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Co-occurrence of Depression and
Other Illnesses
Excerpts reprinted courtesy of NIMH
For full text of these articles please go to http://www.nimh.nih.gov/publicat/index.cfm#disinfo
Depression frequently co-occurs with a variety of other physical illnesses,
including heart disease, stroke, cancer, and diabetes, and also can increase
the risk for subsequent physical illness, disability, and premature death.
Depression in the context of physical illness, however, is often unrecognized
and untreated. Furthermore, depression can impair the ability to seek
and stay on treatment for other medical illnesses. NIMH research suggests
that early diagnosis and treatment of depression in patients with other
physical illnesses may help improve overall health outcome.
NIMH is planning to present a major conference with other NIH Institutes
on depression and co-occurring illnesses. The outcomes of this conference
will guide NIMH investigation of depression both as a contributing factor
to other medical illnesses and as a result of these illnesses.
Depression Facts
Depression is a serious medical condition that affects thoughts, feelings,
and the ability to function in everyday life. Depression can occur at
any age. NIMH-sponsored studies estimate that 6 percent of 9- to 17-year-olds
in the U.S. and almost 10 percent of American adults, or about 19 million
people age 18 and older, experience some form of depression every year.4,5
Although available therapies alleviate symptoms in over 80 percent of
those treated, less than half of people with depression get the help they
need.5,6
Depression results from abnormal functioning of the brain. The causes
of depression are currently a matter of intense research. An interaction
between genetic predisposition and life history appear to determine a
person's level of risk. Episodes of depression may then be triggered by
stress, difficult life events, side effects of medications, or other environmental
factors. Whatever its origins, depression can limit the energy needed
to keep focused on treatment for other disorders, such as cancer.
Depression and Heart Disease
Depression can strike anyone. However, research over the past two decades
has shown that people with heart disease are more likely to suffer from
depression than otherwise healthy people, and conversely, that people
with depression are at greater risk for developing heart disease.1 Furthermore,
people with heart disease who are depressed have an increased risk of
death after a heart attack compared to those who are not depressed.2 Depression
may make it harder to take the medications needed and to carry out the
treatment for heart disease. Treatment for depression helps people manage
both diseases, thus enhancing survival and quality of life.
Heart disease affects an estimated 12.2 million American women and men
and is the leading cause of death in the U.S.3 While about 1 in 20 American
adults experiences major depression in a given year, the number goes to
about 1 in 3 for people who have survived a heart attack.4,5
Depression & Cancer
As with other serious illnesses, such as HIV, heart disease, or stroke,
cancer can be accompanied by depression, which can affect mind, mood,
body and behavior. Treatment for depression helps people manage both diseases,
thus enhancing survival and quality of life.
About 9 million Americans of all ages are living with a current or past
diagnosis of cancer.1 People who face a cancer diagnosis will experience
many stresses and emotional upheavals. Fear of death, interruption of
life plans, changes in body image and self-esteem, changes in social role,
lifestyle, and medical bills are important issues to be faced. Still,
not everyone with cancer becomes depressed. Depression can exist before
the diagnosis of cancer or may develop after the cancer is identified.
While there is no evidence to support a causal role for depression in
cancer, depression may impact the course of the disease and a person's
ability to participate in treatment.
Depression and Diabetes
Depression can strike anyone, but people with diabetes, a serious disorder
that afflicts an estimated 16 million Americans,1 may be at greater risk.
In addition, individuals with depression may be at greater risk for developing
diabetes. Treatment for depression helps people manage symptoms of both
diseases, thus improving the quality of their lives.
Several studies suggest that diabetes doubles the risk of depression compared
to those without the disorder.2 The chances of becoming depressed increase
as diabetes complications worsen. Research shows that depression leads
to poorer physical and mental functioning, so a person is less likely
to follow a required diet or medication plan. Treating depression with
psychotherapy, medication, or a combination of these treatments can improve
a patient's well-being and ability to manage diabetes.
Depression and Parkinson’s Disease
Depression can strike anyone, but people with Parkinson's disease, a progressive
brain disorder affecting more than 500,000 Americans,1 may be at greater
risk. Treatment for depression helps people manage both diseases, thus
improving the quality of their lives.
The true prevalence of depression among people with Parkinson's disease
is difficult to determine because there are no standardized assessment
tools designed to evaluate depressive symptoms in the context of this
illness. However, it is estimated to be quite common—as many as
half of people with Parkinson's may suffer from depression.2
Depression and Stroke
Depression can strike anyone, but people with serious illnesses such as
stroke may be at greater risk. Appropriate diagnosis and treatment of
depression may bring substantial benefits to persons recovering from a
stroke by improving their medical status, enhancing their quality of life,
and reducing their pain and disability. Treatment for depression also
can shorten the rehabilitation process, lead to more rapid recovery and
resumption of routine, and save health care costs (e.g., eliminate nursing
home expenses).
Stroke can occur in all age groups and can happen even to fetuses still
in the womb; but three-fourths of strokes occur in people 65 years of
age and over, making stroke a leading cause of disability in older persons.
Of the 600,000 American men and women who experience a first or recurrent
stroke each year,1 an estimated 10 to 27 percent experience major depression.2
An additional 15 to 40 percent experience some symptoms of depression
within two months following a stroke.2
Depression and HIV
Research has enabled many men and women, and young people living with
human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency
syndrome (AIDS), to lead fuller, more productive lives. As with other
serious illnesses such as cancer, heart disease or stroke, however, HIV
often can be accompanied by depression, an illness that can affect mind,
mood, body and behavior. Treatment for depression helps people manage
both diseases, thus enhancing survival and quality of life.
Despite the enormous advances in brain research in the past 20 years,
depression often goes undiagnosed and untreated. Although as many as one
in three persons with HIV may suffer from depression,1 the warning signs
of depression are often misinterpreted. People with HIV, their families
and friends, and even their physicians may assume that depressive symptoms
are an inevitable reaction to being diagnosed with HIV. But depression
is a separate illness that can and should be treated, even when a person
is undergoing treatment for HIV or AIDS. Some of the symptoms of depression
could be related to HIV, specific HIV-related disorders, or medication
side effects. However, a skilled health professional will recognize the
symptoms of depression and inquire about their duration and severity,
diagnose the disorder, and suggest appropriate treatment.
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