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Even if MDD does not represent an immediate danger to the life of your patient, MDD can have far more harmful consequences than many other serious medical conditions. Consider the following:
- MDD is a leading cause of disability in the U.S. and worldwide
- In any given year approximately 9.5% or 19 million adult Americans have MDD, making it a very common mental health problem.
- More than 2 million Americans have bipolar disorder
- Nearly twice as many women as men are affected by mood disorders
- MDD often begins between ages 15 to 30 but also can occur in children
- While people of all races and social classes can have mood disorders, there appear to be cultural differences in how an individual's symptoms are expressed
- Mood disorders are often chronic disorders with symptoms sometimes better and sometimes worse
- Mood disorders are serious medical illnesses
- Mood disorders are treatable. More than 80% of people with major depression can be helped with appropriate treatment
MDD has high rates of comorbidity with other psychiatric disorders. While problems with depression often begin in young adulthood people often do not, if ever, seek treatment until many years later. As a result, adults with depression are at an increased risk for secondary psychiatric comorbidity, significant occupational and educational under-achievement, social impairment, and increased seeking of medical treatment.
It is unfortunate that people with major depression do not seek appropriate treatment because proven pharmacological and psychotherapies are available. Moreover, appropriate interventions can result in significantly reduced symptoms, disability, and health care utilization.
Current evidence suggests that first line treatment for MDD consists of appropriate pharmacotherapy, Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT) or Cognitive Behavioral Analysis System of Psychotherapy (CBASP). It is important to note that these treatments work very well when properly applied. Current evidence suggests that the most effective treatment in many cases is a combination of pharmacotherapy plus one of the psychotherapies. Unfortunately, although these psychotherapies can be very effective, they are often unavailable to many patients except in large urban areas or academic centres. Training opportunities for these psychotherapies are not widely available and training therapists to do psychotherapy well. Making these services available requires considerable resources.
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