Depression is a serious mental health condition that affects countless people worldwide [1], regardless of age, gender, or cultural background. Many people will struggle with depression repeatedly over the course of their lives. For some, it is debilitating, all-consuming, and visibly affects their behaviors and outward appearance. However, for others, it is less obvious and presents only through inner thoughts and feelings that can be masked by seemingly normal outward behavior.
So what is depression? The answer is not simple. There are many facets to depression, and it is certainly more than just feeling a little down. It is always worth examining some of the different ways depression has been understood through time, and discussing the varied ways depression can affect individuals. We can also help our understanding by keeping aware of the statistics on how prevalent struggles with depression are worldwide. For those who are experiencing depression or who want to support their friends, family members, colleagues, and loved ones experiencing depression, understanding this complex condition is critical. Knowledge is power for those on the journey to recovery from depression.
Depression throughout History
Although the formal term for depression didn’t emerge until the advent of modern medicine, it has long been understood by communities across the world that individuals can be subject to the periods of extreme sadness, low energy, hopelessness, and anxiety that characterize this condition. A recent review of descriptions of depression throughout history shows that early reports of depression as we know it can be found in writings about what was known as melancholia in the 1500s-1600s. At that time, written reports suggested that those afflicted struggled with sadness, fear, doubt, distrust, or despair without cause.[2]
Going much further back, we find descriptions of some of the symptoms of depression in written work as early as 150-200 AD. In the writings of Arateus of Cappadocia, for example, there are vivid depictions of members of the population struggling with seeming dejected, dull or stern, or even “unreasonably torpid” without reason. Notably, most of these descriptions emphasize that there was no obvious reason for individuals to be feeling this way.[3]
Although modern life may have changed how depression is perceived or understood, there is strong historical evidence that this health condition has affected us for centuries.
Different Facets of Depression
As mentioned above, depression does not always look the same from the outside. Our stereotypical image of someone who is depressed might entail a person who cries all the time or who can’t get out of bed, eat, or share in the joy of others. Some individuals who are suffering from major depression may also experience weight loss or gain, feel physically exhausted or in pain, and find it impossible to connect to the things that once brought them joy. However, while some do experience these tangible signs of depression, there are many other ways in which depression is experienced.[4]
Some individuals experience depression intensely but are able to maintain their daily routines and habits and even thrive in their jobs. Comedian Conan O’Brien, for example, has spoken very openly about his experiences with depression. He struggled with this mental health condition during some of the busiest and most successful periods of his career. He experienced depression only internally, as a crippling anxiety and feeling of hopelessness for which the only answer seemed to be working non-stop.[5]
Other individuals experience depression as a numbing of reality; rather than feeling sad all the time, they are likely to feel detached from the world around them. An invisible barrier keeps them from connecting to their friends, family members, romantic partners, or even themselves. Here, depression is manifest in frequent periods of dissociation and, often, thoughts of self-harm or suicidal ideation.
There are also those who experience depression as part of another mood disorder, such as bipolar disorder or cyclothymia, which is characterized by intense periods of lethargy and hopelessness followed by high-energy manias. However, because these individuals experience depression alongside mania does not make the periods of despair, hopelessness, apathy, and lethargy any easier. In fact, some studies suggest that because of the sudden move from mania to depression, those who suffer from these types of mood disorders are at a higher risk of suicide than those who are strictly suffering from depression.
Depression Around the World
Depression is by no means exclusive to the United States. Depression exists in the majority of countries where medical data on mental health conditions is available. While it goes by different names depending on the language – masennus in Finnish, for example, or ịda mba in Igbo – the seriousness of the condition remains the same.
In Russia and Sweden, for example, it is estimated that 6% of people struggle with depression. It would be tempting to suggest that this relates to the dark and cold of the winter environments, but the rate is even higher in Australia, where it is estimated that 1.3 million people are struggling with depression. Other countries where depression affects a high number of people include Brazil, Estonia, and Portugal.[6]
Those who struggle with any type of depression can find it incredibly difficult to live a normal life because depression seeps in and affects even the smallest moments of the day. For those who struggle with this serious health condition, it can feel like an endless journey towards recovery. But remember that you are not alone. As a society, we are moving toward a better understanding of depression as a health condition like any other, but there is still work to be done to shake the stigma. Learning more about the history of depression, its different facets, and how it is present across cultures is a key way to fight against shame associated with this serious, often life-threatening, mental health condition.
Sources:
[1] Geraei E, Shakibaei F, Mazaheri E. Depression: Detecting the Historical Roots of Research on Depression Prevention with Reference Publication Year (2018) Spectroscopy. Int J Prev Med. Jun 19;9:53. doi: 10.4103/ijpvm.IJPVM_308_17. PMID: 30034671; PMCID: PMC6028989.
[2] Kendler K. S. (2020). The Origin of Our Modern Concept of Depression-The History of Melancholia From 1780-1880: A Review. JAMA psychiatry, 77(8), 863–868. https://doi.org/10.1001/jamapsychiatry.2019.4709
[3] Radden, J. (2003). Is This Dame Melancholy?: Equating Today’s Depression and Past Melancholia. Philosophy, Psychiatry, & Psychology 10(1), 37-52. https://dx.doi.org/10.1353/ppp.2003.0081.
[4] Mayo Clinic. (2024) Depression (major depressive disorder). https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
[5] Juby, B. (2022) Conan O’Brien Doesn’t Let Depression Keep Him Down. Psych Central. October 17. https://psychcentral.com/depression/conan-obrien-doesnt-let-depression-keep-him-down
[6] World population review. (2024) Depression rates by country 2024. https://worldpopulationreview.com/country-rankings/depression-rates-by-country
