Pg. 97 Depression and Disease
Depression has a widespread and devastating impact on health. It is associated with disturbances in the endocrine, cardiovascular and immune systems as well as affecting bone health. The risk of coronary artery disease is three times higher among men with a diagnosis of depression; interestingly, there is no increased risk for women. After they have had a heart attack, depressed patients have a 3.5 increase in cardiovascular mortality. Applying new criteria developed by the World Bank, Harvard University, and the World Heath Organization, researches found that major depression is the leading cause of disability and lost days from work in developed countries, including the United States.
Pg. 101 Learning How Depression Works
We are much more successful at treating depression than understanding what causes it. Thomas Insel and Dennis Charney of the National Institute of Mental Health have identified some of the most important priorities for much-needed research on the biology and successful therapy of depression. These are their recommendations:
- Explore the identification of the genes that predispose to depression.
- Describe the systems of the brain involved in the regulation of mood; how the brain changes during the development of severe depression is unknown.
- Define the processes by which the brain recovers from depression, whether with the aid of psychotherapy or medication.
- Identify the experiences that put an individual at risk for depression. These include stress, loss, and abuse, whether in childhood or in adult life; often the impact of these experiences seems to be dormant for years but takes a dreadful toll later in life.
- Fill the need for new treatments: Existing medications take at least three to four weeks to reduce symptoms and require long-term administration to prevent relapse.
- Create better strategies for identifying the individuals at risk for suicide. Targeted, sex-specific methods of treatment are essential.
- Teach physicians that depression is a component or cause of widespread disability and that the treatment of cardiovascular disease, a compromised immune system, and diabetes, among other illnesses, must addresses depression as a cardinal component of illness.
- Significantly improve the treatment of the depressed patient by physicians: Only 25 percent of patients receive appropriate medicine therapy.
The first principle in combating depression is to acknowledge feelings of apathy, loss of pleasure, sadness or even apparently baseless general feelings of irritability and easily provoked anger. Our usual patterns of behavior change too – sometimes in unanticipated directions. Changes in sleep patterns or appetite, an upswing or dip in sexual activity, are all signs that “we are not ourselves”.