Depression

OVERVIEW

 An estimated 3.8% of the world's population suffers from depression, with 5.0% of adults and 5.7% of adults over 60 years of age being affected (1). Around 280 million people worldwide suffer from depression (1). Depression is distinct from common mood swings and fleeting emotional reactions to problems in daily life. Depression may develop into a serious medical condition, especially if it is recurrent and of moderate to severe intensity. The affected person may experience severe suffering and perform poorly at work, in school, and in the family. Suicide can result from depression at its worst. Every year, over 700,000 people die by suicide. For people aged 15 to 29, suicide is the fourth most common cause of death.

Symptoms and patterns

A depressive episode lasts at least two weeks and is characterised by a depressed mood (sad, irritable, or empty feelings) or a loss of enjoyment or interest in activities for the majority of each day. Other signs may include difficulty concentrating, feelings of excessive guilt or low self-worth, a lack of hope for the future, suicidal or death thoughts, disturbed sleep, changes in appetite, and feeling particularly exhausted or low on energy.

Some people may express their mood swings more readily through physical symptoms in certain cultural contexts (e.g. pain, fatigue, weakness). But no other medical condition is to blame for these physical symptoms.

Contributing factors and prevention

A complex interaction of social, psychological, and biological factors causes depression. Depression is more likely to develop in people who have experienced traumatic events, such as unemployment or bereavement. Depression can exacerbate an individual's current situation and the depression itself by increasing stress and dysfunction.

There are connections between physical health and depression. For instance, depression can result from cardiovascular disease, and vice versa.

Programs for prevention have been shown to lessen depression. School-based initiatives to improve children's and adolescents' positive coping behaviours are examples of effective community initiatives to prevent depression. 

Diagnosis and treatment

Depression can be effectively treated.

Health care providers may prescribe antidepressant drugs like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants in addition to psychological therapies like behavioural activation, cognitive behavioural therapy, and interpersonal psychotherapy, depending on the severity and pattern of depressive episodes over time (TCAs). Bipolar disorder is treated with various drugs. The potential side effects of antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences should all be taken into consideration by healthcare professionals. Individual and/or group face-to-face psychological treatments provided by trained professionals and under the supervision of lay therapists are among the various psychological treatment formats to be taken into account. For mild depression, antidepressants are not usually the first course of treatment. They shouldn't be used to treat paediatric depression.