Everybody has sad moments in life, but according to the Mayo Clinic, a lasting and debilitating sadness that impacts one’s ability to function normally in daily life may be depression. Compiling information on Americans aged 18 and older, the 2006 National Survey on Drug Use and Health (NSDUH) found that nearly 16 million people experienced a major depressive episode in the past year, and more than 30 million experienced one in their lifetime. Past-year rates were highest for people aged 26 to 49, of which 16% had an episode. Unfortunately, as ABC News reported in 2007, half the people who meet the clinical criteria for depression do not receive treatment for it. Many make the mistake of trying to hide the depression or thinking it will go away on its own.
What Is Depression?
Some people may hide their depression because they dismiss it as a passing phase or do not recognize the symptoms. The National Institute of Mental Health (NIMH) website describes several potential symptoms of depression, which include the following:
- Chronic sadness, pessimism, anxiety and hopelessness
- Substantial loss of interest in hobbies and social interactions
- Difficulties with concentration, eating, sleeping and making decisions
- Decreases in energy, motivation, happiness and fulfillment
There are two main groups of mood disorders, depression and bipolar, which both involve depressive episodes. Variations of depression may have additional symptoms like psychosis, seasonal episodes and persistent symptoms lasting more than two years, while bipolar, or manic depression, typically involves sweeping shifts between excessive sadness and elation.
In discussing the difference between depression and bereavement, a 2013 fact sheet related to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) explained that loss tends to cause alternating waves of painful grief and positive memories, while depressive moods tend to be exclusively negative. The NIMH adds that the cause of depression is likely a mix of genetic, biological, psychological and environmental influences.
Overcome Depression Stigma
In 2009, PBS noted that untreated depression is the leading cause of suicide, and the rate of depression-related suicide is four times higher for men. Experts attribute the difference to a clash of male stereotypes and stigmatized perceptions of weakness. Stigma is a negative and false association based on misconceptions and mental health prejudice, and it is arguably the main reason people hide their depression. The National Alliance on Mental Illness (NAMI) makes several key points about mental health disorders, including the following:
- Mental health disorders are serious medical illnesses that willpower cannot overcome
- Depression is not related in any way to a person’s character, strength or intelligence
- Untreated disorders can lead to joblessness, incarceration, suicide and substance abuse
- Stigma erodes the belief that depression is a real disorder that needs treatment
- The World Health Organization estimates that depression will be the leading cause of disability for women and children by 2020
- 70% to 90% of depressed patients show significant improvement with professional help, but early identification and treatment is vital
One of the best ways to overcome misinformed stigma is to become informed about mental health disorders and the treatment options available. Depression involves physical chemical changes in the brain, and telling depressed people to toughen up is like telling someone with a broken foot to walk it off.
Depression and Substance Abuse
Trying to hide depression can also increase a person’s risk of addiction. A study published in the Archives of General Psychiatry in 2002 found that the brain reward system in depressed individuals experienced 3.4-fold greater reward from amphetamine use than a control group. The researchers concluded that hypersensitive responses in depressed individuals significantly increase their susceptibility to addiction. Several other studies also highlight the association between depression and addiction, including the following:
- The National Institute on Drug Abuse (NIDA) in 2007 said up to 60% of addicts have a co-occurring mental health disorder
- The 2011 National Survey on Drug Use and Mental Health (NSDUH) argued that people with mental health disorders were three times more likely to be substance abusers
- The American Journal of Psychiatry suggested in 2005 that neurobiological changes from drug abuse share common elements with mental health abnormalities
- Substance Abuse and Mental Health Services Administration (SAMHSA) notes that substance abuse can potentially induce mood disorders like depression
The Journal of Substance Abuse Treatment in 2006 examined what types of mental health disorders had the high prevalence of co-occurring addiction. Mood disorders, i.e., depression and bipolar, topped the list with 40% to 42%, followed by anxiety and post-traumatic stress disorder (PTSD) at 24% to 27%. Likewise, a 2011 NIH report noted the reciprocal relationship between the two issues: substance abuse can unmask or accelerate mental health disorders, while the disorders can motivate substance abuse as an ill-advised way to self-medicate.
How to Get Help for Depression
Professional treatment is the most effective way to deal with depression or bipolar, and most treatment centers can provide integrated care for co-occurring addictions. A protocol paper by SAMHSA in 1998 emphasized the need to address multiple conditions (e.g., depression and addiction) at the same time to facilitate a more effective recovery. Both inpatient and outpatient treatment typically use multiple therapeutic approaches, which often include behavioral therapies, individual and group sessions, relapse-prevention strategies, anger and stress management, motivational tools, family counseling and life skills development. Using the most effective modern therapies makes a significant difference in reducing or eliminating depression.