depression

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Introduction

Clinical, unipolar depression is more than just feeling low for a day or two.

Depression is characterised as episodes of sadness, loss of interest and pleasure, often including feelings of low self-worth. Depression can also include a range of physiological symptoms, such as fatigue, pain, diminished appetite, lack of interest in sex, disturbed sleep, and poor concentration.

The World Health Organisation estimates that, globally, as many as 350 million people are affected at any given time, with one person in 20 reporting an episode of depression in a 12 month period (in a global sample of 17 countries). They describe depression as the leading cause of disability worldwide.

What we know already

We know that, despite the considerable global burden of depression, not everybody receives treatment, with figures ranging from 50% to 10% in less developed countries.

Evidence suggests that combined psychological and pharmacological treatments seem to work well. Broadly, we know that psychotherapies work in many cases – but not every time. We know that neurochemical factors, such as serotonergic dysfunction, play an important role in depression, which goes a long way in explaining the efficacy of SSRI treatments.

We also know that depression has a nasty habit of recurrence, and some psychological interventions, such as Mindfulness-Based Cognitive Therapy (MBCT) is recommended particularly for people who have experienced multiple episodes of depression, but not are currently severely depressed.

We know that people living with chronic physical illness are more likely to experience depression, and this combination is linked with poorer clinical outcomes.

Importantly though, we know that people with depression can still enjoy themselves, and a common misconception in depression is that people feel totally awful all of the time.

Areas of uncertainty

There is much still to determine. For example, we know that depression is hereditable, however the extent of heredity versus environmental influences are unclear.

We are also unsure as to the precise mechanisms that determine those who respond best to treatments, be they psychopharmacological, or psychological, or both.

What’s in the pipeline?

Despite advances in our understanding of depression, and how it is treated, it remains a highly recurrent difficulty, with many people not achieving complete remission between episodes.

Preventative interventions, either physiological, or psychological, may improve people’s resilience to depression, particularly those identified as being highly prone.

References

Cuijpers, P. (2015). Psychotherapies for adult depression: recent developments. Current Opinion in Psychiatry, 28, 24-29. [Abstract]

Naylor, C., Parsonage, M., McDaid, D., Knapp, M., Fossey, M. and Galea, A. (2012) Long-term conditions and mental health: the cost of co-morbidities. The King’s Fund, London, UK [PDF]

World Health Organisation (2015).Factsheet 369: Depression [Link]

Photo Credits

Sascha Kohlmann CC BY 2.0

Acknowledgement

Written by: Patrick Kennedy-Williams
Reviewed by:
Last updated: Nov 2015
Review due: Sep 2016

Our depression Blogs

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In her debut blog, Ariadna Albajara Saenz summarises a recent active ingredients review, which finds that psychological interventions for youth anxiety & depression can improve emotion regulation skills.

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What impact do secondary schools have on the mental health of young people?

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In his debut blog, Chris Fielding reviews a study which uses baseline data from the MYRIAD study, and concludes that the “direct influence of schools on mental health seems to be small”.

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Remote measurement technologies for depression in young people: scalable solution or overplayed potential? #ActiveIngredientsMH

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In her debut blog, Annabel Walsh summarises her #ActiveIngredientsMH project which explored the use of remote measurement technologies for depression in children and young people.

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Dental students, Depression and Covid-19

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In their debut blog, Wezi Mhango & Darya Gaysina explore psychoeducation as an active ingredient that might help young people who are affected by perinatal anxiety or depression.

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In their debut blog, Zill-e-Huma & colleagues explore a systematic review finding family interventions beneficial for child anxiety and depression in low and middle income countries.

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Exposure to air pollution increases mental health service use, according to new UK study

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Wajeeha Raza and Peter Coventry review a retrospective cohort study exploring the association between air pollution exposure and mental health service use among individuals with first presentations of psychotic and mood disorders.

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Parental loss and grief in childhood linked to an increased risk of depression in adulthood #ActiveIngredientsMH

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In her debut blog, Lauren Breen summarises a paper relevant to her Active Ingredients project, which seeks to understand the impact that grief reduction interventions can have on reducing anxiety and depression in young people aged 14-24 years.

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Omega-3 supplements for depression and anxiety #ActiveIngredientsMH

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Ashlee Negrone summarises a systematic review and meta-analysis on omega-3 supplements for depression and anxiety in adults, and briefly introduces their Active Ingredients project on omega-3 for youth depression and anxiety.

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Virtual reality for mental health: are there any freely available apps that show promise?

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Imogen Bell summarises a recent review of virtual reality experiences as tools to support mental health therapy, which finds some freely available applications that may show promise for mental health.

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