Major depressive disorder (or MDD), ranks among the leading causes of disability across the globe. With research increasing its focus on the effects of one’s community on their well-being, mental health professionals have been able to expand their understanding of how depression around the world is experienced and manifested. Read on to find out how this condition is presented across the globe.
Commonly known as depression, major depressive disorder is a mood disorder defined by several symptoms that include emotional, cognitive, behavioral, physical, and social symptoms. Among them are:
● Extreme and pervasive sadness.
● Loneliness.
● Hopelessness.
● Anhedonia (difficulty feeling joy or pleasure).
● Trouble concentrating.
● Irritability.
● Mood swings.
● Disturbed sleep patterns.
● Low self-esteem.
● Guilt over their condition.
● Self-isolation.
● Excessive alcohol or drug use.
● Restlessness
● Suicidal ideation.
Depression is one of the most prevalent mental health disorders in the world, affecting one in 15 adults (or 6.7%) and an estimated 350 million individuals of all ages across the globe. Within the US alone, where much of the depression-focused research is conducted, 17.3 million adults (7.1%) have reported experiencing one or more depressive episodes during their lifetime.
According to the World Health Organization (WHO), depression is the number one cause of years lost due to disability across the globe, shortening the lives of those facing it more than any other factor. Depression is also ranked third in the global burden of disease, where it is expected to rank first by 2030.
The diversity of depressive symptoms means depression can appear quite differently among different sectors of the population, with gender being the most clear-cut example of this, across countries.
For starters, women are 1.5-3 times more likely than men to develop depression (14.4% vs. 11.5%, respectively). This gender-based difference is only significant between the ages of ten and middle age among younger children or older adults, the rates of depression between men and women have been shown to even out.
Depression also tends to present itself differently, depending on one’s gender. Depression among women is more likely to include guilt, hopelessness, mood swings or hypersomnia. Depression among men, on the other hand, is more likely to include irritability, restlessness, alcohol/drug use, or difficulty concentrating.
A possible explanation for these gender differences has to do with emotional recognition and processing: whereas women have been found to be more emotionally attuned than men, they are also more inclined to ruminate moreover negative or distressing feelings.
While gender is the most widely accepted difference in depression prevalence, studies have also noted other correlations, between the mental health disorder and one’s country.
The rate of experiencing a major depressive episode varies greatly between countries, from as low as 1.5% in Taiwan, to 3.0% in the US, and 9.6% in Canada. The lifetime prevalence of a major depressive disorder (which can include one or more depressive episodes) was found to be as low as 1.0% in the Czech Republic, 8.3% in Canada and 16.9% in the US.
A study conducted by the WHO further found that patients living in countries with the highest estimated depression rates tended to underreport the severity of their depression. The finding suggests that the threshold for recognizing one’s depression may be related to how common the condition is within their country, so that those suffering greatly from depression may nevertheless refrain from seeking treatment if their symptom severity is considered relatively common within their local society.
Offering safe and effective treatments for depression benefits not only the individual suffering from this condition, but society as a whole. A number of large-scale studies conducted in the US have already found that companies that substantially expand the depression care they provide employees are able to yield a positive return-on-investment (ROI). That said, only half of US workers diagnosed with depression were found to have received treatment, with fewer than half of them receiving treatment consistent with published guidelines. Treatment rates have been found to be much lower in developing countries.
The association between a country’s level of income and its rate of depression has received a great deal of attention, particularly when factoring in the country’s overall human development index (HDI), age and education.
The human development index offers a quality-of-life ranking based on life expectancy, level of education and income per capita. Countries with a medium HDI ranking have been found to have the highest prevalence of depression (29.2%).
Studies on HDI and depression suggest this is due to a combination of factors: namely, that individuals living in medium-ranking HDI countries may face more stressors, most notably high expectations, a high cost of living, and a relatively high cost of managing their depression. Together, these factors are believed to lead to lower rates of seeking out or receiving treatment for their depression.
Generally speaking, the probability of developing depression greatly increases with puberty, and peaks during one’s 20s. When crossed with a country’s level of income, comparative studies have cited significant variability. Yet within high income countries alone, a greater correlation was found, so that the younger an adult in a high-income country is, the more likely they are of benign diagnosed with depression.
When it comes to global studies on depression, education remains a rather murky variable. As such, high-income countries do not significantly differ from middle-to-low income countries in terms of rates of depression.
Though no definitive conclusion has been reached regarding education and depression the world over, local studies have managed to link education and depression together: specifically, studies in Israel, the US, Mexico and Ukraine have concluded that attaining a low level of education within these countries is associated with an increased likelihood of depression.
Depression was also found in correlation with a 60% increased likelihood of failing to complete secondary school, within high-income countries. This association was not, however, significant in low-to-middle income countries.
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