Facts about chronic depression

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Chronic depression, also known as major depressive disorder, will affect nearly 17 percent of U.S. adults -- more than 45 million people -- at some time in their lives. In any given year, about 7 percent of the population has the disorder.

The World Health Organization now ranks depression as the leading cause of disability worldwide, affecting more than 350 million people.

There is a substantial gender gap in depression, with about twice as many women as men suffering from the disorder. Scientists are still trying to figure out why, but they do not believe it is simply because women are more likely to seek help or admit having the disease.

About 40 percent of people who are depressed don’t seek treatment, some because of the stigma of admitting to having the illness. As one severely depressed patient told the Post-Gazette, “I still feel a great deal of shame and embarrassment. I still have that sense that I should have been able to fix it.”

Antidepressant drugs are still the leading treatment for the disease, although they are not very effective for milder forms of the disorder. In one of the largest real-world trials of antidepressant treatment, the Sequenced Treatment Alternatives to Relieve Depression (STAR*D), only about 30 percent of people with depression who initially took a standard antidepressant had complete remission of their symptoms. In those who went on to a second phase of the trial, where they either switched medications or added a drug or psychotherapy to their existing treatment, just 25 percent achieved remission.

Studies have shown that certain types of talk therapy, particularly cognitive behavioral therapy and interpersonal therapy, are almost as effective as antidepressants.

Still, for those who are resistant to standard treatments, the outlook can be gloomy. As the STAR*D summary put it, “Patients with difficult-to-treat depression can get well after trying several treatment strategies, but the odds of beating the depression diminish with every additional treatment strategy needed.”

Mark Roth:, 412-263-1130 and on Twitter: @markomar.

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