Depressive Disorder (Depression)
Key Facts:
Overview:
Depressive disorder, also known as depression, is a prevalent mental health condition. It is characterized
by a persistent low mood or a prolonged loss of interest and pleasure in daily activities.
Depression differs from ordinary mood fluctuations and the emotional responses to everyday challenges.
It can impact all aspects of life, including relationships with family, friends, and the broader community.
It may result from or lead to academic or professional difficulties.
Anyone can experience depression. Individuals who have suffered abuse or have faced traumatic losses
or other stressful events are more susceptible to depression. Women are more frequently affected than
men.
Approximately 3.8% of the global population is affected by depression, including 5% of adults (4% of
men and 6% of women) and 5.7% of individuals over 60 years old. Worldwide, about 280 million people have depression. It is 50% more common in women than in men. Globally, over 10% of pregnant
and postpartum women experience depression. More than 700,000 people die by suicide each year,
making it
the fourth leading cause of death among 15-29-year-olds.
Despite the availability of effective treatments for mental disorders, over 75% of people in low- and
middle-income countries receive no treatment. Barriers include a lack of resources, insufficient
investment in mental health care, a shortage of trained healthcare providers, and societal stigma
associated with mental disorders.
Symptoms and Types:
A depressive episode is characterized by a low mood (feelings of sadness, emptiness, or irritability)
often accompanied by a loss of interest or pleasure in activities.
Depressive episodes differ from typical mood fluctuations. In a depressive episode, the low mood
persists most of the day, nearly every day, for at least two weeks.
Other symptoms include:
Depression can cause difficulties in all areas of life, affecting relationships, family dynamics, and professional or academic performance.
A depressive episode can be classified as mild, moderate, or severe based on the number and severity
of symptoms and their impact on daily functioning.
Different types of depressive disorders include:
Risk Factors and Prevention:
Depression results from a complex interaction of social, psychological, and biological factors.
Individuals who have faced adversity (unemployment, bereavement, trauma) are more likely to
develop depression. Depression can, in turn, lead to more stress and dysfunction, worsening the
affected person's situation and depression.
Depression is closely linked to physical health. Many factors influencing depression (such as
physical inactivity or harmful alcohol use) are also known risk factors for diseases like cardiovascular diseases, cancer, diabetes, and respiratory conditions. Individuals with these diseases may
also experience
depression due to the challenges associated with managing their condition.
Effective prevention programs for depression exist. Community approaches include school-based
programs aimed at enhancing coping skills in children and adolescents. Interventions for parents of
children with behavioral problems can alleviate depressive symptoms in parents and have positive
effects on their children. Exercise programs for the elderly can also effectively prevent depression.
Diagnosis and Treatment:
Effective psychotherapies and medications are available for depression. If you experience symptoms
of depression, consult a healthcare professional.
Psychotherapies are the primary treatments for depression. In cases of moderate or severe depression,
they may be combined with antidepressants. Antidepressants are not necessary for treating mild
depression.
Psychotherapies can change ways of thinking, coping with challenges, or relating to others. They may involve talking therapy with professionals or supervised lay therapists. Therapy can be conducted in
person or online. Some self-help manuals, websites, and mobile applications offer psychological
support.
Effective psychotherapies for depression include:
Among antidepressants, selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine,
are commonly used.
Healthcare providers should consider possible side effects associated with antidepressants,
the availability of interventions (in terms of skills and/or treatment availability), and individual
preferences.
Antidepressants should not be used to treat depression in children and are not the first line of
treatment for adolescents, who should be monitored closely if prescribed these medications.
Managing bipolar disorder involves various medications and treatments.
Self-Care:
Self-care is important for alleviating depressive symptoms and promoting overall well-being.
What you can do:
If you have suicidal thoughts:
If you believe you are at immediate risk of self-harm, contact emergency services or a crisis hotline.
WHO's Role:
The World Health Organization's (WHO) Mental Health Action Plan 2013-2030 outlines
measures to provide appropriate interventions for individuals with mental disorders, including
depression.
Depression, self-harm, and suicide are among the priority conditions covered by WHO's Mental
Health Gap Action Programme (mhGAP). This program aims to help countries scale up services
for people with mental, neurological, or substance use disorders through care provided by
non-specialist healthcare providers.
WHO has developed brief psychological intervention manuals for treating depression, which
can be delivered by lay therapists to individuals and groups. For example, the "Problem Management
Plus" manual describes the use of behavioral activation, stress management, problem-solving
therapy, and strengthening social support. Additionally, the "Group Interpersonal Therapy
(IPT) for Depression" manual outlines group therapy used to treat depression. Finally, the
"Thinking Healthy" manual covers the use of cognitive-behavioral therapy for perinatal depression.
