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Clinical depression is a common and serious medical illness that
can be effectively treated. The risk of clinical depression is
often higher in individuals with serious medical illnesses, such as
heart disease, stroke, cancer and diabetes. However, the warning
signs are frequently discounted by patients and family members, who
mistakenly assume feeling depressed is normal for people struggling
with serious health conditions. In addition, the symptoms of
depression are frequently masked by these other medical illnesses,
resulting in treatment that addresses the symptoms but not the
underlying depression. It is a myth that depression is a
“normal” emotional response to another illness;
it’s extremely important to simultaneously treat both medical
illnesses.
Impact of Depression in Primary Care
Settings
- Nearly 74 percent of Americans who seek help for depression or
symptoms of depression will go to a primary care physician rather
than a mental health professional.
- The rate of depression among those with medical illnesses in
primary care settings is estimated at five to 10 percent. Among
those hospitalized, the rate is estimated at 10 to 14 percent.
- The more severe the medical condition, the more likely that
patient will experience clinical depression.
- People with depression experience greater distress, an increase
in impaired functioning and less ability to follow medical
regimens, thus hindering the treatment of any other medical
conditions.
- Unfortunately, the diagnosis of depression is missed 50 percent
of the time in primary care settings.
Why Depression and Medical Illnesses
Often Occur Together
- Medical disorders may contribute biologically to
depression.
- Medically ill people may become clinically depressed as a
psychological reaction to the prognosis, the pain and/or incapacity
caused by the illness or its treatment.
- Though occurring together, depression and a general medical
disorder may be unrelated.
Prevalence of Depression
Co-occurring With Other Medical Illnesses
Heart Disease and
Depression
- Depression occurs in 40 to 65 percent of patients who have
experienced a heart attack, and in 18 to 20 percent of people who
have coronary heart disease, but who have not had a heart
attack.
- After a heart attack, patients with clinical depression have a
three to four times greater chance of death within the next six
months.
- Men and women with depression are at increased risk for
coronary artery disease but only men are at greater risk for
dying.
Stroke and Depression
- Depression occurs in 10 to 27 percent of stroke survivors and
usually lasts about one year.
- An additional 15-40 percent of stroke survivors experience some
symptoms of depression within two months after the stroke.
- Individuals reporting five or more depressive symptoms have
more than a 50 percent risk of mortality due to stroke in the
subsequent 29 years.
Cancer and Depression
- One in four people with cancer also suffer from clinical
depression.
- Depression is sometimes mistaken as a side effect of
corticosteroids or chemotherapy, both treatments for cancer.
- Depressive symptoms can be mistakenly attributed to the cancer
itself, which can also cause appetite and weight loss, insomnia and
loss of energy.
Diabetes and Depression
- People with adult onset diabetes have a 25 percent chance of
having depression.
- Depression also affects as many as 70 percent of patients with
diabetic complications.
Eating Disorders and Depression
- Research shows a strong relationship between depression and
eating disorders (anorexia and bulimia nervosa) in women.
Alcohol/Drugs and Depression
- Research shows that one in three depressed people also suffer
from some form of substance abuse or dependence.
Common Symptoms of Depression and
Other Medical Disorders
- Weight loss, sleep disturbances, and low energy may occur in
people with diabetes, thyroid disorders, some neurological
disorders, heart disease, cancer and stroke –and also are
common symptoms of depression.
- Apathy, poor concentration and memory loss can occur in
individuals with Parkinson’s disease and Alzheimer’s
disease – and also are common symptoms of depression.
- Medications for high blood pressure, Parkinson’s disease,
and other medical problems can produce side effects similar to the
symptoms of depression.
Importance of Treatment
- People who get treatment for co-occurring depression often
experience an improvement in their overall medical condition,
better compliance with general medical care and a better quality of
life.
- More than 80 percent of people with depression can be treated
successfully with medication, psychotherapy or a combination of
both.
- Early diagnosis and treatment can reduce patient discomfort and
morbidity, and can also reduce the costs associated with
misdiagnosis, and the risks and costs associated with suicide.
A simple, confidential screening test can help uncover
depression. For a free, confidential depression screening log on to
www.depression-screening.org or call 1-800-520-6373 to find a local
site.
Other Resources:
Contact your local Mental Health Association, community mental
health center, or:
National Mental
Health Association
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental Health Resource Center 800/969-NMHA
TTY Line 800/433-5959
NMHA's Campaign for America's Mental Health works to
raise awareness that mental illnesses are common, real and
treatable illnesses and ensure that those most at-risk receive
proper, timely and effective treatment.
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