Depression

You don't seem to recognize the person you've become anymore. You used to be outgoing and fun-loving. Now, you're constantly irritable and withdrawn. Your family, friends and co-workers don't understand what's happened to you. Personally, you find little pleasure in the things that used to bring you joy and your outlook for the future has become increasingly pessimistic. There is a good chance you are wrestling depression. And its time you stop wrestling it alone --- because help is available. And because without that help there could be serious physical, emotional and financial consequences.

The Cost of Depression

It is estimated that more than 9% of Americans - about 19 million people - deal with depression each year. By some estimates, depression costs the U.S. over $65 billion a year in medical costs and lost productivity, putting it on a par with heart disease. According to the National Institute of Health (NIH) depression ranks "third by prevalence and sixth in terms of economic burden" among diseases and medical conditions.

The Symptoms of Depression

Depression is a medical condition that anyone can get. It is not a personality flaw or weakness. In terms of prevalence, women are almost twice as likely as men to become depressed. Estimates range from 10% to 25% of all women will be depressed during their lives. Men, while their risk is lower, are much more likely to allow depression to go untreated.

A report of the Surgeon General on Childhood Depression indicates "that at any one time between 10 and 15 percent of the child and adolescent population has some symptoms of depression" and that "major depression among all children ages 9 to 17 has been estimated at 5 percent. Among the elderly, estimates of depression range from eight to 20 percent of those living at home and up to 37 percent in primary care settings.

According to the DSM IV, the primary diagnostic reference of Mental Health Professionals in the United States, people diagnosed with major depression have one or more episodes lasting at least two weeks with a depressed mood or loss of interest in nearly all activities accompanied by at least four other symptoms of depression. These symptoms include:

  • Frequent feelings of sadness lasting most of the day
  • Loss of interest
  • Feelings of hopelessness, unworthiness or guilt
  • Loss of self-esteem
  • Sleep problems
  • Difficulty concentrating
  • Irritability
  • Change in appetite and weight
  • Restlessness
  • Thoughts of death or suicide

What Causes Depression?

Depression does not have a single cause but often is the result of a combination of factors. It is related to physical change in the brain connected to an imbalance in the chemical neurotransmitters that carry signals in the brain. Some of the factors involved in depression are:

  • Family history - depression can run across generations
  • Stress or trauma - personal problems, death, separation, and other changes can cause depression
  • Physical conditions - Chronic or acute medical conditions such as heart disease, diabetes, cancer and HIV can contribute to depression
  • Psychological disorders - Anxiety disorders, substance abuse, eating disorders and schizophrenia often appear with depression

What Can be Done?

The good news is that depression is treatable. Most patients show improvement after receiving treatment. Standard treatments for depression are medication management and psychotherapy.

Medication
Antidepressants work by balancing the chemical neurotransmitters in the brain. Today's medications have fewer side effects and are easier to tolerate. However, they can take some time to effectively change a patient's mood. Frequently patients don't stay on the medication long enough. It is important to give it the necessary time, often up to four weeks, to begin to work and talk to your doctor if you have questions or concerns about your medication.

Psychotherapy
Psychotherapy or counseling can help you identify and change the thought and behavior patterns that contribute to depression. It can teach you the skills to react differently to negative thoughts. For some people, especially those with mild to moderate depression, counseling alone may be effective. However others, particularly those who have been diagnosed with major depression, may require a combination of medication and psychotherapy.

If you or a family member needs help dealing depression or related issues, give us a call at (888) 321-4433. Penn Behavioral Health is your Employee Assistance Program and can provide you with reassurance and practical assistance in a confidential and personal way. You can find out more at our web site at www.pennbehavioralhealth.org.

PENN Behavioral Health is available to assist you seven days a week, 24 hours a day.

Additional Resources
National Institute of Mental Health
NIMH Public Inquiries
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
(866) 615-6464
www.nimh.nih.gov

American Psychiatric Association
1000 Wilson Boulevard, Suite 1925
Arlington, VA 22209-3901
(888) 357-7924
www.psych.org

National Foundation for Depressive Illness, Inc.
P.O. Box 2257
New York, NY 10116
(800) 239-1265
www.depression.org