Depression Treatment Deficiencies

As winter continues after the holiday season (some might say as it “drags on”), depression is a bigger topic in the media than at most other times of the year. As David Spero writes in a recent blog entry, many people must deal with seasonal affective disorder (SAD), a form of depression, and people with diabetes are at significantly greater risk for all forms of depression than the general population.


And just in time for this season, a study has found serious problems in treatment for depression in the United States. According to an analysis published in the January issue of the journal Archives of General Psychiatry (as reported in The New York Times), only about half of people with depression receive any treatment at all. Furthermore, of those who are treated, four out of five receive care that does not meet the standards of the American Psychiatric Association, which outline how both drugs and psychotherapy should be used. A separate study from 2008, recounted in an op-ed in the Dallas Morning News, found that few psychologists practice the forms of psychotherapy that have been shown to be most effective. And a story in the Wall Street Journal mentions another problem — namely that more people are being prescribed two or more psychotropic medicines at once when there’s no good evidence that more drugs work better than fewer. (In people with mild or moderate depression, antidepressants aren’t all that effective to begin with.)

While it may represent a serious problem, the fact that many people do not receive treatment for depression is not necessarily surprising. After all, going to see a doctor takes initiative and motivation — qualities that do not come easily to people with depression. But the lack of adherence to treatment guidelines is more difficult to explain logically, and doctors are more clearly responsible for this outcome than for the overall undertreatment of depression.

What has been your experience with depression? Have you sought treatment for it? If so, were you satisfied with the treatment you received? Should there be more emphasis on screening people with diabetes for depression? Leave a comment below!

(Meanwhile, see this older blog entry, also by David Spero, for tips on self-managing depression.)

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  • miss kitty

    I have thyroid & T1 diabetes. Each one has component for depression. My thyroid has had radiation treatment 2x for hyperthyroid. I now have a low thyroid condition due to the threatments.
    Depression from the low thyroid is more troblesome than from the diabetes. Curently I take 200mg of generic Zoloft. I have signed up for 4-6 sessions with a clinical psychologist.
    I’ll let you know how the sessions go.

  • Barb

    I have type 2 diabetes and low thyroid and I have been fighting with depression for well over a year. I take Cymbalta and Wellbutrin XL and I see a therapist every couple of weeks. I also see a psychiatrist every couple of months. I do think all of this has helped. Things still get me down once in a while. But not nearly so bad as they used to.

  • Cathy A.

    Cymbalta was prescribed for my depression. I have been a Type II for 11 years now. It made me a zombie, so i quit taking it. Feeling something – even though it is depression – is better tan not feeling anything. So I deal with it as best I can. Things in my life that should be simple feel like huge obstacles. I don’t know what to do.

  • Marcie

    I’ve had type 2 diabetes for about 10 years and depression on and off for about 40. I’ve tried several different antidepressants through the years, and some worked better than others. Elavil seemed to be THE best, but it gave me a lot of side-effects that were not just troublesome, but intolerable.

    One thing about Cymbalta, which I also tired, one of the lesser-reported side effects it can cause is hard little fat cysts under the skin. I got several on various parts of my body. One of them was on my breast — chest wall area — so the surgeon removed that.

    Currently I’ve been on Wellbutrin XL for a couple of years, and it’s better than nothing, I guess.
    I know I should see someone for CBT, but I just never seem to have the energy at the same time that I’m not too swamped by life events.

    One of these days. . .

  • Elisabeth Fluellen

    I have had depression, off and on, through out my adult life. I’ve accepted the fact that I have chronic depression and I am currently taking Pristiq. it is working well for me, at this time. I have been on different medications and my doctor has suggested therapy in addition to medication. With my other medical problems, I just can not afford both. Now that I am also living with type II diabetes, I am so glad I am being treated for my depression. I did not know, before my diagnosis of diabetes, that many diabetics have chronic depression.

  • James Griner

    Medicine was ineffective. A good multivitamin with plenty of the B group, activity with hope, & meditation did the trick. Please see and & seriously consider the possibility of side effects before beginning medication.

  • Becky

    There are other medications available for depression. Just because one doesn’t work for you, don’t give up. Another medication may work great. I’ve been there and the pit can get pretty deep and difficult to climb out of. Keep trying. It’s worth it.