About Depression
Globally, depression is responsible for more people with disability than any other condition. According to the World Health Organization, approximately 350 million people suffer from depression, which is one of the primary causes of disability. It takes ninth place as the origin of mortality after cardiovascular diseases, stroke, and HIV infection. Generally, depression is widely undiagnosed and not treated. One of the reasons, there is still stigma and a lack of therapies and a lack of mental health resources. Additionally, some clinical studies have shown that patients with depression do not have a satisfactory therapeutic outcome.2
Clinically, depression is present as primary morbidity or associated as co-morbidity in one of every four people with diabetes mellitus type 2,3 and patients with multimorbidity including disability.4 Depression is a frequent complication after stroke,5 cardiovascular diseases.6 Generally, depression is present in the population of the elderly but still stays undiagnosed and improperly treated in the clinical setting.7-9 Indeed, depression is a prevalent and fatal disorder, and approximately one in five adults in the U.S. have at least one severe episode of major depression in their lifetime.10
Major depression is a common, disabling condition seen predominantly and treated first in primary care practices. Some severe medical conditions, including visible and invisible disability, sleep disorders, grief, and other psychiatric conditions, can co-occur and mimic the symptoms of major depressive disorder. Indeed, healthcare providers should assess these conditions when diagnosing major depressive disorder and consider co-morbid conditions to tailor management interventions.11 However, in some cases, antidepressant therapy requires more attention from healthcare providers. Multiple changes of antidepressant treatment without success can suspect drug-resistant depression. Further diagnostic tests such as combinatorial pharmacogenomic tests should be considered to prevent a severe episode of depression when a patient suffers from frequent suicidal thoughts.
Personalized medicine in psychiatry hopes to escape the current standard trial-and-error approach to treatment, moving to a more advanced method that augurs a new era for patients and clinicians alike.12
Respectfully,
Holistic Healthful
References
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2. Cui R. A Systematic Review of Depression. Current Neuropharmacology 2015;4:480.
3. Semenkovich K, Brown ME, Svrakic DM, Lustman PJ. Depression in type 2 diabetes mellitus: prevalence, impact, and treatment. Drugs 2015; 6:577-87.
4. Stanners MN, Barton CA, Shakib S, Winefield HR. Depression diagnosis and treatment amongst multimorbid patients: a thematic analysis. BMC Fam Pract 2014;15:124.
5. Lewin-Richter A, Volz M, Jöbges M, Werheid K. Predictivity of Early Depressive Symptoms for Post-Stroke Depression. J Nutr Health Aging 2015; 7:754-758.
6. Seligman F, Nemeroff CB. The interface of depression and cardiovascular disease: therapeutic implications. Ann N Y Acad Sci 2015;1345: 25-35.
7. Alexopoulos GS. Depression in the elderly. Lancet 2005; 9475:1961-70.
8. Allan CE, Valkanova V, Ebmeier KP. Depression in older people is underdiagnosed. Practitioner 2014;1771:19-22.
9. Forlani C, Morri M, Ferrari B, Dalmonte E, Menchetti M, De Ronchi D, Atti AR. Prevalence and gender differences in late-life depression: a population-based study. Am J Geriatr Psychiatry 2014; 4:370-80.
10. Hirschfeld RM. The epidemiology of depression and the evolution of treatment. J Clin Psychiatry 2012;1:5-9.
11. Bentley SM, Pagalilauan GL, Simpson SA. Major depression. Med Clin North Am 2014; 5:981-1005.
12. Nemeroff CB. The State of Our Understanding of the Pathophysiology and Optimal Treatment of Depression: Glass Half Full or Half Empty? Am J Psychiatry. 2020 Aug 1;177(8):671-685. doi: 10.1176/appi.ajp.2020.20060845.