Recovery from most medical illness is difficult unless depression is recognized and treated.
Depression often co-exists with other illnesses. Major depression is one of the most disabling mental disorders in the U.S.. (read more: & see Huffington Post article). Diseases as diabetes, chronic pain problems, substance abuse, arthritis, hypertension and heart disease are frequently complicated by depression.
What is wrong with Peter’s father?
Ben, now 67, felt tired, sad and hopeless about life and things in general. He felt blue and empty and cried a lot. He felt cold all the time, with no energy, poor sleep and appetite. He wondered whether life was worth living. His son Peter was becoming more concerned, especially as his father was living alone after the death of his wife one year prior. Peter had his dad see his family physician who ran some test and referred him to an integrative psychiatrist. Ben was not suicidal, but was felt to have significant depression with associated grief from the loss of his wife. Tests showed that Ben was also severely hypothyroid (low thyroid) and had some nutritional deficiencies from his poor eating habits. He recovered from his depression with his active participation in therapy work and his coming to terms with his losses (death of his wife, retirement from his accounting career). Antidepressant medication was considered but felt not needed with Ben’s rapid improvement. He began thyroid hormone for his thyroid problems and nutritional support for his identified deficiencies. He joined several community support programs and moved into a smaller apartment which was near his son where several of his friends lived. Peter had offered his dad a place to live with his family, but Ben prized his independence and felt positive about getting back on his own two feet again. *(To protect confidentiality, the above is a composite of some clinical experiences and does not represent an actual person or any prior patients).
Effective identification and treatment of depression may bring:
- marked benefit in the form of medical improvement
- enhanced quality of life
- reduction in the degree of disability
- improvement in treatment compliance (see “Depression and Negative Health Outcomes” )
Depression is costly to everyone.
Health care money spent for depression in the United States, plus the cost of lost work, is enormous. Effective intervention for depression, when occurring with substance abuse or medical problems, lowers health care costs. (read more “Economic Impact of Depression” )
Depression can clearly predate a medical or addiction problem. It may also occur as a reactive response to illness related stress. Depression can also relate to the physiology of the illness or to the treatment interventions or medications. In neurological conditions such as Parkinson’s disease, multiple sclerosis, Alzheimer’s disease and strokes, the lifetime prevalence of depression is 30 to 60 percent*, compared to a much lower percent in the general population.
In diabetes, the lifetime prevalence of depression is double to triple that of the general population. It can cause increased insulin requirement and increase the risk of diabetic complications. People with coronary artery disease and depression are estimated to have a 40 percent* higher risk of having a cardiac event. Depression increases the risk of death from a heart attack five-fold* and is a significant predictor of disability one month after a heart attack or one year after coronary bypass surgery. Estimates of depression and cocaine dependence range from 33 to 53 percent*. Estimates of depression in alcoholics seeking treatment range from 15 to 67 percent*. Those who are dependent on opiates have rates of depression estimated as high as 75 percent*. ( read more & also to see additional information )
Early diagnosis and treatment of depression is critical in preventing and alleviating sickness, suffering, and possible death. Some studies suggest that in primary care settings, 30 to 50 percent* of depressed patients go unrecognized – and only about 20 percent* of those recognized receive adequate treatment. Health care providers, friends, family and employers all need to make a greater effort. Community education about key signs of depression is important.
Symptoms of depression include:
- loss of interest or pleasure in doing things
- often feeling down, hopeless or sad
- trouble sleeping or sleeping too much
- feeling tired or having little energy
- poor appetite or overeating
- frequently feeling bad about yourself
- trouble concentrating
- slowing down of speech or movements
- being fidgety or restless more than usual
- thoughts of dying or of hurting yourself
- difficulty functioning at home, work or getting along with people.
When suicidal feelings, thoughts or statements occur, get immediate help and assessment from a qualified mental health professional or resource. In U.S. for help, call 1-800-273-8255 for the National Suicide Prevention Lifeline.
An integrative approach to treatment gives the best chances for improvement or recovery.
Identification and treatment of contributing factors can be as important as taking an antidepressant medication or other remedies. Consultation, which may include specialized testing, may uncover:
- hormone deficiencies such as hypothyroidism
- deficiencies in nutrients as B12, folic acid, minerals, amino acids or essential fatty acids
- toxic environmental exposures such as to mercury or lead
- environmental illness such as allergies to mold
- food sensitivities as to wheat, gluten or diary
- other medical or addiction problems
People with depression, beyond simply taking an antidepressant pill or a natural remedy, can benefit greatly from social support, psychotherapy and other complementary approaches. Seek out help from qualified health professionals when needed – preferably those with a holistic orientation. Learn as much as possible about depression by seeking information, reading, or attending educational programs or support groups.
*(some statistics noted above are from Dr. Parks prior research on this topic without specific references given here, however, some recent articles and statistical references are presented in the links above)
Article by Ronald R. Parks, M.D., edited by Shan Parks
If you or a significant other has signs of depression, what would be your concerns and first steps to take? I’d be interested in your comments.