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Depression

I'm Sarah Long with Doug Johnson, and this is the VOA Special English program SCIENCE IN THE NEWS.

This week -- we look at some recent news about depression. The findings appeared last month in a special issue of the Journal of the American Medical Association.

A new study finds that more than half of Americans with major depression seek treatment. Ten years ago, only one-in-three sought help. Yet many people who go for treatment do not receive enough care or the right care. In fact, the study says only twenty-one percent of all Americans with major depression get the kind of care that the government says they should.

The researchers questioned more than nine-thousand people age eighteen and older. The year-long study began in February of two-thousand-one.

Kathleen Merikangas is with the National Institute of Mental Health. She was one of the lead researchers of the study of depression in the United States. Mizz Merikangas says major depression is now the number one cause of disability in the general population across the world. She notes that heart disease was the leading cause of disability as recently as nineteen-ninety-six.

Mizz Merikangas says about sixteen percent of Americans suffer major depression at some point in their lives. That is more than thirty-million people. She says around thirteen-million experienced depression last year. Those numbers are about the same as they were ten years ago.

The study found that women have a fifty-six percent greater chance then men to become depressed at some time in their life. But this difference between men and women has gotten smaller over the years. Also, the study found that poor people and less-educated people have among the highest rates of depression.

The researchers say depression is more common in people ages eighteen to forty-four than in people over the age of sixty. Mizz Merikangas says that is possibly because older people have learned to accept their situation and better deal with the realities of life.

Most people who reported having depression in a given year said the sickness had a major affect on their lives. Mizz Merikangas says it can affect jobs, marriage, and parenting. Those with severe depression in the past year reported being unable to work or carry out other normal activities for an average of thirty-five days.

Ronald Kessler of Harvard Medical School led the study. He says many doctors may not know about new treatments for depression. Professor Kessler says research has shown that the best treatment is a combination of medication and help from doctors in dealing with psychological problems. He says treatment should be based on the individual. That is because no treatment works for everyone.

In the study, patients were considered to have been treated correctly if they met either of two requirements. If they received medicine, they received it for at least a month and met four times with a doctor. If they did not receive medicine, they met at least eight times for thirty minutes with a mental health expert.

Another study in the Journal of the American Medical Association reported about the cost of depression in the workplace. The researchers estimate that lost productive time from depression adds at least thirty-one-thousand-million dollars a year in costs for employers. The researchers questioned more than one-thousand American workers by telephone over a two-month period last year.

The study says workers without depression reported an average of one-and-a-half hours of lost productive time a week. But workers with depression reported more than five-and-a-half hours a week in lost productivity. The researchers say most of that time is lost through reduced performance while the employees are at work.

Researchers from the AdvancePCS Center for Work and Health in Maryland led the study. Eli Lilly, the company that makes the antidepressant drug Prozac, provided money for the research.

Many depressed people continue to go to work. But the researchers say these people do not perform at their normal level. Many are unable to think clearly or get along well with others in the workplace.

Yet many people still avoid treatment because they do not want others to know they are depressed. Some people who do seek treatment stop their medicine before they are supposed to. Still others do not get enough medicine. And there are generally more doctors and other resources to help people who live in cities than those in less populated areas.

Depression is often difficult to recognize. So it can often go untreated. Experts say many employers do not take the disorder as seriously as they would other sicknesses. The experts say interventions such as employee assistance programs and groups that help people deal with depression are ways to help.

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Depression affects not just the mind but also the body. The symptoms include feelings of sadness, hopelessness, not wanting food and trouble sleeping. Depression has been linked to other disorders, including heart disease.

Researchers now say the risk of death is three times greater in people who have heart attacks and later develop depression. That is compared to those who have heart attacks and do not develop depression. It is the same level of risk as from smoking.

Depression can also run in families. Health experts say depression is the main reason people kill themselves.

It is hard to tell if someone is depressed. Doctors do not always ask patients with possible symptoms. Researchers say doctors who do not have special training in mental health may not recognize the signs or do enough to treat them. Also, some health plans may limit the ability of patients to receive the expert care they need.

Another report in the Journal of the American Medical Association deals with depression among doctors. It says that doctors often fail to recognize depression in themselves and seek treatment. Studies have found that doctors have a greater risk of suicide than the general population. Yet fewer doctors die from cancer and heart disease than the general population. Experts say that is because cigarette use dropped among doctors when they recognized the dangers of smoking.

Researchers say all these findings show that depression must be taken more seriously. Doctor Thomas Insel [IN-suhl] is director of the National Institute of Mental Health. He notes that about thirty-thousand people a year in the United States kill themselves. That is almost twice the number as those killed by others. Doctor Insel says there is no scientific reason to treat mental disorders any differently than physical disorders.

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There are drugs that doctors use to treat depression. But in developing countries, not many people are able to get these antidepressants. Paul Bolton is a professor at the Johns Hopkins University School of Public Health in Baltimore, Maryland. Mr. Bolton says the drugs are too costly, have a lot of side effects and must be taken for a long time -- months to years. He says that in developing countries, the best medicine may be just to have people talk about their problems.

Professor Bolton led a study of depression in Uganda. The Journal of the American Medical Association included the results in its special issue last month on depression.

His team studied two-hundred-twenty-five Ugandan men and women. They went through four months of treatment. Each week they met in groups led by the researchers. The researchers found that eighty-six percent of the people had signs of major depression. After the therapy, only seven percent of the people still had those signs.

Paul Bolton calls the early results very promising. He says he and his team still do not know what it was about this intervention that worked. Perhaps the important part was meeting in groups and talking. He says he feels this study has demonstrated that it is possible to have few resources and still be effective.

SCIENCE IN THE NEWS was written by Cynthia Kirk and Nancy Steinbach. Our producer was Cynthia Kirk, with audio assistance from Dwayne Collins. This is Sarah Long. And this is Doug Johnson. Join us again next week for more news about science in Special English on the Voice of America.


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