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“You can now think about how you have been since yesterday afternoon and what positive experiences you have experienced,” says the therapist in a calm voice.
She is sitting in a chair with a notepad and pen.
Five patients, each at a single large table, look attentively at her.
"I managed to go to Edeka," says a woman quietly under her mask.
Another reports: "I made waffle batter for the children." The therapist nods approvingly.
“And you?” She turns to a younger patient.
There is silence for a moment.
“At home, I felt sad right away,” she finally replies.
"I could hardly eat anything."
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Every morning the patients in the psychiatric day clinic at the Ingolstadt Clinic discuss how they felt the day before.
The facility welcomes patients Monday to Friday from 8 a.m. to 4 p.m., in the evenings and on weekends they are on their own.
A red poster hangs on the wall in the lounge with the inscription: "You don't get a good day for free, you have to take it." Since the outbreak of the corona pandemic, there have been more and more people who are no longer able to do so .
The Ingolstadt Clinic in Ingolstadt in Upper Bavaria
Source: Oliver Soulas
According to a survey by the German Depression Aid Foundation in March, almost every second person suffering from depression experienced a deterioration in their disease progression in the past six months.
Eight percent of those surveyed had thoughts of suicide.
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For the general population, too, the situation is more stressful than ever before: 71 percent of German citizens perceive the situation in the second lockdown as emotionally depressing, in the first lockdown it was 59 percent.
"At the limit of what is affordable"
It is precisely in this tense situation that most psychiatric day clinics can accept fewer patients than usual. Thomas Pollmächer is director of the clinic in Ingolstadt and chairman of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology.
"Many day clinics reduce the number of patients by more than 50 percent because of the distance rules," he reports.
In many cases, video therapy sessions would be offered as a substitute.
Clinic director Thomas Pollmächer
Source: Claudia Burger / DGPPN
During the first lockdown, a number of facilities had closed, including the day clinic in Ingolstadt for two months.
"After the supply freeze, there was a rush of patients in the summer that continues to this day," says Pollmächer.
Initially, it was people whose treatment had been postponed in the spring.
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Later came those who experienced a worsening of their symptoms - or who only became ill because of the circumstances in the lockdown.
In addition, there are more and more patients who no longer want to stay in clinics overnight.
"Since then we have been at the limit of what is affordable."
After all, the day clinic in Ingolstadt is lucky: In order to be able to adhere to the prescribed distance rules, theoretically half of the patients would have had to be discharged here as well.
The everyday rules for fighting corona also apply here
Source: Oliver Soulas
However, the facility has been able to use the rooms on the floor below since the beginning of the Corona crisis.
In normal times, the acute geriatric unit is housed there, i.e. a ward for very old people.
Because of the high risk of infection for this group of patients, the department has been closed since last spring.
For example, the daily morning round of the day clinic can take place in two rooms at the same time.
Most patients suffer from depression, some from anxiety and bipolar disorder.
On average, they come here for seven weeks, some for up to six months.
"For the first time it's all about me"
On this Tuesday morning, occupational therapy is on the program.
30-year-old Sophie Meyer, who doesn't want to read her real name in the media, sits at a long wooden table and sews a jute bag with concentration.
She is wearing a dress with a floral pattern, and her dark blonde hair is tied in a braid.
“In the beginning, this exercise was a waste of time for me,” she says as she pulls a long piece of fabric through the sewing machine.
Then she looks up.
"I now know: The point is that I enjoy the exercise." Meyer is in the clinic because of a psychosis.
At the beginning of winter she was first placed in a closed facility and later in an open ward;
now the day clinic is her last stop.
Occupational therapy for depressed people: a look at the psychiatric day clinic in Ingolstadt
Source: Oliver Soulas
This is what the room for occupational therapy looks like
Source: Kaja Klapsa / WELT
The young mother was on the verge of her strength last year, also because of the pandemic-related homeschooling and home office.
Her symptoms finally began during a two-week quarantine after a corona case occurred in her family.
That's how she tells it.
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Her thoughts went increasingly crazy, experiences of violence from her childhood came up.
Then there was panic, later delusions.
"I had both feet on my feet and two weeks later I was picked up by the ambulance screaming," she says.
In the clinic, she now holds discussions with psychologists several times a week, and music and occupational therapy as well as meditation are also on the program.
This is very unusual for Meyer, who became pregnant at the age of 18.
“For the first time in my life, it's all about me,” she says.
She is determined to pay more attention to her own needs even after the treatment.
As a first step, she ordered a sewing machine.
Waiting time for the first preliminary talk: six weeks
Iris Urmann, a psychological psychotherapist, sits two rooms away at her desk in her office.
There are pictures on the wall that the patients painted during occupational therapy.
"Since the beginning of the second wave, we have seen an increase in those suffering from corona," says the 49-year-old.
Iris Urmann: "Corona is usually not the sole cause of the disease"
Source: Kaja Klapsa / WELT
It is mostly about people who already have a predisposition to a mental illness.
Because of the social isolation or the pandemic-related overload due to family and work, those affected now experienced an outbreak or an exacerbation of their symptoms, reports Urmann.
"Corona is usually not the sole cause of the disease, but it is an extreme intensifier," she says.
Urmann looks worriedly at the screen of her computer, the current occupancy schedule can be seen.
“The waiting time for the first preliminary talk is currently six weeks,” she says.
The demand for the 24 seats is high.
Not everyone who needs treatment will be able to get it.
It is noticeable that the referred patients are getting younger and younger.
The youngest patient in the Ingolstadt day clinic is currently 21 years old.
He's sitting at lunch in a black hoodie and sneakers.
In front of him is a plate with pasta, bacon and cream sauce.
He's been in the clinic for two weeks, diagnosed with depression.
What he likes most is everyday life in the facility, he says shyly.
Having to be on site at eight o'clock every morning gives structure to his day.
At home he had an irregular rhythm, he says.
On some nights he only slept three hours, on others 20. He managed to get out of the house less and less.
The lectures at the university were only held online anyway.
His social isolation increased.
Learning to understand your own mental illness - that's also what it's about
Source: Oliver Soulas
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“This is my first time talking to people again,” he says.
"And then they are just like me." It is comforting to know that he is not the only one who is feeling bad.
Before, before his illness, he liked to meet friends, played the piano and wanted to get a license.
And today?
"I feel nothing.
Neither sadness nor joy. ”Every day he takes pills, antidepressants that give him more drive, but also make him tremble and his pulse rise.
Clinic director Pollmächer hopes that mental health will get more attention after the pandemic.
“More than one in four suffers from a mental illness within a year,” he says.
He would like politics to put prevention high on the agenda in the super election year 2021.
Education in schools and at work as well as more contact points for people from precarious backgrounds is particularly important.
“In the pandemic in particular, many people do not notice for months that they are becoming depressed.
They do feel symptoms, such as sleep disorders and restlessness, but think that this is normal and hope that it will soon go away on its own, ”explains Pollmächer.
Only when they can no longer go to work in the morning do they realize that something is wrong.
But then a quick recovery is already difficult.