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The Common Cold of Mental Illness
In the United States, about 10 percent of the population (7 percent women and 3 percent men) meet the criteria for major depression, and another 4 or 5 percent undergo a depressive experience that is not sufficient to be officially classified as clinical depression. Depression is an expensive illness, costing the American society about $44 billion in lost workdays, poor job performance, and psychotherapeutic care. Although the financial consideration is significant, the personal costs are incalculable. Depression is more isolating and debilitating than any other chronic illness. During their lifetime, nearly one fourth of all women will suffer a major depression. In the 1998 Department of Defense Survey of Health Related Behaviors Among Military Personnel, 18.9 percent of the Army members surveyed screened positively for depressive symptoms. This screen indicated that these Soldiers were "in need of further evaluation for depression". Depression was addressed in a keynote at the American Society of Surgeons meeting in November 1998, indicating an increasing concern for depression in military personnel. Listed as one of the top 20 health concerns, a Veterans Administration/Department of Defense working group was established to develop a practice guideline for primary care physicians. The guideline is anticipated to be adopted shortly throughout the military. Clearly, depression is a growing concern. What is major depression? The American Psychiatric Association and Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition classifies it as a mood disorder when at least five of the following symptoms occur within the same two-week period and represent a key change from previous functioning:
Depression is a huge challenge to the medical system. According to the book, Mind, Body, Health, by Hafen, Karren, Frandsen, and Smith, approximately one-fourth of all primary care medical patients come from the 15 percent of the population with major depression and anxiety disorders. If minor depression and anxiety-related issues are included, this figure climbs to almost half of the patients who present themselves to health care facilities for treatment. (Depression and anxiety are combined here because they frequently overlap and have neurochemical similarities.) Depression and anxiety generate many physical ailments. Patients with complaints of physical problems are often only treated for their physical concerns, and not questioned about potential psychological factors that may be the underpinnings of the symptoms. Only about one third of the people who do undergo treatment for depression experience significant improvement within just a few months. New medications effectively alleviate symptoms with minimal, if any, side effects. The most effective treatment of major depression is the combination of psychotherapy and medication. Although there are many types of psychotherapy available, studies on treating depression primarily support two types: cognitive behavioral therapy and interpersonal therapy. The key for depression, as in most diseases, is early detection followed by swift and effective intervention. For information see:
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| Sponsored by the Army National Guard, and the Office of the Chief, Army Reserve. Copyright 2008 |
Depression has been dubbed the common cold of mental health. Steven Paul, Chief of Clinical Neuroscience at the National Institute of Mental Health states, "Depression is like a fever. It's a nonspecific response to an internal or external insult. Like fever, it has a number of origins and treatments".