Depression

What is Depression?

Depression is a mental illness characterized by a depressed mood and reluctance to act. Depression affects a person's thoughts, conduct, motivation, feelings, and sense of well-being, and is classified medically as a mental and behavioral condition. Anhedonia is thought to be the most common symptom of depression, and it refers to a loss of interest or pleasure in things that normally bring individuals delight. Depressed mood is a symptom of some mood disorders, such as major depressive disorder or dysthymia; it is also a typical transitory reaction to life events, such as the death of a loved one; and it is a sign of some physical ailments and a side effect of some drugs and medical treatments.

“Every man has his secret sorrows which the world knows not; and often times we call a man cold when he is only sad.”

― Henry Wadsworth Longfellow

Sadness, difficulty thinking and concentrating, and a large rise or decrease in hunger and sleep duration are all possible symptoms. People who are depressed may experience feelings of despair, hopelessness, and suicidal ideation. It can be either short-term or long-term in nature.

Epidemiology

According to the United Nations (UN) health organization, depression is the largest cause of disability globally, affecting over 300 million people, the majority of whom are women, young people, and the elderly. According to a survey provided by the United Nations World Health Organization (WHO), an estimated 4.4 percent of the global population suffers from depression, with an 18 percent increase in the number of individuals living with depression between 2005 and 2015.

Depression is a leading cause of disease burden in the mental health sector. Its implications have a substantial influence on public health, including an increased risk of dementia, premature mortality due to physical illnesses, and the effects of maternal depression on infant growth and development. In low- and middle-income nations, between 76 percent to 85 percent of depressed persons do not obtain treatment; hurdles to treatment include erroneous assessment, a lack of qualified healthcare practitioners, societal stigma, and a lack of money.

The stigma stems from erroneous cultural beliefs that people with mental illnesses are different from everyone else and can only choose to improve if they want to. As a result, more than half of those suffering from depression who require treatment do not obtain it. 

The World Health Organization has constructed guidelines—known as The Mental Health Gap Action Programme (mhGAP)—aiming to increase services for people with mental, neurological, and substance use disorders. Depression is listed as one of the conditions prioritized by the program. Trials conducted show possibilities for the implementation of the program in low-resource primary-care settings dependent on primary-care practitioners and lay health workers. Examples of mhGAP-endorsed therapies targeting depression include Group Interpersonal Therapy as a group treatment for depression and "Thinking Health," which utilizes cognitive behavioral therapy to tackle perinatal depression. Furthermore, effective screening in primary care is crucial for access to treatments. The map adopted its approach of improving detection rates of depression by training general practitioners. However, there is still weak evidence supporting this training.

The Mental Health Gap Action Programme (mhGAP) is a set of guidelines developed by the World Health Organization to improve services for people with mental, neurological, and substance use problems. Depression is one of the conditions that the program prioritizes. Trials have shown that the program may be implemented in low-resource primary-care settings with the help of primary-care practitioners and lay health workers. Group Interpersonal Therapy, group treatment for depression, and "Thinking Health," which uses cognitive behavioral therapy to address postpartum depression, are two mhGAP-endorsed depression therapies. In addition, good screening in primary care is critical for treatment access. The map took the strategy of training general practitioners to improve depression identification rates. However, the evidence for this training is still inconclusive.