DEPRESSIVE ILLNESSES ARE A MAJOR PUBLIC HEALTH PROBLEM

Depression Takes a Terrible Toll. The economic cost of depressive illnesses is $16 billion a year; the human costs cannot be estimated. The lives of 10 million people and millions more--family and friends--are affected, often disrupted.

MANY SUFFER NEEDLESSLY

Depression Often Is Not Treated. Even though effective treatments are available, only one in three depressed people gets help.

Most people with a depressive illness do not get appropriate treatment because their symptoms:

• are not recognized
• are blamed on personal weakness
• are so disabling that people cannot reach out for help
• are misdiagnosed and inappropriately treated.

DEPRESSIVE ILLNESSES ARE SERIOUS

Depression Affects the Whole Person. Serious depressions are "whole body" disorders, affecting body, feelings, thoughts, and behaviors. They are not the temporary blues or the passing sad moods that everyone experiences after a loss.

Depression Sometimes Can Disable. Depressive illnesses involve a set of painful symptoms that can last for months, sometimes years. They change people. Sometimes symptoms are so disabling that they interfere with the ability to function. Some who suffer severe forms of depression are unable to eat or get out of bed. An estimated 15 percent of people hospitalized for depression eventually take their own lives.

DEPRESSIVE ILLNESSES COME IN VARIOUS FORMS

Depression Can Occur More Than Once. Some people have one episode of depression in a lifetime; many have recurrent episodes. Others have ongoing, chronic symptoms.

Depression Can Involve Mood Cycles. Almost two million people experience cycles of terrible "lows" and inappropriate "highs." This emotional roller coaster is called "bipolar disorder" or "manic-depressive illness."

CAUSES OF DEPRESSION

Causes Are Not Always Known. In some cases, symptoms appear suddenly for no apparent reason. In others, the symptoms seem to be associated with a life crisis, stress, or other illness. Research shows that depressive illnesses run in families.

AN ACCURATE DIAGNOSIS IS NEEDED

Diagnosis Involves a Good Checkup. To diagnose clinical depression and rule out other problems there should be:

• A complete physical examination and medical workup
• A complete history of current and previous symptoms
• Questions about illnesses of other family members
• Questions about mood, memory, and changes in relationships.

KNOW THE SYMPTOMS OF DEPRESSION

Depression Hurts. Symptoms of depression can include:

• Persistent sad or "empty" mood
• Loss of interest or pleasure in ordinary activities, including sex
• Decreased energy, fatigue, being "slowed down"
• Sleep disturbances (insomnia, early-morning waking, or oversleeping)
• Eating disturbances (loss of appetite and weight, or weight gain)
• Difficulty concentrating, remembering, making decisions
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Thoughts of death or suicide; suicide attempts
• Irritability
• Excessive crying
• Chronic aches and pains that don't respond to treatment.

KNOW THE SYMPTOMS OF MANIA

Mania Can Cause Chaos. The symptoms of mania are:

• Excessively "high" mood
• Irritability
• Decreased need for sleep
• Increased energy
• Increased talking, moving, and sexual activity
• Racing thoughts
• Disturbed ability to make decisions
• Grandiose notions
• Being easily distracted.

GET HELP

Treatment Is Needed. When four or more of these symptoms last longer than 2 weeks or interfere with ordinary functioning, professional treatment is needed.

EFFECTIVE TREATMENTS ARE AVAILABLE

Research Has Improved Treatments. There are effective medications and psychological treatments that often are used in combination.

A number of short-term talk therapies to treat clinical depression have been developed in recent years.

Several types of medications are available. People with severe depression respond more rapidly and more consistently to treatment with medication. Those with recurring forms of depression, particularly bipolar disorder, may need to stay on medication to prevent or lessen further episodes.

Many patients need psychotherapy to deal with the psychological or interpersonal problems typically associated with their illness.

Electroconvulsive treatment (ECT) may also be a very effective treatment for the most severe depressions. Research is being done on light therapy.

NEARLY EVERYONE CAN BE HELPED QUICKLY

Symptoms Can Be Relieved in Weeks. With available treatment, 80 percent of the people with serious depression can improve and return to daily activities, usually in a matter of weeks.

Individuals respond differently to treatments. If after several weeks symptoms have not improved, the treatment plan should be discussed with the doctor.

ENCOURAGE ANYONE WHO IS DEPRESSED TO GET HELP

Depressive Illnesses Sap Energy. The very nature of a depressive illness can interfere with a person's ability or wish to get help. Depression makes a person feel tired, worthless, helpless, and hopeless.

People with serious depression need encouragement from family and friends to get an accurate diagnosis and to seek the treatment that can ease their pain. Some people need even more help; they become so depressed that they must be taken for treatment.

SEEK TREATMENT OR REFERRAL

You Can Get Help From:

• Physicians
• Mental health specialists
• Health maintenance organizations
• Community mental health centers
• Hospital departments of psychiatry or outpatient psychiatric clinics
• University- or medical school-affiliated programs
• State hospital outpatient clinics
• Family service/social agencies
• Private clinics and facilities.

DEPRESSION AWARENESS, RECOGNITION, AND TREATMENT (D/ART)

D/ART Offers Information to All. D/ART, sponsored by the National Institute of Mental Health (NIMH), is a national education program that offers up-to-date information on depressive disorders to:

• The general public
• Primary health care providers
• Mental health specialists.

GET MORE INFORMATION ABOUT DEPRESSION

D/ART. Write:

D/ART, NIMH, 5600 Fishers Lane, Room 10C-03, Rockville, MD 20857

Call for free brochures: 1-800-421-4211

Mutual and Family Support Groups. In addition to professional treatment, many people benefit from joining mutual and family support groups. For a list of groups in your local area, contact:

National Alliance for the Mentally Ill
200 North Glebe Road, Suite 1015
Arlington, VA 22203-3754
1-800-950-NAMI (6264)

National Depressive and Manic Depressive Association 730 North Franklin Street, Suite 301
Chicago, IL 60610
1-800-826-DMDA (3632)

National Mental Health Association
1021 Prince Street
Alexandria, VA 22314-2971
1-800-969-NMHA (6942)

U.S. Department of Health and Human Services Public Health Service

National Institutes of Health
National Institute of Mental Health

NIH Publication No. 94-3875
Printed 1987, Reprinted 1989, 1992, 1994

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