Lisa Keating: Depression in America

In recent months, depression has been a focus in the press, and this is why: About one in 10 Americans now report suffering from depression. The National Institute of Health reports that these numbers translate to about 14 million Americans who experience depression and that depression is now one of the top 10 chronic health problems nationwide.Depression is particularly important to treat not only because of the unhappiness and dysfunction it causes people in their everyday life, but also because it can lead to other serious physical illnesses. For this reason, medical professionals are now screening for, and treating depression, more than ever before.The debate now is how best to treat depression. A concerning trend, according to the American Psychological Association, is that the number of people taking antidepressant medication increases each year, while the number of people seeking psychotherapy or counseling for depression, decreases. According to Consumer Reports, U.S. doctors prescribed $9.9 billion worth of antidepressants in 2009. Yet, only one-third of people taking one antidepressant medication, and less than half of those taking multiple antidepressants, seek treatment from mental health professionals. (The pharmaceutical industry spends $4.2 billion a year in advertising!)Certainly, antidepressant medications have a place in the treatment of depression. Depression can range from mild, moderate to severe and some people also experience psychosis (a mental loss of reality) while depressed. Suicidal thoughts, and suicide, can arise when people are severely depressed. Traditionally, antidepressant medication and psychotherapy are typically used when people have more acute levels of depression and are almost always used when someone feels suicidal. However, mild to moderate cases of depression can often be successfully treated with just psychotherapy.If you see a therapist for depression you are likely to work on the underlying causes of depression, and to learn coping skills to handle sadness. Therapists typically help people identify negative and pessimistic thoughts and gradually change thinking to productive and hopeful thoughts. Aiding people to develop healthier lifestyles and healthier relationships is usually an important part of therapy as well. In the last couple of years, several major research studies showed that psychotherapy and lifestyle changes are much more effective in treating depression than antidepressant medications. Depression has a high treatment success rate.Psychotherapy typically lasts from two to 12 months and people go weekly or bimonthly to sessions. The changes people work on in therapy: finding someone they can talk to, reducing stress and conflict, increasing hopeful thoughts, and developing a regular exercise and eating routine, are changes that will dramatically improve the rest of your life.I am a psychologist, so, obviously, I have my biases and believe therapy should almost always be tried if someone is depressed. This seems even more important when a child or adolescent is depressed as research is beginning to indicate that treating depressed children and adolescents positively affects their life-long mental health.If you feel depressed, or if someone you care about is depressed, it is a serious condition and should be treated as such. Always talk with your physician about depression and the possibility of taking medications. Equally important, though, is finding a mental health professional in our community who can help you. • Lisa Keating, Ph.D., is a Carson City clinical psychologist.