Been feeling down or hopeless? Do you find little pleasure in things you used to enjoy? These may be signs of depression. Many Americans are depressed, but have not been diagnosed, and are therefore missing out on treatment. Find out if you or someone you love should be screened.
Soon your doctor may start asking more questions about your mental health. Prompting these changes are innovative new recommendations from the US Preventive Services Task Force (USPSTF) on screening for depression in adults.
Scope of the Problem
We’ve known for years that
depression
is a big problem; one in four women and one in eight men suffer from this disorder. Depression currently afflicts an estimated 19 million adults in the US. Compared to the past, the disorder now tends to start at an earlier age. It decreases quality of life, increases healthcare costs, and contributes to $17 billion in lost workdays per year. By 2020, experts expect depression to become the world’s second most debilitating ailment after heart disease.
And this is just the tip of the iceberg.
A huge number of people with the disorder don’t even know they have it. Depression is often disguised by other problems. And, though the stigma tied to the disorder is easing, up to half of those affected still go undetected and untreated.
In response to these problems, the USPSTF recently convened an expert panel to study the best ways to identify depression. The panel considered a number of recent studies and concluded that patients fare best when they’re routinely screened for depression and given appropriate medical care.
The USPSTF is now urging primary care doctors to regularly screen all adult patients for signs of depression.
Which Tests Are Best?
According to USPSTF, the following two questions are a good place to start:
Over the past two weeks, have you ever felt down, depressed, or hopeless?
Over the past two weeks, have you felt little interest or pleasure in doing things?
If your answer is “yes” to either question, contact your primary care doctor for an evaluation. Your physician may advise completing a more in-depth questionnaire or having a thorough checkup.
Risks for Depression
Research suggests depression comes from an imbalance of certain brain hormones. The disorder is more common in people who inherit a tendency for depression or are exposed to certain environmental triggers. Factors that can increase your chance of developing depression include:
If you suspect you suffer from depression, your doctor can make a diagnosis after a complete exam. The diagnosis requires having at least five symptoms for more than two weeks that are severe enough to interfere with your daily routine. The symptoms of depression include the following:
Persistent sad, anxious, or empty feelings*
Loss of interest or pleasure in activities that were once enjoyable*
Frequently feeling guilty, hopeless, helpless, or worthless
Persistent feelings of decreased energy, tiredness, or listlessness
Sleeping too little or sleeping too much
Reduced appetite and weight loss, or increased appetite and weight gain
Feelings of restlessness or irritability, or feeling slowed down
Difficulty thinking, concentrating, remembering, or making decisions
Thoughts of death or suicide
*Either the first or second symptom on this list must be present for a diagnosis of depression.
Effective Treatment
Depression is very treatable. Research has conclusively shown that antidepressant drugs and counseling—alone or in combination—are effective in combating the disorder; however; the combination of "talk-therapy" and "drug therapy" is more effective than either alone. Studies are currently underway on several alternative remedies. And adjusting your lifestyle to include more exercise and social activities may help as well.
You are encouraged to talk to your doctor if you have concerns about your mental health. With better screening and medical care the future looks brighter for adults with depression.
RESOURCES
National Institute of Mental Health
http://www.nimh.nih.gov
American Psychiatric Association
http://www.psych.org
American Academy of Family Physicians
http://www.familydoctor.org
SOURCES:
US Preventive Services Task Force. Screening for depression: Recommendations and rationale.
Annals of Internal Medicine
. 2002;136:760-764.
US Preventive Services Task Force now finds sufficient evidence to recommend screening adults for depression [press release]. Agency for Healthcare Research and Quality. May 20, 2002.
The numbers count: Mental disorders in America. National Institutes of Public Health website. Available at:
http://www.nimh.nih.gov/publicat/numbers.cfm
.
Diagnosis and management of depression.
American Family Physician
; 2000.
US Preventive Services Task Force. Screening for Depression in Adults: Summary of the Evidence.
Annals of Internal Medicine.
2002;136:765-776.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
