# data[].attributes.headline
Why does depression make you feel tired?

# data[].attributes.subject
Why does depression make you feel tired?

# data[].attributes.body
There’s no single answer to this question — depression and fatigue are associated in many ways. Depression might directly cause fatigue, but it also has indirect effects on our sleep, diet, and exercise that can drain us of energy.

Depression can cause you to feel low-energy in many ways:

It may make it more difficult to sleep.

It can affect your eating habits.

It can disrupt your exercise or workout routines.

It can cause general stress in your life.

Cutting back on pleasurable activities can increase fatigue and lower motivation.

When depression takes away the fun activities and lowers your motivation, this creates a vicious cycle of depression. It can be hard to break, but breaking it is possible — especially using behavioral activation (which we’ll discuss below).

Again, getting a solid understanding of your own experience of depression fatigue is a great first step in managing it. Here’s a more in-depth look at the ways depression may be causing your fatigue:

You don’t sleep as well

Depression may be disrupting your sleeping patterns in some way. About 80%
Trusted Source of people with depression, for example, experience insomnia.

But it’s not just a lack of sleep that causes tiredness. Oversleeping, which is also a common symptom of depression, can cause similar feelings of fatigue over a period of time.

These kinds of sleep irregularities are among the biggest causes of fatigue in those who experience depression.

Depression affects your diet

When you’re feeling depressed, you might have less of an appetite, skip meals, or have an overwhelming desire for sweet foods that have less nutritional value.

Large quantities of fat and sugar can make you feel groggy and tired.

Nutritious foods, like fruits, vegetables, and whole grains can provide healthy antioxidants and nutrients with energy-boosting effects — and these are the foods that we tend to put to aside when depression arises.

It’s harder to exercise when you’re depressed

Exercise is a great source of energy, but feelings of depression might make it harder for you to want to work out on a regular basis. Depression can cause you to experience a lack of motivation in many aspects of life, and this can channel into a lack of desire to exercise.

But don’t think that this lack of exercise is because of laziness. This couldn’t be further from the truth!

Summoning the motivation to exercise is already hard enough. But feelings like reduced self-esteem and pessimism are specific depressive attitudes that research suggests may be interfering with your exercise.

It’s completely understandable that you might not be working out as much as you used to or would like to. Recognizing that these thought patterns are a result of depression means you’re better equipped to deal with the challenge of motivating yourself to exercise.

Depression is stressful

Keep in mind that depression can increase chronic stress, and stress can lead to depression. No matter which one occurred first, they’re closely related. Depression-linked stress can lead to a loss of energy and exhaustion.

An inability to manage stress can play a major role in developing and maintaining depression.

An overactive amygdala, which is the part of the brain associated with anxiety, stress, and fear, creates a cognitive (thinking) bias towards interpreting the world and the self negatively. These are feelings associated with depression.

Simply put, depression-related stress might be creating overactivity in your brain that’s making you feel drained.

Depression and Fatigue: Why It Happens and How to Cope | Psych Central

# data[].attributes.attachment_link.readable_text
Tired. Low energy. Exhausted. Lethargic. These are some of the ways depression might make you feel.

Of the many feelings depression can cause, fatigue is one of the most common. Fatigue occurs in over 90% of people who are experiencing depression.

If you're currently experiencing depression fatigue, know that millions of people are in a similar situation. It may not feel this way, but you're far from alone.

Aside from fatigue, depression is often associated with:

persistent feelings of sadness or anxiety

hopelessness

a loss of interest in activities that you used to enjoy

But the good news is that there are strategies for managing your feelings of exhaustion and low energy.

Let's take a closer look at the relationship between depression and fatigue. What, exactly, is the link?

There's no single answer to this question - depression and fatigue are associated in many ways. Depression might directly cause fatigue, but it also has indirect effects on our sleep, diet, and exercise that can drain us of energy.

Depression can cause you to feel low-energy in many ways:

It may make it more difficult to sleep.

It can affect your eating habits.

It can disrupt your exercise or workout routines.

It can cause general stress in your life.

Cutting back on pleasurable activities can increase fatigue and lower motivation.

When depression takes away the fun activities and lowers your motivation, this creates a vicious cycle of depression. It can be hard to break, but breaking it is possible - especially using behavioral activation (which we'll discuss below).

Again, getting a solid understanding of your own experience of depression fatigue is a great first step in managing it. Here's a more in-depth look at the ways depression may be causing your fatigue:

You don't sleep as well

Depression may be disrupting your sleeping patterns in some way. About of people with depression, for example, experience insomnia.

But it's not just a lack of sleep that causes tiredness. Oversleeping, which is also a common symptom of depression, can cause similar feelings of fatigue over a period of time.

These kinds of sleep irregularities are among the biggest causes of fatigue in those who experience depression.

Depression affects your diet

When you're feeling depressed, you might have less of an appetite, skip meals, or have an overwhelming desire for sweet foods that have less nutritional value.

Large quantities of fat and sugar can make you feel groggy and tired.

Nutritious foods, like fruits, vegetables, and whole grains can provide healthy antioxidants and nutrients with energy-boosting effects - and these are the foods that we tend to put to aside when depression arises.

It's harder to exercise when you're depressed

Exercise is a great source of energy, but feelings of depression might make it harder for you to want to work out on a regular basis. Depression can cause you to experience a lack of motivation in many aspects of life, and this can channel into a lack of desire to exercise.

But don't think that this lack of exercise is because of laziness. This couldn't be further from the truth!

Summoning the motivation to exercise is already hard enough. But feelings like reduced self-esteem and pessimism are specific depressive attitudes that research suggests may be interfering with your exercise.

It's completely understandable that you might not be working out as much as you used to or would like to. Recognizing that these thought patterns are a result of depression means you're better equipped to deal with the challenge of motivating yourself to exercise.

Depression is stressful

Keep in mind that depression can increase chronic stress, and stress can lead to depression. No matter which one occurred first, they're closely related. Depression-linked stress can lead to a loss of energy and exhaustion.

An inability to manage stress can play a major role in developing and maintaining depression.

An overactive amygdala, which is the part of the brain associated with anxiety, stress, and fear, creates a cognitive (thinking) bias towards interpreting the world and the self negatively. These are feelings associated with depression.

Simply put, depression-related stress might be creating overactivity in your brain that's making you feel drained.

Depression is one of the most treatable mental health conditions. Somewhere between 80 and 90% of people with depression eventually respond well to treatment.

Almost all people who choose to treat their depression gain some relief from their symptoms.

What are my options?

Since depression is at the core of your depression fatigue, it's important to look into ways that you might want to treat your mental health above anything else.

There are many options, and each type of treatment can offer a different approach in helping you to deal with the challenges (like fatigue) that come as a result of your feelings of depression.

Here are two main treatment options to consider:

Therapy

Talk therapy, also called psychotherapy, is an umbrella term for many therapeutic methods.

The following therapies all seek to treat depression, but do so in distinct ways:

Of course, therapy isn't one-size-fits-all. Don't be discouraged if one or even a few modes of therapy don't work for you. It may take time for you to find the therapy and therapist that are most effective in your day-to-day life.

With patience and commitment, you'll likely see the benefits of therapy.

Medication

If you're experiencing ongoing depression, you may want to consider medication for it. Antidepressants are the most common medication prescribed to people who experience depression.

To ensure your safety, a doctor will assess a variety of factors before prescribing an antidepressant. These factors include your:

medical history

personal history

family history

possible co-existing mental health conditions

If a doctor thinks antidepressants could be right for you, you'll discuss receiving a prescription. It usually takes over a month to begin experiencing the effects of antidepressants.

While this may seem like a bit of a process, medication can be effective in treating depression. It's an option to consider, even while going to therapy or implementing different management habits in your everyday life at the same time.

Because treating depression is a journey with no exact timeframe, it can be helpful for you to consider ways to directly address your depression fatigue in the meantime.

Here are some of the ways that you might consider alleviating feelings of low-energy and exhaustion:

Prioritize getting good sleep

Since depression may be causing you to have disordered sleeping habits, it can be helpful to develop better sleep habits.

"Sleep hygiene" pretty much just means "good sleeping habits." Here are some of implementing sleep hygiene:

Be consistent with sleep and wake times. Try going to bed at roughly the same time each night and getting up at the same time each morning. This way, your body becomes accustomed to a certain routine that optimizes healthy sleeping.

Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature. You can experiment with different room temperatures or try out a white noise machine. With patience, you might discover the best room environment to promote sleep.

Remove TVs, computers, and smartphones from the bedroom. This may seem like an impossible task sometimes, but avoiding harsh blue light will help you fall asleep faster.

Try eating a few more nutritious foods

Depression disrupts eating habits, which in turn can cause feelings of fatigue. Like implementing better sleeping habits, developing a more nutrient-rich diet can improve fatigue and exhaustion.

Some foods might help with depression, and a balanced diet helps to boost energy. This typically includes a range of unrefined carbs, proteins, and fats, with an emphasis on veggies, whole grains, and healthy oils.

Aside from just the types of food you should aim to eat, it also might be better to eat small meals and snacks every few hours than three large meals a day. More frequent eating, as opposed to a food overload in a few sittings, may result in more sustained fuel for your body.

Make an effort to connect with loved ones

It's not always easy to reach out, but it's important to have a support system. Because depression can cause you to feel isolated or alone, it can be especially comforting to connect with loved ones who care about you.

Practice self-care

As cliché as it might sound, self-care is of the utmost importance when addressing depression fatigue.

Remember to prioritize your own needs whenever possible. Don't be afraid to take personal mental breaks or time-outs when you really need to. Pay better attention to how you talk to yourself. Learn to recognize and heal your relationship with yourself.

Aim to exercise more, and start small if you need to

Though depressive attitudes may make it harder to work out, implementing an exercise routine that's realistic and attainable in your everyday life can ease depression fatigue.

Exercise has the added benefit of improving your sleep, too.

It's OK to start small - even just walking for 30 minutes a day will likely boost your energy and mood. Exercise is truly an organic and reliable way to help address your depression fatigue.

Think about new hobbies

Some hobbies can help you express your emotions in a healthy and cathartic way. Creative expression, such as journaling, painting, drawing, or instrument playing, may be useful hobbies to take up as a way of channeling and managing your depression.

By incorporating certain self-healing hobbies in your routine, you may begin to alleviate your feelings of depression and fatigue.

Try increasing your activities

It can be hard to find the motivation to do pretty much anything when you're depressed. And when your activity level drops, you might feel even less motivated and more tired. This leads to a vicious cycle.

With physical tiredness, you need to rest. But with depression, it's the opposite. Sleeping and sitting around often make you feel more tired and also gives you time to sit with depressive thoughts, which can make you feel worse.

One way to break this cycle is to start gently increasing your activities. This is a cognitive behavioral therapy (CBT) technique known as behavioral activation. The theory is that doing things will help give you the energy to do more things.

Again, start small, and prioritize manageable, reasonable activities that bring some enjoyment, or activities that provide a sense of achievement.

Here are some ideas for gentle activities to try:

Go for a small walk, and smell the flowers that you pass on the way.

Watch birds in your local park.

Make a playlist of upbeat music.

Move your body in a way that feels good.

Research a topic that you're interested in.

Do a jigsaw or a crossword puzzle.

Make a warm drink.

Light a scented candle.

Rewatch a favorite movie.

Have a spontaneous picnic.

For more ideas and for a worksheet to help you monitor your activities and mood changes, you can check out the Behavioural Strategies for Managing Depression worksheet from the Center for Clinical Interventions in Australia.

Depression and fatigue are closely related. Most people who experience depression also report feeling fatigue. So if you're feeling this way, you're not alone.

After recognizing this, you may want further information and tips about depression and fatigue. For more support, you can read more here at Psych Central or visit:

# data[].attributes.attachment_link.title
Depression and Fatigue: Why It Happens and How to Cope

# data[].attributes.attachment_link.description
Tired. Low energy. Exhausted. Lethargic. These are some of the ways depression might make you feel. Of the many feelings depression can cause, fatigue is one of the most common. Fatigue occurs in over 90% of people who are experiencing depression. If you're currently experiencing depression fatigue, know that millions of people are in a similar situation.

# data[].attributes.body
Mental health statistics worldwide

Anxiety affects 284 million people in the world.

Depression affects 264 million people.

Alcohol use disorder affects 107 million people.

Drug use disorder affects 71 million people.

Bipolar disorder affects 46 million people.

Schizophrenia affects 20 million people.

Eating disorders affect 16 million people.

Our World in Data, 2018

Mental health statistics in the U.S.

More than a quarter (26.3%) of adults aged 18 to 25 years old had any mental illness in 2018.

Nearly 8% of adults aged 18 to 25 years old had a serious mental illness in 2018.

Anxiety disorders affect 40 million adults in the U.S. (18.1% of the population) making them the most common mental illness. (Anxiety and Depression Association of America)

The rate of individuals aged 18 to 25 years old that reported symptoms consistent with major depression increased 63% from 2009 to 2017. (American Psychological Association, 2019)

(SAMHSA, 2018)

Source:
https://www.singlecare.com/blog/news/mental-health-statistics/#us-mental-health-stats

# data[].attributes.attachment_link.readable_text
What is mental illness? | How common is mental illness? | Global mental health statistics | U.S. mental health statistics | Mental health treatment | Resources | Research

Mental health and substance use disorders affect 13% of the world's population. That number could increase as people around the world shelter in place and adjust to a new normal amid the coronavirus pandemic. In our national survey on mental health and coronavirus, we found that the COVID-19 pandemic has affected the mental health of 59% of people in the United States. Dismantling the stigma around mental illness is important now more than ever. The following mental health statistics illustrate the scope and impact of mental illness.

What is mental illness?

Mental illness comprises two categories-those with any mental illness (AMI) and those with serious mental illness (SMI), though these are not mutually exclusive.

AMI is defined by the Substance Abuse and Mental Health Services Association (SAMHSA) as having any mental, emotional, or behavioral health disorder that met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria. A person with an AMI is defined as having an SMI by SAMHSA if their disorder substantially interferes with or limits one or more major life activities.

Some mental health conditions include:

Anxiety: Anxiety disorders are characterized by persistent worry, fear, and stress that interferes with one's everyday life.

Depression: Persistent low mood, fatigue, and profound sadness are prominent symptoms of major depression.

Substance use disorders: The frequent use of alcohol and/or drugs that interferes with a person's behavior in day-to-day life.

Bipolar disorder: Bipolar disorder consists of radical shifts in depressive or "low" moods and manic "high" moods that can last weeks long.

Schizophrenia: Schizophrenia is a chronic and severe mental disorder that affects a person's thoughts, feelings, and behaviors

Eating disorders: Eating disorders are illnesses that affect a person's relationship with food and body image.

Obsessive-compulsive disorder (OCD): OCD is a chronic, long-lasting anxiety disorder where a person experiences unreasonable, uncontrollable, recurring thoughts followed by a behavioral response.

Post-traumatic stress disorder (PTSD): PTSD is a disorder that develops in some who have experienced a shocking or dangerous event and have difficulty recovering from the trauma the event caused.

How common is mental illness?

970 million people worldwide have a mental health or substance abuse disorder. (Our World in Data, 2018)

Anxiety is the most common mental illness in the world, affecting 284 million people. (Our World in Data, 2018)

Globally, mental illness affects more females (11.9%) than males (9.3%). (Our World in Data, 2018)

Major depression, anxiety, alcohol use disorders, schizophrenia, bipolar disorder, and dysthymia (persistent mild depression) were identified as leading causes of disability in the U.S. (U.S. Burden of Disease Collaborators, 2013)

The mortality rate of those with mental disorders is significantly higher than the general population, with a median life expectancy loss of 10.1 years. (JAMA Psychiatry, 2015)

It is estimated mental disorders are attributable to 14.3% of deaths worldwide, or approximately 8 million deaths each year. (JAMA Psychiatry, 2015)

RELATED:
Mental health statistics worldwide

Anxiety affects 284 million people in the world.

Depression affects 264 million people.

Alcohol use disorder affects 107 million people.

Drug use disorder affects 71 million people.

Bipolar disorder affects 46 million people.

Schizophrenia affects 20 million people.

Eating disorders affect 16 million people.

Our World in Data, 2018

Mental health statistics in the U.S.

More than a quarter (26.3%) of adults aged 18 to 25 years old had any mental illness in 2018.

Nearly 8% of adults aged 18 to 25 years old had a serious mental illness in 2018.

Anxiety disorders affect 40 million adults in the U.S. (18.1% of the population) making them the most common mental illness. (Anxiety and Depression Association of America)

The rate of individuals aged 18 to 25 years old that reported symptoms consistent with major depression increased 63% from 2009 to 2017. (American Psychological Association, 2019)

(SAMHSA, 2018)

Mental health treatment

Mental health treatment varies among the types of mental disorders. Those seeking treatment should consult a medical or mental health professional to discuss the range of therapies and medications that are the best fit for them.

Treatment can be expensive, with costs of therapy and medication scaling thousands of dollars. The U.S. spent $187.8 billion on mental health conditions and substance use disorders in 2013. Seventy billion of that cost was spent on depression treatment alone.

According to a study published by Lancet Psychiatry, the total cost of treatment of anxiety and depression disorders across 36 countries worldwide is estimated to be $147 billion by 2030. This cost will produce a net benefit, based on an estimated and modest 5% improvement in work productivity resulting in a $399 billion economic gain.

Does insurance cover mental health services?

All Marketplace health insurance plans cover mental health and substance abuse services, according to healthcare.gov. These services include psychotherapy, counseling, inpatient services, and substance use disorder treatment. Additionally, Marketplace plans can't deny you coverage for having a pre-existing mental health condition.

Furthermore, Medicaid is "the single largest payer for mental health services in the United States."

As far as Medicare coverage goes, Medicare Part A covers hospitalizations, including admissions due to mental health problems, and Medicare B covers mental health visits. Here's a full list of covered services.

A study conducted in 2006 estimated the average charges, cost to provide care, and the amount of reimbursement for inpatient psychiatric care in 418 community-based hospitals in the U.S.

Average cost to deliver treatment to those with Medicare:

Schizophrenia treatment: $8,509 for 11.1 days

Bipolar disorder treatment: $7,593 for 9.4 days

Depression treatment: $6,990 for 8.4 days

Unfortunately, according to the 2006 study, uninsured patients are more likely to receive suboptimal care. Notice that treatment duration for uninsured patients is shorter than treatment for the insured.

Average cost to deliver treatment for those who are uninsured:

Schizophrenia treatment: $5,707 for 7.4 days

Bipolar disorder treatment: $4,356 for 5.5 days

Depression treatment: $3,616 for 4.4 days

(Psychiatric Services, 2012)

Mental health treatment statistics

The National Survey on Drug Use and Health defines mental health services as receiving inpatient or outpatient treatment or counseling or taking prescription drugs for mental health problems.

15% of American young adults (aged 18 to 25) received mental health care in one year. (SAMHSA, 2018)

A quarter of college students have mental health disorders such as anxiety, depression, and alcohol use disorder. (Psychological Services, 2020)

The majority (93%) of students are aware of on-campus services related to mental health. (American Psychological Association, 2018)

Only 13% of students with a mental health problem utilize on-campus resources, such as counseling. (American Psychological Association, 2018)

Less than a third of white adolescents do not receive mental health services, but half of minority adolescents do not receive needed care. (The National Alliance to Advance Mental Health, 2007)

More than half of young people who have been involved with the juvenile justice system meet the criteria for at least one psychiatric disorder, yet only 15% of them have received treatment. (Office of Juvenile Justice and Delinquency Prevention, 2017)

Treatment and medication guides

If you've been diagnosed with one of the following mental health conditions, you can use these guides to better understand the treatment options available to you and compare commonly prescribed medication. However, the only one who can determine the best treatment for you is your healthcare provider.

Mental health resources

If you are experiencing symptoms of mental illness and/or having suicidal thoughts, help is available. Use the following support groups and lifelines to get the care you need.

Research:

Mental health, Our World in Data

Key substance use and mental health indicators in the United States, Substance Abuse and Mental Health Services Association

The state of U.S. health, 1990-2010: Burden of diseases, injuries, and risk factors, U.S. Burden of Disease Collaborators

Mortality in mental disorders and global disease burden implications, JAMA Psychiatry

Any anxiety disorder, National Institute of Mental Health (NIMH)

By the numbers: The cost of treatment, American Psychological Association

An examination of costs, charges, and payments for inpatient psychiatric treatment in community hospitals., Psychiatric Services

Scaling-up treatment of depression and anxiety: a global return on investment analysis, Lancet Psychiatry

Training psychologists to address social determinants of mental health, Training and Education in Professional Psychology

The relationship between on-campus service utilization and common mental health concerns in undergraduate college students, Psychological Services

Ethnic and gender disparities in needed adolescent mental health care, The National Alliance to Advance Mental Health

Intersection between mental health and the juvenile justice system, Office of Juvenile Justice and Delinquency Prevention

Facts & statistics, Anxiety and Depression Association of America

Mental health issues increased significantly in young adults over the last decade, American Psychological Association, 2019

# data[].attributes.attachment_link.description
What is mental illness? | How common is mental illness? | Global mental health statistics | U.S. mental health statistics | Mental health treatment | Resources | Research Mental health and substance use disorders affect 13% of the world's population.

# data[].attributes.headline
Why is asking for help is still being stigmatized

# data[].attributes.subject
Why is asking for help is still being stigmatized

# data[].attributes.body
The fear of being stigmatised by others often leads people to avoid professional help. This stigma can also be internalised, further reducing the likelihood of seeking help. Understanding these different forms of stigma can help psychologists target interventions at different levels to help people overcome the barriers to seeking help.

One of the most common reasons for people to not seek treatment is concern about stigma. In the psychotherapy literature, stigma has generally referred to the public stigma of having a mental illness, with the clearest example being schizophrenia. Public stigma is society’s rejection of a person due to certain behaviours or physical appearances that are deemed unacceptable, dangerous or frightening. Although in most industrialised societies today the mentally ill are no longer overtly persecuted, there are clear indications of the presence of public stigma towards individuals with a mental illness. These perceptions of the mentally ill are not lost on those needing treatment and can lead to the hiding of mental health concerns and avoidance of treatment in an attempt to reduce the negative consequences associated with stigma (Corrigan, 2004).

But what other forms of stigma might prevent people from seeking psychological services, and what can be done about them?

Public stigma over help-seeking
The public stigma attached to having  a mental illness is not the only type of stigma that inhibits the decision to seek therapy. There is also a public stigma associated with seeking professional services, separate from the public stigma associated with mental illness. With this stigma, what one suffers from is less important than the simple behaviour of seeking psychological help, whether that is for a chronic, diagnosable mental disorder or for processing the death of  a loved one. Simply seeking professional psychological help appears to carry its own mark of disgrace. Research indicates that people tend to stigmatise clients more than they stigmatise non-clients.

In scenario-based research, individuals described as depressed and having sought help were rated more emotionally unstable, less interesting, and less confident than those described as depressed and not seeking help (Ben-Porath, 2002). In addition, those who have sought help are more likely to report being stigmatised by others than those who have not (Jorm & Wright, 2008).

# data[].attributes.attachment_link.readable_text
One of the most common reasons for people to not seek treatment is concern about stigma. In the psychotherapy literature, stigma has generally referred to the public stigma of having a mental illness, with the clearest example being schizophrenia. Public stigma is society's rejection of a person due to certain behaviours or physical appearances that are deemed unacceptable, dangerous or frightening. Although in most industrialised societies today the mentally ill are no longer overtly persecuted, there are clear indications of the presence of public stigma towards individuals with a mental illness. These perceptions of the mentally ill are not lost on those needing treatment and can lead to the hiding of mental health concerns and avoidance of treatment in an attempt to reduce the negative consequences associated with stigma (Corrigan, 2004).

But what other forms of stigma might prevent people from seeking psychological services, and what can be done about them?

Public stigma over help-seeking
The public stigma attached to having a mental illness is not the only type of stigma that inhibits the decision to seek therapy. There is also a public stigma associated with seeking professional services, separate from the public stigma associated with mental illness. With this stigma, what one suffers from is less important than the simple behaviour of seeking psychological help, whether that is for a chronic, diagnosable mental disorder or for processing the death of a loved one. Simply seeking professional psychological help appears to carry its own mark of disgrace. Research indicates that people tend to stigmatise clients more than they stigmatise non-clients.

In scenario-based research, individuals described as depressed and having sought help were rated more emotionally unstable, less interesting, and less confident than those described as depressed and not seeking help (Ben-Porath, 2002). In addition, those who have sought help are more likely to report being stigmatised by others than those who have not (Jorm & Wright, 2008).

Self-stigma
These are compelling findings. Public stigma regarding mental illness and seeking profession help has a significant impact on those who suffer from problems that could be treated. However, there is a growing awareness of a potent stigma that might be more directly related to negative experiences with mental illness and help-seeking.

In contrast to the outward, other-oriented focus of public stigma, self-stigma has been described as an internal form of stigma, wherein one labels oneself as unacceptable because of having a mental health concern (Corrigan, 2004; Vogel et al., 2006). We originally conceived of self-stigma as the specific threat to one's sense of self, including esteem, regard and confidence, that seeking psychological help might pose. We hypothesised that the more a person saw psychological help as a threat to their sense of worth, confidence or self-regard, the less likely they would be to seek out that help.

The distinction between the public and self-stigma associated with seeking professional help allows for a more nuanced assessment of what people feel about their own psychological concerns and their treatment. Although perception of public stigma is likely to be related to self-stigma for many individuals, this does not have to be the case for everyone. Individuals might perceive the possibility of public stigma for seeking help (perhaps accurately), and yet have little or no internalisation of that stigma. For example, people might have less self-stigma due to previous experiences with therapy or knowing someone who benefited from therapy. Thus, they might perceive a general public stigma toward help-seeking, but know from personal experience that seeking help is beneficial and have less concern about it personally.

This distinction is important, as it allows psychologists to intervene at either individual (i.e. self-stigma) or more global levels (i.e. public stigma).

Most of the focus by researchers has been on the self-stigma associated with having a mental illness. Findings indicate that negative interactions from others, along with largely negative portrayals of mental illness in the media, lower an individual's self-esteem and self-efficacy (Corrigan, 2004). Internalised negative perceptions of mental health issues also appear have a negative impact on mental health and 'adjustment and growth' (Mak et al., 2007).

However, we believe that for many people a separate self-stigmatisation process exists, specifically associated with seeking help. One reason for this is that in the case of the self-stigma associated with a mental illness, the label of mental illness to which the stigma is attached is often externally given and then the person decides whether to accept it. In contrast, seeking therapy, which is often a voluntary activity, may result in an internally driven label (or self-label). This may be particularly true in situations where the symptoms are troubling yet not so severe that the counselling is perceived as mandatory. In this case, we argue that the role of self-stigma in the decision to seek help might be even more pronounced because it is difficult for many to both acknowledge the need for professional help and not feel a sense of failure or loss as our society portrays needing help as a weakness. In an attempt to further explore the self-stigma associated with seeking professional help, we have recently developed the Self-Stigma of Seeking Help Scale (SSOSH: Vogel et al., 2006). Based on Corrigan's (2004) discussion of self-stigma, the items assess concerns about the loss in self-esteem a person would feel if they decided to seek help from a psychologist or other mental health professional. We have found that self-stigma is conceptually different from other potentially related constructs such as self-esteem and public stigma, and that self-stigma uniquely predicts attitudes towards seeking psychological help and willingness to seek counselling over and above previously identified factors, such as gender or the perceived risk of counselling (Vogel et al., 2006). Furthermore, supporting our notion that self-stigma is particularly important in the help-seeking process, in a second study we found that the self-stigma of seeking therapy fully mediated the relationship between the public stigma associated with mental illness and attitudes towards seeking help as well as willingness to seek help (Vogel et al., 2007). In other words, perceptions of public stigma initially contributed to the experience of self-stigma, but then self-stigma and not public stigma influenced help-seeking attitudes and eventually help-seeking willingness. We argue from these results that public stigma's effect on help-seeking is indirect, by influencing the tendency to internalise stigma. The flip-side of this finding is that lower self-stigma (i.e. less internalisation of public stigma) might act to buffer the effects of public stigma on help-seeking.

Our research, as well as others', is starting to identify how self-stigma may be related to cultural and gender-role norms (i.e. external expectations about how we should behave). Among many other prescriptions and proscriptions, these norms teach us who is an appropriate person to ask for assistance. For example, scholars in the area of psychotherapy for men have written of the personal risks (e.g. sense of failure, loss of control, perception of weakness) experienced by men when admitting the need for and seeking mental health services (Addis & Mahalik, 2003). Self-stigma may be particularly salient for men because the traditional male gender role's prescription that men should be independent, controlled and self-sufficient may lead to increased concerns about seeking help, as seeking help may mean admitting an inability to handle things on one's own. Therefore, a man who believed that he needed counselling may feel a strong sense of failure, which could make the act of asking for help particularly difficult. Consistent with this, Pederson and Vogel (2007) found that men who endorsed more traditionally masculine gender roles were more likely to self-stigmatise for seeking professional help. Specifically, they found that although the relationship between perceived public stigma and self-stigma is present for both women and men, the relationship was stronger for men than for women

Interventions
A number of efforts have been implemented to try to reduce public and self-stigma, though most of these have been directed towards reducing the stigma associated with having a mental illness - less attention has been spent on reducing the stigma surrounding seeking treatment. Although efforts to reduce the stigma associated with a mental illness are clearly important, ignoring the stigma associated with seeking professional help does nothing to reduce the difficulty for many individuals who might consider therapy as an option, particularly if they are not exhibiting severe symptoms. Next, borrowing from the literature on stigma reduction for mental illness, we will discuss some strategies to potentially reduce the public and self-stigmas associated with seeking professional help.

Reducing public stigma
Corrigan and Penn (1999) have suggested three approaches to reducing public stigma: protest, education and contact.

Firstly, protest. Psychologists and other mental health providers should be vocal in their objection to inaccurate portrayals of psychotherapy and clients in popular media and other sources. Psychologists have a right to object. The media's portrayals of therapy are often negative, which is particularly problematic because most people have little contact with actual therapists (Orchowski et al., 2006). Recent research supports this media effect; the more people watch comedy and drama shows on television the more stigmatisation they perceive for seeking therapy (Vogel et al., 2008). Thus, psychologists have a responsibility to protest the stereotyped and often inaccurate portrayals of therapy. If those of us who know therapy and its effectiveness do not speak out, who will?

In terms of education, there is a need for accurate information about psychotherapy to help reduce public stigma. Education efforts can take many forms including books, videos, audiotapes, posters, advertisements and even commercials. Even brief educational programmes have been shown to have
at least short-term effects on people's attitudes (Pinfold et al., 2003). A number of larger-scale public education campaigns have been implemented around the globe. One current example is the National Institute of Mental Health (NIMH) 'Real Men, Real Depression' campaign, which uses broad-based advertisements (print, radio and television) to educate the public about men and depression. This campaign is attempting to reach men who might not seek help for depression by reducing
the public and self-stigma related to psychological treatment.

Finally, contact. This is one of the most effective ways to change individuals' endorsement of stigma towards others. Those who have more contact with people who have experienced a mental illness tend to stigmatise them less (Angermeyer et al., 2004). Personal contact can also be incorporated into educational efforts by having individuals not only learn about counselling but also interact with individuals who have sought treatment (Pinfold et al., 2003). Contact with people who have been in counseling can also be elicited through reading stories about individuals who have sought treatment and through public service announcements. In general, contact seems to have the most effect when the person is (a) of at least equal status, (b) perceived as an in-group member, and (c) likeable (Corrigan & Penn, 1999). Thus, having famous individuals such as sports or movie stars come out as having sought counselling is one way that help seeking can be normalised.

Reducing self-stigma
In trying to change the self-stigma associated with seeking professional help a number of lessons can also be learned from the studies on mental illness stigma. Specifically, a number of researchers have suggested cognitive-behavioural (C-B) strategies to build the necessary skills to manage stigma. Hayward and Bright (1997) for example, suggested C-B strategies focusing on changing inaccurate beliefs, providing accurate information, describing health and illness as a continuum with no clear cutoff, and fostering self-acceptance. Corrigan and Calabrese (2005) also suggested that C-B interventions including desensitisation of feared stimulus and cognitive reframing of negative beliefs could have a positive impact on self-stigmatisation. Cognitive-behavioural interventions to reduce self-stigma can be implemented through a number of modalities including in person and via computer or web-based programmes (e.g. see tinyurl.com/6abeqo; Griffiths et al., 2004).

Some evidence also suggests that people may feel less self-stigma (i.e. less shame and guilt) if their symptoms are normalised and if they are given an explanation for their symptoms that suggests that their problems are not their fault and are reversible (Rosen, 2003). This normalising of the therapeutic process may be a key component. Recently, Addis and Mahalik (2003) noted how 'any strategy that increases the normativeness for particular problems should be effective in facilitating help seeking' (p.12). Thus, help-seeking is increased when people see the problem they are dealing with as common. Normalising issues may make seeking treatment less threatening and more typical. Outreach interventions and public marketing could, therefore, discuss the commonness of mental illness and therapy.

Empowerment may also help reduce self-stigmatisation (Corrigan, 2004). Framing therapy as a type of empowerment ('it takes courage to face one's problems'), rather than something that is perceived as a weakness ('I could not handle this on my own'), may increase service use. The depression campaign in the US noted above, for example, describes seeking treatment as taking courage ('It takes courage to ask for help: These men did'). NIMH has a website where this statement is followed by pictures of men who sought treatment and links to their stories as well as information about depression (see tinyurl.com/6ben7o).

Another major implication for mental health professionals is the awareness that clients are evaluating their decisions to seek professional help even after they have made the initial decision to seek help. Although outreach programmes may be able to acknowledge this, a major benefit may come from examining with actual clients how stigma affects them even after they enter therapy (Vogel et al., 2007). The number of clients who drop out of treatment suggests that concerns about seeking help do not vanish after the initial visit, and that for some these concerns may intensify after seeking treatment. Therapists may need to acknowledge and address the stigmas some clients perceive about therapy in order to increase service utilisation and decrease premature termination.

Conclusion
The decision to seek professional help is typically not an easy one. Understanding this difficult and complex process can help facilitate the use of mental health services by those who can truly benefit. Understanding the unique roles of public and self-stigma associated with professional help will allow psychologists to develop interventions designed to overcome these stigmas. Importantly, the discussion offers different possible routes of intervention, rather than restricting intervention only to those individuals who actually sit in our offices.

We can intervene at the individual, community, family, and societal levels to help people make the most informed and healthy choices for themselves. We believe that psychologists will be more effective at helping people overcome the barriers to seeking professional help if they are able to focus their efforts at these different levels. Although reducing the hesitancy to seek professional help is a large task, psychologists can help by using interventions that focus specifically on the stigmas associated with seeking help.
David L. Vogel
is at Iowa State University
[email protected] Nathaniel G. Wade
is at Iowa State University
[email protected]
references

Addis, M.E. & Mahalik, J.R. (2003). Men, masculinity, and the contexts of help-seeking. American Psychologist, 58, 5-14.Angermeyer, M.C., Matschinger,

H. & Corrigan, P.W. (2004). Familiarity with mental illness and social distance from people with schizophrenia and major depression. Schizophrenia Research, 69, 175-182.

Ben-Porath, D.D. (2002). Stigmatization of individuals who receive psychotherapy. Journal of Social and Clinical Psychology, 21, 400-413.

Corrigan, P.W. (1994). How stigma interferes with mental health care. American Psychologist, 59, 614-625.

Corrigan, P.W. & Calabrese, J.D. (2005). Strategies for assessing and diminishing self-stigma. In P.W. Corrigan (Ed.) On the stigma of mental illness. Practical strategies for research and social change (pp.239-256). Washington, DC: American Psychological Association.

Corrigan, P.W. & Penn, D.L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54, 765-776.

Griffiths, K.M., Christensen, H., Jorm, A.F. et al. (2004). Effects of web-based depression literacy and cognitive-behavioral therapy interventions on stigmatizing attitudes to depression. British Journal of Psychiatry, 185, 342-349.

Hayward, P. & Bright, J.A. (1997). Stigma and mental illness: A review and critique. Journal of Mental Health, 6, 345-354.

Jorm, A.F. & Wright, A. (2008). Influences on young people's stigmatizing attitudes towards peers with mental disorders: National survey of young Australians and their parents. British Journal of Psychiatry, 192, 144-149.

Mak, W.W.S., Poon, C.Y.M., Pun, L.Y.K. & Cheung, S.F. (2007). Meta-analysis of stigma and mental health. Social Science and Medicine, 65, 245-261.

Orchowski, L.M., Spickard, B.A. & McNamara, J.A. (2006). Cinema and the valuing of psychotherapy: Implications for clinical practice. Professional Psychology: Research and Practice, 37, 506-514.

Pederson, E.L. & Vogel, D.L. (2007). Men's gender role conflict and their willingness to seek counseling: A mediation model. Journal of Counseling Psychology, 54, 373-384.

Pinfold, V., Toulmin, H., Thornicroft, G. et al. (2003). Reducing psychiatric stigma and discrimination: Evaluation of educational interventions in UK secondary schools. British Journal of Psychiatry, 182, 342-346.

Rosen, A. (2003). What developed countries can learn from developing countries in challenging psychiatric stigma. Australian Psychiatry, 11, Supplement.

Vogel, D.L., Gentile, D. & Kaplan, S. (2008). The influence of television on willingness to seek therapy. Journal of Clinical Psychology, 63, 1-20.

Vogel, D.L., Wade, N.G. & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology, 53, 325-337.

Vogel, D.L., Wade, N.G. & Hackler, A.H. (2007). Perceived public stigma and the willingness to seek counseling. Journal of Counseling Psychology, 54, 40-50.

# data[].attributes.attachment_link.description
One of the most common reasons for people to not seek treatment is concern about stigma. In the psychotherapy literature, stigma has generally referred to the public stigma of having a mental illness, with the clearest example being schizophrenia. Public stigma is society's rejection of a person due to certain behaviours or physical appearances that are deemed unacceptable, dangerous or frightening.

# data[].attributes.headline
Why Some People Are More Prone to Depression Than Others

# data[].attributes.subject
Why Some People Are More Prone to Depression Than Others

# data[].attributes.body
Why do some people experience depression while others don't—even when under the same circumstances? Figuring out what makes someone more prone to clinical depression continues to be one of the most pressing questions for researchers and mental health professionals.

Although researchers don’t have an exact answer as to why some people are more prone to depression than others, there's likely more than one causative factor. Research has implicated everything from physical and chemical differences in the brain to social and environmental risk factors.1

The complexity of depression is what makes it a challenging condition to diagnose and treat. Understanding what could make a person more likely to experience depression is the first step in developing prevention and treatment strategies tailored to reduce individual vulnerability to the condition.2

Developing a more complete understanding of the various mechanisms that drive depression could also help researchers get better at predicting who will get depressed as well as predicting how the condition will present over time.3

With this information, mental health professionals would be better prepared to predict how a person might respond to antidepressants or other forms of therapeutic treatment.

# data[].attributes.attachment_link.readable_text
Why do some people experience depression while others don't-even when under the same circumstances? Figuring out what makes someone more prone to clinical depression continues to be one of the most pressing questions for researchers and mental health professionals.

Although researchers don't have an exact answer as to why some people are more prone to depression than others, there's likely more than one causative factor. Research has implicated everything from physical and chemical differences in the brain to social and environmental risk factors.﻿﻿

The complexity of depression is what makes it a challenging condition to diagnose and treat. Understanding what could make a person more likely to experience depression is the first step in developing prevention and treatment strategies tailored to reduce individual vulnerability to the condition.﻿﻿

Developing a more complete understanding of the various mechanisms that drive depression could also help researchers get better at predicting who will get depressed as well as predicting how the condition will present over time. ﻿﻿

With this information, mental health professionals would be better prepared to predict how a person might respond to antidepressants or other forms of therapeutic treatment.

What Causes Depression?

According to the World Health Organization, over 300 million people worldwide live with depression. While the experience of depression is shared by many, the contributing factors will be different for each person with the condition.

There are some factors, like genetics, that you don't have control over. However, there are others, such as your diet, that can be modified. While making a change won't necessarily prevent depression, it may help reduce your risk.

Whether you can change them or not, it's helpful to be aware of factors that could make you more likely to develop depression in your lifetime. Just remember that researchers are still figuring out the role each factor plays. Having one-or even several-of the factors thought to contribute to depression doesn't mean you will definitely become depressed.

Depression is common in people of all ages, races, gender identities, and socioeconomic status. According to the 2017 report from the National Institute of Mental Health, depression affects approximately 17.3 million people in the United States. And in 2018, the CDC reported that approximately 1.9 million children (ages 3-17) in the U.S. have been diagnosed with depression.

Biological Factors

Some risk factors for depression are rooted in your biology.

Brain Chemistry

Researchers don't agree on precisely how brain chemicals relate to depression, but the connection has been discussed for many decades. Some established theories suggest that low certain levels of neurotransmitters (which the brain cells use to send signals to each other) could cause depression. Other researchers have proposed that being depressed causes low levels, rather than it being the other way around. The relationship may even go both ways.

What is known is that some people with depression feel better when they take medications that work on these neurotransmitters. However, researchers aren't convinced this is enough to prove specific relationships between brain chemistry and depression, in large part because some people with depression don't feel better when they take antidepressants.

Researchers know that people who have family members who are depressed are more likely to become depressed themselves. But having a family history of depression doesn't mean you will experience depression in your lifetime.﻿﻿ There are still other factors that have to line up in order for a genetic predisposition to result in depression.

That said, large genome-wide study published in The American Journal of Psychiatry in 2019 found that people with a genetic predisposition for major depression have an increased risk for suicide attempts across psychiatric disorders.

Chronic Pain and Illness

Depression is common in people living with chronic illnesses such as multiple sclerosis, type 2 diabetes, and migraines. Research has shown that chronic pain conditions may cause biochemical changes that lead to symptoms of depression.﻿﻿ A person with chronic pain and illness may become depressed due to their situation, especially when they are facing a loss of quality of life, a reduced level of day-to-day functioning, prolonged pain, and/or death.﻿﻿

It's also been shown that people who are diagnosed with one mental illness are more likely to develop another.﻿﻿ Conditions such as anxiety and depression commonly co-occur.

While different mental health conditions may be diagnosed at the same time and can influence one another, they may need to be treated in different ways.

Certain hormonal shifts can increase your risk of depression as well. For example, the hormonal changes associated with the menstrual cycle, pregnancy, giving birth, and menopause can all contribute to depression.

The Centers for Disease Control and Prevention (CDC) estimates that around 1 in 9 women in the U.S. report experiencing postpartum depression. And according to a 2010 study, approximately 4% of fathers report depression in the first year after a child is born.

It's also not unusual for people with thyroid conditions to experience depression.﻿﻿ While symptoms tend to be more common in people with a low-functioning thyroid (hypothyroidism), people with an overactive thyroid (hyperthyroidism) can also experience anxiety and depression.

Environment Factors

Environmental factors also appear to play a role in the development of depression in some people.

Early Trauma and Abuse

One of the more well-studied depression risk factors is trauma in early childhood. Adverse Childhood Experiences (ACEs) are known to increase a person's lifetime risk of developing both mental and chronic physical illness, including depression.﻿﻿ Research into ACEs is ongoing, but previous studies have confirmed a strong link between specific childhood experiences and depression later in life.

The CDC groups ACEs into three types:

Abuse (physical, emotional, sexual)

Neglect (physical, emotional)

Household Dysfunction (domestic violence, divorce, substance use, a parent who is mentally ill, a parent who is incarcerated)

An individual's ACE score is strongly linked to their risk of mental and physical illness, poverty, and even early death. Risk increases as the number of ACEs increases and a person with four or more ACEs is at the highest risk.

Researchers believe that child abuse may change the brain physically, as well as alter its connectivity structure.﻿﻿ Studies have also shown that neuroendocrine function may be altered in people who experienced high levels of stress as children.﻿﻿

A 2019 study from the Massachusetts General Hospital has even proposed that traumatic experiences in the first three years of life may even change a child's DNA.

According to a 2015 survey from the American Psychological Association, 64% of American adults said money was a significant source of stress in their lives. People living in poverty were twice as likely to have depression compared to those living at or above the poverty level.﻿﻿

Not only does living in poverty place a person at higher risk for depression but if they are unable to work or do not have access to support and social services, mental illness can make it harder for someone to break out of a cycle of socioeconomic disadvantage.﻿﻿

Several studies and pilot programs have shown that when people with mental illness were given financial assistance, symptoms of depression and anxiety improved.﻿﻿

Environmental Exposures

Where a person lives can also have an impact on mental health in a number of ways. For example, some people report they become depressed during certain months of the year, sometimes called seasonal affective disorder (SAD).

There are also studies that cite pollution and other environmental exposures as potential contributing factors to depression.﻿﻿ For example, some research has linked lead exposure in childhood to poor mental health later in life.

In another study, children who grew up in areas with poor air quality appeared to be more likely to be depressed or be diagnosed with conduct disorder by the time they turned 18.

Social Factors

In addition to biological and environmental factors, social factors such as a person's personality, experiences of stress and conflict, and even social media can also influence depression risk.

Personality

Certain personality traits, including low self-esteem, pessimism, neuroticism, and being self-critical or "a perfectionist" have been associated with a greater tendency toward depression and other mental health conditions, such as anxiety and eating disorders.﻿﻿

Researchers are especially interested in learning more about a personality trait that may make someone less likely to experience depression. Resilience, or the qualities or traits that make some people more likely to "bounce back" from adverse experiences, may also be key to preventing and treating depression.﻿﻿

Stress and Conflict

Major life events-including traditionally positive events like getting married or negative events like losing a job-can all create stress. When we are stressed, our cortisol levels rise. One theory is that high levels of cortisol (especially when they are chronically elevated) could affect serotonin levels.﻿﻿

Work-related stress, in particular, can be a driver of depression. Losing a job is an obvious stressor, but the work environment can also contribute to stress-especially if it doesn't feel supportive.

Conflict at work or school can also make it more likely a person will become depressed. A 2010 study in Japan linked interpersonal conflict at work to depression (particularly among male employees with a higher socioeconomic status).

The year before, researchers in Sweden had published a study showing that having serious conflicts with coworkers or bosses, and/or feeling excluded or left out at work, contributed to depression in employees.

It's not just adults who experience conflict away from home: Kids and teens can encounter interpersonal challenges at school that have the potential to affect their short and long term mental andphysical health.

A 2017 report from the National Center for Education Statistics found that 20% of students between the ages of 12-18 said they had been bullied at school in the previous year.

According to the CDC, kids who are bullied are more likely to experience mental health problems, including anxiety and depression. They're also more likely to have physical ailments, particularly headaches and stomachaches.

Going through conflicts with friends and/or family may also increase the chances that a person who is prone to depression will develop the condition.﻿﻿

Grieving is a process that can look and feel like depression, except that it usually follows a particular timeframe beginning with an event (such as the death of a loved one) and gradually moving toward resolution or a stage of acceptance.﻿﻿

Researchers are learning, though, that bereavement can take on the qualities of a condition similar to clinical depression, particularly in terms of how long it persists (years as opposed to months).﻿﻿

Complicated grief, as it is often termed, appears to be more likely when someone loses a loved one in a sudden, unexpected, and especially violent way (such as a car accident).﻿﻿

Additional studies are needed to formally define complicated grief as a distinct condition, but it appears to have a relationship to depression and post-traumatic stress disorder (PTSD).﻿﻿

The stress caused by a death, major loss, or another life stressor can be enough to trigger an episode of depression in someone who already possesses the tendency towards this condition.

Social Media

While the research is still fairly new and ongoing, many studies have investigated the effect of social media on mental health, especially in young people.﻿﻿

Several studies have indicated that social media use can trigger depressive symptoms and anxiety through insecurity, comparison,﻿﻿ "fear of missing out,"﻿﻿ and bullying/harassment (which, whether experienced in-person or online, raises a child's lifetime risk for depression).﻿﻿

Overuse of social media may also contribute to depression by reducing a person's level of physical activity and real-life interaction. A sedentary lifestyle and being socially isolated are two factors that can contribute to poor mental health independent of social media habits.﻿﻿

The research hasn't been all bad, though. Technology, the internet, and social media may also prove useful for helping to detect and manage depression.﻿﻿

Lifestyle Factors

Last, but not least, lifestyle factors from the medications you take to your diet can have an effect on your risk of experiencing depression.

Prescription Medications

Certain medications are known to have the potential to increase a person's risk of depression, including:

Medications used to treat mental illness and sleep disorders can also worsen or cause depression in some people.﻿﻿ People under the age of 25 are at some increased risk for increased suicidality after starting certain antidepressants. Therefore, the FDA has given these medications a black box warning.

Substance Use

It's not uncommon for people with mental illness to self-medicate with drugs and alcohol. However, it's also important to note that not unlike certain prescription medications, illicit drugs can also make a person feel depressed.

According to data from the National Alliance on Mental Health's Drug and Health Survey, 7.9 million people in the U.S. were living with both depression and a substance use disorder in 2014.

When substance use and depression occur at the same time (sometimes called "dual diagnosis") it can be difficult to find the right treatment.﻿﻿ People often require a diverse team of doctors and mental health professionals with experience in substance use disorders for support.

If a person needs to withdraw from a substance, it's sometimes safest for them to do so under medical care. Treatment at a mental health facility can also help a person address both substance use disorders and symptoms of depression that may accompany them.

Diet and Physical Activity

Recent studies have indicated that adults with mild depression may be able to prevent an episode of major depression through a combination of lifestyle changes.

Gut microbes and diet may also play a role in the development of depression.﻿﻿ Some research has also shown that certain diets, such as the Mediterranean diet, might help older adults avoid depression.﻿﻿

On the other hand, diets that are high in sugar and trans fat, especially heavily processed food, can promote or worsen depression, especially when paired with a sedentary lifestyle.﻿﻿ A possible reason for the link is that diets high in these foods can lead to weight gain.

In fact, a 2018 study found that people were more likely to become depressed if they were overweight-even if the extra weight wasn't causing other health problems such as high blood pressure or type 2 diabetes.

The benefits of exercise for our health are well known, but we are learning more about how exercising can help people with depression manage their symptoms.﻿﻿ Several recent studies confirmed previous research indicating that regular exercise and a healthy diet doesn't just help people manage depression, but can help prevent it.﻿﻿

A Word From Verywell

Each person's experience of living with depression will vary, as will the individual factors that contribute to the development and course of the condition. Mental illness is common and treatable, but it can take time to find the safest and most effective treatment. Working with doctors and mental health professionals, developing coping strategies at work and school, and having support from family and friends are of vital importance to every person living with depression, as well as those with risk factors for developing the condition in their lifetime.

# data[].attributes.attachment_link.title
Why Some People Are More Prone to Depression Than Others

# data[].attributes.attachment_link.description
Why do some people experience depression while others don't-even when under the same circumstances? Figuring out what makes someone more prone to clinical depression continues to be one of the most pressing questions for researchers and mental health professionals.

# data[].attributes.body
Depression is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years (1). Approximately 280 million people in the world have depression (1). Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when recurrent and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide.

Over 700 000 people die due to suicide every year. Suicide is the fourth leading cause of death in 15-29-year-olds.

Source:
https://www.who.int/news-room/fact-sheets/detail/depression

# data[].attributes.attachment_link.readable_text
Key facts

Depression is a common mental disorder.

Globally, an estimated 5.7% of adults suffer from depression.

More women are affected by depression than men.

Depression can lead to suicide.

There is effective treatment for mild, moderate and severe depression.

Depressive disorder (also known as depression) is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods of time.

Depression is different from regular mood changes and feelings about everyday life. It can affect all aspects of life, including relationships with family, friends and community. It can result from or lead to problems at school and at work.

Depression can happen to anyone. People who have lived through abuse, severe losses or other stressful events are more likely to develop depression. Women are more likely to have depression than men.

An estimated 4% of the population experience depression, including 5.7% of adults (4.6% among men and 6.9% among women), and 5.9% of adults aged 70 years and older. Approximately 332 million people in the world have depression (1). Depression is about 1.5 times more common among women than among men. Worldwide, more than 10% of pregnant women and women who have just given birth experience depression (2). In 2021, an estimated 727 000 people lost their lives to suicide. Suicide is the third leading cause of death in 15-29-year-olds.

In high-income countries, only about one third of people with depression receive mental health treatment (3).

Barriers to effective care include a lack of investment in mental health care, lack of trained health-care providers and social stigma associated with mental disorders.

Symptoms and patterns

During a depressive episode, a person experiences a depressed mood (feeling sad, irritable, empty). They may feel a loss of pleasure or interest in activities.

A depressive episode is different from regular mood fluctuations. They last most of the day, nearly every day, for at least two weeks.

Other symptoms are also present, which may include:

poor concentration

feelings of excessive guilt or low self-worth

hopelessness about the future

thoughts about dying or suicide

disrupted sleep

changes in appetite or weight

feeling very tired or low in energy.

Depression can cause difficulties in all aspects of life, including in the community and at home, work and school.

A depressive episode can be categorized as mild, moderate, or severe depending on the number and severity of symptoms, as well as the impact on the individual's functioning.

There are different patterns of depressive episodes including:

single episode depressive disorder, meaning the person's first and only episode;

recurrent depressive disorder, meaning the person has a history of at least two depressive episodes; and

bipolar disorder, meaning that depressive episodes alternate with periods of manic symptoms, which include euphoria or irritability, increased activity or energy, and other symptoms such as increased talkativeness, racing thoughts, increased self-esteem, decreased need for sleep, distractibility, and impulsive reckless behaviour.

Contributing factors and prevention

Depression results from a complex interaction of social, psychological, and biological factors. People who have gone through adverse life events (unemployment, bereavement, traumatic events) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person's life situation and the depression itself.

Depression is closely related to and affected by physical health. Many of the factors that influence depression (such as physical inactivity or harmful use of alcohol) are also known risk factors for diseases such as cardiovascular disease, cancer, diabetes and respiratory diseases. In turn, people with these diseases may also find themselves experiencing depression due to the difficulties associated with managing their condition.

Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive coping in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for older persons can also be effective in depression prevention.

Diagnosis and treatment

There are effective treatments for depression. These include psychological treatment and medications. Seek care if you have symptoms of depression.

Psychological treatments are the first treatments for depression. They can be combined with antidepressant medications in moderate and severe depression. Antidepressant medications are not needed for mild depression.

Psychological treatments can teach new ways of thinking, coping or relating to others. They may include talk therapy with professionals and supervised lay therapists. Talk therapy can happen in person or online. Psychological treatments may be accessed through self-help manuals, websites and apps.

Effective psychological treatments for depression include:

behavioural activation

cognitive behavioural therapy

interpersonal psychotherapy

problem-solving therapy.

Antidepressant medications include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine.

Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences.

Antidepressants should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with extra caution.

Different medications and treatments are used for bipolar disorder.

Self-care

Self-care can play an important role in managing symptoms of depression and promoting overall well-being.

What you can do:

try to keep doing activities you used to enjoy

stay connected to friends and family

exercise regularly, even if it's just a short walk

stick to regular eating and sleeping habits as much as possible

avoid or cut down on alcohol and don't use illicit drugs, which can make depression worse

talk to someone you trust about your feelings

seek help from a healthcare provider.

If you have thoughts of suicide:

remember you are not alone, and that many people have gone through what you're experiencing and found help

talk to someone you trust about how you feel

talk to a health worker, such as a doctor or counsellor

join a support group.

If you think you are in immediate danger of harming yourself, contact any available emergency services or a crisis line.

WHO response

WHO's Comprehensive Mental Health Action Plan 2013-2030 highlights the steps required to provide appropriate interventions for people with mental disorders including depression.

Depression and self-harm/suicide are among the priority conditions covered by WHO's Mental Health Gap Action Programme (mhGAP). The Programme aims to help countries increase services for people with mental, neurological and substance use disorders through care provided by health workers who are not specialists in mental health.

WHO has developed brief psychological intervention manuals for depression that may be delivered by lay therapists to individuals and groups. An example is the Problem Management Plus (PM+) manual, which describes the use of behavioural activation, stress management, problem solving treatment and strengthening social support. Moreover, the Group Interpersonal Therapy for Depression manual describes group treatment of depression. Finally, the Thinking Healthy manual covers the use of cognitive-behavioural therapy for perinatal depression.
References
1. 2021 Global Burden of Disease (GBD) [online database]. Seattle: Institute for Health Metrics and Evaluation; 2024 ( https://vizhub.healthdata.org/gbd-results/, accessed 13 August 2025).

2. Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86-92.

3. Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, et al. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med. 2018;48(9):1560-1571.

# data[].attributes.attachment_link.description
WHO fact sheet on depression, providing information on prevalence, symptoms, prevention and contributing factors, diagnosis and treatment, and WHO's work in the area.

# data[].attributes.headline
How Does Filipino culture affect one's perspective about mental health

# data[].attributes.subject
How Does Filipino culture affect one's perspective about mental health

# data[].attributes.body
How does the Filipino language influence our view of mental health and illness?

Filipino culture encourages coping through social means. Even our language is devoid of nuances for various mental health conditions. And while such coping mechanisms cannot be discounted or done away with, there are instances or cases that require formal treatment depending on the condition.

# data[].attributes.attachment_link.readable_text
Filipino families greatly influence patients' decisions about health care. Patients subjugate personal needs and tend to go along with the demands of a more authoritative family figure in order to maintain group harmony.

What are the Filipino cultural beliefs and practices related to health?

Filipinos, especially older adults, tend to cope with illness by relying on advice from family and friends, and by faith in God. In fact, experiencing a complete recovery from an illness is often regarded as personally witnessing a miracle-greatly influencing how Filipinos view healthcare.

What are the beliefs of Filipino?

The Philippines proudly boasts to be the only Christian nation in Asia. More than 86 percent of the population is Roman Catholic, 6 percent belong to various nationalized Christian cults, and another 2 percent belong to well over 100 Protestant denominations.

How does culture influence everyday life?

According to Wikipedia culture is a "way of life" of a group of people, it is what they do daily and how they behave. ... This means that every single thing that we learn during the course of our life is influenced by the cultural lenses that our family, environment and infancy have given to us.

What are major cultural influences?

Cultural influences means historical, geographical, and familial factors that affect assessment and intervention processes.

What are the negative effects of culture?

Other consequences of negative culture include gossiping, low employee engagement, higher rates of absenteeism and presenteeism, a lack of empathy, a lack of flexibility and high employee turnover.

What are the top 10 causes of death in the Philippines?

The leading causes of death are diseases of the heart, diseases of the vascular system, pneumonias, malignant neoplasms/cancers, all forms of tuberculosis, accidents, COPD and allied conditions, diabetes mellitus, nephritis/nephritic syndrome and other diseases of respiratory system.

What is the most issue in the Philippines?

The Philippines also suffers major human-caused environmental degradation aggravated by a high annual population growth rate, including loss of agricultural lands, deforestation, soil erosion, air and water pollution, improper disposal of solid and toxic wastes, loss of coral reefs, mismanagement and abuse of coastal ...

What is the number 1 cause of death in the Philippines?

Leading causes of mortality Philippines 2018, by disease

In 2018, one of the leading causes of death in the Philippines was ischemic heart disease impacting around 88.4 thousand people. The other four leading causes of death were malignant neoplasms, cerebrovascular disease, pneumonia, and diabetes mellitus.

# data[].attributes.attachment_link.title
How does Filipino culture affect health?

# data[].attributes.attachment_link.description
Filipino families greatly influence patients' decisions about health care. Patients subjugate personal needs and tend to go along with the demands of a more authoritative family figure in order to maintain group harmony. Filipinos, especially older adults, tend to cope with illness by relying on advice from family and friends, and by faith in God.

# data[].attributes.body
Obesity is a common, serious, and costly disease

The US obesity prevalence was 42.4% in 2017 – 2018.

From 1999 –2000 through 2017 –2018, US obesity prevalence increased from 30.5% to 42.4%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%.

Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer. These are among the leading causes of preventable, premature death.

The estimated annual medical cost of obesity
external icon in the United States was $147 billion in 2008. Medical costs for people who had obesity was $1,429 higher than medical costs for people with healthy weight.

Source:
https://www.cdc.gov/obesity/data/adult.html#:~:text=The%20US%20obesity%20prevalence%20was,from%204.7%25%20to%209.2%25.&text=The%20estimated%20annual%20medical%20cost,was%20%24147%20billion%20in%202008.

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.readable_text
Obesity Prevalence Maps
Adult obesity prevalence by state and territory using self-reported information from the Behavioral Risk Factor Surveillance System.

Obesity is a common, serious, and costly disease

The US obesity prevalence was 42.4% in 2017 - 2018.

From 1999 -2000 through 2017 -2018, US obesity prevalence increased from 30.5% to 42.4%. During the same time, the prevalence of severe obesity increased from 4.7% to 9.2%.

Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer. These are among the leading causes of preventable, premature death.

The estimated annual medical cost of obesityexternal icon in the United States was $147 billion in 2008. Medical costs for people who had obesity was $1,429 higher than medical costs for people with healthy weight.

Obesity affects some groups more than others

[ Read CDC National Center for Health Statistics (NCHS) data brief]

Non-Hispanic Black adults (49.6%) had the highest age-adjusted prevalence of obesity, followed by Hispanic adults (44.8%), non-Hispanic White adults (42.2%) and non-Hispanic Asian adults (17.4%).

The obesity prevalence was 40.0% among adults aged 20 to 39 years, 44.8% among adults aged 40 to 59 years, and 42.8% among adults aged 60 and older.

Obesity and socioeconomic status

[ Read the Morbidity and Mortality Weekly Report (MMWR)]

The association between obesity and income or educational level is complex and differs by sex and race/ethnicity.

Overall, men and women with college degrees had lower obesity prevalence compared with those with less education.

The same obesity and education pattern occurred among non-Hispanic White, non-Hispanic Black, and Hispanic women, and non-Hispanic White men. However, the differences were not all statistically significant. Although the difference was not statistically significant among non-Hispanic Black men, obesity prevalence increased with educational attainment. No differences in obesity prevalence by education level were noted among non-Hispanic Asian women and men and Hispanic men.

Among men, obesity prevalence was lower in the lowest and highest income groups compared with the middle-income group. Researchers observed this pattern among non-Hispanic White and Hispanic men. Obesity prevalence was higher in the highest income group than in the lowest income group among non-Hispanic Black men.

Among women, obesity prevalence was lower in the highest income group than in the middle and lowest income groups. Researchers observed this pattern among non-Hispanic White, non-Hispanic Asian, and Hispanic women. Among non-Hispanic Black women, there was no difference in obesity prevalence by income.

Connect with Nutrition, Physical Activity, and Obesity

Page last reviewed:

# data[].attributes.attachment_link.title
Obesity is a Common, Serious, and Costly Disease

# data[].attributes.attachment_link.description
Obesity Prevalence Maps Adult obesity prevalence by state and territory using self-reported information from the Behavioral Risk Factor Surveillance System. The US obesity prevalence was 42.4% in 2017 - 2018. From 1999 -2000 through 2017 -2018, US obesity prevalence increased from 30.5% to 42.4%.