Depression is a Global Healthcare Issue and one of the most common mental health issues in the world (WHO, 2012). There are an estimated 350 million people globally suffering from depression (WHO, 2012). In 2005 to 2006, one out of every 20 Americans reported currently having depression (Pratt & Brody, 2008). Depression is even more common among persons 65 years and older, with one in six suffering from depression (CMS, 2013). Depression is usually characterized with feelings of sadness, loss of interest or pleasure, feelings of guilt, hopelessness, low self-worth, disturbed sleep or appetite, fatigue or tiredness, and poor concentration. Another serious and often dangerous symptom is thoughts of death and suicide. Every year over 800,000 (1.4% of global deaths) people commit suicide and depression is one of the leading causes for suicide attempts (WHO, 2014).
Depression is different from the normal changes in mood that we experience day to day. It is a complex interaction of social, psychological, and physiological mechanisms. Depression results in long-lasting and intense symptoms that cause substantial challenges to everyday life. These symptoms can result in lasting periods of impaired ability to engage in the activities that typically hold worth and value in our lives. Depression often results in difficulties at work, school, relationships, and daily life. Moreover, depression is the leading cause of disability in the word and can also impact physical health problems (WHO, 2012). Depression has been shown to decrease the quality of someone’s health more than diabetes, asthma, and arthritis (WHO, 2007).
Effective treatments for depression include psychosocial support, antidepressant medications, and psychotherapy. There are several types of psychotherapy for depression with some including cognitive behavioral techniques, interpersonal psychotherapy, or problem-solving based treatments (WHO, 2012). It is often recommended to utilize a combination of these treatments to gain the most benefit, particularly for moderate or severe depression. Treating depression requires collaborative care that often begins at the primary care level and includes healthcare providers as much as the person suffering from depression and their families (Unützer et al, 2001). Even though there are effective treatments for depression fewer than half of people with depression receive treatment (WHO, 2012). A crucial aspect to getting appropriate treatment is accurate screening and diagnosis.
Depression is usually diagnosed by trained healthcare providers and often in primary care settings (WHO, 2012). One of the most common screeners for depression is called the Patient Health Questionnaire (SAMHSA, 2014). This screener is available in a nine question and two question format and is a self-administered tool to assess for depression. It only takes minutes to complete and can provide helpful information to healthcare providers including primary care clinicians that may only have moments to assess for various healthcare needs. It is available free of cost and has been reproduced in many languages. However, formal screening or diagnostic evaluation are only part of the effort to address the global issue of depression. Increasing awareness and reducing the stigma of depression and other mental health issues are also important undertakings.
Leonardo J. Caraballo, PsyD
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