Depression: prevalence, pathogenesis and treatment options

ABSTRACT

Depression represents a major public health problem that is characterized by disturbance of mood, poor concentration, loss of sense of control and a subjective experience of great distress. It affects the thinking and functioning processes of an individual, greatly diminishes his or her social role and productivity, even leading to suicide. The incidence of depression is gradually on a rise and afflicts all socioeconomic levels. Prevalence studies give very high figures of depression in all parts of the world. The pathogenesis of this mental health problem is very complex. Genetic factors greatly contribute in etiology of depression and the heritability of this illness is greater in females. Abnormalities in membrane bound signal transduction systems and intracellular signaling systems play an important role in the etiology of depression. Deregulation of the hypothalamic-pituitary-adrenal axis and altered levels of several brain neurotransmitters such as serotonin, norepinephrine, glutamate, gamma amino butyric acid and dopamine are also implicated in depression. The cause and effect relationshiop in this mental disorder still remains unclear. Therapies that are available to treat depression are limited and suboptimal with regard to their efficacy and tolerability. These therapies include pharmacotherapy, psychotherapy, exercise therapy, electro convulsive therapy, repetitive transcranial magnetic stimulation, phytotherapy, meditation, phototherapy and negative ion therapy