Depression is a major public health problem

Depression is a major public health problem

We can all get down from time to time with the usual ups and downs of life. However if this becomes a persistent problem every day for about 2 weeks then this may be a warning that you are becoming depressed. Symptoms of depression can be psychological, physical and social and hence its treatment needs to address all of these problems.

Physical symptoms can include:

changes to your eating or sleeping patterns;
lack of energy or loss of interest in sex and
unexplained aches and pains.

Psychological symptoms can include:

constant low mood;
lack of enjoyment and
feelings of hopelessness and helplessness.

Social symptoms can include:

difficulties in your work and home life;
losing interest in your usual activities and hobbies and
avoiding social activities and contact with your friends.

Depression can be mild, moderate or severe depending on how many symptoms you may be experiencing and how seriously it is impacting upon your daily life. About 6% of the population meet the clinical criteria for depression or dysthymia (low-grade depression for more than 2 years) at any one time. 20% of those will have persistent symptoms for more than 2 years.

Depression is most prevalent in the 18-44 year old age group with the average age of onset at 27 years. Women are twice as likely to suffer fom depression than men.

Depression is highly recurrent with 30% of people affected experiencing a relapse within 3 months of recovery. Without regular medication (an antidepressant) for 6 months in moderate or severe depression, 50% will have a further episode within 2 years.

The overall prevalence of depression appears to be rising with a lifetime prevalence of 10-20%. At least 50% will also have anxiety problems.

Depression increases death from natural causes by 1.7 times, and from suicide by 19.7 times.

People born since 1945 in industrialised countries have a higher lifetime risk and an earlier age of onset of depression. The risk of depression is doubled in those of lower socioeconomic class. There are significantly higher rates of depression in urban and inner city areas. Alcohol and illicit substance abuse, e.g. cocaine, can also cause and worsen depression.

Direct health care costs of treating depression are greater than the respective costs of treating hypertension (high blood pressure) and diabetes put together. Direct health care costs are dwarfed by the indirect costs:

days lost from work due to depression exceed all other disorders;
the economic burden on family members and society is considerable.

1. Chisholm, D, Diehr, P, Knapp, M, Patrick, D, Treglia, M & Simon, G (2003). Depression status, medical comorbidity and resource costs. Longitudinal Investigation of Depression Outcomes (LIDO) study in primary care. The British Journal of Psychiatry, 183: 121-131.

2. Fombonne, E (1994). Increased rates of depression: update of epidemiological findings and analytical problems. Acta Psychiatrica Scandinavica, 90(3): 145-156.

3. Gelder, Harrison & Cowen (2006). Shorter Oxford Textbook of Psychiatry, 5th edition, Oxford University Press.

4. Gelder, Lopez-Ibor & Andreasen (2000). New Oxford Textbook of Psychiatry, 1st edition, Oxford University Press.

5. Keller, M B, Lavori P W, Mueller T I, Endicott J, Coryell W, Hirschfield R M A & Shea T (1992). Time to recovery, chronicity, and levels of psychopathology in major depression: a 5 year prospective follow-up of 431 subjects. Arch Gen Psychiatry, 49(10): 809-816.

6. Kessler, R C, McGonagle, K A, Zhao, S, Nelson, C B, Hughes, M, Eshleman, S, Wittchen, H-U & Kendler, K S (1994). Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States Results From the National Comorbidity Survey. Arch Gen Psychiatry, 51(1): 8-19.

"Happiness is when what you think, what you say, and what you do are in harmony."

Mahatma Gandhi (1869-1949)

Call Pam on 07872 920 907 (Mon-Fri 10am-4pm) to book a private consultation (Mon-Fri from 6.30pm)