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10 Myths and Facts About Depression

1. Myth: Depression is a character flaw and is a sign of weakness.
Fact: Depression has nothing to do with strength of one’s character. It happens due to a complex interplay of biological and environmental risk factors and is a treatable condition like any other physical illness. With all the attached stigma, seeking help for depression is a sign of courage and not weakness.


2. Myth: Depression is just “having the blues.”
Fact: Depression is more just feeling sad or down in the dumps. The sadness is more persistent and pervades your day-to-day life and it, along with other symptoms of depression, makes it harder for you to function at your normal levels.

3. Myth: You can just “snap out” of depression.
Fact: Telling people with depression to just “snap out of it” never helps as depression, like other physical illnesses, takes time to heal. While treated episodes of depression lasts about three months, untreated depression may last from 6 to 13 months (Sadock et al., 2015).

4. Myth: Depression affects only women.
Fact: Although women are 1.5 to 3 times more likely to get depressed compared to men, men are not immune from it. According to the National Institute of Mental Health (NIMH), men may experience depression differently than women. While feelings of sadness, worthlessness, and excessive guilt are more common in women, men usually show signs and symptoms of extreme tiredness, irritability, lack of interest in once-pleasurable activities, and difficulty sleeping. In addition, men with depression are more prone for alcohol or drug use. Men may also avoid talking about their depression with relatives or friends and may turn to work as an escape, but ultimately becoming more frustrated, discouraged, and angry. Although suicide attempts are more common in women, more men than women actually die due to this reason in the United States.

5. Myth: Depression only affects adults.
Fact:  Depression does affect children and teenagers. The National Comorbidity Study found that 11.7% of the 10,123 surveyed adolescents aged 13-18 met diagnosis of either major depression or dysthymia (Merikangas et al., 2010). Of note, the rate of depressive disorders doubled in the 17-18 year age group compared to 13-14 age group. In contrast to adults, children and adolescents, when depressed, may experience irritability rather than sadness. While not all teenagers who are moody should be investigated for depression, but if the mood symptoms are persistent and exist with other symptoms suggestive of depression, then it may prudent to rule out depression.

6. Myth: If you have depression in your family, you will also develop depression.
Fact:  Depression, like diabetes and high blood pressure, is a heritable illness. However, genes alone account for about 37% of causality in depression and the rest is non-genetic, including environmental and physical factors (Flint & Kendler, 2014).

7. Myth:  Depression is only for losers or those who feel sorry for themselves.
Fact: Depression is an equal opportunity illness and cuts across nationalities, education level, social status, occupation, race, and culture. Celebrities, politicians, scientists, artists, and other professionals who have been successful in their respective fields have dealt with depression.  

8. Myth: Depression is a life-long illness.
Fact: Most individuals with depression do eventually improve. Recovery begins within three months for about 40% of people with depression and within one year for about 80% (Bentley et al., 2014). In one study, only 17% of people with depression had symptoms of depression when followed up at 39 months (Stegenga et al., 2012). While majority improve, some also tend to get recurrent episodes of depression.   

9. Myth: Depression can be diagnosed by a medical test.
Fact: Unfortunately, there is no medical test to diagnose depression like there are for diabetes or other medical conditions. Whereas you can try to self-diagnose depression using some internet-based rating scales, a formal diagnosis should best be left to a professional. This is important because a professional can rule out other psychological or medical conditions that can mimic depression.

10. Myth: Depression only responds to medications.
Fact:  Over the last few decades, the trend in print media has been to present depression as a bio-medical disorder rather than an entity caused by a variety of reasons (Clarke & Gawley, 2009). This in turn has perpetuated a belief that the antidepressants may be the only effective way of treating depression. While antidepressants alone may be more effective in more severe forms of depression, both cognitive-behavioral therapy and interpersonal psychotherapy are effective by themselves in mild or moderate depression (American Psychiatric Association, 2010). In addition, mindfulness-based cognitive therapy helps prevent future episodes of depression in people with multiple depressive episodes (Kuyken et al., 2012). A caveat when choosing therapy as a treatment modality for depression is to seek an expert trained in depression-focused therapy as there a lot of other therapies that are not helpful for depression.

To learn more about self-management techniques for depression, please refer to the evidence-based bestseller The Complete Guide to Self-Management of Depression: Practical and Proven Methods. This comprehensive and easy-to-read book offers the reader a menu of options to self-manage depression that go above and beyond the traditional approaches to treat depression and includes complementary and alternative medicine approaches, exercise, mindfulness, role of social support, and bright light therapy. Besides therapy techniques, the book also provides an evidence-based overview of the role medications in treating depression - when to take them, how long to take them, when and how to stop them, and what to do when medications stop working.


Hapreet Duggal, MD, FAPA


References:


American Psychiatric Association (2010). Practice guidelines for the treatment of patients with major depressive disorder (3rd ed.). Arlington, VA: American Psychiatric Association.

Bentley, S. M., Pagalilauan, G. L., & Simpson, S. A. (2014). Major depression. Medical Clinics of North America, 98, 981-1005. 

Clarke, J., & Gawley, A. (2009). The triumph of pharmaceuticals: the portrayal of depression from 1980 to 2005. Administration and Policy in Mental Health, 36(2), 91-101.

Flint, J., & Kendler, K. S. (2014). The genetics of major depression. Neuron, 81(3), 484-503.

Kuyken, W., Crane, R., & Dalgleish, T. (2012). Does mindfulness based cognitive therapy prevent relapse of depression? BMJ345:e7194. doi: 10.1136/bmj.e7194. 

Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the national comorbidity study-adolescent supplement (NCS-A). Journal of American Academy of Child and Adolescent Psychiatry, 49(10), 980-989.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). PhiladelphiaIn, PA: Wolters Kluwer. 

Stegenga, B. T., Kamphuis, M. H., King, M., Nazareth, I., & Geerlings, M. I. (2012). The natural course and outcome of major depressive disorder in primary care: the PREDICT-NL study. Social Psychiatry and Psychiatric Epidemiology, 47, 87-95.








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