Summary Depression is a major public health concern. Depressed individuals have received increasing treatment with antidepressants in Western countries. In this study, we examine the relationship among individual symptoms (sadness, worry and unhappiness), human development factors and antidepressant use in 29 OECD countries. We report that increased antidepressant prescribing is not associated with decreased prevalence of sadness, worry or unhappiness. However, income, education and life expectancy (measured using the Human Development Index) are associated with lower prevalence of all these symptoms. This suggests that increasing spending on depression treatment may not be as effective as general public health interventions at reducing depression in communities.