Dear Dr. Roach • Could you say something about depression? What can it do to you in the long run if it isn’t treated? — Anon.
Answer • Depression is a huge topic. There are many types of depression, and the effects of depression on a person depend in large part on age, sex, pregnancy status and many other unique characteristics of a person.
Depression is one of the most important conditions that doctors diagnose and treat. Major depression is the second leading cause of disability among all diseases and injuries. Nonetheless, many people are embarrassed to talk about it, tell their doctors about it or get treatment. Short screening tests for depression are available, and people at risk for depression can use a longer instrument, the PHQ-9, widely available to help diagnose and monitor treatment for depression.
Treatment for depression is pretty effective. Initial treatment of people with mild to moderate depression is effective (resulting in response or remission) in about 60% of people affected. Most primary care doctors, including family doctors and internists, are comfortable treating their patients with mild or moderate depression. Some people will need additional treatment, and those with severe depression or who do not respond to initial therapies will benefit from seeing an expert, such as a psychiatrist. Treatment is more effective when begun promptly after symptoms begin. However, some people have difficulty recognizing their symptoms as being due to depression, in addition to the barriers to treatment I mentioned above.