Adults With Depression Still Struggle Due to Lack of Information

A new survey of 2,001 adults living with depression revealed that despite being diagnosed for an average of 12 years, many unknowingly took actions that could have sabotaged their chances of getting well. Furthermore, on average, it took about six years for respondents to seek diagnosis from a health care professional, suggesting these adults may have been coping with depression for as long as 18 years.

Nearly three in five (57 percent) of those who delayed seeking a diagnosis felt they could manage their own depression symptoms. Among respondents who had taken antidepressants for depression, nearly half (47 percent) did not discuss when it might be necessary to change medications with their doctor, despite the fact that they were still experiencing depressive symptoms. Among those who have stopped taking antidepressants, about two in five (41 percent) did so without telling their doctor. More than 70 percent noted that talk therapy should always be part of a depression treatment plan, yet only 22 percent were currently enrolled in talk therapy.
"The survey strongly suggests that many people living with depression are unaware or are 'missing pieces' of vital information that may be preventing them from getting well," said Dr. Susan Kornstein, professor of psychiatry and obstetrics and gynecology at Virginia Commonwealth University. "Depression needs to be treated by a health care professional. To increase the likelihood of recovery from depression, it's important that people with depression have a comprehensive treatment plan that may include medications, psychotherapy and lifestyle changes. The goal is to help them to recovery." Depression, which includes a variety of symptoms, is a highly treatable illness, but it can become more difficult to treat the longer it goes undiagnosed or undertreated.

The survey showed that among those who waited six months or more to be diagnosed, 69 percent reported they delayed diagnosis because they lacked knowledge about depression or lacked basic facts about available depression treatments and where to go for help. Additionally, among those who wanted more information about depression treatment at the time of diagnosis, 64 percent said they wanted to know what it means to "get well.". Surprisingly, 91 percent have been prescribed an antidepressant for depression, but among them, just seven percent felt very knowledgeable about all basic aspects of the treatment.

120 Million People Worldwide Are Depressed

Depression affects around 120 million people worldwide and by the year 2020 will be the 2nd most common health problem in the world, according to World Health Organisation (WHO). Around 20% of the world's children and adolescents are estimated to have mental disorders or problems. About 10-15% of older people are thought to suffer from depression, and the incidence in nursing homes is much higher. In 2002, depression accounted for 4.5% of the worldwide total burden of disease. The UK has one of the highest rates of self harm in Europe, at 400 per 100,000 population. 1 in 4 British adults experience at least one diagnosable mental health problem in any one year, and one in six experiences this at any given time, according to The Office for National Statistics Psychiatric Morbidity report. Depressive disorders affect approximately 18.8 million American adults or about 9.5% of the U.S. population age 18 and older in a given year. 54% of people believe depression is a personal weakness. 15% of depressed people will commit suicide. 80% of people who see physicians are depressed.

Depression often co-occurs with other illnesses and medical conditions: 25% of cancer patients experience depression; 10-27% of post-stroke patients experience depression; 1 in 3 heart attack survivors experience depression; 1 in 3 HIV patients may experience depression; 50% of Parkinson's disease patients may experience depression; 50-75% of eating disorder patients (anorexia and bulimia) experience depression; 27% of individuals with substance abuse disorders (both alcohol and other substances) experience depression; 8.5-27% of persons with diabetes experience depression.

Women are almost twice as likely to become depressed as men. The higher risk may be due partly to hormonal changes brought on by puberty, menstruation, menopause and pregnancy. About 10 to 15 percent of women experience postpartum depression after giving birth.

Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.

Mild to moderate depression can often be successfully treated with psychotherapy, sometimes known as "talk therapy". Exercise can help reduce feelings of depression by increasing the body's supply of endorphins, chemicals in the body that increase the feeling of well being.

For some cases, especially in more severe depression, psychotherapy combined with medication may be needed. After a complete evaluation, your health care professional will decide if medication is appropriate in your case and what medication or combination of medications will work best for you. Medications affect individuals differently and it may be necessary to adjust dosages or even change medications, depending on your response and reaction. Commonly prescribed types of antidepressants include SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin and norepinephrine reuptake inhibitors), MAOIs (monoamine oxidase inhibitors), and tricyclics. Side effects can vary among these medications, but may include nausea, headache, insomnia, nervousness, sexual problems, drowsiness during the day, bladder problems, blurred vision, and dry mouth.

In some situations in which medications and psychotherapy have not been effective, depression may be treated by electroconvulsive therapy (ECT). Also known as "shock therapy", ECT has come a long way from its early days.

Antidepressants: selective serotinin reuptake inhibitors: Fluoxetine, Sertraline, Fluovoxamine, Paroxetine, Citalopram, Venlafaxine.

Tricyclic antidepressants (tricyclics): Clomipramine, Imipramine.

Monoamine oxidase inhibitors (MAOIs): Tranylcypromine, Isoprocarboxazid.

Benzodiazepines: Clonazepam, Alprazolam, Lorazepam.

Azipirones: Buspirone.

Beta blockers: Propanolol

WHO data suggests that depression causes 6% of the burden of all diseases in Europe in terms of disability adjusted life years. The cost of depression corresponds to 1% of the total economy of Europe.