Introduction:

Depression is a mental health condition that affects millions of people worldwide, yet it remains one of the most misunderstood and stigmatized disorders. While everyone experiences sadness or low moods from time to time, depression is more than just feeling down; it’s a persistent, often debilitating condition that can impact all aspects of a person’s life. Understanding the causes, symptoms, and ways to cope, is crucial for those who experience it and those who wish to support others who are struggling.

Key Facts Abbout Depression [WHO]

• Depression is a widespread mental health disorder.
• Globally, around 5% of adults suffer from depression.
• Women are more commonly affected by depression than men.
• Depression can lead to suicide if left untreated.
• There are effective treatments available for mild, moderate, and severe depression.

What is Depression?

Depressive disorder, commonly referred to as depression, is a prevalent mental health condition marked by a persistent feelings of sadness, hopelessness, and a loss of interest in activities once enjoyed. It is not a sign of personal weakness or something that can simply be “snapped out of.” It is a complex mental health condition with biological, psychological, and environmental factors at play. Unlike regular mood swings or temporary feelings of sadness, depression can interfere with daily life, including work, relationships, and social engagement.

Depression is a serious condition that affects anyone, though it is more common among individuals who have experienced trauma, abuse, or significant life stressors. Women are more likely than men to experience depression. Globally, about 3.8% of the population has depression, including 5% of adults (4% in men and 6% in women) and 5.7% of adults aged 60 or older. In total, approximately 280 million people worldwide live with depression. Women are nearly 50% more likely to develop depression than men, and over 10% of pregnant women and new mothers experience depression.

Tragically, over 700,000 people die by suicide each year, and suicide is the fourth leading cause of death among 15–29-year-olds. Despite the availability of effective treatments, more than 75% of people in low- and middle-income countries do not receive the care they need. Barriers to care include insufficient mental health resources, lack of trained professionals, and the stigma surrounding mental health.

Symptoms of Depression

Depression shows various symptoms that can affect a person emotionally, mentally, and physically. The main symptom is a persistent low mood or a loss of interest in activities once enjoyed. These feelings last for at least two weeks and interfere with daily functioning. The symptoms of depression can vary widely from person to person, but common symptoms include:

• Persistent feelings of sadness, hopelessness, or emptiness
• Loss of interest in activities once enjoyed (such as hobbies, socializing, or work)
• Fatigue or lack of energy despite getting enough rest
• Changes in appetite or weight, either weight loss or weight gain
• Sleep disturbances, such as insomnia or excessive sleeping
• Difficulty concentrating or making decisions
• Feelings of worthlessness or guilt, often disproportionate to the situation
• Thoughts of death or suicide (in severe cases)

For a diagnosis of depression, these symptoms must persist for at least two weeks and interfere with daily life. It’s important to note that not everyone with depression will experience all these symptoms, and some people may experience additional symptoms, such as physical pain (headaches, backaches), without the typical emotional symptoms.

Depression can cause difficulties in all aspects of life, including in the community and at home, work and school. Depending on the number and severity of symptoms as well as the impact on the individual’s functioning a depressive episode can be categorized as mild, moderate, or severe. There are different patterns of depressive episodes including:

• Single episode depressive disorder: The individual experiences a first and only episode.
• Recurrent depressive disorder: The individual has a history of two or more depressive episodes.
• Bipolar disorder: Depressive episodes alternate with periods of manic symptoms, which include euphoria or irritability, increased activity or energy, and other symptoms such as increased talkativeness, racing thoughts, increased self-esteem, decreased need for sleep, distractibility, and impulsive reckless behaviour.

Causes of Depression

Depression can result from a combination of factors such as biological, psychological, and social factors. Life stressors such as unemployment, bereavement, and trauma are significant contributors to the development of depression. Furthermore, depression can create a vicious cycle making life challenges seem more insurmountable, which in turn worsens the depression.

Physical health also plays a significant role in depression. Factors like physical inactivity and alcohol misuse not only contribute to depression but also increase the risk of conditions like heart disease, cancer, diabetes, and respiratory diseases. Managing chronic illnesses may be particularly challenging for those also experiencing depression. The following are common contributors:

1. Genetic Factors: Depression tends to run in families, suggesting a genetic predisposition. If a person has a parent or sibling with depression, they may be more likely to experience it. According to Stanford Medicine 50% of the depression is releted to Genetic Factors. For more details please read more here.
2. Life Events and Stress: Traumatic events such as the loss of a loved one, a divorce, financial problems, or work-related stress can trigger depression. Chronic stress, particularly during childhood, can increase the likelihood of depression later in life.
3. Hormonal Changes: Major life changes, such as pregnancy, childbirth, menopause, or thyroid problems, can trigger depressive episodes due to hormonal shifts.
4. Chronic Illness: Long-term illnesses like cancer, diabetes, and chronic pain conditions can increase the risk of depression. Additionally, depression often worsens symptoms of physical illness, creating a cycle of worsening health.
5. Negative Thought Patterns: People who have a tendency to focus on negative thoughts, self-criticism, or pessimism are more prone to depression. Cognitive distortions can affect how a person perceives themselves, their life, and the world around them.

How Depression Affects Quality of Life

Depression can have a profound impact on various aspects of life. It may affect:

• Relationships: People with depression may withdraw from family and friends, making communication difficult. The emotional distance can strain relationships and create feelings of loneliness or isolation.
• Work or School Performance: Depression can reduce energy and motivation, making it difficult to meet deadlines, concentrate, or perform tasks effectively.
• Physical Health: Depression can also affect the body in terms of sleep patterns, appetite, and physical discomfort. People with depression are at higher risk for developing other health problems, such as heart disease or diabetes, due to the stress and neglect of self-care.
• Overall Quality of Life: Depression can diminish a person’s enjoyment of life and make even basic activities seem overwhelming. This can lead to a cycle of negativity, where the person feels incapable of breaking out of their condition.

Coping with Depression

Although depression can feel overwhelming, there are ways to manage and cope with the symptoms. Prevention is possible through early intervention and support. Community-based programs such as school-based mental health programs and exercise initiatives for older adults have proven effective in reducing depression. Addressing parental depression can also benefit children’s well-being and prevent further mental health issues.

There are effective treatments available for depression, including both psychological therapy and medications. The goal is to provide individuals with the tools they need to manage their symptoms and improve their quality of life. Here are some strategies that can help:

1. Seek Professional Help: The most effective treatment for depression is often a combination of therapy and medication. Cognitive-behavioral therapy (CBT) is a common form of talk therapy that helps individuals reframe negative thought patterns. Antidepressants may also be prescribed to help regulate mood and improve mental well-being. If you are struggling with depression, it’s important to talk to a healthcare provider or mental health professional about your symptoms and treatment options.
2. Build a Support System: Isolation can worsen depression. Reaching out to friends, family, or support groups can provide emotional comfort and validation. Sharing your experiences with others who understand can reduce feelings of loneliness.
3. Exercise Regularly: Physical activity can boost serotonin and endorphins, chemicals that improve mood. Regular exercise has been shown to have a significant positive impact on mental health and can help reduce the severity of depression symptoms.
4. Create a Routine: Establishing a daily routine can bring structure to your day and help combat feelings of chaos or helplessness. Try to set small, achievable goals that give you a sense of accomplishment.
5. Practice Mindfulness and Meditation: Techniques like mindfulness, deep breathing, and meditation can help you focus on the present moment and reduce feelings of anxiety or rumination. These practices promote relaxation and mental clarity.
6. Limit Alcohol and Drug Use: Alcohol and drugs can exacerbate symptoms of depression and make it harder to recover. Limiting or avoiding substance use can improve your mood and help you focus on recovery.
7. Take Care of Your Health: Depression can affect sleep and appetite, but it’s important to prioritize self-care. Make sure you’re getting adequate rest, eating healthy meals, and staying hydrated. Healthy habits support mental well-being.

When to Seek Immediate Help

If you or someone you know is experiencing thoughts of self-harm or suicide, it’s critical to seek help immediately. Contact a mental health professional, a trusted friend or family member, or a helpline. In many countries, there are suicide prevention hotlines that offer 24/7 support.

Conclusion

Depression is a serious mental health condition that requires understanding, compassion, and treatment. It’s essential to acknowledge the importance of seeking help and building a support system. While it may take time to manage depression effectively, with the right treatment and coping strategies, it’s possible to live a fulfilling life and regain a sense of joy and purpose. If you are struggling, remember that you are not alone, and there is help available to guide you through the journey toward recovery.

References

1. Institute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx). https://vizhub.healthdata.org/gbd-results/ (Accessed 4 March 2023).
2. Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92.
3. Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, et al. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med. 2018;48(9):1560-1571.