Rates of depression and disability are increasing rapidly. Mental health disorders are extremely common across the globe. In one international study the United States, for example, had the second highest world wide rates for major depression, indicating that about 1 in 5 people will suffer from major depression at some time in their life and about 1 in 12 will suffer from major depression every year. (Bromet et al., 2011). The World Health Organisation estimates that 450 million people world-wide suffer from a mental health illness (WHO, 2001) yet they go relatively unnoticed by public health schemes. In 2013, Whiteford et al published an article discussing the global burden of disease attributed to mental health disorders. The study, using data from 2010, looked at how mental illnesses can cause a burden on the lives of those who suffer from them. This was assessed in terms of the number of years of their lives affected by the disability, including years of life lost due to premature mortality as a result of the disease. The study found that mental health disorders accounted for 22% of all years living with disability, and that the disability burden of mental health illnesses had risen 7.4% since 1990.
The authors found that depression was the specific mental health disorder which held the greatest burden of disease; it accounted for 40.5% of the disability-adjusted life years measured. That is, depression and disability had a huge impact on quality of life. It affected young adults to the greatest extent (in terms of disability-adjusted life years) but there was a strong rise in its burden from young childhood onwards. A small reduction in burden was seen after 25 years of age, but it still remained the greatest across all ages compared to other mental health disorders. Depression and disability was also found to have the greatest burden regardless of global region. Even in high income regions like the United States, the depression and disability rates were higher than any other mental or substance abuse disorder. This is not surprising in light of how frequently major depression occurs in the U.S.
These findings have extremely important implications for the diagnosis and treatment of depression, and show that it needs to be a priority for public health systems due to the debilitating effects depression has on the lives of those who suffer from it across the globe. Thankfully, attempts have been made to significantly reduce the burden depression creates. Reynolds et al (2012) looked at how depression could be prevented specifically in older adults due to the negative effects it can have on premature mortality, health, and how disabling it can be both in primary care and long-term medical settings. There is also an expected increase in the number of older adults in low-income countries to develop depression so preventing disorders in that population should be a priority. The authors propose that over 1-2 years, rates of ‘incident’ depression in older adults can be reduced by 20-25%, and that recurrent major depression can also be significantly reduced through both psychotherapy and psychopharmacology. They claim that the focus of therapy should be to increase protective factors; in other words, factors which can help to prevent the disease from occurring, including exercise and diet. They also praise therapies which promote self-efficacy and resilience. Cuijpers et al (2012) have suggested multiple ways in which depression can be reduced as a cause of global burden of disease; for instance, they implore academics to perform more research into how mental health disorders in general develop in order to promote an awareness of risk factors which will improve the efficacy of preventative interventions. They also suggest that the most effective way to reduce the global burden of depression is unknown, and that targeted research is direly needed which will focus on how to increase prevention whilst also keeping costs low. Reducing the costs of interventions is a very important step in reducing the global burden of disease.
It is unlikely that the burden of depression and disability will be reduced significantly without huge commitment from all those who have the power to help; from clinicians to government officials. It is however, hard to ignore just how important it is that attempts are made. If governments take into account the suggestions made by empirical research such as those above, policies can be put in place which significantly reduce the global burden of disease and help those who suffer to live more years of their lives without the burden of disability.
In the mean time, however, with 1 in 5 individuals likely to experience major depression in their lifetime, it is likely that you know someone who is depressed. Fortunately, although depression can be fatal, it is also a highly treatable disorder. Because our treatment center relies on evidence based practices, our Intensive Outpatient Program shares many common methods with other successful treatment methods. The foundation of our treatment program for relies on the principles of the stages of change, cognitive behavioral therapy, solution focused treatment, skills training and identifying repetitive dysfunctional behavioral relationship patterns to promote recovery from depression and other mental health disorders. In fact, our Intensive Outpatient Program in Memphis, TN that has been proven to be effective in the treatment of these disorders in six peer reviewed treatment outcome studies. Our treatment center provides services to those who need more treatment than one hour a week, but less than 24 hour care, by providing three hours of treatment per day, three to five days per week, in an intensive outpatient setting. If you or a loved one is showing signs of depression, they should be assessed by a trained mental health professional who can help design a treatment plan that can result in recovery. Treatment for depression can be highly successful. Call us at 901-682-6136 to schedule an appointment.