Most people get depressed at times due to life’s stresses and tragedies, but it’s almost always temporary. It goes beyond grieving and occasional sadness or anxiety. For those with the condition of clinical depression, which is severe and persistent, it may require mind-altering drugs to avoid crippling, even suicidal, thoughts and self-destructive behavior. It has long been a hidden illness which some who suffer from it write off as a sign of weakness or an unwelcome personality trait. However, recent suicides of celebrities and famous people who seem to have it all have raised public awareness and the realization that people who seem normal and happy on the outside can be barely coping on the inside.  It also explains why so many cases of what is also known as Major Depressive Disorder are not being reported and treated.

—How prevalent is severe and persistent depression among the populace?

There are various kinds of depression— the most common of the severe types being Major Depressive Disorder, Persistent Depressive Disorder and Bipolar Disorder. More than 16 million Americans, almost 6.9 percent, are estimated to be suffering some type of depression. More than double that number will or have suffered from recurring depression in their lifetimes. Children, who still haven’t coped with most of life’s challenges, also face these crippling disorders in staggering numbers.

Depression continues to be on the rise in this country and, with increased awareness comes increased diagnoses to help people function with what can be a crippling mental illness. Chances are that most of us know at least one person who has been diagnosed with some related disorder, whether it be postpartum depression after giving birth or post-stress traumatic disorder (PTSD) after returning from war or traumatic experiences. The numbers and percentages of those battling depression can only be estimated because so many are undiagnosed.

Two of the top reasons for people missing work, whether it is in accrued sick days or hospitalization, is linked to depression and obesity, which often sustain each other.  Certain findings reveal that the disorder that turns out to be most costly to employers is depression, followed closely by obesity. Not only is depression costly in absenteeism from the workforce, but productivity for the depressed who do show up for work on any given day suffers.

Depression takes a greater toll on women than men and on the elderly more than younger age groups.

—Why are we failing to diagnose and treat so many for depression?

Depression is both undiagnosed and under-diagnosed as a mental disorder, mostly because it is misunderstood in terms of signs and symptoms. As noted before, people are reluctant to take the crucial step toward seeing a doctor because of the stigma attached to the disorder. Even family members who should encourage a loved one to seek medical help might hesitate, believing it is a rough patch and they’ll get over it.

Even primary care physicians might miss a diagnosis or a referral for depression because of familiar complaints they hear from patients that also point to sleep disorders or just a general malaise where the patient under the weather, so to speak, but isn’t quite sure why. They complain about not having the energy or interest to do things they once enjoyed doing and assume it can be blamed on getting old. That’s where family members and caregivers need to step up report personality changes, overall disinterest and other signs of depression.

—Fear of Antidepressants Keeps Some Away….

Although there are non-drug and noninvasive treatments of depression, the chief treatments for the more serious and recurring types of depression are medications generally lumped together as antidepressants avoid a diagnosis of depression and psychotherapy. Prospective patients and family members may steer clear of diagnosis leading to these treatments due to unproven fears of mind control and mind-altering that might trigger unnatural changes in thought processes and personality.

Antidepressants are very effective as a rule, but they may be dangerous if a patient decides, for whatever reason, to go off his or her meds. Because they feel better, patients might assume they have been cured and stop taking the medication without telling anyone. It is important that both physicians and pharmacists apprise of possible side effects. Pharmacists and physicians must also review the regimen of daily medication with patients while also patiently discussing all the symptoms, reviewing possible side effects of the drugs and the impact of discontinuing or changing prescriptions.

Effective diagnosis and treatment of depression relies on a network of support, including not just the pharmacists and health professionals but family, friends and co-workers who may recognize some of the signs.