Today, it seems that everyone knows someone suffering from depression. From Charlie Brown to Tony Soprano, depression has become the equivalent of the common cold for mental-health disorders. The National Institute of Mental Health estimates that 16.5 percent of the adult population in the United States will experience a depressive episode sometime during their lifetime. Given the possibility that it might affect you or someone you know, it’s important to have a general understanding of this complex disorder to make the best decisions possible about care and treatment.
Depression is categorized as a mood disorder and thought to be brought on by changes in the brain’s chemistry usually associated with low serotonin levels. Serotonin is a neurotransmitter that relays messages throughout the brain — especially the areas that control mood, sleep, memory and appetite. When this occurs for periods lasting more than two weeks, symptoms normally appear, including: an inability to concentrate, decreased energy, insomnia, persistent sadness, loss of appetite or overeating. Depression can be triggered by numerous events, including the loss of a loved one, living in chronic pain or with chronic illness, substance abuse, physical abuse, genetics, certain medications or other personal problems.
Unlike physical illness, depression can be hard to detect. Symptoms among the elderly, such as fatigue or lack of appetite, are often attributed to the aging process itself. Depression in teens can manifest itself as anger, which parents attribute to age-appropriate teen angst or a phase in their development that will pass. Sometimes, men can successfully hide their depressive symptoms or they may withdraw from behaviors or hobbies that they previously enjoyed.
A stigma that is attached to depression is another reason why it often remains undetected. It’s not uncommon to hear those with depression continually encouraged to "snap out of it." Sadly, these misguided efforts often reinforce the shame and embarrassment many individuals already experience. In worst-case scenarios, the sense of isolation and helplessness felt by the person can lead to suicide.
There are, however, many effective ways to deal with depression, and with the right help and support, people often return to their normal lifestyles. One common approach involves the use of medications. Over the past 25 years, many antidepressant medications have been developed, and certain classes have been demonstrated to cause fewer side effects. It is not uncommon for people to undergo several adjustments in dosage or changes to their medication during the course of treatment.
There also are many lifestyle changes that can help. These can be done in combination with the use of medications or separately, depending on the severity of one’s condition and the advice of a trained mental-health professional. Some of these choices include exercise, talk therapy, stress reduction and developing a support system.
Exercise has been shown to increase serotonin levels in the brain, while talk therapy helps provide coping mechanisms. Stress reduction has been found to reliably ease symptoms and prevent the condition from worsening, while developing a support system successfully combats the isolation that often accompanies depression. Learning about these and other treatment options will help you decide what measures work best for your particular situation and needs.
Fidelis Care works with members to ensure they have access to the mental-health care and services they need. A dedicated call center for behavioral health issues is staffed by social workers and other specially trained employees. Fidelis Care also helps members access mental-health providers across the state, ensuring that individuals have convenient access to specialists who can help them determine the cause of their depression and develop a treatment plan. Ensuring that members receive follow-up care and ongoing support in their community also is key to successful treatment.
In summary, while there are no quick fixes or instant cures for depression, with the right treatment plan and lifestyle changes, individuals can resume their normal lifestyles and activities much sooner.
Engrassia is director of behavioral health for Fidelis Care, the health-insurance plan provider founded by New York state’s Catholic bishops.