be able to obtain partial cost reimbursement from their insurer.

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