Every October 10, World Mental Health Day invites the globe to pause and look inward. The goal isn’t just awareness; it’s action—reducing stigma, improving access to care, and reminding us that mental health is health. The World Health Organization (WHO) now estimates that nearly 1 in 7 people worldwide—about 1.1 billion—were living with a mental disorder in 2021, with depression and anxiety leading the list.
The Global Picture—Scope, Hot Spots, and Why They Vary
- How widespread is it? Depending on the year and method, global estimates range from ~970 million to 1.1 billion people living with a mental disorder. Anxiety and depression account for the largest share of disability worldwide.
- Where is burden highest? Recent global burden analyses show high prevalence in Australasia, Tropical Latin America, and high-income North America—patterns driven by measurement, help-seeking, and real differences in risk factors and health systems.
- Who is at risk? Suicide remains a leading, preventable cause of death with ~727,000–700,000+ deaths annually; most occur in low- and middle-income countries where services are limited.
Bottom line: Mental disorders are common everywhere. Apparent country differences often reflect a mix of true risk, socioeconomic stressors, conflict, substance use, climate and pollution exposures, as well as better detection (in high-income settings) versus under-reporting (in low-resource settings).
The U.S. Over the Last Decade—A Steady Rise
- Trend: U.S. depression indicators have significantly increased over the last ten years. A CDC analysis shows depression (12+ population) rose from 8.2% (2013–2014) to 13.1% (Aug 2021–Aug 2023). Gallup finds current depression ≥18% in 2024–2025—the highest since tracking began.
- Who gets treatment? For adults with any mental illness, ~51% received treatment in 2022; for serious mental illness, ~65%. Barriers include cost, access, and stigma.
- NSDUH caution: Method changes after 2021 complicate direct year-to-year comparisons, but the overall direction is upward.
Do Food, Substances, and the Environment Play a Role?
- Diet: A landmark randomized trial (“SMILES”) showed that improving diet toward a Mediterranean pattern reduced depressive symptoms versus social support control (12 weeks). Large cohort data also link higher ultra-processed food intake to greater depression risk.
- Substances: Alcohol use disorder commonly co-occurs with depression and anxiety and worsens outcomes. Cannabis use disorder is associated with increased risks of depression, bipolar disorder, and psychosis, especially with high-THC products and heavy use.
- Environment: Air pollution (outdoor and indoor) is linked in meta-analyses to higher depression risk; climate stressors (e.g., heat) also affect mental health.
Retirees & Older Adults—What to Watch
Depression is not a normal part of aging, yet late-life risk rises with chronic illness, pain, bereavement, isolation, mobility limits, and financial stress. Warning signs can look different from “classic sadness”: fatigue, sleep/appetite changes, irritability, slowed thinking, loss of interest, social withdrawal, or worsening control of chronic diseases. Suicide rates among older men (75+) are particularly high, underscoring the need for screening and support.
Good news: Medicare covers one depression screening each year under Part B, and outpatient mental health services are covered after the deductible. Ask about screenings like PHQ-9 during the Annual Wellness Visit.
What Caregivers & Families Can Do (Today)
- Start the conversation. Express concern with empathy; avoid judgment.
- Book a primary-care visit and ask for a depression/anxiety screening and a medication review (polypharmacy can worsen mood/cognition in older adults).
- Mobilize supports: rides, meals, companionship, faith/community groups. Consider NAMI Family-to-Family or local caregiver groups.
- Promote protective habits: regular movement (walking, yoga, light strength), social connection, sleep routines, and a minimally processed, Mediterranean-style diet.
- Know crisis resources: In the U.S., call/text 988 or chat at the 988 Lifeline 24/7. Call 911 for imminent danger.
Do Antidepressants Help? What About Taking Them Long-Term?
Yes. A major network meta-analysis in The Lancet found that all 21 commonly used antidepressants outperformed placebo for acute major depression (differences between specific drugs were modest). Psychotherapies (e.g., CBT, behavioral activation) and exercise are also effective; combined care often works best.
Staying on medication: In the ANTLER randomized trial, people who stopped long-term antidepressants had higher relapse at 52 weeks (56%) than those who continued (39%). That doesn’t mean everyone must stay on meds forever, but it highlights the importance of shared decision-making and a careful taper when appropriate.
Pros & cons of long-term medication
Pros
- Reduces relapse risk in recurrent depression.
- Can stabilize mood while therapy and lifestyle changes take hold.
Cons
- Side effects (weight, sleep, sexual dysfunction, GI symptoms), drug interactions.
- Discontinuation symptoms and relapse risk if stopped abruptly or too soon.
Can people recover and come off medication?
Many do—especially after sustained remission, therapy skills, and stable life context—but the relapse risk is real. Work with a clinician on timing, taper speed, relapse monitoring, and non-drug supports (therapy, exercise, sleep, social routine, substance-use reduction).
Quick Guide for Retirees & Caregivers
- Ask for annual screening (Medicare Part B). Bring a list of medications and supplements.
- Build a weekly routine: walking or chair-friendly strength/yoga 3–5 days/week; regular social activities; daylight exposure; consistent sleep.
- Cook simple, minimally processed meals (olive oil, legumes, fish, nuts, whole grains); limit ultra-processed snacks/sodas.
- Limit alcohol and high-THC cannabis; both can worsen mood and cognition and raise psychiatric risk in some people.
- Use caregiver education/support (NAMI) and plan for crises (988).
A final word
World Mental Health Day is a reminder that effective help exists—from psychotherapy and medication to movement, nutrition, and community. If you or a loved one is struggling, reach out today. In the U.S., dial 988 for immediate support.
-Nguyễn Duy Khiêm-
Note: This article is for general education and is not a substitute for personalized medical advice. Talk with your clinician about the best plan for you.
Key Global / Epidemiology & Policy Sources
- WHO – Mental Disorders Fact Sheet
Offers up-to-date global prevalence, burden, and service gaps.
→ Mental disorders (WHO) World Health Organization - WHO – Mental Health (Strengthening Our Response)
A broader view on determinants, responses, and opportunities.
→ Mental health – strengthening our response (WHO) World Health Organization - PAHO / WHO — The Burden of Mental Disorders
Focused on the Americas region; useful for comparisons and regional trends.
→ The Burden of Mental Disorders (PAHO) Pan American Health Organization - World Mental Health Survey Initiative
A multi-country epidemiological survey effort (in many WHO regions) for mental and behavioral disorders.
→ World Mental Health Survey Initiative (Wikipedia summary) Wikipedia
U.S. Trends, Treatment Use & Outcomes
- Trends in U.S. Depression Prevalence (2015–2020)
A peer-reviewed article showing changes in major depressive episodes over time.
→ Trends in U.S. Depression Prevalence From 2015 to 2020 PMC - NIMH — Mental Illness Statistics
Broad overview of prevalence, serious mental illness, treatment rates, etc.
→ Mental Illness (NIMH) National Institute of Mental Health - CDC — Antidepressant Use Among Adults: 2015–2018
Useful for understanding the proportion of the population on antidepressants and how usage changes by age, sex, race.
→ Antidepressant Use Among Adults: United States, 2015-2018 (CDC) CDC - National Comorbidity Survey (NCS / NCS-R)
Landmark U.S. epidemiologic surveys of mental disorders, lifetime / 12-month prevalence, comorbidity, etc.
→ National Comorbidity Survey (Wikipedia summary) Wikipedia - Breedvelt et al. — Switching / Tapering vs Continuing Antidepressants
A meta-analysis of individual patient data comparing relapse risk when tapering antidepressants with psychological support vs continuing medication.
→ Continuation of Antidepressants vs Sequential Psychological Intervention (JAMA Psychiatry) JAMA Network - Horowitz et al. — Antidepressants Withdrawal Effects & Duration
Study of withdrawal phenomena, duration, and difficulty of discontinuing.
→ Antidepressants withdrawal effects and duration of use ScienceDirect - Al-Harbi — Treatment-Resistant Depression
A review on how many patients fail to respond to standard antidepressant regimens, and what alternative strategies exist.
→ Treatment-resistant depression: therapeutic trends PMC
Reviews, Conceptual / Lifestyle & Environmental
- Ormel et al. — “More treatment, but no less depression”
A thoughtful critique about how treatment access has grown but population-level burden remains stubborn.
→ More treatment but no less depression: The paradox of increasing care but persistent prevalence ScienceDirect - Therapeutic Lifestyle Change (TLC) for Depression
A model emphasizing non-pharmacologic lifestyle interventions (exercise, diet, sleep, social connection) as part of mental health care.
→ Therapeutic Lifestyle Change (depression treatment) (Wikipedia summary) Wikipedia - SANE Australia – Factsheets & Guides
A useful resource of mental health fact sheets (Australia, but many concepts are generalizable).
→ Factsheets & Guides (SANE Australia) SANE - NIMH Brochures & Fact Sheets
A library of downloadable, peer-reviewed fact sheets on many mental health conditions and topics.
→ Brochures & Fact Sheets (NIMH) National Institute of Mental Health