Understanding depression: More than just feeling 'down'
Depression is on the rise in Korea, yet treatment rates remain alarmingly low. The National Health Insurance Service reports that over 1.09 million individuals were diagnosed with the condition in 2023 — a 25 percent increase from 2020. However, only about 10 percent sought treatment, such as medication or therapy. While most people respond well to treatment, untreated depression can have severe, even fatal, consequences.
To address depression effectively, we must first challenge common misunderstandings that obscure its complexity. Media often portrays depression through a narrow lens, such as a woman staring despondently out of a window, tears streaming down her face, leading many to believe it is merely an emotional condition. In truth, depression involves a complex interplay of cognitive, emotional and physical symptoms. It is not something one can simply “snap out of” by sheer willpower. Cognitively, individuals may experience slowed thinking, difficulty concentrating and recurrent suicidal thoughts. Emotionally, they may struggle with persistent feelings of worthlessness or guilt, a diminished capacity to experience pleasure and heightened irritability. Physically, depression can present as chronic fatigue, changes in appetite or weight and disrupted sleep patterns. For a clinical diagnosis, the symptoms must persist for at least two weeks and substantially interfere with daily functioning.
Depression does not stem from a single cause; rather, it often arises from a combination of factors and may be triggered by a wide range of circumstances. Stressful life events, such as the loss of a loved one, divorce, illness, unemployment, financial hardship, academic pressure or relocation, can all contribute to its onset. Certain personality traits, including low self-esteem and perfectionism, may also increase vulnerability. A family history of depression can further elevate risk, as can significant hormonal changes, such as those experienced during pregnancy, after childbirth or throughout menopause. Additionally, the misuse of alcohol and drugs can play a substantial role in the development or worsening of depressive symptoms.
Socio-cultural factors also influence how depression is understood and expressed. In many Asian cultures, psychological distress is often communicated through physical symptoms — a phenomenon known as “somatization.” This tendency reflects a holistic cultural perspective that views the mind and body as intrinsically connected. In contrast, Western traditions, shaped by Cartesian dualism, typically clearly delineate between mental and physical health, resulting in a more compartmentalized approach to illness. Additionally, in many Asian societies, mental illness carries considerable stigma and is often perceived as a source of shame not only for the individual but also for their family. Consequently, discussing physical ailments is generally more socially acceptable than acknowledging emotional or psychological struggles. These cultural dynamics underscore the importance of cultural competence among health care providers, enabling them to interpret symptoms accurately and deliver care effectively.
Depression warrants serious attention, particularly because of its strong link to suicide. Korean Statistics reported that 13,978 people died by suicide in 2023 — equivalent to one death every 40 minutes. Depression intensifies negative thinking, causing individuals to ruminate on past wounds and regrets, perceive the present as unbearable and envision no hope for the future. In this state of despair and entrapment, some come to believe that ending their life is the only way to escape their emotional pain. Alarmingly, the time between contemplating suicide and acting on it can be as brief as 10 minutes.
In Korea, awareness of depression and suicide tends to increase in winter. However, depression-triggered suicides actually peak in spring, particularly between March and May. Researchers suggest that this rise may be tied to major life transitions, such as school admissions, graduations, weddings and new jobs, that often occur during this time. While these milestones are typically viewed as positive, they can be stressful for individuals who struggle with change. Moreover, increased sunlight in spring stimulates the brain and can elevate energy levels; for some individuals with depression, this physiological shift may heighten emotional instability. To mitigate these risks, conversations about depression must take place year-round, promoting awareness and timely support.
Depression is a complex illness with symptoms and severity varying widely across individuals. As such, there is no one-size-fits-all solution. While practicing self-care like a balanced diet and regular exercise is beneficial, the critical first step is recognizing depression as a serious mental health condition that requires appropriate treatment. Equally important is addressing the cultural stigma surrounding mental illness. This calls for a sustained, society-wide effort, including continuous public awareness campaigns that encourage help-seeking. Such a comprehensive and inclusive approach can effectively confront the challenges posed by this widespread and often misunderstood condition.
Ma Kyunghee is an editor and researcher specializing in mental health.