Department of Psychiatry
Penn Behavioral Health

Depression Research Unit (DRU)

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Depressive Disorders

Depressive

 

According to the World Health Organization (WHO), depression is one of the most disabling disorders in the world. It affects nearly 121 million people worldwide. Roughly 25% of women and 10% of men will experience depression at some point in their lifetime. In addition to its widespread prevalence, depression appears to be present in family members, sometimes from generation to generation. It also has a high relapse rate. Depression can often occur in association with other medical disorders such as diabetes, cardiovascular disease, chronic fatigue syndrome, fibromyalgia, and in association with other psychiatric disorders such as anxiety disorders, eating disorders, and substance abuse. In particular, depression in women can also occur during and after pregnancy, and at times of hormonal change (e.g., menopause). Depression that goes untreated can lead to social, professional, financial and personal (e.g., marital) difficulties including academic problems, and career and financial difficulties. At its worst, depression may lead to suicidal ideation and even death by suicide - which is estimated to result in about 850,000 deaths per year worldwide. Many individuals with depression have never been diagnosed, let alone treated. Moreover, in those individuals who are treated, it is estimated that up to 30% receive antidepressant treatment that is insufficient to fully address the symptoms of the depressive episode. In addition, antidepressant treatment is rarely continued long enough after recovery to prevent relapse or recurrence of future depressive episodes.

The precise causes of depression for the most part remain unknown. However, the current thinking is that depression is a hereditary imbalance of one or more brain chemicals called neurotransmitters. Depression may also be associated with current or early life stress. Both the genetic and environmental factors may cause specific changes in brain neurotransmitters such as serotonin, nor-epinephrine, or dopamine that could possibly explain some of the physical and psychological symptoms of depression.

The mainstay treatment for depression includes antidepressant medication and several forms of talk therapy. Both treatment approaches are relatively safe and effective, and are currently available for most forms of depressive disorder. Many clinicians believe that a combination of pharmacotherapy and psychotherapy is the most adequate treatment of depression. Antidepressant medications such as the class of serotonin reuptake inhibitors (SSRIs) or mixed serotonin / nor-epinephrine reuptake inhibitors (SNRIs), or psychotherapy with cognitive behavioral therapy (CBT) will often give relief to most patients with depression. Antidepressant medications can also be used to prevent recurrent episodes of depression in individuals who suffer from recurrent depressive disorders.

As we are trying to learn more about how the brain is associated with depression, new antidepressants are being developed that will alleviate many of the symptoms of the illness. There is much hope regarding the diagnosing and treatment of depression, for the most depressed individuals.

 

 

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