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Depression

Symptoms

  • Depression is a serious medical illness. It affects all aspects of life, including work, family life, and social activities. 
  • A diagnosis of major depressive disorder is made if an individual has five or more of the following symptoms during the same two-week period.1 Symptoms may vary from person to person but often include:
    • Persistent sad mood
    • Loss of interest or pleasure in activities that were once enjoyed
    • Significant change in appetite or body weight
    • Difficulty sleeping or oversleeping
    • Physical slowing or agitation
    • Loss of energy
    • Feelings of worthlessness or inappropriate guilt
    • Difficulty thinking or concentrating
    • Repeated thoughts of death or suicide

Prevalence

  • In any one-year period, 9.5 percent of the U.S. population, or an estimated 19 million American adults, suffer from a depressive illness.2
  • One of every 4 women and 1 in 10 men can expect to be diagnosed with depression during their lifetime.  This gender difference may be attributable to the fact that men are less likely to admit depression and doctors are less likely to diagnose it.3
  • Women are almost twice as likely as men to be diagnosed with depression and reasons may include hormonal changes women go through during menstruation, pregnancy, and menopause.  Doctors are also more likely to diagnose depression in women. 3
  • Depression can also be caused by stress, medication, or other medical illnesses. Certain personality traits and family history can also contribute to depression. 

Causes

  • The multiple causes of depression include biological, cognitive, gender, co-morbid (having other conditions at the same time), drug-related, genetic, and situational factors.4
  • Medical illnesses such as a heart attack, stroke, or cancer can also cause or contribute to depressive symptoms5 and vice versa.

Impact

  • According to the World Health Organization, depression is projected to become the leading cause of disability and the 2nd leading contributor to the global burden of disease by the year 2020.6
  • At any one time, 1 employee in 20 is experiencing depression.7
  • Depression costs the United States an estimated $44 billion each year in terms of absenteeism, lost productivity, reduced quality of work, employee turnover, and on-the-job accidents.7

Treatment

  • Depending upon the patient, depression may be treated with medication, psychotherapy, or a combination of treatments.  
  • More than 80 percent of those who seek treatment for depression show improvement.8
  • Selective serotonin reuptake inhibitors (SSRIs) are the most common forms of treatment for depression.9

Depression and Other Illnesses

  • Depression and anxiety are distinct disorders, with a notoriously high incidence of comorbidity between them - some studies have shown that up to 90 percent of patients suffer from both disorders at some point during their lives.10 
  • Comorbid depression is common in people diagnosed with a range of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and others.11
  • In comparison to patients with either depression or anxiety, people with comorbid disease have increased psychological, physical, and social impairment.  They typically have a more severe disease, are more likely to be chronically ill, have an increased risk of suicide, have greater occupational impairment, higher rates of alcohol and substance abuse, and are likely to have poorer prognoses.12

Click here for more information about depression or other mental health issues.

  1. American Psychiatric Association, (1994) DSM-IV Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition); Washington, D.C.
  2. National Institute of Mental Health: The Numbers Count: Mental Illness in America; Science on Our Minds Fact Sheet Series. Accessed August 1999. Bethesda, Maryland
  3. Blehar MD, Oren DA. Gender differences in depression. Medscape Women's Health, 1997;2:3. Revised from: Women's increased vulnerability to mood disorders: Integrating psychobiology and epidemiology. Depression, 1995;3:3-12.
  4. National Mental Health Association, Depression: What You Need to Know.  Fact Sheet accessed October 2003.  Found at: http://www.nmha.org/infoctr/factsheets/21.cfm
  5. National Mental Health Association, Depression and Co-Occurring Illnesses.  Fact Sheet accessed October 2003.  Found at: http://www.nmha.org/ccd/support/cooccurfacts.cfm
  6. Murray CJL, Lopez AD, eds. Summary: The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Harvard University Press, 1996.
  7. National Institute of Mental Health, Effects of Depression in the Workplace; June 1,1999. NIMH. Bethesda, Maryland. Found at: http://www.nimh.nih.gov/publicat/workplace.cfm
  8. National Institute of Mental Health, What to Do When an Employee is Depressed; Updated: November 1, 1999. NIMH Publication No. 96-3919. Bethesda, Maryland. Found at: http://www.nimh.nih.gov/publicat/depemployee.cfm
  9. Mental Help Online, Treatment for Depression.  Accessed October 2003.  Found at: http://mentalhelp.net/poc/view_doc.php?type=doc&id=611&cn=5&clnt%3Dclnt00001&
  10. Comorbid depression and anxiety spectrum disorders. Depress Anxiety.  1996-97; 4:160-8
  11. Greco, N., Zajecka, J.M. Evaluating and Treating Comorbid Depression and Anxiety in Women. Women's Health in Primary Care. May 2002; 3:349-60
  12. Lydiard RB, Brawman-Mintzer O. Anxious depression. J Clin Psychiatry. 1998;59(suppl 18):10-17.


Created: 11/2/2003  -  Donnica Moore, M.D.


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