Why the world’s wealthiest nations are getting sadder—and what that says about progress. As waistlines expand and sleep shrinks, a quiet epidemic has crept up on the world’s richest societies— depression.

New research suggests that the very forces driving prosperity may be fuelling despair. If happiness lies in living well, modernity might be selling us short.

Progress and its Discontents

In 2025, the world economy stands taller than ever. Yet, behind the glass towers and glowing screens, something is amiss. Rates of major depressive disorder (MDD) have climbed steadily in the developed world, now affecting one in five adults over a lifetime. In Malaysia, mental health situation has worsened significantly over the past five years. The survey estimates about one million Malaysians aged 16 and above are experiencing depression — up from roughly 500,000 in 2019 — with prevalence rising from 2.3% to 4.6%. Survey found one in six children aged five to 15 is affected by mental health issues, emphasising that this is not merely a statistic but a lived reality

The paradox is stark: where GDP rises, so too does the risk of melancholy. A recent US meta-analysis found college students in 2007 were six times likelier to score as clinically depressed compared to their 1938 peers. Swedish study showed youth saw a tenfold increase in depression from the late 1950s to the early 1970s. Meanwhile, Japan—wealthy yet mysteriously resilient—remains a notable outlier.

The question is no longer whether modernity brings disease, but why the fruits of progress come with such bitter aftertaste.

A Double-Edged Sword of Modernisation

Biological Backfire

The central thesis: human biology evolved for an ancient life of movement, sunlight, and tight-knit tribes. Modernity—urbanisation, industrialisation, and technological acceleration—has engineered an environment mismatched to these roots.

Drastic shifts in diet, activity, and social structure have left Homo sapiens maladapted, and increasingly morose.

Obesity, the quintessential disease of modernity, offers a case study. Once rare, it now afflicts over 50% of Malaysian adults. Depression tracks obesity with uncanny fidelity: obese individuals face a 55% higher risk of developing depression, while the depressed are 58% likelier to become obese. Chronic inflammation, metabolic dysregulation, and poor body image all play roles in this uncomfortable marriage.

Diet is another villain. The Western menu—energy-dense, micronutrient-poor—fuels chronic disease and saps mental health. Deficiencies in omega-3 fatty acids, folate, and vitamin D have each been linked to depressive symptoms. The Mediterranean diet, with its abundance of fresh produce and fish, not only protects against heart attacks but also seems to ward off despair.

Physical inactivity compounds these woes. In Paleolithic times, daily energy expenditure hovered around 3,000 kcal; today, nearly two-fifths of adults are “completely inactive.” Exercise reduces depressive symptoms in a dose-dependent manner; aerobic workouts rival antidepressants for efficacy and even relapse prevention.

Sunlight and sleep deprivation round out the picture. As jobs move indoors and screens glow deep into the night, exposure to natural light plummets and circadian rhythms unravel. Vitamin D deficiency is now epidemic; insomnia doubles the risk of major depression. The average adult sleeps over an hour less than in 1960—a loss measured not just in grogginess but in psychological resilience.

Social Fragmentation

If biology explains part of the malaise, society delivers the coup de grâce. Modern social environments are characterised by competition, inequality, and isolation. Income inequality tracks lifetime risk of mood disorders across developed countries with unsettling precision.

“Cultural emphasis has shifted from intrinsic values (relationships, community) to extrinsic ones (money, status), leaving many chasing hollow rewards.”

The shrinking number of confidants—down from three in 1985 to two in 2004—is more than a statistic; it signals a decay of social capital. Loneliness spreads through social networks like a virus, amplifying distress. Geographic mobility disrupts connections; secularisation erodes communal bonds; technology promises connection but delivers alienation.

The rise of individualism brings choice and self-determination—laudable goals—but also paralytic indecision, stress and regret. Cultural emphasis has shifted from intrinsic values (relationships, community) to extrinsic ones (money, status), leaving many chasing hollow rewards.

From Melancholy to Major Depressive Disorder

Depression is not new; ancient texts record sorrow and despondency as universal human experiences. The difference is scale—and perhaps context. Systematic study began only in the twentieth century. Initially, clinicians noted patients growing younger and less severely afflicted—possibly reflecting changing norms around emotional distress.

What is clear? definitions have shifted, recall bias plagues retrospective studies, and true historical prevalence remains elusive. Yet longitudinal data—from Minnesota schoolchildren to Swedish adults and Malaysian’s statistic—lines up with a story of rising rates and earlier onset.

Modernity’s diseases—atherosclerosis, diabetes, osteoporosis—share risk factors and physiological profiles with depression: inflammation, metabolic disruption, and chronic stress. If these are “diseases of modernity”, why should depression be any different?

“Humans have dragged a body with a long hominid history into an overfed, malnourished, sedentary, sunlight-deficient, sleep-deprived, competitive, inequitable, and socially-isolating environment—with dire consequences.”

How Modern Life Makes Us Ill

Environmental Mismatch

• Diet: High glycaemic load, poor fatty acid composition (low omega-3s), micronutrient deficiencies.
• Physical Inactivity: Sedentary behaviour increases inflammation and risk of chronic disease.
• Sleep Disruption: Reduced sleep quantity/quality impairs endocrine function; insomnia predicts depression.
• Sunlight Deficiency: Indoors employment reduces vitamin D synthesis; low levels tied to mood disorders.
• Social Isolation: Fewer confidants; increased loneliness; geographic mobility disrupts networks.
• Inequality: Higher Gini coefficients predict greater lifetime risk of mood disorders.

Genetics—and Their Limits

Genetic predispositions matter but cannot explain rapid rises across generations or societies. Twin studies suggest heritability for depression around 40%, but environmental triggers dominate observed trends.

Evolutionary Perspective

Homo sapiens are adapted for a hunter-gatherer lifestyle—the so-called environment of evolutionary adaptedness (EEA). Modern environments diverge ever further from this template. The mismatch theory posits that chronic diseases (including depression) result from this gap between evolved biology and current living conditions.

When Prosperity Fails to Deliver

Economic Growth vs Well-being

Curiously (and perhaps uncomfortably for economists), more money does not buy more happiness—or less depression. GDP per capita correlates positively with mood disorder risk; Japan’s seafood-rich diet and low inequality are protective exceptions.

Policy Conundrums

Attempts to address depression have focused on pharmacological treatments and psychotherapy—useful but insufficient. Population-level interventions targeting health behaviours (diet, exercise), urban design (walkable cities), and inequality (taxation policies) offer untapped potential.

Interventions to reverse obesity would not only improve physical health but likely curb depression rates—cost-saving as well as humane. But resistance is fierce from entrenched interests and status quo defenders.

The Technology Dilemma

Digital life promises connection but often delivers isolation. Internet use correlates with smaller social circles and more depressive symptoms. Social media amplifies status anxiety and dissatisfaction.

Towards a Resilient Future

Modernity has delivered prosperity but struggled to cultivate well-being. The rise in depression offers a mirror for societal choices—a reminder that technical progress divorced from biological reality comes at a cost.

Policy interventions must move beyond treating symptoms to addressing root causes: unhealthy diets, inactivity, sleep disruption, social disintegration, inequality. The evolutionary lens is illuminating but incomplete; much remains unknown about how microbiota and environmental toxins interact with mood.

If happiness lies not in having more but living better—in meaningful work, close relationships, physical fitness—then the future depends on societies willing to rethink what progress should mean. The race for GDP may be over; the pursuit of well-being has just begun.

by Tony Y, editor-in-chief of PP Health Malaysia (PPHM)