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Facts for Policymakers: Treatable Causes of Disability

Major Depression

  • Unlike normal emotional experiences of sadness, major depression is persistent and can significantly interfere with an individual’s thoughts, behavior, mood, activity, job productivity and physical health.
  • There is no single cause of major depression and scientific research has firmly established that major depression is a biological brain disorder.
  • Depression is a biological disorder that results in a syndrome of sleeping, eating and energy disturbance that impairs functioning and may lead to suicide. Depression is not just a bad day, the blues or being moody.

Treating Depression is Good Economics

It is estimated that the economic benefits of expanded diagnosis and treatment of depression is $7,100 annually or a return of $7 for every $1 invested.

 
  • Among all major medical illnesses, major depression is the leading cause of disability in the U.S.

  • Major depression affects approximately 10 million American adults, or about 5.0 percent of the U.S. population age 18 and older in a given year.

  • Depression affects all ethnic, racial and socioeconomic groups.

Public Perception of Depression

Newer medications for treating depression have led to a fundamental change in the public’s perception of mental illness. When describing a typical person with depression, 75 percent of people in one survey attributed the person’s problems to a chemical imbalance in the brain and suggested that medications would help.

  • If untreated, episodes of depression commonly last anywhere from six months to a year. (Figure 1)
  • If untreated, 50 percent of people suffering from a first episode will have a recurrence.
  • Left untreated, depression can lead to suicide. Lack of treatment or undertreatment of depression, and suicide are frequently linked; it is estimated that 90 percent or more of completed suicides are by people who have a psychiatric illness – such as depression.

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  • Many types of treatment are available, and the type chosen depends on the individual and the severity and patterns of his or her illness.
  • Newer medications, called SSRIs, have been more effective in treating depression than older medications because there are fewer side effects, making them easier for patients to sustain. Furthermore, the reduced need for physician visits and rehospitalization keeps costs down.
  • There is agreement in the mental health field about which anti-depressant medications are effective in treating depression and how medications should be prescribed and used for maximum benefit.
  • Because of different presentations of depression (agitation, melancholy, in concert with another medical condition) physicians need to be able to individually recommend treatment – medications and psychotherapy – and monitor adherence to medications. (Figure 2)
  • In addition to the health benefits, there are economic benefits for society. Newer medications are helping more people with depression enter the workforce.
  • The Institute of Medicine of the National Academy of Sciences recently identified screening and treatment of major depression as a national health care priority.
  • In 2002, the U.S. Preventive Services Task Force formally recommended that doctors screen for depression.
  • Although major depression can be a devastating illness, it is highly treatable. Between 80 and 90 percent of those suffering from serious depression can be effectively treated and return to their normal daily activities and obtain emotional stability.

Depression Can be Treated


Although major depression can be a devastating illness, it is highly treatable. Between 80 and 90 percent of those suffering from serious depression can be effectively treated and return to their normal daily activities and feelings.

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  • Treating depression is good economics -- It is estimated that the economic benefits of expanded diagnosis and treatment of depression is $7,100 annually or a return of $7 for every $1 invested. 


Next Page: Depression in Children and Adolescents

 
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