DR. SHAIFALI SANDHYA

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Depression

Rates of Depression in Adults

 

According to the National Institute of Mental Health, 6.7% of the United States adult population or 14.8 million adults experience Major Depressive Disorder with 30.4% of cases considered to be severe as measured over a 12-month period.  Women are 70% more likely to experience depression throughout the course of their lifetime.  Approximately 51.7% of individuals suffering from major depressive disorder receive treatment.  The prevalence rate of all mood disorders in the United States is 9.5% or 20.9 million adults with 45% considered severe over a 12-month period.  Again, women are 50% more likely to experience a mood disorder over the course of their lifetime.  Approximately 50.9% of individual suffering from a mood disorder receive treatment (NIMH).

 

Rates of Depression in Children

 

According to the National Institute of Mental Health, the lifetime prevalence rate for adolescent children ages 13 to 18 is 11.2% with girls being more likely to experience the disorder.  The prevalence rate for adolescent children between the ages of 13 to 18 is 14% with girls being more likely to experience a mood disorder.  Approximately 4.7% of these cases are considered to be severe (NIMH). 

 

Rates of Depression Worldwide

 

Studying depression worldwide has many obstacles the most challenging of which is the fact that the definition of depression in based largely on Western cultural assumptions (Tsai & Chentsova-Dutton, 2009).  Nevertheless, the World Health Organization Global Burden of Disease Study ranked depression as the single most burdensome disease in the world when viewing total disability across the lifespan.  It is estimated that 350 million people worldwide suffer from depression.  Despite the existence of effective treatments, less than half of those impacted receive treatment.  In some countries it is estimated that fewer than 10% if individuals receive treatment (WHO, 2012).  Rates of depression have also been observed to be on the increase.  For example, the rates of depression in Japan have more than doubled according to Dr. Kawakimi of the University of Tokyo (WKC public health forum, 2011).

 

Research conducted with the World Health Organization World Mental Health Survey Initiation found that 15% of people suffering from depression are from high-income countries with a 5.5% lifetime prevalence rate. In contrast, 11% were from low or middle-income countries.  Episodes of major depressive disorder were also elevented in high-come counties with rates as high as 30% in France, the Netherlands, and America and as high as 36% in India.  The lowest rates of depressive episodes were found in China, where the rate was at 12% (Biomed, 2011). 
 

Treatment of Depression

   

A variety of treatments are available for Major Depressive Disorder.  Although medication alone can reduce symptoms, the inclusion of psychotherapy is generally found to provide the most effective and sustained response.

 

Drug treatment of depression involves the use second-generation antidepressants including selective serotonin inhibitors, monoamine oxidase inhibitors, atypical antidepressants and tricyclic antidepressants. 

 

There is a range of psychotherapeutic approaches that are effective in the treatment of Major Depressive Disorder. These include behavior and cognitive-behavioral therapy, interpersonal psychotherapy, psychodynamic psychotherapy, support psychotherapy, mindfulness-based cognitive therapy, family therapy, and group psychotherapy. 

 

Depression in Children

 

Single episodes of sadness are a normal part of life for all children.  Indeed, there are many times when children experience subjective distress that is short term and largely situational in nature.  Major Depressive Disorder has rarely been assessed in infants and is fairly uncommon amongst very young children.  The rates of depression also vary depending on the type of depression and the age of the child.  It can also be difficult to assess whether or not a child meets the criteria for a diagnosis.  Nevertheless, rates do seem to increase during adolescence (Garber, Gallerani, & Frankel, 2009). 

 

The understanding of depression in children and adolescents has grown immensely over the past decade.  Children has been observed to experiences sadness as well as other observable symptoms including irritability, sleep disturbances, eating problems and decreased energy.  Although such observations have been made in children as young as infants, the existence of clinical depression in infancy is still debated.  The commonly understood symptoms of depression in adulthood must be viewed differently when considering the manifestation of depression in children.  For example, dysphoric mood is more commonly expressed through irritability and the length of dysthymic mood is shorter in duration.  It is generally agreed that children may also differ from adults in their express particular symptoms.  For example, children may be more prone to excessive crying when very young, less talkative and withdrawn when somewhat older, and irritable in adolescence.  This is likely the result of variation in development and at he differing ability of a child to understand the affective and cognitive experiences of depression.  Despite this, the assertion that depression will look categorically different across the lifespan is still debated (Garber, Gallerani, & Frankel, 2009).