Depression is a common mental disorder. Globally, it is estimated that 5% of adults suffer from the disorder. It is characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities. It can also disturb sleep and appetite. Tiredness and poor concentration are common. Depression is a leading cause of disability around the world and contributes greatly to the global burden of disease. The effects of depression can be long-lasting or recurrent and can dramatically affect a person’s ability to function and live a rewarding life.
The causes of depression include complex interactions between social, psychological and biological factors. Life events such as childhood adversity, loss and unemployment contribute to and may catalyse the development of depression.
Psychological and pharmacological treatments exist for depression. However, in low- and middle-income countries, treatment and support services for depression are often absent or underdeveloped. It is estimated that more than 75% of people suffering from mental disorders in these countries do not receive treatment.
Depression and associated mental disorders can have a profound effect on all aspects of life, including performance at school, productivity at work, relationships with family and friends, and ability to participate in the community. Research also shows strong relationships between depression and physical health, including tuberculosis and cardiovascular disease. Depression affects all types of people – young and old, rich and poor – in all countries. Women are more likely to have depression than men.
WHO works with Member States and partners to reduce the burden of mental disorders such as depression. The World Health Assembly has discussed mental health on a number of occasions and, in 2019, approved the extension of WHO’s Comprehensive Mental Health Action Plan to 2030.
WHO has developed brief psychological intervention manuals for common mental health conditions including depression that may be delivered by lay workers. An example is Problem Management Plus, which can be used individually and in group format and employs behavioural techniques, relaxation training, problem-solving treatment and ways to strengthen social support. The manual Group Interpersonal Therapy (IPT) for Depression describes a group counselling approach that focuses on identifying and addressing interpersonal difficulties. Thinking Healthy covers the use of cognitive-behavioural therapy for perinatal depression.
WHO has also developed self-help approaches which may help people with depression and can prevent the onset of mental disorders. Self-Help Plus (SH+) can be delivered to large groups and uses pre-recorded audio and WHO's illustrated guide (Doing What Matters in Times of Stress) to teach stress management skills. The illustrated guide Doing What Matters in Times of Stress can also be used by individuals, alone or with the accompanying audio exercises.
WHO’s mental health Gap Action Programme (mhGAP) focuses on helping countries to scale up first-line support for mental health conditions through training of non-specialists. The WHO mhGAP Intervention Guides (mhGAP-IG and mhGAP HIG for humanitarian settings) can be used by trained and supervised general health staff and cover basic clinical mental health care for priority conditions including depression. This allows gaps in service to be filled and broadens the overall capacity of a country’s health-care system.