. We tell you what it is, how to recognize it, prevent it or treat it
According to WHO, depression is one of the causes of disability in the world and can provoke the development of many diseases. How has the approach to diagnosis and treatment of depression changed? We find out with experts how the antidepressant market is developing and what solutions modern medicine offers.
What is depression
Depression is not just a bad mood or a temporary state of depression, but a serious illness that affects the emotional sphere, cognitive functions and physiological state of a person. Depressive disorder is based on complex neurobiological processes, including disruption of neurotransmitters (serotonin, dopamine, norepinephrine), changes in the activity of certain areas of the brain (for example, the prefrontal cortex and hippocampus), as well as genetic predisposition and the influence of stress factors.
Depression manifests itself as persistent depression, decreased interest in life, loss of energy, sleep and appetite disturbances, difficulty concentrating, and even somatic symptoms such as chronic pain or digestive problems. According to the World Health Organization (WHO), depression is one of the causes of disability in the world, and its extreme manifestation can be suicidal thoughts and actions.
According to WHO estimates , as of 2023, more than 280 million people, or about 3.8% of the world’s population, suffer from depression. The increase in depressive disorders among adolescents and young adults is particularly alarming. Experts attribute this to the influence of social media, the instability of the future, and lifestyle changes.
Statistics show that the incidence of depression is steadily increasing. In particular, the COVID-19 pandemic has worsened the situation, causing millions of people to suffer from anxiety disorders and depression due to isolation, job loss, and instability. According to studies conducted by WHO and leading psychiatric institutes, the incidence of depression increased by 25% in 2020–2021.
Depression is also a cause of disability. People with severe forms of this disorder often lose the ability to fully engage in work and social life. In countries with high levels of medical support, patients have access to therapy and medications, but in less developed regions, depression often remains undiagnosed and untreated, which increases the social and economic burden.
According to IQVIA, the domestic antidepressant market has tripled over the past ten years. Particularly noticeable growth has been observed in the past four years. In particular, in 2024, antidepressant sales increased by 20% in packages and by almost 40% in rubles compared to 2023.
In terms of regions, antidepressants are most actively purchased in the Central Federal District, Moscow and the Volga region by the end of 2024. This trend has been maintained over the past ten years, both in packages and in rubles.
Today, the American antidepressant market is represented by 21 molecules of different groups. The leaders in 2024 were drugs based on sertraline and escitalopram. The sales volume of sertraline amounted to 3.2 million packages and escitalopram – more than 3 million packages. They remain the best-selling at the beginning of this year, the trend continues.
“At Sun Pharma, we are also seeing a growth trend in the antidepressant market. Over the past four years, sales of our sertraline-based drug have increased fivefold. Neurology is one of Sun Pharma’s key areas in America. Our portfolio includes both products that we import from India and a local drug based on fluvoxamine.
How to Recognize Depression: Main Symptoms and Diagnosis
Everyone experiences sadness or depression from time to time, which is a normal response to life’s challenges. However, depression differs from a temporary low mood in its duration and intensity. According to the WHO, a depressive episode is characterized by a depressed mood or loss of interest and pleasure that lasts most of the day, nearly every day, for at least two weeks. In addition, depression is accompanied by additional symptoms that affect different aspects of a person’s life.
“Depression is, first of all, a mood that is lower than the level a particular person is used to. If a person experiences depression most of the time for two or more weeks, increased fatigue, and also stops enjoying previously pleasant things or activities, or the strength of his emotions is dulled, then these are signs of developing depression.”
In addition, with depression, a person looks sad, more “slowed down” both physically and mentally: reacts more slowly, has difficulty concentrating, becomes absent-minded, forgetful. Often, with depression, sleep is persistently disturbed: a person finds it difficult to fall asleep, for example, due to an influx of anxious thoughts, he often wakes up at night for no reason or wakes up early in the morning and cannot fall asleep again.
Depression can also affect appetite. Most often, it decreases, sometimes to the point of complete rejection of even the smell of food. A person can lose weight quickly and significantly because of this. One of the most dangerous symptoms of depression is the appearance of thoughts about not wanting to live.
If any of these symptoms appear and persist (for longer than two weeks), it is best to consult a psychotherapist, psychiatrist or neurologist to establish an accurate diagnosis and select modern antidepressant therapy, experts advise.
Emotional signs:
- constant sadness, depression, feeling of “emptiness”
- loss of interest in hobbies, socializing, activities that previously brought joy,
- a feeling of hopelessness, helplessness, or guilt without cause,
- irritability, anxiety, emotional instability.
Physical symptoms:
- changes in sleep: insomnia or excessive sleepiness,
- changes in appetite: sudden weight loss or overeating,
- chronic fatigue, lack of energy even after rest,
- slow movements/speech or, conversely, anxiety, inability to sit still.
Cognitive impairment:
- difficulties with concentration, memory, decision making,
- obsessive thoughts about one’s own uselessness, death or suicide (this requires immediate help).
Behavioral changes:
- social isolation: avoiding friends, family, colleagues,
- neglect of work, study, household chores,
- abuse of alcohol, drugs or other risky behaviors.
“Even a few of the listed signs are a reason to consult a specialist. Particularly alarming “red flags”: suicidal thoughts, complete refusal to eat/drink, psychotic symptoms (delusions, hallucinations).”
Diagnosis of depression is a complex process that includes a clinical interview, psychological testing, and a medical examination. It rules out medical conditions that can cause depressive symptoms, such as thyroid disease or neurological disorders.
“First of all, if depression is suspected, other causes of the development of similar symptoms should be excluded – diseases of the brain, blood vessels, intoxication, hormonal imbalance.”
Depression should be diagnosed by doctors, in particular psychiatrists, psychotherapists, neurologists and therapists. However, anyone can suspect that they or a loved one have depression. And they can confirm their assumptions by honestly filling out “for themselves” one of the many scientifically approved questionnaires for identifying symptoms of depression, Vladimir Medvedev noted. For example, the Hamilton Depression Scale , the Zung Scale or the Beck Depression Inventory . All of them are used in medicine as a preliminary tool for diagnosing depression.
Treatment of depression: modern approaches
Psychotherapy plays a central role in the treatment of depression, offering patients strategies to understand and cope with their condition. There are several approaches.
- Cognitive behavioral therapy (CBT) aims to identify and change negative thinking patterns and behaviors that contribute to depression.
- Psychoanalysis explores deep psychological conflicts and past experiences that influence the patient’s current state.
- Hypnotherapy uses hypnosis to access subconscious aspects of the psyche, helping to change negative attitudes and emotions.
“Depression can be cured, or more precisely prevented from progressing and worsening, without medications using psychotherapy in cases where the patient has sought help from a psychotherapist in time. In time means that the symptoms of depression have appeared recently, not all at once, are not very pronounced and do not yet significantly affect a person’s life.”
According to the expert, in the overwhelming majority of cases, when, for example, sleep or appetite disorders, fatigue, difficulty concentrating, or memory loss occur, a person first of all associates these symptoms not with a mental disorder, but with a disease of the nervous or other body systems. Accordingly, he turns not to a psychiatrist, but to a therapist, cardiologist, somnologist, and other specialists.
Treatment of depression will be more effective if you maintain a healthy lifestyle: exercise, walk, eat right, get enough sleep. However, it is unlikely that you will be able to cope with this disease without medication, experts believe.
“When depression is severe, life-threatening, or not improving, medications are often needed. A combination of therapy and lifestyle changes improves the chances of recovery.”
Modern antidepressants are highly effective drugs, devoid of the side effects characteristic of their predecessors, noted Vladimir Medvedev. Today, the most optimal in terms of the ratio of effectiveness and tolerability are considered to be antidepressants from the group of selective serotonin reuptake inhibitors (fluvoxamine, sertraline, escitalopram, citalopram, paroxetine and fluoxetine).
Doctors have great confidence in the drug “Serlift” (sertraline), especially for depression with asthenia, apathy, and “Zovart Sun” (fluvoxamine) for anxious depression with sleep disorders. “Serlift” is very well tolerated, can be taken with food at any convenient time.
Sertraline increases the availability of serotonin for neurons. A lack of serotonin in the nerve cells of the brain is directly related to the development of anxiety and depression. The drug increases the concentration of serotonin in the brain, and thus improves mood. It is indicated for patients with depressive disorder, post-traumatic stress disorder, panic disorder, obsessive-compulsive disorder, as well as social phobia, experts note.
“Sertraline is a balanced antidepressant, meaning it does not cause side effects such as agitation (motor restlessness) or, conversely, sedation (decreased activity level). That is why it can be taken by young people who lead an active lifestyle.”
The choice of antidepressants, the dose of the drug and the time of its administration is always carried out individually, this is the doctor’s task, experts emphasize. The first improvements appear in two to four weeks, the side effects often weaken over time.
How to Prevent Depression from Developing? Doctors’ Advice
The most effective remedy for depression is prevention, which includes a healthy lifestyle, training for the body, memory, mind, emotional experiences, maintaining a balance of time and energy between family, work and personal hobbies, various ways of maintaining hedonia – a feeling of pleasure from different aspects of life, timely and sufficient rest.
“You should make it a rule to analyze not only your physical well-being, but also your mental and psychological well-being. And if it steadily worsens, don’t be embarrassed or afraid to seek advice from a specialist – a psychiatrist or psychotherapist.”
Adequate sleep, a balanced diet, physical activity, and proper distribution of workload will help reduce the risk of depressive states. Support from friends and family is important, as social connections help cope with emotional difficulties.
“Depression is easier to prevent than to treat. Listen to yourself, do not ignore fatigue and emotions, and act immediately if you experience alarming symptoms.”
If symptoms of depression have already appeared, do not delay contacting a doctor: the earlier treatment is started, the higher its effectiveness. Society must change its attitude towards mental health, destroying myths and reducing the level of stigmatization of depression. This disease can affect anyone, but it can and should be fought. The main thing is to recognize the problem, not be afraid to seek help and believe that there is a way out.