Major depressive disorder (MDD) or unipolar major depression, is a leading cause of illness and disability globally and in South Africa. It is the most common psychiatric disorder worldwide with a prevalence that is increasing over time.
Despite the high prevalence rates, few people with depression discuss their symptoms with a doctor. This is known as the ‘treatment gap’. Instead, nearly two-thirds of people with depression who see a healthcare provider for routine care come in complaining of physical symptoms, such as headache, back problems or chronic pain.
People are often reluctant to discuss their symptoms of depression. Often, they are concerned about the stigma of mental illness or they may be worried that a primary health care provider is not the appropriate healthcare professional to approach. Some people still see depression as a personal weakness rather than a real illness. Yet, there are effective treatments available for depression and not treating depression may have serious and lasting consequences.
People with untreated depression have a lower quality of life, a higher risk of suicide and a worse prognosis if they have any medical conditions besides depression. In addition, depression not only affects the person with the disorder, but also those around him or her. However, with appropriate treatment, 70 to 80% of individuals with major depression can achieve a significant reduction in symptoms. This module discusses major depression and its medical management in adults, adolescents and the elderly.