Improvements in treatment delivery and effectiveness will undoubtedly shorten episode duration and recurrence risk, which will lessen the burden of depression. However, the impact is likely to be modest because treatment does not always lead to better long-term outcomes. Episodic depression must be avoided if we are to further minimise the load. Sadly, preventive measures have not, to now, been able to lessen the burden of depression. This, we contend, results from a lack of socially embedded structural preventative initiatives and the challenge of minimising the influence of key factors.
We begin by summarising the data on period prevalence, treatment trends, and the shortcomings of current preventative tactics that have prevented their widespread adoption and hampered their efficacy. Then, we examine the major factors that can be changed to reduce the burden of depression and identify the necessary conditions for successful prevention. We also discuss the significance of these conditions. Early life start-up, simultaneous targeting of key personal and environmental factors, as well as their interplay, structural funding, legal consolidation, and embedding in significant social institutions are all requirements. This entails addressing both suboptimal parenting and children’s unhealthy personality traits and inadequate life skills, as well as combining universal, selective, and suggested preventative tactics with a focus on universal prevention. Studies that met the criteria had baseline data from before the COVID-19 pandemic and reported prevalence of depression or anxiety disorders during the pandemic. We followed the timetables established by each study for these intervals. Without comparable pre-pandemic data (i.e., using the same instrument, location, and age group) gathered since 2013 to evaluate the change in prevalence, prevalence surveys done during the pandemic could not be included. Cross-sectional studies were also considered if similar pre-pandemic prevalence data were available, although longitudinal studies utilising samples that were representative of the general population were preferable. Random sampling studies were preferable, but there weren’t many of them because of the COVID-19 pandemic’s difficulties.
