Depression and suicide is off the radar for most of us but major depressive disorders affect almost one in ten individuals and account for $80 billion dollars in medical expenses and lost productivity. Tragically depression and suicide disproportionately affect the young, military and LGBTQ communities. 30% of college students report feeling depressed disrupting their ability to function in school. The involvement of the young makes the need to combat this often silent killer and cause of untold suffering more pressing. For the 10% of adolescents suffering major depressive disorders, another 10% have mild to moderate symptoms.
Adding to the problem of the large number of individuals suffering in silence is the appalling lack of services for mental health/ behavioral/substance abuse issues. Less than half of adults and children in need of services get treatment, services or support. While the ACA requires coverage, too many fall through the cracks.
The United State Preventative Services Task Force (USPSTF) has recommended more comprehensive screening for depression http://goo.gl/ra1gBv. Fortunately depression remains treatable and meaningful interventions can be employed. The recommendations by the USPSTF are directed at health care providers especially because two thirds of patients with depression present with somatic complaints. In addition, there is a real opportunity for all of us to become screeners for depression and suicide. Simple questions can reveal possible depression including loss of interest or pleasure in doing things, feeling hopeless, poor appetite, sleep disruption, lack of energy and feelings of suicide as well as others. As a society we need to educate and inform the public about mental illness and substance abuse to destigmatize the conditions. Lastly, each of us can make a difference; if you notice a friend, family member or colleague behaving in a way which raises the specter of depression, especially in a high risk group, ask how they are feeling. You could be saving a life.
Nicolas Argy, MD, JD