If you think living in a pandemic for the past few years has affected your mental well-being, you’re not alone. Incidents of depression, which already affect 280 million people worldwide, have increased since the arrival of COVID-19.
But while rates of depression and anxiety rose globally by more than 25% in 2020, according to one study, this hasn't necessarily led to a surge in people seeking help.
“Since the start of the pandemic, we’re seeing people becoming much more aware of their depressive symptoms,” says John Zajecka, MD, a psychiatrist at Rush University Medical Center. “However, we aren’t seeing more people seeking treatment. And if depression is left untreated, it can increasingly affect other medical conditions, along with the ability to function at work, school and relationships, and suicide rates.”
Zajecka points out five pertinent facts about depression and when to seek help.
1. Depression comes in many forms.
Depression is more than just feeling down or having a bad day: It interferes with daily functioning and can affect people in different ways.
Here are the most common types of depression:
- Major depressive disorder (the most common type) occurs when someone feels sad, has trouble enjoying activities or experiences previously enjoyed. Other symptoms include difficulty sleeping, changes in appetite, a lack of energy, problems with concentration/making decisions, a sense of hopelessness or experiencing thoughts that life is not worth living, or thoughts of suicide that last for more than two weeks.
- Bipolar disorder (depression) happens when someone switches between a depressed state to a hypomanic or manic state. However, most people who have bipolar disorder spend most of their time feeling depressed having symptoms which are the same as a major depressive disorder.
- Chronic depression is defined as those who have been depressed for two or more years. This type is commonly found in people who have never received treatment.
- Seasonal depression usually takes place during the fall or winter, and then a person’s mood may lift in the spring and summer. The reverse can also be true.
2. Depression is treatable.
Depression is one of the most treatable illnesses in medicine. “There is no reason that we can’t get everyone’s depression under good control, even the more difficult-to-treat types of depression,” Zajecka says.
The goal of treating depression is remission — when people return to their selves and level of functioning as they were before the illness — not just improving symptoms.
“You have to get rid of every symptom because even if you have one residual symptom, your risk of getting depressed again increases, and it’s almost inevitable."
Treating depression is not a one-size-fits-all approach and can depend on your biology, medical background, family history, among other factors.
Here are a few common strategies to treat depression:
- Antidepressants are medications prescribed for those with moderate-to-severe symptoms of major depressive disorder.
- Augmentation is when other medications are added to the antidepressant to achieve greater impact when the antidepressant alone has not provided a full remission.
- Psychotherapy is a form of treatment in which practitioners learn about the conditions, moods, feelings, thoughts and behaviors of a person. This strategy focuses on training the brain to adapt to negative feelings or emotions.
- Cognitive behavioral therapy is among the most common evidence-based form of psychotherapy that focuses on patients’ present thoughts, behaviors and ways of communicating rather than on past experiences. It teaches problem-solving as a solution.
3. There are a lot of myths about antidepressants.
There are many misconceptions about antidepressants. A common one is that they change your personality.
“Personality features are lifelong patterns of behaviors and interpersonal reactions,” Zajecka says. “Those are not going to change with antidepressants unless personality features have been affected by the depression.”
Another myth is that antidepressants may worsen or cause suicidal thoughts.
“Rare studies report the worsening suicidal thoughts for people under the age of 25 treated with antidepressants, but that does not mean antidepressants cause these events,” Zajecka says. “Everyone treated with an antidepressant should always be monitored closely for worsening or new suicidal thoughts, and the risks associated with untreated depression. The goal of treatment is toward the ultimate improvement of depressive symptoms including suicidal thoughts.”
Zajecka stresses the importance of contacting 911 or your doctor if you or someone you know is having significant new or worsening of suicidal thoughts or behavior
4. There’s a stigma with depression — as with every mental illness.
Depression and seeking help for the illness have long been seen as a form of weakness within society.
Although many people, including celebrities and professional athletes, have come forward to share their experiences with this illness, there is still more work to be done before depression is seen as a serious disease, not just something someone can choose to get better from.
If not taken seriously, depression can be deadly. Studies show that up to 20% of people with depression may die by suicide, which increases to 25% for those with bipolar depression.
“For some, depression can be seen as something people can pull themselves up by their bootstraps, when actually it is an illness that affects people’s ability to function,” Zajecka says. “And for those with depression who can function, they have to force themselves to in certain instances. It is a very debilitating illness and should be treated as such.”
5. Remission is possible.
The earlier one seeks and receives treatment, Zajecka says, the easier it is to achieve remission of the disease. He also advises that if one treatment doesn't work for you, don’t give up — there are other options.
“People should not hesitate to pursue treatment,” Zajecka says. “Remember that asking for help is not a weakness of character. It’s a strength to strive for a healthier version of yourself and life. And with that, remission is possible.”
If you or someone you know is experiencing symptoms of depression, consider scheduling an appointment with a psychologist, psychiatrist or social worker.