Growing 1, September 29, 1994
Depression: Bad News & Good News

Featured Writer: R. Cotton Fite, Ph.D., Licensed Clinical Psychologist

Life was never meant to be all happiness. When important relationships become painful, stress becomes chronic, jobs are lost or disappointments add up, anyone can become discouraged... even “depressed.” In everyone’s life, there are times when we are “blue” or “down in the dumps.” That’s normal. And we all find ways to work through it. We talk with a friend, give ourself a little slack to be angry or sad, draw upon spiritual resources, realize that life will continue in spite of whatever has happened. This kind of depression is a normal part of life. So is getting over it.

Clinical depression is something else. It doesn’t give way to some of the normal remedies. It lasts longer, has more debilitating symptoms and generally interferes with a person’s normal social and vocational functioning.

There are some clear warning signs. A depressed mood is obviously one of them. Another is a loss of interest in pleasurable activities. Constant fatigue, feelings of worthlessness and hopelessness, inability to concentrate, changes in appetite and sleep patterns are other signs. If these symptoms persist for more than two weeks, help should be sought.

The bad news—clinical depression is a very common illness that affects 1 in 20 Americans every year.
The tragedy in America is that so many people suffering from clinical depression never get help. Many believe that depression is a moral failure or personal weakness. It is neither; it is an illness. Even more tragic is the fact that this illness probably underlies the majority of suicides-the eighth leading cause of death in America.

Clinical depressions are not all the same. The most severe and common depressions are called major depressions. Dysthymia, the second most common type, is less severe but tends to be chronic and therefore may be more debilitating. It often goes unnoticed because its onset is gradual and its symptoms do not cause major impairments. The other one to know about is called a bipolar or manic-depressive illness. Depressions are interspersed with periods of recklessness and exhausting “highs;” and the oscillation between these two extremes can bewilder friends and family.

The good news—clinical depression is one of the most treatable illnesses.
Between 80 and 90% of all depressed people respond positively to the right kind of treatment. The major treatments include medications which act upon the brain chemistry to relieve symptoms, and psychotherapies which focus on internal conflicts, interpersonal problems or negative mental attitudes toward oneself and/or the world. Quite often medication is combined with psychotherapy for the most effective results.

If you, or someone you love, show signs of a clinical depression, the first step is to seek help. Have a physician or knowledgeable mental health professional evaluate your condition. If treatment is prescribed, stick with it. Most medications take several weeks to take effect, and they are not addictive. Sticking with the psychotherapy will not only help treat the illness, it may also prevent a recurrence.

Family and friends can help someone through a depression by:

	encouraging them to stay with their treatment,
	being patient and understanding,
	providing them the hope they have temporarily lost.

Most of all and best of all, we can just be with each other, through the normal ups and downs of life—as well as through the more serious clinical depressions which can strike any one of us.

R. Cotton Fite, Ph.D.

Mental Illnesses are a Matter of Fact
What are the Facts? Test your knowledge with the following quiz:

1. How many adult Americans each year experience a mental illness?
1. Unknown
2. 40,000
3. 400,000
4. 40 million


2. How many American children will develop a mental or behavioral disorder?
1. None—they all get the care they need
2. 12 million
3. 120,000
4. 12,000


3. What percentage of Americans over 65 suffer from significant symptoms of mental illnesses?
1. More than 15%
2. Less than 1%
3. None
4. 10%


4. How many Americans each year suffer from substance abuse problems?
1. 18,000
2. 180,000
3. 1,800
4. Nearly 18 million

Let’s talk facts about mental illnesses.

Answers: 1, d; 2, b; 3, a; 4, d

The facts are...
Mental illnesses strike across all social and racial boundaries:

	They account for more “sick” days—people not at work and in bed—than any illness except for cardiovascular disease.
	Of the 30,000 Americans who commit suicide each year, a majority suffer from a mental or addictive disorder.
	More than 7% of people held in the nation’s jails (excluding prisons) are seriously mentally ill, suffering from schizophrenia, manic-depressive illness and other severe disorders.
	Nearly one-third of homeless people have a severe mental illness.

In 1988, mental illnesses and substance use disorders cost the nation more than $273.3 billion in direct medical care and economic and other losses, including:

	$207.7 billion in indirect costs (lost and reduced productivity in the workplace, lost earnings due to premature death, and other costs such as law enforcement.)
	$65.6 billion in treatment-related costs.

A more recent study indicates that depressive illness alone costs society $43.7 billion annually, of which 55% is paid directly by American business through lost income due to depression-related absenteeism and reduced productivity.

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