Throughout my years of caring for people, many seem caught in the deep-seated joy-starving depression. I have seen the devastation from that awful diagnosis involve not only those sad and melancholy, but greatly affect those around them. For those who are 18 to 45 years of age, depression is the number one cause for disability, resulting in an estimated 200-plus billion dollars of lost earnings per year. I have looked on aghast when depression caused such helplessness that the patient chose to escape life with suicide. There are about 40,000 deaths per year to suicide, which accounts for about the same number of deaths resulting from breast cancer. Despite a similar death rate, the money invested in depression research is about one percent of that spent studying breast cancer.
Science has not yet defined why depression occurs, but theoretical causes for this malady include a genetic predisposition, a learned process, a troubled childhood and adolescence, a stressful environment, sad or traumatic situations, addiction, or even not enough sun. Most of us periodically have what is called “situational depression,” such as the appropriate sadness that follows severe loss or death of a loved one. What is more typical of harmful depression is when there is no “situation,” no reason for it to happen, no sad story to explain why one is filled with sadness. When the patient says, “there is no reason for my being so sad,” then the clinician knows there is a problem.
The diagnosis is not always that easy. We physicians often suspect depression when people experience chronic pain, find it hard to concentrate, are without energy, have flares of temper, sleep too much or too little, have a loss of appetite or have over-eating binges, have unexplained crying spells, or become filled with anxiety for minimal reasons. People often make things worse by covering-up depression with alcohol, sleeping pills, anti-anxiety medications, or substance abuse, and these meds all make the diagnosis even more difficult.
Two-thirds of people with depression do not seek or receive help. But when the one-third that do get help follow-through with treatment, 80% are better in four to six weeks. There is help and hope for those with this miserable condition, but people need to be open to the possibility of such a problem (and men are usually the worst deniers). Treatment typically includes a half-hour of exercise or walking daily, someone to talk to, and often a medication with minimal side-effects.
If you are possibly struggling with depression, please get help. At least do it for those around you.