Has depression become an epidemic?
How Common is depression?
Depression is one of the most undiagnosed and disabling medical conditions in society today. It costs the U.S. economy $27 billion annually in medical costs, lost productivity, unemployment, increased susceptibility to illness, suicide, family disruption, relationship failure, alcohol abuse and personal suffering. The Canadian costs are estimated at $5 billion annually. Only heart disease causes comparable disability and cost to society.
Mental disorders cause a much broader degree of disability than most other medical conditions like back pain, diabetes and heart disease. A psychiatric condition affects all levels of functioning as compared to other diseases which only affect one organ system. Insurance companies are now very concerned at the staggering number of disability claims that are being submitted due to emotional disability. There are several corporations in Canada who realize that mental disability has become for them the most common cause of days off work due to illness. They have started prevention and early detection programs for their employees.
Depression is more disabling than most chronic illnesses. Even though there are now very effective treatments available, most people with depression remain undiagnosed and untreated due to lack of awareness and not accepting depression as a legitimate illness. The unnecessary suffering often continues for a lifetime, causing intense mental, emotional and physical anguish, disrupting all relationships both at home and work.
If a person acknowledges this condition and goes for help, they then must endure the unfair stigma of an uninformed public that presumes that depression is a character defect, lack of will power or a personal weakness. Not only does a depressed person have to cope with the illness but also with the scorn of society. No other chronic illness is treated so unfairly by the public.
Six to ten percent of the population is depressed at any given time. This very common condition is undiagnosed and untreated in eighty percent of its victims.
Depressed people have to endure misunderstanding and isolation
The problem with the Y chromosome
Depression is more common in women due to poorly understood genetic factors. It is not because they are the "weaker sex" or because emotional issues are "women's problems." There are some medical conditions that are more common to one sex or the other. Heart disease for example is more common in males for genetic reasons only. It has been estimated that ten to twenty percent of women will at some time in their lives have symptoms of chemical imbalance depression. The condition for the majority of them will usually be mild and remain untreated but that means that there are a very large number of untreated women who are not feeling as well as they could be.
The lifetime risk for men is a much more difficult statistic to estimate. When I first started treating depression, the lifetime risk for depression in men was four percent. The number has now climbed closer to ten percent in the past fifteen years. I'm not convinced that men are more depressed now than they were when I started practicing. I think the difference has come due to improved detection techniques for the symptoms of depression in men. It is much more difficult to diagnose depression in men and I have a theory as to why that is so.
We know that the difference between the sexes in the incidence of depression is due to genetic factors. The genetic difference between males and females is that males have a Y chromosome that females don't have. After many years of observation of men and through being one myself, I have come to the conclusion that the Y chromosome is likely made of "denial!" It is extremely difficult to get a man to admit he is depressed or to accept treatment.
In my years of practice I have noticed a profound difference in how men and women suffer with depression. When a woman is depressed, she will usually come to my office and complain that there is something wrong, that it is her fault and she wants help to fix the problem. When a man is depressed, if he comes to the office at all, which in itself is rare, he will say that there is something wrong, it's the fault of his wife and would I please fix her.
Instead of admitting to the problem, he will run from it, busy himself, watch TV or abuse alcohol to distract himself from the discomfort. It is very frustrating to try and get men into treatment for depression.
Men have a problem with denial
Depression is more common as people age and unfortunately the elderly assume that it is normal to be depressed and don't come for treatment. It is found in all races and social classes, even occurring in those who are not stressed and are otherwise completely well.
All disorders of mood are strongly inherited. If one parent has depression, there is a thirty percent risk that a child will also become depressed. If both parents are depressed the risk may rise to seventy five percent.
Depression is not a benign illness. Fifteen percent of untreated depressed people will commit suicide and eighty percent of all those who commit suicide have a treatable mental illness. This means that there are a very large number of preventable suicide deaths.
At least ten percent (some researchers say twenty percent) of the population will suffer from a mood disorder at some time in their life. Most will not be treated because of the stigma attached to the diagnosis and treatment. Stigma is the single most important obstacle to treatment. Sufferers are afraid to report their symptoms due to the negative consequences which may come in their work and family as a result of their diagnosis.
Effective treatment will only begin when a person recognizes the problem and overcomes the obstacles to treatment. Through public education, awareness of these conditions should increase and the stigma attached to these illnesses should dissolve.
Society has placed unnecessary condemnation
and shame on depressed people
The text of this section contains excerpts from "Healthy Moods"
Illustrations by Rev. Jim Keddy
For more information visit Answers to common mental health questions.
Copyright Dr. Grant Mullen. No part of this website can be reproduced without the written permission of the author and publisher.
