Experts Examine Ways to Reduce Global Burden of Depression

With a mountain of evidence indicating successful methods to prevent depression and aid in treatment efforts, a new study shows that 5% of adults worldwide or suffering from depression. Of these individuals in high-income countries, approximately half are not diagnosed or treated, which increases to between 80% and 90% in low- and middle-income countries, according to the study, conducted via a joint effort between The Lancet and World Psychiatric Association Commission on Depression.

The COVID-19 pandemic created supplementary challenges, such as social isolation, bereavement, uncertainty, hardship, and limited access to health care services, which had a significantly negative impact on the mental health of millions.

The commission “Time for United Action on Depression,” authored by 25 experts from 11 countries, seeks to unify global efforts among governments, health care providers, researchers, people living with depression, and their families to improve care and prevention, fill knowledge gaps, and increase awareness.

“We know that most individuals with depression at all stages of life will recover if they obtain adequate support and treatment. With sound science, political will, and shared responsibility, depression can be prevented and treated and potentially disabling consequences avoided,” said co-author Charles Reynolds, MD, from the University of Pittsburgh, in a press release. “We must empower people with experience of depression together with families, practitioners, policymakers and civil society to address the tsunami of unmet need—through sharing their experiences to reduce stigma, supporting others with information about the condition and possibilities for help, and advocating for greater resources for evidence-based approaches.”

The panel of experts noted that depression is not only feelings of sadness, but is a health condition characterized by having a significant impact on daily functioning and long-term health consequences that can affect anyone.

“There is arguably no other health condition which is as common, as burdensome, as universal, or as treatable as depression, yet it receives little policy attention and resources”, said commission co-chair, associate professor Christian Kieling from the Universidade Federal do Rio Grande do Sul in Brazil, in a press release. “Effective psychosocial and medical treatments are difficult to access, while high levels of stigma still prevent many people, including the high proportion of adolescents and young people at risk for or experiencing depression, from seeking the help required to have healthy and productive lives.”

Whole-of-society strategies are recommended by the commission to further eliminate exposure to both adverse experiences in childhood through adulthood to reduce the occurrence of depression. The panels also suggest interventions at the individual level, which would focus on lifestyle factors and other risk factors that can impact mood.

“Prevention is the most neglected aspect of depression. This in part because most interventions are outside of the health sector,” said co-author Lakshmi Vijayakumar, MD, from the Suicide Prevention Centre and Voluntary Health Services, Chennai, India, in the press release. “In the face of the lifelong effects of adolescent depression, from difficulty in school and future relationships to risk of substance abuse, self-harm, and suicide, investing in depression prevention is excellent value for money. It is crucial that we put into practice evidence-based interventions that support parenting, reduce violence in the family, and bullying at school, as well promoting mental health at work and addressing loneliness in older adults. Common risk factors and high rates of depression among people with chronic health problems also support shared preventive approaches.”

In the current classification system, people with symptoms of depression are split into clinical depression or no clinical depression; however, the commission noted that depression is more complex than that. A more personalized, staged approach that can recognize the intensity of symptoms tailored to a person’s specific needs is better supported, according to the commision.

“No 2 individuals share the exact life story and constitution, which ultimately leads to a unique experience of depression and different needs for help, support, and treatment”, said commission co-chair, professor Vikram Patel from Harvard Medical School, in a press release. “Similar to cancer care, the staged approach looks at depression along a continuum—from wellness, to temporary distress, to an actual depressive disorder—and provides a framework for recommending proportional interventions from the earliest point in the illness.”

As for solutions, the commission noted that using low-cost non-specialists, such as community health workers, can help to address the shortage of skilled providers and financial barriers. This was recommended especially for low-income countries, but also applies to any area in the world to help with the depression rates.

REFERENCE

THE LANCET: Overlooked and underfunded—experts call for united action to reduce the global burden of depression. EurekAlert! February 15, 2022. Accessed February 18, 2022. https://www.eurekalert.org/news-releases/943069