Managing depression Depression is a disorder that can be reliably diagnosed and treated in primary care.

As outlined in the WHO mhGAP Intervention Guide, preferable treatment options consist of basic psychosocial support combined with antidepressant medication or psychotherapy, such as cognitive behavior therapy, interpersonal psychotherapy or problem-solving treatment. Antidepressant medications and brief, structured forms of psychotherapy are effective. Antidepressants can be a very effective form of treatment for moderate-severe depression but are not the first line of treatment for cases of mild or sub-threshold depression. As an adjunct to care by specialists or in primary health care, self-help is an important approach to help people with depression. Innovative approaches involving self-help books or internet-based self-help programs have been shown to help reduce or treat depression in numerous studies in Western countries (Andrews et al, 2011). . Reducing the burden of depression While the global burden of depression poses a substantial public health challenge, both at the social and economic levels as well as the clinical level, there are a number of well-defined and evidencebased strategies that can effectively address or combat this burden. For common mental disorders such as depression being managed in primary care settings, the key interventions are treatment with generic antidepressant drugs and brief psychotherapy.Economic analysis has indicated that treating depression in primary care is feasible, affordable and cost-effective. As the global disease burden of depression grows and has an increasingly large impact, the prevention of depression is an area that deserves attention.Many prevention programs implemented across the lifespan have provided evidence on the reduction ofelevated levels of depressive symptoms. Effective community approaches to prevent depression focus on several actions surrounding the strengthening of protective factors and the reduction of risk factors. Examples of strengthening protective factors include school-based programs targeting cognitive, problem-solving and social skills of children and adolescents as well as exercise programs for the elderly. Interventions for parents of children with conduct problems aimed at improving parental psychosocial well-being by information provision and by training in behavioral childrearing strategies may reduce parental depressive symptoms, with improvements in childrens outcomes. . A SOLUTION FOR DEPRESSION IS AT HAND... EFFICACIOUS AND COSTEFFECTIVE TREATMENTS ARE AVAILABLE TO IMPROVE THE HEALTH AND THE LIVES OF MILLIONS OF PEOPLEAROUND THE WORLD..

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A Global Public Health Concern

Depression is a significant contributor to the globalburden of disease and affects people in all communities across the world. Depression is one of the leading causes of disability worldwide. Today, depression is estimated to affect 350 million people.The World Mental Health Survey conducted in 17countries found that on average about 1 in 20 people reported having an episode of depression in the previous year. Depressive disorders often start at a young age; they reduce peoples functioning and often are recurring. For these reasons, depression is currently near the top of the global list of disabling conditions in global burden of disease studies. The demand for curbing depression and other mental health conditions is on the rise globally. A recent World Health Assembly called on the World Health Organization and its member states to take action in this direction (WHO, 2012). What is depression? Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration. Moreover, depression often comes with symptoms of anxiety. These problems can become chronic or recurrent and lead to substantial impairments in an individuals ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide. Almost 1 millionlives are lost yearly due to suicide, which translates to 3000 suicide deaths every day. For every person who completes a suicide, 20 or more may attempt toend his or her life (WHO, 2012). There are multiple variations of depression that a person can suffer from, with the most general distinction being depression in people who have or do not have a history of manic episodes. Depressive episode involves symptoms such as depressed mood, loss of interest and enjoyment,and increased fatigability. Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe. An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities, but will probably not cease to function completely. During a severe depressive episode, on the other hand, it is very unlikely that the sufferer will beable to continue with social, work, or domestic activities, except to a very limited extent.

DEPRESSION

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