Resumo

SEQUEIRA-CORDERO, Andrey; BLANCO-VARGAS, Marilyn  e  BRENES, Juan Carlos. Major depression disorder in Costa Rica: epidemiological and neurobiological aspects. PSM [online]. 2022, vol.19, n.2, pp.465-489. ISSN 1659-0201.  http://dx.doi.org/10.15517/psm.v0i19.48038.

Introduction: Major depression is one of the most common mental illnesses and one of the principal causes of disability worldwide, with an increasing prevalence in recent decades. The aim of this essay is to present epidemiological data, as well as to briefly review the psychobiological mechanisms of depression related to the exposure to chronic stress. Finally, we will also discuss some strategies for the prevention and/or treatment of the disease. Proposal: Alternative treatments complementing medication and psychotherapy could be much more effective in preventing and mitigating the effects of chronic stress and the risk of depression than these treatments alone. Arguments for discussion: Chronic stress can precipitate a depressive episode due to hyperactivity of the amygdala and hypothalamic-pituitary-adrenal (HPA) axis, failure of the HPA negative feedback, monoamine depletion, decreased levels of neurotrophins, increased glutamatergic excitotoxicity, reduced hippocampal neurogenesis, prefrontal cortex dysfunction, and excessive inflammatory response. Conclusions:The chronic accumulation of uncontrollable psychosocial stressors plus a sedentary lifestyle, a poor diet, and limited time or places for recreational activities underlie the high depresogenic potential of our current lifestyles. In contrast, activities that include exercise, meaningful social interactions, recreational activities, exposure to natural environments, a balanced diet, and healthy routines would represent a highly effective strategy for managing depression and improving overall health.

Palavras-chave : Depression; prevalence; psychobiologic factors; environmental enrichment.

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