Depression is more prevalent, costly and treatable than you think

Major Depressive Disorders can strike anyone of any race, ethnicity or socio-economic background and at essentially any age. It affects the marginalized and the mighty — there is strong evidence that Winston Churchill and Abraham Lincoln suffered from depression. Studies show that only about half of Americans experiencing major depression seek help — and only half of those that do, receive appropriate treatment. Our best epidemiological study to date, conducted by the National Comorbidity Study-Replication (NCS-R), found that about one in every six adults will have a diagnosable Major Depressive Disorder in their lifetime, and that in a 12-month period nearly seven percent of adults will meet diagnostic criteria for depression. While episodes of depression can recur and in some people become very persistent, the NCS-R study found that the average duration of an episode of major depression was only 16 weeks in length.

But those 16 weeks disrupt lives. That same study also found that major depression is associated with significant impairments in the performance of work and other duties in over half of all cases (59.3%). Depression, especially when left untreated, can be a significant drain on the American economy. One study calculated the annual economic burden of depression, including productivity losses, absenteeism and increased health care costs (including co-morbid chronic illnesses, such as diabetes), as between $17 and $52 billion.

While most people with depression can obtain outpatient care while continuing to work, depression can affect work performance and functional impairments, so it is sometimes a good decision for people to take time out to obtain treatment and care. For most people, treatment is effective and can return people to work in a reasonably short amount of time. Studies have found that people often experience clinically significant relief of their symptoms around 8 to 14 weeks after initiating treatment.

However, despite its prevalence, and despite decades of scientific research that show depression to be a brain disorder and not a character flaw, there’s still a persistent stigma attached to the disease. In a recent poll conducted by the Meadows Mental Health Policy Institute, nine out of 10 respondents said it’s harder to talk about a mental health condition than a physical one. That was true even though the vast majority of respondents (76%) had a close friend or family member who has experienced a mental health issue (the same proportion as cancer).

Researchers have found that the stigma of mental illness is often the most powerful factor in people failing to seek care and treatment. Sadly, when the stigma of mental illness interferes with early treatment, depression can become severe and debilitating. We must work together to change that outcome.

If we can reduce the stigma associated with depression and other mental health issues, more people will feel comfortable seeking treatment. Appropriate treatment helps most people with major depression improve significantly within two to three months. That means they can return to full functioning in a matter of weeks.

We also need to make it easier to access effective mental health care. Because depression, like most health conditions, is best treated early on, we need to develop comprehensive mental health care that is integrated within primary care settings. At the University of Texas Southwestern Medical Center (UTSW) in Dallas, Madhukar Trivedi, M.D., a leading research psychiatrist internationally, has been at the forefront of developing better ways to make the treatment of depression more effective in primary care settings. His research team found that providing primary care providers with tools to screen and treat depression result in better clinical outcomes and decrease stigma as well, and the new Depression Center that UTSW has opened will support primary care practices across Dallas in making effective treatment widely available.

Integrating mental and physical health care could diminish the stigma of mental illness by making mental health screening a routine part of any exam. It would increase the number of people who can find treatment. It could improve outcomes by diagnosing patients earlier and offering more effective, consistent care. It can also improve a range of health outcomes, as depression often co-occurs with diabetes and other physical health conditions that can complicate care. Depression does not have to control a person’s life; with proper treatment and support, Texans struggling with depression can manage their symptoms and live full and fulfilling lives.

 

About The Meadows Mental Health Policy Institute

The Meadows Mental Health Policy Institute is a nonpartisan, nonprofit organization that supports the implementation of policies and programs that help Texans obtain effective, efficient mental health care when and where they need it. The Institute’s vision is for Texas to be the national leader in treating people with mental health needs. For more information about the Meadows Institute, please visit texasstateofmind.org

Andy Keller, PhD, Meadows Mental Health Policy Institute

Dr. Andy Keller is President and Chief Executive Officer of the Meadows Mental Health Policy Institute

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