What is depression?

Depression is a mood disorder characterized by persistent sadness and/or a loss of interest or pleasure in daily activities [1]. Unlike normal mood fluctuations, a depressive episode lasts at least two weeks and impairs a person’s functioning, often accompanied by physical and cognitive symptoms such as insomnia or hypersomnia, changes in appetite, fatigue, difficulty concentrating, negative thoughts, and, in more severe cases, suicidal ideation [2].

It should not be confused with simple sadness in response to difficult life events: in depression, symptoms are more intense, longer-lasting, and often accompanied by feelings of emptiness or excessive guilt.

Consequences of depression

If left untreated, depression can profoundly affect quality of life and daily functioning, interfering with study, work, and social relationships [2]. It is often associated with other mental disorders, such as anxiety, or it can worsen pre-existing medical conditions, for example cardiovascular or neurological diseases [4]. Alterations of cognitive functions are also common - affecting memory, attention, and processing speed - and may persist even after mood symptoms have remitted, limiting full recovery of daily activities and social functioning [5]. The consequences extend beyond the individual, affecting families and society as a whole (e.g., isolation, healthcare costs, and loss of productivity), highlighting the importance of timely and integrated intervention.

Epidemiological data

Depression is among the leading causes of disability worldwide: according to the WHO, approximately 280 million people are affected. The disorder can occur at any age, and women are more affected than men, with a risk approximately 50% higher [2].

In recent years, the COVID-19 pandemic has increased the burden of mental health disorders: in the first year alone, the WHO reported a rise of around 25% in cases of depression [3].

Treatments

Standard treatments are divided into pharmacological approaches (using antidepressant medications) and non-pharmacological approaches (such as psychotherapy). In addition to these, an important role is played by lifestyle-based non-pharmacological interventions, including regular physical exercise, stress management techniques, good sleep hygiene, and maintaining supportive social networks [2].

In practice, pharmacological therapy alone is often not sufficient to address all aspects of the disorder: a significant proportion of patients with depression continue to show alterations in cognitive functioning even after mood symptoms improve, as traditional antidepressant medications only partially alleviate these dysfunctions. For this reason, the scientific community is increasingly focusing on cognitive rehabilitation programs to promote more complete functional recovery and reduce the risk of relapse [6]. Overall, evidence supports the effectiveness of an integrated and personalized approach that combines pharmacotherapy, psychotherapy, and lifestyle interventions.

Sitography

Depressive Disorder – Psychiatric Disorders – MSD Manuals https://www.msdmanuals.com/professional/psychiatric-disorders/mood-disorders/depressive-disorders
Depressive disorder (depression) https://www.who.int/news-room/fact-sheets/detail/depression
Mental Health – Consilium https://www.consilium.europa.eu/en/policies/mental-health/
Depression – Passi 2023-2024 https://www.epicentro.iss.it/passi/dati/depressione
Cognitive function following a major depressive episode: a systematic review and meta-analysis – PubMed https://pubmed.ncbi.nlm.nih.gov/31422920/
Cognitive remission: a novel objective for the treatment of major depression? - PubMed https://pubmed.ncbi.nlm.nih.gov/26801406/