Clinical depression affects 15 million American adults--or 5 to 8 percent of the population each year--and is the leading cause of disability in the U.S. Although it is highly treatable, 80 percent of those who suffer from clinical depression fail to seek help. Clinical depression is so prevalent that, according to The Depression Project, every person in our country will be affected by it at some point in their lives--either themselves own or someone close to them.
Features
Clinical depression differs significantly from the normal sadness everyone occasionally experiences. Clinical depression is a medical illness related to multiple factors including genetic predisposition, physical illness and life events. In order for an individual to be diagnosed with clinical depression, a mental health professional assesses for certain criteria. A patient should be considered to have clinical depression if he has either a depressed mood or a decreased level of interest in most or all activities, plus at least four of the following symptoms for two weeks or longer: significant loss or gain of weight; difficulty sleeping, or sleeping more than usual; agitated behavior, or behavior that is slowed down; diminished energy; feelings of guilt or worthlessness; decreased ability to concentrate or make decisions; or frequent thoughts of death or suicide.
Age
The average age of onset for a first major depressive episode is in the mid-20s, though that age is decreasing. In fact, among youth ages 10 to 14 years, the rate of depression has doubled over the past two decades. Four to 5 percent of children--over 1 million--suffer from clinical depression, and they represent the fastest-growing market for antidepressants with an increase in usage of 23 percent per year.
Clinical depression is most common among those aged 25 to 44. Depression is one of the leading causes of absenteeism from work, costing employers over $51 billion in lost productivity. By the year 2020 clinical depression is expected to be the second leading cause of death after heart disease.
The National Alliance on Mental Illness reports that over 6.5 million of our nation's elderly over the age of 65 suffer from clinical depression--the highest rate of any age group. Yet the elderly's symptoms are often mistaken for signs of dementia, or as a natural reaction to losses. And the individuals who suffer from depression are more likely to complain of physical ailments than recognize that they feel depressed.
Approximately 5 percent of all teenagers suffer from clinical depression at any given time. Risk factors include a history of trauma as well as a family history: 20 to 50 percent of teens who suffer from depression have a family member with a history of mental illness. Drug or alcohol abuse is a major risk factor in all age groups, but particularly for teens; two-thirds of those suffering from depression also suffer from another mental disorder or from drug or alcohol abuse.
Gender and Race
Although among children boys and girls are affected in equal proportions by depression, by adulthood women suffer at twice the rate of men. Hispanic women have the highest rate of depression at 24 percent, followed by Caucasian women at 22 percent and African American women at 16 percent. There is also a racial disparity among those who seek treatment for clinical depression: while the overall figure of those who do not seek treatment is 80 percent, 92 percent of African-American males do not seek treatment.
Suicide
A threat by an individual to harm himself should always be taken seriously--15 percent of all depressed people end their lives in suicide. Men commit suicide at four times the rate of women, but women attempt suicide three times as often as men. Firearms account for more than 50 percent of all suicides.
The highest rate of suicide is among elderly men, who commit suicide at seven times the rate of elderly women. The greatest risk factors for suicide among the elderly are social isolation and access to means--such as a firearm in the home. Many elderly victims reach out for help just before acting: 20 percent see a doctor on the day they die, 40 percent see a doctor in the week they die, and 70 percent see a doctor during the month they die.
Suicide is the third leading cause of death among adolescents and teenagers, despite the estimate that eight out of 10 try to ask for help before killing themselves. According to a survey by the National Youth Violence Resource Center, 19 percent of all teenagers in high school had seriously thought about suicide, nearly 15 percent had planned how they would attempt suicide, and just under 9 percent had attempted suicide during the preceding year. Leading risk factors for suicide among youth include a mental illness in addition to depression, drug and/or alcohol abuse, situational stress, and access to firearms.
Treatment
Once diagnosed, clinical depression can be treated with medication, psychotherapy, and/or electroconvulsive therapy--a combination of the three treatments is effective for 80 to 90 percent of all individuals. Although many will recover completely and suffer no further episodes, 50 to 60 percent of those who have suffered one episode of clinical depression will suffer a second episode--and 70 percent of those who have suffered a second episode will suffer a third. Long-term psychotherapy is an essential component of treatment for these individuals.
References
- "Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR" American Psychiatric Association 2000
- The Depression Project: Staggering Statistics
- Surviving Depression: Depression Statistics
- National Youth Violence Prevention Resource Center: Youth Suicide Facts
- National Alliance on Mental Illness: Depression in Older Persons Fact Sheet
