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Dealing With Depression
A Common Problem
Depression is a common problem that effects just about everybody to
some degree, sometime in their life. It is second only to high blood
pressure as the most common chronic health problem encountered in
medicine. Estimates are that at least 1 in 10 patients visiting a
doctor is suffering from depression. Unfortunately, most cases are
unrecognized1.
If depression becomes severe and sustained, (major
depression) it can have a debilitating affect on the whole person. It
can disrupt normal life process such as eating, sleeping, activity
level, and the ability to concentrate and accomplish tasks. If
unrelieved it leads to lost productivity, functional decline, and
increased mortality.
 Being
depressed or unhappy seems to have a negative affect on the heart as
well as the mind. In a study of 1250 people who survived a heart
attack, researchers found that the presence of depression lowered
survivability. During the 10 year study, 52% of those who were
depressed died while only 35% of those not depressed died (see chart
on right). That's nearly a 50% increase in mortality of those
suffering depression2.
 A
happy, hopeful mind has a positive affect on physical health. The
Alameda County Health Study3
found that unhappy people had a mortality rate 2-3 times higher than
those people reporting a happy and satisfied life (see chart on left).
These differences in mortality rates are as large as high blood
pressure or obesity. Maintaining a happy, hopeful outlook is a
positive strategy for a healthy heart and a happy life.
Look for ways you can incorporate fun activities
into your life every day. Play with the kids. Go for a walk in the
park. Read a good book. Go on outing with a friend. Enjoy the many
small blessing around you each day such as the flowers, a bird's song,
a sunset, a child's laugh, or your pet's affection. Take time to smile
and cheer someone else up each day as well. Happiness is contagious!
The U.S. Preventive Services Task
Force has recently (2002) recommended that primary care
doctors screen their patients for depression4.
Depression is often overlooked. A formal screening can help identify
depression so it can be treated (see screening questions below).
The Task Force found that 5 to 9 percent of adult patients visiting
their primary care doctor have depression. Persons who have the highest
risk of depression are: women, those with a family history of depression,
persons with chronic disease, and the unemployed.
The Task Force estimate that depression results in $17 billion in lost
workdays in the U.S. each year.
In the U.S., depression is the second leading cause of
disability, second only to heart disease.
In a study by the World Health Organization,
depression and other mental health problems was the leading cause of
work loss time, world wide.
Causes of
Depression
Depression can be caused by a variety of reasons.
-
Genetic tendencies
-
Hormonal and chemical changes in the body
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Low levels of serotonin in the brain
-
Excessive stress, conflict, abuse
-
Unhealthy lifestyle -- heavy smoking, alcohol or drug dependency
-
Sedentary lifestyle and obesity
-
Loss of loved ones, isolation, tragedy
-
Lack of love, loneliness
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Low self-esteem, angry or disappointed in yourself
-
Illness, pain, neurological problems
Treatment
Options
The good news is that depression is a treatable illness.
Unfortunately, many people ignore their symptoms and are hesitant to seek
help. If you think you may be suffering from depression see your doctor
and he or she will help you find an appropriate treatment.
Common treatments include:
-
Medications to help correct chemical imbalances in the
brain
-
Counseling with a trained mental health counselor such as
a psychologist or psychiatrist
-
Medication plus counseling and support to help the
individual deal with life problems, crises, alcohol/drug dependencies, and
other problems often associated with depression.
Self Help
Approaches1,5
-
Self-help books can help persons better understand and
incorporate effective mental health elements into their life.
-
Support groups and classes lead by qualified leaders in
depression management can be very helpful and supportive.
-
Identifying exaggerated negative or self critical thoughts
and developing more realistic and self accepting attitudes.
-
Breaking current life problems into smaller components and
identifying specific steps to address them. Get help from supportive
family members, pastor, and mental health counselors.
-
Regular physical activity, such as walking briskly for
30-45 minutes daily. Regular physical activity has been shown in many
studies to be as effective in helping prevent and improve mental
depression as taking medications. When done together it is even more
effective.
-
Schedule relaxing/enjoyable activities daily. Look for
ways to bring diversion and healthy pleasures into your life.
Recognizing Depression6
The
following two questions provide a quick way to screen for the presence of
depression. These questions were recommended by the U.S. Preventive
Services Task Force for doctors to use to screen their patients.
1. During the past month, have you often been
bothered by feeling down, depressed, or hopeless?
[ ] Yes, [ ] No
2. During the past month, have you often been
bothered by having little interest or pleasure in doing things?
[ ] Yes, [ ] No
If you answered “No” to both questions, you probably
aren’t bothered with depression. If you answered “Yes” to either or
both questions, you may have a depression problem. Ask your doctor for
further evaluation.
References
1. MA Whooley, GE Simon, Managing Depression in Medical Outpatients,
New England Journal of Medicine 2000; 343(26):1942-50
2. American Journal of Cardiology, July 1997
3. Berkman L and Breslow L, Health and Ways of Living, the Alameda
County Study, pp 145-7, Oxford University Press, 1983
4. U.S. Preventive Services Task Force, Annals of Internal Medicine,
May 21, 2002
5. JAMA Patient Page, Depression, JAMA 2000;284(12):1606
6. John Williams Jr, et al, Is this patient clinically depressed?,
JAMA Mar 6, 2002; 287:1160-1170
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