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Hey there, Pam Coburn-Litvak here.
As a
brain researcher specializing in stress management, I help my clients overcome
the challenges of stress and stress-induced problems like anxiety and
depression.
Let’s take a big picture look at depression: what it is, what it costs in terms of health and resources, and the best ways to treat it.
What is Depression?
It’s different from the mood fluctuations we all feel over the course of our day, especially when we’re dealing with challenges or problems. With depression, our mood sinks and stays down for weeks or months.
Symptoms of Depression
Major depression is diagnosed when you experience at least 5 of 9 common symptoms every day for at least 2 weeks.
The two
most common symptoms are sadness and apathy. Depressed
individuals wake up already feeling down and stay down for the rest of the day.
They also lose interest in activities or relationships they usually enjoy.
But because depression is a complex disorder, other symptoms can vary a lot. Different people will experience different sets of symptoms, including: changes in appetite and weight, disrupted sleep patterns (either sleeping too little or too much), feeling agitated, feeling dog tired all the time, having constant brain fog, and feeling ashamed, guilty, worthless, and hopeless.
According to the World Health Organization, about one in every 22 adults around the world suffer from depression every year.[1]
What Causes Depression?
The short
answer is, it’s complicated! Several social, psychological, and biological
factors can be involved.
But one big factor is stress. People who have recently gone through something stressful or traumatic, like losing a job, grieving a loved one, or being in an accident, are at greater depression risk.
But this cycle can start feeding itself, where depression leads to more stress and dysfunction, which worsens one’s life situation and leads to more depression.
Financial Cost of Depression
In the United States alone, the annual cost of treating depression with prescription drugs and medical services has now reached almost $30 billion.
But this
is just the tip of the economic iceberg: for every one dollar spent on direct
treatment, nearly seven more are spent to treat other problems that flare up.
Suffering
from depression increases the odds of also suffering from chronic health
conditions spanning cardiovascular, respiratory, gastrointestinal, metabolic,
and chronic inflammation/pain disorders.[2]
Altogether, this brings the national economic burden of depression to over $210 billion each year.[3]
The global cost of depression and anxiety disorders is estimated at $1 trillion each year, with an eye-popping 12 billion days of lost productivity.[4]
It’s the single largest contributor to medical disability around the world and causes more “days out of role” (these are days that you or I can’t carry out our normal functions) than any other mental disorder.
Health Cost of Depression
The link
between mental and physical health goes both ways: illness increases the risk
of depression, but depression also increases the risk of illness.
Depressed
people are less likely to take care of themselves by exercising and eating
right. Poor health behaviors will naturally lead to poorer health.
Once they get sick, depressed people are also less likely to comply with their treatment plans. And once this downward spiral has started, it’s hard to stop. Losing control over one’s health can deepen one’s feelings of depression and despair, which can then lead to more self-neglect and maybe even self-harm.
Relationship Cost of Depression
But just
as depression depletes financial capital, it also depletes social capital.
Depression cripples our ability to engage positively or provide others with emotional
support.
Depression
shrinks the odds of ever marrying. But if we do get married, depression
increases the odds of divorce.
And unfortunately, depression can continue to affect the next generation. Children of depressed parents can be more hyperactive and aggressive, can struggle more in school, and exhibit more emotional problems, like their own depression.
Depression and Suicide
At its
most severe, depression can make us start thinking of death as a way out.
Major
depression is the top predictor of suicide attempts around the world.
About
800,000 commit suicide worldwide every year, placing it among the top 20 causes
of death globally. Suicide is the second leading cause of death among teens and
young adults.[5]
How to Treat Depression
To
understand how depression is treated, it’s helpful to think of the brain like a
computer. Computer glitches can result from hardware problems or software
problems, and sometimes both.
Examples
of problems in the brain’s hardware are faulty brain circuits and depleted
brain chemicals. These problems are often treated with antidepressant drugs.
Drugs are
not normally used for children; nor are they the first line of treatment for
adolescents or for adults with mild depression.
Examples of problems in brain software are faulty thinking patterns that increase our stress and feelings of anxiety and depression. These are treated with psychotherapies, like behavioral activation, cognitive behavioral therapy (CBT), and interpersonal psychotherapy (IPT).
One of the benefits of psychotherapy is learning to re-frame the stressful things that happen to us in more positive ways. Across all ages, this can help prevent depressive episodes.
Conclusion
Talk to
your doctor if you are experiencing symptoms of depression. He or she can also
gauge if your depression is mild, moderate, or severe.
If you’re interested in finding out more, I invite you to visit my website often and follow me on social media. You will find a wide range of topics to help you feel better and deal more effectively with stress and stress-related problems like depression.
[1] Thornicroft, G., Chatterji, S., Evans-Lacko, S.,
Gruber, M., Sampson, N., Aguilar-Gaxiola, S., … & Bruffaerts, R. (2017).
Undertreatment of people with major depressive disorder in 21 countries. The
British Journal of Psychiatry, 210(2), 119-124.
[2] Scott KM, Lim C, Al-Hamzawi A, et al. Association of
Mental Disorders With Subsequent Chronic Physical Conditions: World Mental
Health Surveys From 17 Countries. JAMA psychiatry. 2016;73(2):150-158.
doi:10.1001/jamapsychiatry.2015.2688.
[3] Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike,
C. T., & Kessler, R. C. (2015). The economic burden of adults with major
depressive disorder in the United States (2005 and 2010). The Journal
of clinical psychiatry, 76(2), 155-162.
[4] Chisholm, Dan, et al. “Scaling-up treatment of
depression and anxiety: a global return on investment analysis.” The
Lancet Psychiatry 3.5 (2016): 415-424.
World Health
Organization. (2017). Depression and other common mental disorders: global
health estimates.
[5] Center for Disease Control’s and Prevention (CDC) Data
& Statistics Fatal Injury Report for 2015
Möller, H. J. (2003).
Suicide, suicidality and suicide prevention in affective disorders. Acta
Psychiatrica Scandinavica, 108(s418), 73-80.
Nock, M. K., Hwang, I.,
Sampson, N., Kessler, R. C., Angermeyer, M., Beautrais, A., … & De Graaf,
R. (2009). Cross-national analysis of the associations among mental disorders
and suicidal behavior: findings from the WHO World Mental Health Surveys. PLoS
medicine, 6(8), e1000123.
World Health
Organization. (2017). Depression and other common mental disorders: global
health estimates.
Buy the Book
If you found this valuable, click below to buy Dr. Coburn-Litvak's latest book, Leaving the Shadowland of Stress, Anxiety, and Depression:
Dr. Pamela Coburn-Litvak has published research articles on exercise and stress in Neuroscience and Neurobiology of Learning and Behavior. Her latest book, Leaving the Shadowland of Stress, Anxiety, and Depression, was published in 2020.
After receiving a Ph.D. in Neurobiology and Behavior from the State University of New York at Stony Brook, she served as both Assistant Professor of Physiology & Pharmacology and Special Assistant to the Vice President for Research Affairs at Loma Linda University in Loma Linda, California. She then joined the Biology department at Andrews University and developed courses in human physiology as well as the neurobiology of mental illness. She also founded Rock @ Science LLC, a company that specializes in health and science education and web development. She co-developed the brain and body physiology segment of the Stress: Beyond Coping seminar with its creator, Dr. William “Skip” MacCarty, DMin.
Dr. Coburn-Litvak currently lives in California with her husband. Their two daughters are mostly grown and attending school elsewhere.
When she’s not studying or teaching about stress, she enjoys stress-relieving activities like puttering around the garden, taking nature walks with her family, knitting, cooking, and reading.