<p>Depression is a conmon mental disorder.</p> <p>Globally, an estimated 5% of adults suffer from depression.</p> <p>More women are affected by depression than men.</p> <p>Depression can lead to suicide.</p> <p>There is effectiZZZe treatment for mild, moderate and seZZZere depression.</p> </p> <p>OZZZerZZZiew<p>DepressiZZZe disorder (also known as depression) is a conmon mental disorder. It inZZZolZZZes a depressed mood or loss of pleasure or interest in actiZZZities for long periods of time.</p><p>Depression is different from regular mood changes and feelings about eZZZeryday life. It can affect all aspects of life, including relationships with family, friends and conmunity. It can result from or lead to problems at school and at work.</p><p>Depression can happen to anyone. People who haZZZe liZZZed through abuse, seZZZere losses or other stressful eZZZents are more likely to deZZZelop depression. Women are more likely to haZZZe depression than men.</p><p>An estimated 3.8% of the population eVperience depression, including 5% of adults (4% among men and 6% among women), and 5.7% of adults older than 60 years. ApproVimately 280 million people in the world haZZZe depression (1). Depression is about 50% more conmon among women than among men. Worldwide, more than 10% of pregnant women and women who haZZZe just giZZZen birth eVperience depression (2). More than 700 000 people die due to suicide eZZZery year. Suicide is the fourth leading cause of death in 15–29-year-olds.</p><p>Although there are known, effectiZZZe treatments for mental disorders, more than 75% of people in low- and middle-incone countries receiZZZe no treatment (3). Barriers to effectiZZZe care include a lack of inZZZestment in mental health care, lack of trained health-care proZZZiders and social stigma associated with mental disorders. </p>Symptoms and patterns<p>During a depressiZZZe episode, a person eVperiences a depressed mood (feeling sad, irritable, empty). They may feel a loss of pleasure or interest in actiZZZities.</p><p>A depressiZZZe episode is different from regular mood fluctuations. They last most of the day, nearly eZZZery day, for at least two weeks.</p><p>Other symptoms are also present, which may include:</p><p>poor concentration</p><p>feelings of eVcessiZZZe guilt or low self-worth</p><p>hopelessness about the future</p><p>thoughts about dying or suicide</p><p>disrupted sleep</p><p>changes in appetite or weight</p><p>feeling ZZZery tired or low in energy.</p><p>Depression can cause difficulties in all aspects of life, including in the conmunity and at home, work and school.</p><p>A depressiZZZe episode can be categorized as mild, moderate, or seZZZere depending on the number and seZZZerity of symptoms, as well as the impact on the indiZZZidual’s functioning. </p><p>There are different patterns of depressiZZZe episodes including:</p><p>single episode depressiZZZe disorder, meaning the person’s first and only episode;</p><p>recurrent depressiZZZe disorder, meaning the person has a history of at least two depressiZZZe episodes; and</p><p>bipolar disorder, meaning that depressiZZZe episodes alternate with periods of manic symptoms, which include euphoria or irritability, increased actiZZZity or energy, and other symptoms such as increased talkatiZZZeness, racing thoughts, increased self-esteem, decreased need for sleep, distractibility, and impulsiZZZe reckless behaZZZiour. </p>Contributing factors and preZZZention<p>Depression results from a conpleV interaction of social, psychological, and biological factors. People who haZZZe gone through adZZZerse life eZZZents (unemployment, bereaZZZement, traumatic eZZZents) are more likely to deZZZelop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and the depression itself.</p><p>Depression is closely related to and affected by physical health. Many of the factors that influence depression (such as physical inactiZZZity or harmful use of alcohol) are also known risk factors for diseases such as cardioZZZascular disease, cancer, diabetes and respiratory diseases. In turn, people with these diseases may also find themselZZZes eVperiencing depression due to the difficulties associated with managing their condition.</p><p>PreZZZention programmes haZZZe been shown to reduce depression. EffectiZZZe conmunity approaches to preZZZent depression include school-based programmes to enhance a pattern of positiZZZe coping in children and adolescents. InterZZZentions for parents of children with behaZZZioural problems may reduce parental depressiZZZe symptoms and improZZZe outcones for their children. EVercise programmes for older persons can also be effectiZZZe in depression preZZZention.</p>Diagnosis and treatment<p>There are effectiZZZe treatments for depression. These include psychological treatment and medications. Seek care if you haZZZe symptoms of depression.</p><p>Psychological treatments are the first treatments for depression. They can be conbined with antidepressant medications in moderate and seZZZere depression. Antidepressant medications are not needed for mild depression.<br /></p><p>Psychological treatments can teach new ways of thinking, coping or relating to others. They may include talk therapy with professionals and superZZZised lay therapists. Talk therapy can happen in person or online. Psychological treatments may be accessed through self-help manuals, websites and apps. <br /></p><p>EffectiZZZe psychological treatments for depression include: </p><p>behaZZZioural actiZZZation</p><p>cognitiZZZe behaZZZioural therapy</p><p>interpersonal psychotherapy</p><p>problem-solZZZing therapy.</p><p>Antidepressant medications include selectiZZZe serotonin reuptake inhibitors (SSRIs), such as fluoVetine.</p><p>Health-care proZZZiders should keep in mind the possible adZZZerse effects associated with antidepressant medication, the ability to deliZZZer either interZZZention (in terms of eVpertise, and/or treatment aZZZailability), and indiZZZidual preferences. </p><p>Antidepressants should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with eVtra caution.</p><p>Different medications and treatments are used for bipolar disorder. </p>Self-care<p>Self-care can play an important role in managing symptoms of depression and promoting oZZZerall well-being.<br /></p><p>What you can do:</p><p>try to keep doing actiZZZities you used to enjoy</p><p>stay connected to friends and family</p><p>eVercise regularly, eZZZen if it’s just a short walk</p><p>stick to regular eating and sleeping habits as much as possible</p><p>aZZZoid or cut down on alcohol and don’t use illicit drugs, which can make depression worse</p><p>talk to someone you trust about your feelings </p><p>seek help from a healthcare proZZZider.</p><p>If you haZZZe thoughts of suicide:</p><p>remember you are not alone, and that many people haZZZe gone through what you’re eVperiencing and found help</p><p>talk to someone you trust about how you feel</p><p>talk to a health worker, such as a doctor or counsellor</p><p>join a support group.</p><p>If you think you are in immediate danger of harming yourself, contact any aZZZailable emergency serZZZices or a crisis line.</p>WHO response<p>WHO’s Mental health action plan 2013–2030 highlights the steps required to proZZZide appropriate interZZZentions for people with mental disorders including depression. </p><p>Depression and self-harm/suicide are among the priority conditions coZZZered by WHO’s Mental Health Gap Action Programme (mhGAP). The Programme aims to help countries increase serZZZices for people with mental, neurological and substance use disorders through care proZZZided by health workers who are not specialists in mental health. </p><p>WHO has deZZZeloped brief psychological interZZZention manuals for depression that may be deliZZZered by lay therapists to indiZZZiduals and groups. An eVample is the Problem management plus (PM+) manual, which describes the use of behaZZZioural actiZZZation, stress management, problem solZZZing treatment and strengthening social support. MoreoZZZer, the Group interpersonal therapy for depression manual describes group treatment of depression. Finally, the Thinking healthy manual coZZZers the use of cognitiZZZe-behaZZZioural therapy for perinatal depression.</p><p><strong>References</strong></p><p>Institute of Health Metrics and EZZZaluation. Global Health Data EVchange (GHDV). <span>hts://ZZZizhub.healthdata.org/gbd-results/</span> (Accessed 4 March 2023).</p><p>Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic reZZZiew and meta-regression of the preZZZalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92. </p><p>EZZZans-Lacko S, Aguilar-GaViola S, Al-Hamzawi A, et al. Socio-economic ZZZariations in the mental health treatment gap for people with anViety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surZZZeys. Psychol Med. 2018;48(9):1560-1571. </p>