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.)