"Depression—the Under Recognized and Growing Problem" By Allen Weiss, MD, MBA, President and CEO

Depression—the Under Recognized and Growing Problem

September 1, 2009 - Are you ever sad or irritable, lose interest in your usual activities, unable to experience pleasure, feel guilty or worthless, and have thoughts of death or suicide? Have you had difficulty concentrating or making decisions? How about uncommon fatigue, restlessness, insomnia, or loss of appetite?

The above symptoms and behavior sound depressing because they are, in fact, all signs of depression. You—or someone you care about—may be joining the more than 5.4% of Americans over age 12 who have experienced depression, if more than a few of the above symptoms exist and have been present for more than two weeks.

Over 80% of people with depression report some level of functional impairment because of their condition. According to a recent Centers for Disease Control and Prevention (CDC) publication, 27% report having serious difficulties in their home life and at work. These difficulties include the inability to get along with colleagues and family members.

Mental illness still carries a certain stigma even though depression and anxiety are the fastest growing illnesses in older adults in the country. Among all people with depression only 29% reported contact with a mental health professional. Those with severe depression are receiving treatment only 39% of the time which is tragic because so much can be done with modern therapy. Please understand that mild transient sadness or fluxes in emotional states are not mental illnesses but normal variations in daily life.

Why are so few people who suffer from depression getting the care they need? Many people who are depressed don't realize they actually have a problem, nor do they have the energy or ability to seek help. Additionally, friends and family members of the individual affected may mistake depression for just a minor deviation from normal behavior and ignore the aberrancies.

Depression and mental illness in general, seems to be more common in America today than ever. America has evolved over hundreds of years from an agrarian society to the industrial age and next into the information age. As of 2001 we are in the genetic age. Through each of the first three epochs, population density increased linearly, while the speed and volume of communication has increased exponentially. Simultaneously, our longer lifespan has given the day to day stresses a longer period to wear down our mental defenses. As all these trends combine with the current economic hardships, we have a higher incidence of mental illness with worsening severity.

The first step in solving or controlling any problem—whether medical or otherwise—is to recognize there is a problem. Hiding, denying, or hoping the symptoms will disappear is unrealistic and will not change anything. It will only delay diagnosis, subsequent treatment and, in turn, worsen the prognosis.

There are simple short lists of questions which can be used to determine if depression exists (http://www.depression-screening.org/). Be smart and proactive by having yourself screened—or encouraging others around you to do so—if there are any doubts or questions.

There are many medical advances, including treatments ranging from individual to group therapy, medications, support groups, and behavioral changes, which can be effective. Please help yourself and those around you to recognize and treat this common but controllable illness. Let's put the social stigma of mental illness behind us.

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.