Levels of Depression and Anxiety are increasing worldwide. What do we do?
Around the world, mental health is deteriorating. Between 2005 to 2015 the amount of people suffering from depression has increased by eighteen percent. Likewise, over that same time, the amount of people living with anxiety has increased by nearly fifteen percent. It is estimated that hundreds of millions of people currently have depression, anxiety, or a combination of the two. In this post, I will look into the causes of these disorders, their global context, and describe solutions to decrease their prevalence.
Depression affects over 300 million people worldwide and is separated into two subgroups — major depressive disorder and dysthymia. The former typified by extreme sadness, tiredness, and impassiveness and the latter being a longer yet less intense version of the former. Neurologically, depression is caused by a deficiency of neurotransmitters (chemicals which transmit messages between neurons), specifically dopamine, serotonin, and norepinephrine.
Additionally, anxiety affects nearly 300 million people worldwide. Anxiety drives people into a chronic state of nervousness and fear. It is made up of several sub-disorders such as “generalized anxiety disorder (GAD), panic disorder, phobias, social anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).” Neurologically, the lack of the neurotransmitter GABA is the most significant contributor to anxiety disorders, however, low amounts of serotonin, dopamine, and epinephrine can engender anxiety too.
A newly published report from the World Health Organization titled Depression and Other Common Mental Disorders reveals the extent of depression and anxiety across the globe. As of recently there has been a noteworthy increase of people suffering from mental disorders in developing countries. This can largely be explained by parallel growth in the population and life expectancy in those countries.
Yet, there are a number of other salient factors to consider. Poverty, violent conflict, and traumatic personal events contribute to the development of mental disorders too.
Females are about fifty percent more likely to suffer from depression than men.
Africa as a percentage of the population has the highest rate of people with depression followed by the Americas, the Eastern Mediterranean, South-East Asia, Europe, and the Western Pacific.
Also, as age increases the likelihood of developing depression increases.
Moreover, while slightly less widespread, anxiety impacts millions of people globally. Like depression, the rise in worldwide anxiety levels can be largely attributed to the growth in population. Though other factors, such as those mentioned previously play a significant role too.
Anxiety is nearly twice as more common among females than males.
As a percentage of the population, the Americas have the highest level of anxiety followed by the Eastern Mediterranean, Europe, South-East Asia, Africa, and the Western Pacific.
Unlike the relationship between age and depression, there is not a clear trend between age level and prevalence of anxiety.
Furthermore, weakening health conditions as a result of depression and anxiety is enumerated as Years Lived with Disability (YLD). It’s calculation is shown below:
YLD = number of cases x disability weight
In 2015, there were a total of over fifty million Years Lived with Disability for those suffering with depression. No other condition contributes more to health loss around the world than depression.
Anxiety has about half as many Years Lived with Disability than depression. It is the sixth most common cause of health loss.
When is comes to mental disorders, their most tragic effect on humans is suicide. Each year about 800,000 people take their own life.
Suicide is a difficult topic both to talk about and to strategize plans to reduce it. As displayed by the graph, it is far more than an economic issue. High income countries, especially when looking at men, tend to have a higher suicide rate per 100,000 people. And what should be surprising is that even though women are more likely to have depression and anxiety, men are still more likely to commit suicide. This paradox baffles me. Daniel Freeman, a clinical psychology professor at the University of Oxford suggests that this disparity may have to do with men choosing more violent methods to take their lives and that men tend to be more impulsive than women.
To reduce the prevalence of mental disorders around the world there needs to be serious, cooperative action. It is essential that there is an effective and equitable distribution of medical resources and services. The World Health Organization (WHO) estimates that fifty percent of the people in the world live in countries where there is at most one psychiatrist for every two-hundred thousand people.
In low and middle income countries around eighty percent of those with mental disorders are not treated (about forty percent in high income countries). Dreadfully, in low income countries spending on mental care is less than $0.25 cents per person compared to a global amount of $2.00 per person (though per capita global spending needs to increase!). To expand mental healthcare to low and middle income countries WHO’s Mental Health Gap Program (mhGAP) is designed to train people in local communities — not necessarily qualified health specialists — to treat millions of people with mental disorders worldwide.
Moreover, countries around the world need access to basic medicine in combination with an expansion of primary health services. Treating mental disorders in a community primary healthcare clinic is both effective as well as cost-saving compared to investing in mental hospitals which do no guarantee effectual care. Plus, primary health services not only include general and mental care, but also reproductive and child care.
For higher income countries, the focus should be on investing more in their own mental health services, increasing R&D spending for new medicine and technology, and helping poorer countries develop robust mental health services.
The lack of investment in worldwide mental care needs to be addressed now. The United Nations’ Sustainable Development Goal #3 Good Health and Wellbeing plans to ensure mental well-being by 2030. The time is now to act via international partnership to tackle the growing amounts of depression and anxiety among the global populace. We must secure the future that we want for us and for succeeding generations.
