Published: 18 November 2023 08:00 (EAT)
Depression is on the rise in the United States. Chances are, if you don’t struggle with this condition, you almost certainly know someone who does.
Nearly 18% of U.S. adults, more than 1 in 6, said they were currently depressed or receiving treatment for depression, according to a 2023 Gallup survey.
In 2015, when Gallup first began collecting information on the topic, that number was under 11%.
Gallup’s data shows that clinical depression was growing slowly in the country before the pandemic, but it grew faster after it, along with social isolation, loneliness, fear of infection, mental exhaustion, substance abuse and disruptions in mental health care. Rates among women, young adults, and black and Hispanic adults are rising the fastest.
For adolescents, ages 12 to 17, the statistics are also dire: According to the US Centers for Disease Control and Prevention, of the 5 million children in that age group, just over 20% experienced an episode of major depression in 2021 (the most recent year with available data ), with 3.7 million severely impaired.
Psychiatrist Charles Reason, a professor of human ecology and psychiatry at the University of Wisconsin-Madison, said he struggles with depression.
Raison, who is also the director of the Vail Health Behavioral Health Innovation Center and a former mental health expert for CNN Health, described the state of mental health in the United States in one word: bad.
“There’s no question that depression and anxiety and suicide and substance abuse have been on the rise in the United States for probably 20, 25 years, maybe longer,” Reason told CNN Chief Medical Correspondent Dr. Sanjay Gupta recently on the Chasing Life podcast.
But they’ve really been on the rise over the last 10 years, and the data is really consistent.
Growth is not equal among all age groups, Raison said.
The people who really suffer are young people. So people between the ages of 15 and 35, that’s where you see this really, really disturbing increase.
While the rise in depression among Americans is alarming, what is also troubling is the difficulty in pinpointing the cause.
We can’t see it on a brain scan. We don’t have a blood test for that. We cannot accurately measure its weight.
Raison compared depression to dropsy, an old-fashioned term for edema that can be caused by a variety of underlying conditions or factors.
It could be heart failure. It could be pneumonia. It could be cancer. There are (are) different reasons for the appearance of those symptoms, he said.
Will we ever find a test to diagnose depression? No, because depression is like dropsy, he said, pointing to possible different underlying causes. Depression isn’t the only thing that will undergo a test.
And that may be one of the reasons why depression is so difficult to treat.
Take an antidepressant such as Prozac, also known by the generic name fluoxetine. It was launched in the country 35 years ago as the first in a new class of drugs called selective serotonin reuptake inhibitors, or SSRIs.
The idea was that depression was the result of a chemical imbalance in the brain, and the imbalance could be corrected by targeting the neurotransmitter serotonin. Serotonin norepinephrine reuptake inhibitors, or SNRIs, which target two neurotransmitters, followed in 1993.
But antidepressants don’t work for everyone.
The issue of using antidepressants, which are the first line of treatment for depression in the United States, is incredibly complex, Reason said, noting that they are lifesaving for some people.
But as we’ve gone through the last 20 years, we’ve had to metabolize, as a field, a number of very hard truths about antidepressants and their effectiveness, he said.
One hard truth, and the most obvious, is that they don’t work nearly as well as we thought they did 30 years ago, estimating that only 30% of patients get a complete response.
So what can you do to help yourself if you are depressed. Raison has these five tips.
Make an appointment with a mental health professional.
If you feel unmoved, if you’ve lost interest in life, if your sleep and appetite have changed, if you feel hopeless, if you have thoughts of hurting yourself, those kinds of things are what depression is, Rayson said.
Getting help is especially important if you’ve had these symptoms for several months.
All of us who struggle with depression know that a clinician can help you with either psychotherapy or medication or both, he said.
It turns out that what’s good for the body is good for the brain.
Really try to do the things you would do for your physical health, Raison said. I often tell people: Think about what you would do if you wanted to address heart health and do the same thing.
All of these things are also antidepressants. So, weight management, eating healthy foods, getting enough sleep, getting enough exercise, getting sunlight.
Try to maintain close relationships.
(Council) No. 3 is sometimes very difficult when you are depressed. But it’s probably the most important thing trying to maximize our interpersonal connections with other people, Raison said.
If you have caring, smaller relationships with other people, that’s a big protective factor against depression. It is also a factor that can really help you overcome depression.
Be persistent in seeking help.
The way people, especially in the United States, respond to antidepressants tends to be very divided, Reason said.
There is a small group of people who just start taking an antidepressant and feel better within a few weeks and the depression goes away, while others struggle with chronic depression.
So if one antidepressant doesn’t work, he said: Try another.
But don’t be afraid to move on.
We’ve long known, for example, that people who don’t respond to a stack of antidepressants in a row are less likely to respond to the next one, but are no less likely to respond to psychotherapy, he said.
Create a state of gratitude.
Work on developing an attitude of gratitude, Raison said.
Raison admits it’s not always easy when you’re depressed.
If you can make it a habit, it can be very powerful in both preventing depression and making you feel better if you’re depressed, he said.
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