Like other mental disorders, the onset of a depressive episode is frequently linked to a prolonged psychological exertion (e.g., a stressful workload for an extended period of time) or sudden stressors (e.g., the loss of a loved one), coupled with the lack of effective coping mechanisms or the absence of a support system, subsequently impeding our ability to adapt [4].

In addition to the various professional therapeutic treatment options for depression, preventive measures can contribute to the avoidance of depressive symptoms, the reduction of the severity of an existing episode, or the prevention of relapses. In general, preventive measures can be divided into three categories: primary, secondary, and tertiary prevention [1].

Primary prevention includes all measures that either help prevent individuals from developing depressive symptoms in the first place or help delay the onset of the disease [2]. Measures include the identification of individual risk factors (e.g., genetic predisposition, stressors in everyday life or continuous conflicts), as well as existing and potential protective factors (e.g., social support, self-confidence). Additional skills and techniques should be developed to acquire further protective factors or to strengthen already existing resources.

Possible methods include all things beneficial to stress reduction, such as:

• sufficient sleep,
• sports and exercise,
• meditation or relaxation exercises,
• positive social contacts
• a healthy diet,
• the creation of a weekly schedule to include sufficient positive activities in addition to one’s chores
• and the identification and either elimination or avoidance of existing stressors [3].

Secondary prevention aims to detect the onset of a depressive disorder as early as possible, to ensure that the most suitable therapy can be implemented at an early stage, thus preventing symptoms from worsening, or becoming chronic [2].

Among other things, screening procedures and preventative examinations for early detection can be advisable (e.g., at the general practitioners). Knowing your own family history regarding mental illness can also be useful, as the likelihood of developing symptoms of depression is increased if family members suffer or have suffered from previous mental disorders. Furthermore, individual early warning signs (e.g., sleep disturbances, changes in eating habits, social withdrawal, or decreased drive) should also be identified and observed [3].

Tertiary prevention is concerned with mitigating the consequences of an existing depressive illness and avoiding relapses [2].

In addition to the continuation of drug treatment (“maintenance therapy”) or psychotherapy, tertiary prevention includes concepts such as supportive training courses for patients and relatives (e.g., in order to recognize early warning signs and to establish a mutual crisis plan in order to be able to initiate countermeasures at an early stage) [3].

Whether acutely in a depressive episode or currently symptom-free, attending to our basic needs, such as social integration, sufficient sleep, proper nutrition, and physical activity, as well as cultivating the ability to recognize one’s own distress and the capability to confide in people and seek professional assistance in a timely manner, are the most useful and effective preventive strategies we have, to influence our mental well-being.

The salutogenic model of health (Antonovsky, 1997) is one of the most influential models regarding the multidimensional causes of health, offering explanations on why certain people stay healthy despite the existence of risk factors. In his theory, Antonovsky describes heath and illness not as two individual factors, but rather as two poles of one continuum, along which individuals move dynamically, depending on certain factors. According to the model, the most important factors influencing health are individual stressors, the manner in which one deals with them, and the resources or protective factors that contribute to the management of stressors.

According to the model, one of the key components determining the capacity of individuals to cope with everyday life stressors, is one’s „Sense of Coherence“. Developing over the course of a person’s life, it reflects the degree to which a person trusts that his or her life is understandable, manageable, and meaningful; with meaningfulness (and the belief that life is worth making an effort for) being cited as the most important factor. According to the model, individuals with a higher sense of coherence are associated with more positive (more healthy) outcomes on the health continuum than individuals with a lower sense of coherence [5].

The second important concept of the salutogenetic model, the “Generalized Resistance Resources”, comprises all individual (e.g. intelligence, physical factors, coping strategies), social and cultural factors (e.g. social support, cultural stability, financial opportunities) that help individuals cope with stressors. Psychosocial resilience resources, in particular, play an important role in prevention strategies, as these are potentially influenceable and can thus directly increase a person’s resilience. Resources include characteristics, skills, and attributes of a person (e.g., knowledge about prevention, coping mechanisms, self-esteem), as well as social factors (e.g., involvement in a social network and opportunities for support) [5].

The model of salutogenesis demonstrates that health is a dynamic process and not a fixed condition, and that it is not a matter of reducing illness, but rather of promoting health. The model emphasizes the need to examine health with a holistic perspective and underlines one’s own agency!

Therefore: whether currently experiencing a depressive episode or presently symptom-free, attending to our basic needs, such as social integration, sufficient sleep, proper nutrition, and physical activity, as well as cultivating the ability to recognize one’s own distress and the capability to confide in people and seek professional assistance in a timely manner, are the most useful and effective preventive strategies we have, to influence our mental well-being.