Depression is a mental disorder that affects how one feels, thinks, and acts. Despite being a treatable mental problem, many people consider it a usual mental problem, but the outcome is usually unattractive. It is associated with various health and social issues, which affects the ability to function normally. This mental illness is prevalent globally as it affects approximately 3.8 percent of the world’s population (WHO). Adults above 60 years of age represent the more significant portion of the affected group with 5.7 percent (WHO). The current statistics by the World Health Organization (WHO) shows that about 280 million people are affected by depression.
Depression is significantly different from the typical mood changes that people experience as it involves the challenge that individuals encounter in their day-to-day activities. When this condition upgrades from minor to severe, it becomes a serious health problem. The people who suffer from this disorder may commit suicide because of a lack of suitable intervention. WHO statistics show that suicide is the fourth cause of death, with over 700 000 people. Despite this condition having multiple interventions, approximately 75 percent of the people in developing countries cannot receive treatment (WHO). This is because various barriers prevent them from accessing medical attention, such as social stigma, inadequate resources, and inadequately trained health care personnel. The paper investigates depression among individuals as it is a widespread mental condition. Furthermore, it focuses on the effects of depression that results from this condition, coping strategies that people implement, the sign and symptoms, and depression during the COVID-19 pandemic. The literature review is organized on themes associated with depression.
Effect of Depression
Depression has various effects grouped into physical and social. The physical effects of depression include pain, gastrointestinal pains, immunity, sleep problems, fatigue, high blood pressure, and loss of appetite. Theories have been established regarding the connection between pain and depression (Akturk et al. 122). It has been noted that individuals undergoing depression have a higher pain than those that are not depressed. The most common pain that depressed people experience is lower back pain (WHO). The gastrointestinal pains results from the effect of the neurotransmitter and the serotonin in the gut (Akturk et al. 122). The mood regulator chemical in the brain is associated with depression as it helps regulate the mood. Individuals’ immune system is affected during this period due to negative feelings. Most people tend to develop complications not linked with a medical condition that later poses a significant threat. The physical effects alter an individual’s body performance, making them have a reduced life span (Aktürk et al. 122).
Depression is linked to poor social functioning, social impairments, and risk factors. NIMH research shows that depression leads to multiple social problems such as social anhedonia, diminished cooperativeness, and impaired social network. Other social effects of depression include engagement in alcoholism and substance abuse, family withdrawal, and low performance at work, school, or other significant areas (NIMH). Individuals tend to have a negative attitude that reduces their psyche when performing tasks (NIMH). This usually results in poor performance of organizations because they are dependent on the human capital to accomplish most of the tasks.
According to Firouzbakht et al., coping strategies incorporate mental and behavioral performances to handle the distressing or depressing condition that an individual is experiencing (1). Melendez et al. argue that the relationship between divergent thinking and coping is facilitated by the individual’s mood (1605). Coping stand out to be the initial strategy that people presume at the early stage of depression. Several studies have shown the relationship between mood, health, and coping strategy. The positivity of this relationship is when the three are connected with an active and rational way of focusing on the problem, the outcome is positive. For instance, an individual may seek information regarding the problem, the situation, and the opinion from various areas within one’s limit. However, the relationship may turn negative when coping is based on passive and emotional strategies.
Mélendez et al. claim that the pattern of coping is dependent on the age of individuals (1606). Older people tend to use passive coping methods more than young individuals. The reason being older people have less control over the environment and are usually dependent. Firouzbakht et al. study show that individual prefers using avoidance strategy to handle problem or situations that are very demanding (6). Despite the strategy being effective in the short term, they are not successful in the long run as avoiding a problem only gives one an escape route while the real problem remains unsolved (Melendez et al. 1605; Firouzbakht et al. 6). Li argues that emotional-focused and problem-focused coping strategies are significant in handling depression (735). However, Guo et al. studies illustrate that using an emotional-focused coping strategy is inappropriate (6). Guo et al. claim that instead of an emotional-focused strategy reducing the problem, it increases depression and is therefore not a suitable method (6).
Obembe et al. debate that coping strategy selection should depend on multiple factors such as health status (146). The author portrays that active coping is suitable for children with disabilities such as cerebral palsy as it helps them face reality and reduce their depression levels (147). Wahab et al. support this finding by showing that active and emotional focus combined with other coping strategies such as self-distraction and social support are helpful in managing depression among patients on multimodal therapy. Sawhney et al. study show that individuals with high depressive symptoms prefer using avoidant coping strategies compared to those with low depressive symptoms (267). Furthermore, the author portrays that gender is significant in determining coping strategies as women are more users of problem avoidance coping strategies than men (267).
Signs and Symptoms
The signs and symptoms of depression vary from mild to severe depending on the individuals’ attempt at coping. Some people face depression in the early stage of its development, while others let it take the best part of them (Langer et al. 532). In a depression episode, an individual usually experiences depressed feelings such as emptiness, irritability, sadness, or loss of interest in certain activities that one used to enjoy (WHO). This stage usually takes up to two weeks as individuals continue to experience depressed moods frequently. The symptoms of this stage include disrupted sleep, low energy, and loss of appetite (Mata et al. 2375). There are instances where depressed individuals experience mood swings in the form of physical health symptoms such as general body weakness, pain, and fatigue (NIMH). The symptoms are usually not a result of the medical condition. During this period, depressed individuals tend to experience challenges in significant areas of their life such as education, family management, occupation, personal care, and other critical areas (CDC). The symptoms extend to severe when the person begins to experience poor concentration, low self-worth, excessive guilt, thoughts of committing suicide, and being hopeless about the future.
During the depression period, individuals experience various episodes such as single episodes, recurrent episodes, and bipolar disorder. In single episodes, the individuals have one episode (WHO). The recurrent episode is associated with individuals experiencing a minimum of two depressive episodes. The bipolar episodes occur with an alternative manic period where one can have increased talkativeness, energy, and self-esteem (CDC). At some period, one experiences irritability and a series of reckless, impulsive behavior.
Pandemic and Depression
The COVID-19 pandemic that began in late December 2019 raised significant issues. The pandemic resulted in various health restrictions that impacted the typical lifestyle of people. Strict regulations were imposed to help curb the virus, resulting in various mental problems. Various researchers have investigated the depression of people during this period. Le et al.’s study shows that the condition during the pandemic individuals who got fired reported a higher level of this mental disorder (6). Despite losing jobs being common in the economy, the pandemic increased the rates of losing jobs without providing solutions for job replacement as many companies were laying off employees. Additionally, most governments were unable to help their citizens to have an alternative method of earning, thus increasing the levels of depression.
Pokharel et al. claim that the pandemic problem on the economy is so vast that it is challenging to identify its exact effect (3). The high-income countries have had a significant problem managing the pandemic despite having more than enough resources. The depression rate in this region increased significantly as people lost their usual lifestyles. Most people used to interact in a social way of life, but the pandemic forced them to follow regulations. These countries have an effective healthcare system, but they were overwhelmed during the pandemic. This made it impossible to handle the increased cases of COVID infections leading to intense pressure among the public. The effect significantly promoted stress buildup and burnout as COVID-19 claimed people’s lives worldwide. Furthermore, Pokharel et al. show that the impact of the pandemic in low and middle-income countries was also challenging, considering that they have a weak healthcare system to handle the infections. This enhanced mental disorders as patients and the public, in general, could not bear the perception of getting infected with COVID-19.
Quarantine and isolation were significant sources of stress and depression. Brooks et al. define quarantine as the control and separation of the individuals exposed to highly infectious disease to establish whether they are unwell to reduce the risk of spreading the contagious disease (912). They also defined isolation as the separation of individuals who have tested positive to the contagious disease from those who are not infected. Quarantine and isolation were rampant during the COVID-19 pandemic as the virus was very infectious and deadly (Brooks et al. 912). Quarantine was first introduced in Venice, Italy, to curb the spread of leprosy in reaction to the Black Death (Brooks et al. 912). The recent use of quarantine was in Africa during the control of Ebola in 2014 and the control of severe acute respiratory syndrome (SARS) in 2003 in Canada. The outbreak of COVID-19 forced mass quarantine while others were directed to undertake individual isolation.
Le et al. study also shows that individuals were subjected to great levels of stress that promoted the development of depression (7). The idea of contacting the COVID-19 virus was critical as the complication associated with the virus was severe. Most people became worried that they would end up in unsafe quarantine zones as many individuals succumb to the virus. The handling of COVID-19 patients significantly promoted increased depression (Le et al. 7). The infected patients were isolated in zones for more than two weeks without physical contact with family and friends. This measure was effective in containing the virus but ineffective in handling the mental condition of patients. Brooks et al.’s study also portray that anxiety and nervousness increased rapidly (917). This promoted depression among individuals as isolation and quarantine were challenging, considering that the pandemic was deadly and that most people had never had such an experience.
Bahadur et al. claim that the people in quarantine were affected by the COVID-19 both physically and mentally (3). The physical effect resulted from the virus affecting their immunity, and the mental effect was from various negatives factors associated with quarantines. They developed depression since they feared the virus could lead to outcomes of the disease such as death, adverse effects on their physical health, that of family members, and the financial responsibilities that await them while they are still battling for life and good health (Bahadur et al. 3). The discrimination that the people experienced, together with the poor conditions of the quarantine zones, significantly promoted depression. Xin et al. study indicated that depression was greatly enhanced by the peers, workers, and the community. The individuals infected with COVID-19 were discriminated even after fully recovering from the disease (615). They were perceived as infectious and this promoted mental distress that resulted in depression.
According to Pokharel et al., the individuals in the quarantine areas were highly affected by depression because of the fear of dying and suffering from the COVID-19 (3). The increased anxiety during this period was enhanced by the news speaking about death tolls and the increasing number of infected cases. The authors also argue that the dissemination of accurate and inaccurate information during this period was at its peak. The information had a negative effect more than the pandemic itself, as it was misleading the public, leading to anxiety, fear, and depression.
Rubin and Wessely argue that the media exposure and the frequent update on the COVID-19 also played a significant role in promoting depression (6). Many people were unaware of the virus, and in the process of alertness, the media over presented the issue leading to mental problems (Rubin and Wessely 6; Shigemura et al. 282). Becoming an asymptomatic carrier also enhanced the depression rate as individuals fear being the ones transmitting the deadly disease that may lead to deaths of family and friends.
According to Adhikari et al., the economic challenge experienced during the COVID-19 pandemic resulted in the increased stress that promoted depression (3). In many parts of the world, job losses were perceived as economies struggled to regain momentum. Also, the most affected people with depression were health workers who were constantly at work (Zakeri et al. 6). The number of deaths involving nurses increased because they were pioneers in handling COVID-19 patients. They were mostly worried because they posed a significant threat to their family members and friends.
In conclusion, depression is a significant mental health problem. It affects a large population in society as more than 3.8 percent of the world is affected by this issue. The effect of depression is grouped into physical and mental. The physical problems include pain, gastrointestinal pains, immunity, sleep problems, fatigue, high blood pressure, and loss of appetite. The social problems are alcoholism, substance abuse, family withdrawal, and low performance at work, school, or other significant activities. The research shows that coping strategies are significant in handling depression. Problem-focused strategy is identified as the most suitable method. However, emotional-based is insignificant because it promotes mental problems and avoidance strategies are only effective in the short term. The symptoms of depression varies from mild to severe; mild symptoms include feelings such as emptiness, irritability, sadness while severe symptoms involve low self-worth, excessive guilt, thoughts of committing suicide, and being hopeless about the future.
During the pandemic period, depression increased rapidly because of the effects such as isolation, quarantine, and economic problem. Losing jobs and operating in high-risk areas increased the depression among people. Health workers were the most affected by depression because of the nature of their work. These individuals were at the frontline in the fight against COVID-19, which claimed the life of most of their colleagues. Individuals in the isolation and quarantine sections were seriously troubled with depression because of the physical condition that they were experiencing in those zones and the surrounding environment. However, the existing literature on depression is associated with several mental health problems. Therefore, it is necessary for future studies to focus on depression as a single entity to provide further insights into the case.
Akturk, Ummuhan et al. “The Effects of Depression, Personal Characteristics, and Some Habits on Physical Activity in the Elderly.” Perspectives in Psychiatric Care, vol 55, no. 1, 2018, pp. 112-118. Wiley, Web.
Bahadur, Udaya et al. “Anxiety and Depression among People Living in Quarantine Centers During COVID-19 Pandemic: A Mixed Method Study From Western Nepal.” Plos One, vol 16, no. 7, 2021, pp. 1-13. Public Library of Science (Plos), Web.
Brooks, Samantha K et al. “The Psychological Impact of Quarantine and How to reduce it: Rapid Review of The Evidence.” The Lancet, vol 395, no. 10227, 2020, pp. 912-920. Elsevier BV, Web.
CDC. “Mental Health Conditions: Depression and Anxiety.” Cdc.Gov, 2022, Web.
Firouzbakht, Mojgan et al. “Coping Strategies and Depression during the COVID-19 Pandemic in Pregnant Women: A Cross Sectional Study.” BMC Psychiatry, vol 22, no. 1, 2022, pp. 1-9. Springer Science and Business Media LLC, Web.
Guo, Jing et al. “Coping With COVID-19: Exposure to COVID-19 and Negative Impact on Livelihood Predict Elevated Mental Health Problems in Chinese Adults.” International Journal of Environmental Research and Public Health, vol 17, no. 11, 2020, pp. 1-6. MDPI AG, Web.
Langer, Julia K. et al. “Symptoms of Social Anxiety Disorder and Major Depressive Disorder: A Network Perspective.” Journal of Affective Disorders, vol 243, 2019, pp. 531-538. Elsevier BV, Web.
Le, Huong Thi et al. “Anxiety and Depression among People under the Nationwide Partial Lockdown in Vietnam.” Frontiers in Public Health, vol 8, 2020, pp. 1-8. Frontiers Media SA, Web.
Li, Q. “Psychosocial and Coping Responses toward 2019 Coronavirus Diseases (COVID-19): A Cross-Sectional Study within the Chinese General Population.” QJM: An International Journal of Medicine, vol 113, no. 10, 2020, pp. 731-738. Oxford University Press (OUP), Web.
Mata, Douglas et al. “Prevalence of Depression and Depressive Symptoms among Resident Physicians.” JAMA, vol 314, no. 22, 2015, pp. 2373-2383. American Medical Association (AMA), Web.
Melendez, Juan Carlos et al. “Idle Minds Are the Devil’s Tools? Coping, Depressed Mood And Divergent Thinking In Older Adults.” Aging &Amp; Mental Health, vol 22, no. 12, 2017, pp. 1606-1613. Informa UK Limited, Web.
NIMH. “Depression.” National Institute of Mental Health (NIMH), 2022, Web.
Obembe, Olajide Benjamin et al. “The Relationship between Coping Styles and Depression among Caregivers of Children with Cerebral Palsy in Nigeria, West Africa.” Archives of Clinical Psychiatry (São Paulo), vol 46, no. 6, 2019, pp. 145-150. Fapunifesp (Scielo), Web.
Pokharel, Sunil et al. “Coronavirus Disease 2019 Pandemic – Public Health Preparedness in Nepal and One Health Approach.” Disaster Medicine and Public Health Preparedness, vol 15, no. 5, 2020, pp. 1-6. Cambridge University Press (CUP), Web.
Rubin, G James, and Simon Wessely. “The Psychological Effects of Quarantining a City.” BMJ, 2020, pp. 1-12. BMJ, Web.
Sawhney, Manisha et al. “Depressive Symptoms and Coping Strategies among Indian University Students.” Psychological Reports, vol 123, no. 2, 2018, pp. 266-280. SAGE Publications, Web.
Shigemura, Jun et al. “Public Responses to the Novel 2019 Coronavirus (2019‐Ncov) In Japan: Mental Health Consequences and Target Populations.” Psychiatry and Clinical Neurosciences, vol 74, no. 4, 2020, pp. 281-282. Wiley, Web.
Wahab, Suzaily et al. “Risk of Depression among MMT Patients: Does Coping Strategies and Perceived Social Support Play a Role?” Substance Abuse: Research and Treatment, vol 15, 2021, pp. 1-9. SAGE Publications, Web.
WHO. “Depression.” Who.Int, 2021, Web.
Xin, Meiqi et al. “Negative Cognitive and Psychological Correlates of Mandatory Quarantine during the Initial COVID-19 Outbreak in China.” American Psychologist, vol 75, no. 5, 2020, pp. 607-617. American Psychological Association (APA), Web.