Grand Roundups: Depression, June 2018

Keep up to date with our monthly collection of stories and studies on major depressive disorder and depression.
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Grand Roundups is a monthly highlight of stories and studies from the heart of the depression community. By sharing these stories — from patient advocate perspectives to the latest clinical research — we hope to help create a larger framework for dialogue.

Major Depression: The Impact on Overall Health
This month, the Blue Cross Blue Shield Association published an overview of the “second most impactful condition on overall health for commercially insured Americans,” major depression. Here are some statistics from the report:

  • Major depression affects more than 9 million commercially insured people in the United States. 
  • Women are diagnosed with higher rates of major depression than men. 
  • Connecticut, Delaware, Idaho, Massachusetts, Maine, Minnesota, Missouri, North Dakota, and New Hampshire have the highest rates of major depression. 
  • Major depression diagnoses are growing quickly, especially for adolescents and millennials. 

Read the entire overview to learn more about how major depression is affecting our nation and our healthcare.

The Best Medical Care in the World
“Once they find out you have a mental illness, he said, it’s like the lights go out.”

Featured in the New England Journal of Medicine, Brendan M. Reilly, M.D., writes about losing his brother due to the bias of mental illness. After a fender-bender, Reilly’s brother, Kenneth, was transferred to three different institutions, and they all missed his quadriplegia. When the psychiatrist said Kenneth had “psychomotor retardation,” his brother insisted on a neurology consult. Given the delay in diagnosis — CT myelography showed “multiple disc herniations with severe cord compression at C3-C5” — Kenneth’s neurosurgeon predicted postoperative results no better than “improvement of neck pain and possible return of some upper extremity function.” Was the negligence due to bias against patients with psychiatric diseases? Reading this story reminds us all that the presence of a mental illness does not explain everything.

The Largest Health Disparity We Don’t Talk About
Did you know that Americans with serious mental illnesses die 15 to 30 years earlier than those without? The New York Times published an eye-opening article explaining this phenomena.

“We may assume that people with mental health problems die of ‘unnatural causes’ like suicide, overdoses and accidents, but they’re much more likely to die of the same things as everyone else: cancer, heart disease, stroke, diabetes and respiratory problems. Those with serious mental illness are more likely to struggle with homelessness, poverty and social isolation. They have higher rates of obesity, physical inactivity and tobacco use. Nearly half don’t receive treatment, and for those who do, there’s often a long delay.”

Nutritional psychiatry: Your brain on food
In a recently updated post, the Harvard Health Blog covered the link between what you eat and how you feel. The field of nutritional psychiatry is relatively new, but there is data on the link between diet quality and mental health — depression in particular — across countries, cultures, and age groups. This new focus revolves around the thought that “what you eat directly affects the structure and function of your brain and, ultimately, your mood.” The author, Eva Selhub M.D., suggests trying a “clean” diet for two to three weeks — cutting out all processed foods and sugar. She also suggests observing how you feel and being conscious of the food you are putting in your body.

New link identified between inflammation and depression in type-1 diabetes
In a study published in Endocrine Connections, researchers found depression in Type 1 diabetes patients to be associated with higher levels of the inflammatory protein galectin-3 (an important protein that operates at the cellular level and is involved in cell growth, cell adhesion, and a variety of other biological functions).

Although the results were revealing, larger, long-term studies are needed, as well as further analyses and investigating in order to determine how galectin-3 levels are linked to the increased risk of depression, what inflammatory processes are altered, and whether they can be targeted to treat depression.

Diagnosing and Treating Male-Type Depression
Women and girls are nearly twice as likely as men and boys to experience depression (at approximately a 5.5 to 3.2 ratio respectively). But as Psychology Today points out, this statistic has been calculated by measuring “overt depression” and “reported depression.” Overt and reported depression are favored by females while “covert depression” is favored by males. Covert depression is harder to diagnose because the majority of the most common symptoms of depression like expressed feelings of guilt or shame, irritability, insomnia, and excessive rumination, require communication of those symptoms, which then turns it into overt depression. The author poses three questions:

  • Will we admit that there is something called “male-type depression” and that its incidence rate is reaching crisis proportions in America?
  • Will we allow ourselves to see beyond our culture-based approach to what causes male depression, i.e., the “pressures of masculinity?”
  • Will we invest in training parents, teachers, mental health workers and policy makers in male-specific depression assessment and treatment modalities?

The article notes that boys and men “do not fit in the pattern of communication inherent in recognizing the listed symptoms of depression. This causes for parents, friends, teacher, counselors, and professionals to “miss this extent of what is going on in the male.”

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