The Disease Burden of Depression

The Disease Burden of Depression

Depression manifests in myriad forms, and can significantly affect not only the patient, but also those within hers or his spheres of influence, including the family, the community, the workplace, even entire civilizations (Goode, 1998). Depression is characterized by two or more weeks of feelings of sadness/antipathy, inhibited social instinct, blunted attention span, periodic and episodic suicidal ideations, etc. (NIMH, 2017). Psychiatric comorbidities may include conditions such as acute dysthymic state (DS), attention deficit disorder (ADD), bipolar disorder (BPD), to name a few (Sansone & Sansone, 2009). Additionally, there is strong correlation between depression and physical/biological conditions such as renal failure and cardiovascular disease (Glassman, 2007).

In developed, Global North nations of the world, depression is epidemiologically the second most prevalent public health crisis, only behind ischemic cardiopathy (heart disease), as expression of disease burden (Aragonès, et al, 2004). The United States is the world’s leading consumer of antidepressant drugs (GVR, 2017).

Economic Dynamics

Research and literature are infrequent and scarce as to immediate and prospective influences depression has upon economic dynamics. However, recent studies are shedding light upon localized and collective domestic, governmental, and commercial impacts. It is beginning to appear that some of the numbers may be somewhat astonishing. Although real dollar amounts may be impracticable to calculate, the complex motilities are far more significant than previously thought.

Some studies reveal that in the workplace, diminished productivity aggregates arising from depressed workers may be staggering (Evans-Lacko & Knapp, 2016), numbering in the hundreds of billions of dollars, impacting elements from the individual to the organization to the culture, and even to the gross domestic product (GDP) (p. 1525). This loss of productivity is not only measured by absenteeism, but also poor work performance, idiomatically referred to as “preabsenteeism” (p. 1526). Personal spending is also strongly influenced by depression, as social decision making is often compromised by inhibited concerns over monetary divestment (Harlé, Allen & Sanfey, 2010, p. 443).

Bio-physiological

As prior mentioned, bio-physiological outcomes can arise from depressive symptoms/expression, such as conditions like asthma, high blood pressure, cardiovascular disease (CVD), and the like. Very recent literature and research is emerging indicating medical causatum from depression may be contributory to impactive disease burdens, most notably heart disease (or CVD), and these revelations indicate the link between the two speak to a considerable rise in medical costs (Egeberg, et al, 2016).

Myths About Depression

There are myths about depression, and there are facts. In the U.S., depression is commonly viewed in light of personal weakness in public (and personal) discourse. The mainstream media portrays the conditions[s] as a neuropsychiatric illness (Kanter, et al, 2008), not necessarily in a positive hue. Some facts are not to be disregarded, however based upon empirical evidence. It is now believed that depressive episodes in adolescence are likely to follow into adulthood (Craighead, et al, 2011). Cognitive behavioral therapy (CBT) is almost always recommended as a standardized and homogeneic treatment therapy, yet recent research and literature suggest that many patients do not respond to that regimental therapy (Beard, et al, 2016), and more intensive, case-by-case modalities are in order (p. 298). Age variations of depressive state expression vary over time, and tend to decrease as one ages, with adequate treatment (Cagliostro, 2018).

Treatment Methodologies

Treatment methodologies can be broad and myriad, yet there are established therapies that the primary care physician (PCP) will typically manage. As mentioned, CBT supplemented with selective serotonin reuptake inhibitors (SSRIs) are the traditional treatment modalities, depending on the severity and etiology of disease expression. As no two cases are alike, so too should a regimen of talk therapy and pharmacotherapy be administered on a case-specific basis.

As with any therapeutic measure, there are caveats to be observed in execution of psychopharmaceutical and CBT-rooted treatment plans. Some literature suggests that caution is to be observed when prescribing SSRIs to adolescents, as there appears to be elevated risk of suicide (Gunnel & Ashby, 2004, p. 35). SSRIs appear to be linked to lowering of seizure threshold in epilepsy patients (Stone, 2010, p. 173), and more recently, emergency rooms are reporting a spike in cases of serotonin syndrome in drug overdoses because of severe adverse interactions from SSRIs and Fentanyl (Greenier, Lukyanova & Reede, 2004, p. 340).

There are an abundance of empirical benefits that derive from the use of SSRIs, such as marked diminishment of obsessive compulsive disorder (OCD) symptoms (Umehara, et al, 2016, pp. 6-7), and significant life outcome in depressed elderly patients (Bowen, 2009). Moreover, many posttraumatic stress disorder (PTSD) patients show significant improvement with a combination CBT and SSRI therapies in their treatment plan execution (Schneier, et al, 2015, p. 570).

References

APA – American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Arlington, VA. American Psychiatric Association Publishing.

Aragonès, E., Piñol, J.L., Labad, A., Masdéu, R.M., Pino, M., & Cervera, J. (2004). Prevalence and determinants of depressive disorders in primary care in Spain. International Journal of Psychiatry in Medicine, 34(1), 21-35. National Institute of Health. US National Library of Medicine. Washington, DC. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15242139 (Links to an external site.).

Beard, C., Stein, A.T., Hearon, B.A., Lee, J., Hsu, K.J., & Björgvinsson, T. (Apr. 2016). Predictors of depression treatment response in an intensive partial hospital. Journal of Clinical Psychology, 72(4), 297-310. Retrieved from EBSCOhost database.

Bowen, P.D. (Apr. 2009). Use of selective serotonin reuptake inhibitors in the treatment of depression in older adults: Identifying and managing potential risk for hyponatremia. Geriatric Nursing, 30(2), 85-89. National Institute of Health. US National Library of Medicine. Washington, DC. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19345847 (Links to an external site.).

Cagliostro, D. (2018). Depression: Persistent sadness and loss of interest in life. PSYCOM – Depression Central. Montclair, NJ. Vertical health, LLC. Retrieved from https://www.psycom.net/depression.central.html (Links to an external site.).

Craighead, W.E., Sheets, E.S., Craighead, L.W., & Madsen, J.W. (Apr. 2011). Recurrence of MDD: A prospective study of personality pathology and cognitive distortions. Personality Disorders: Theory, Research, and Treatment, 2(2), 83-97. Retrieved from EBSCOhost database.

Egeberg, A., Khalid, U., Gislason, G.H., Mallbris, L., Skov, L., & Hansen, P.R. (Feb. 2016). Impact of depression on risk of myocardial infarction, stroke and cardiovascular death in patients with psoriasis: A Danish nationwide study. Acta Dermato-Venereologica, 96(2), 218-222. Retrieved from EBSCOhost database.

Evans-Lacko, S., & Knapp, M. (Nov. 2016). Global patterns of workplace productivity for people with depression: Absenteeism and preabsenteeism costs across eight diverse countries. Social Psychiatry and Psychiatric Epidemiology, 51(11), 1525-1537. Retrieved from EBSCOhost database.

Glassman, A.H. (Mar. 2007). Depression and cardiovascular comorbidity. Dialogs in Clinical neuroscience, 9(1), 9-17. National Institutes of Health. US National Library of Medicine. Washington, DC. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181839/ (Links to an external site.).

Goode, E. (Nov. 1998). Insane or just evil: A psychiatrist takes a new look at Hitler. The New York Times. Retrieved fromhttps://www.nytimes.com/1998/11/17/science/insane-or-just-evil-a-psychiatrist-takes-a-new-look-at-hitler.html (Links to an external site.).

Greenier, E., Lukyanova, V., & Reede, L. (Jul. 2004). Practice News – Serotonin syndrome: Fentanyl and selective serotonin reuptake inhibitors.AANA Journal, 82(4), 340-345. Retrieved from EBSCOhost database.

Gunnel, D., & Ashby, D. (Jul. 2004). Antidepressants and suicide: What is the balance of benefit and harm. British Medical Journal, 329(1), 34-38. Retrieved from EBSCOhost database.

GVR – Grand View research. (2017). Regional Insights. Anxiety Disorders and Depression Treatment Market Analysis. Retrieved fromhttps://www.grandviewresearch.com/industry-analysis/anxiety-disorders-and-depression-treatment-market (Links to an external site.).

Harlé, K., Allen, J., & Sanfey, A. (Aug. 2010). The impact of depression on economic decision making. Journal of Abnormal Psychology, 119(3), 440-446. Retrieved from EBSCOhost database.

Kanter, J.W., Busch, A.M., Weeks, C.E., & Landes, S.J., (2008). The nature of clinical depression: Symptoms, syndromes, and behavior analysis. The Behavior Analyst, 31(1), 1-21. Washington, DC. National Institutes of Health. US National Library of Medicine. Retrieved fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2395346/ (Links to an external site.).

Ludwig, A.M. (2018). Mental health facts in America. New Orleans Musicians Clinic (NOMC). New Orleans LA. Retrieved fromhttps://neworleansmusiciansclinic.org/health/topics/mental-health/ (Links to an external site.).

Martin, J. (Sept. 2018). Depression in the U.S. Good Life Protection, LLC. Retrieved from https://goodlifeprotection.com/depression/ (Links to an external site.).

NIMH – National Institute of Mental Health. (2017). Major Depression. National Institutes of Health. US National Library of Medicine. Washington, DC. Retrieved from https://www.nimh.nih.gov/health/statistics/major-depression.shtml (Links to an external site.).

Sansone, R A., & Sansone, L.A. (May 2009). Dysthymic Disorder: Forlorn and overlooked? Psychiatry, 6(5), 46-51. National Institute of Health. US National Library of Medicine. Washington, DC. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719439/ (Links to an external site.).

Schneier, F.R., Campeas, R., Carcamo, J., Glass, A., Lewis-Fernandez, R., Neria, Y., Sanchez-Lacay, A., Vermes, D., & Wall, M.M. (Jun. 2015). Combined Mirtazapine and SSRI treatment of PTSD: A placebo-controlled trial. Depression and Anxiety, 32(8), 570-579. Washington, DC. National Institutes of Health. US National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515168/ (Links to an external site.).

Stone, M. (2010). Selective serotonin reuptake inhibitors. Nurse Prescribing, 8(4), 173-177. Retrieved from EBSCOhost database.

Umehara, H., Numata, S., Tajima, A., Nishi, A., Nakataki, M., Imoto, I., Sumitani, S., & Ohmori, T. (Jun. 2016). Calcium signaling pathway is associated with long-term response to selective serotonin reuptake inhibitors (SSRI) and SSRI with antipsychotics in patients with obsessive-compulsive disorder. PLOSone, 0157232, 1-9. Creative Commons Attribution 3.0. Washington, DC. National Institutes of Health. US National Library of Medicine. Retrieved from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0157232 (Links to an external site.).

Our team of highly qualified and skilled writers is ready to help you with a similar paper within a specified deadline. Please ORDER NOW and provide us with your assignment details, contact information and make payments. You will get periodic updates on the order progress in your email.