Depression is one of the most prevalent mental health conditions worldwide and, according to the World Health Organization (WHO), it affects more than 280 million people - 18% more than a decade ago - which shows an alarming growth.

In the framework of the World Day to Fight Depression, we want to reflect on the alarming figures that reveal a constant increase in its incidence and, above all, understand what we can do to prevent and treat it.

Deep sadness, despondency, hopelessness are feelings that have taken hold of millions of people in the world. Why is depression increasing?

The severity of depression can range from mild and temporary episodes of sadness to persistent and serious conditions.

In addition to traumatic life events, such as the death of a loved one or the diagnosis of a serious illness, there are many other risk factors for depression that are not as well known, but are still important: modern lifestyle, work stress, loneliness and social pressure have increased exponentially in recent decades.

The COVID-19 pandemic played a crucial role: a study by The Lancet in 2022 noted that major depressive disorders increased by 28% during the health crisis.

These were caused by social isolation, limitations on people's ability to work, help their loved ones and participate in the life of their communities. Also loneliness, fear of infection, suffering and dying, or that loved ones will suffer that fate, the pain caused by the loss of loved ones and economic worries.

Added to this are other triggers such as:

• Excessive use of social media, which can lead to constant comparison and low self-esteem (there is a superego imperative for success, consumption, and unlimited enjoyment)
• Pessimistic thought patterns
• Economic uncertainty and stressful events in the workplace
• Genetic factors and family predisposition.

Symptoms to keep in mind

Depression is not just feeling sad; it goes much further. Among the most common symptoms are:

• Loss of interest or pleasure in everyday activities.
• Significant changes in appetite or weight.
• Insomnia or excessive sleep.
• Constant fatigue and lack of energy.
• Feelings of guilt, worthlessness, or hopelessness.
• Difficulty concentrating.
• Recurrent thoughts of death or suicide.

Although depression can be debilitating, there are multiple options for treating it. Treatment is usually individualized and may involve a combination of medical, therapeutic, and lifestyle approaches.

• Psychotherapy: Cognitive behavioral therapy (CBT) is one of the most recommended.
• Medication: Antidepressants, under medical supervision, may be necessary in moderate or severe cases.
• Lifestyle changes:

1. Exercise: Physical activity that you find pleasurable releases endorphins, which help you feel better. Endorphins bind to opioid receptors in the brain and reduce the perception of pain, while generating a feeling of well-being and pleasure. This release of endorphins has been directly associated with improved mood and reduced symptoms of depression. Depression is often associated with sleep problems, such as insomnia or excessive sleepiness. Regular physical exercise can help regularize the sleep cycle, promoting a greater quality and quantity of nighttime rest.
2. Maintain a balanced diet and establish healthy routines: Trying to feel better by drinking or eating excessively and obsessing about how bad you feel makes symptoms worse. Improving body image, promoting a sense of control and autonomy, and practicing progressive muscle relaxation all help reduce depression. Meditation also breaks the cycle of overly critical thoughts and feelings of worthlessness. Meditation trains the brain to achieve sustained focus and to return to it when negative thoughts, emotions, and physical sensations arise.

Doing something positive to manage depression is a healthy coping strategy.

Global statistics:

• Depression can affect anyone, however, women are more likely to suffer from this condition than men. This disorder, both in adolescents and adults, is twice as common in women than in men. The risk of developing depression in women is between 10% and 25% and for men between 5% and 12% of the world's population.
• The tendency to depression can be inherited: first-degree relatives of patients with depression show an approximately three-fold higher risk of developing this disorder.
• Comorbidity: Limitations resulting from a chronic illness (pain, shortness of breath, mobility problems) promote the development of depression (most likely as a consequence of the disability) and the presence of depression worsens the course of the disease.
• More than 75% of people in low- and middle-income countries do not receive adequate treatment.
• In adolescents, depression has increased by 15% in the last decade.

We live in a world that seems to demand that we always be well, smiling and productive. The phrase "we must move on" has become a mantra that, although well-intentioned, can invalidate the time we need to heal, reflect and process our emotions. It is crucial to remember that feeling sad, allowing ourselves to grieve or simply stopping to listen to our inner self is not synonymous with weakness, but an act of courage.

This World Day to Fight Depression we highlight that with adequate treatment, emotional support and small changes in our daily lives, it is possible to enjoy life again. Every step counts: consult a specialist, educate yourself and remember that it is a treatable condition and that recovery is always possible.