Most Patients Diagnosed With Depression Never Start Treatment


A new study has found that only a small fraction of patients diagnosed with depression actually start treatment—approximately one-third.1 This statistic is even more startling in light of the fact that, between the ages of 15 and 44, major depressive disorder is the leading cause of disability in the US and affects about 6.7% of the population age 18 and older in any given year.2 Persistent depressive disorder is a form of depression that usually continues for at least two years; it affects about 1.5% of the US population, or 3.3 million adults.2

Of the patients who do seek treatment for depression, non-adherence to antidepressants is common.3 A 2017 study found that 68% of the females surveyed were non-adherent to their prescribed antidepressant therapy.3 Forgetfulness was the main reason for missing doses. Another study showed that antidepressant non-adherence is common among veterans, with ineffectiveness and side-effects as commonly reported reasons.4

Major life stressors, especially those involving interpersonal stress and social rejection, are among the strongest proximal risk factors for depression because stress upregulates inflammation.5 Proinflammatory cytokines are known to elicit profound changes in behavior, including depressive symptoms such as low mood, anhedonia, fatigue, psychomotor retardation, and social-behavioral withdrawal.5

Links between sleep and depression are also strong.6 Researchers have found that about three-quarters of depressed patients have insomnia symptoms, and sleep disorders also affect mood disorders. The symptoms cause distress, have a major impact on quality of life, and are a strong risk factor for suicide.6

The Functional Medicine model emphasizes a multi-pronged approach to health and wellness, engaging patients in a therapeutic partnership that recognizes that the current conventional paradigm does not optimally address the needs of patients with depressive symptoms.

Learn more about the Functional Medicine model in our free, online CME course Introduction to Functional Medicine

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  1. Waitzfelder B, Stewart C, Coleman KJ, et al. Treatment initiation for new episodes of depression in primary care settings [published online February 8, 2018]. J Gen Intern Med. doi:10.1007/s11606-017-4297-2.
  2. Facts & statistics. Anxiety and Depression Association of America. https://adaa.org/about-adaa/press-room/facts-statistics#. Accessed February 21, 2018.
  3. Shrestha MJ, Shrestha R, Basnet N, et al. Study of adherence pattern of antidepressants in patients with depression. Kathmandu Univ Med J. 2017;15(57):3-9.
  4. Zivin K. Antidepressant non-adherence is common among veterans, with ineffectiveness and side effects as commonly reported reasons. Evid-Based Ment Health. 2011;14(4):91. doi:10.1136/ebmh.2011.100177.
  5. Slavich GM, Irwin MR. From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychol Bull. 2014;140(3):774-815. doi:10.1037/a0035302.
  6. Nutt D, Wilson S, Paterson L. Sleep disorders as core symptoms of depression. Dialogues Clin Neurosci. 2008;10(3):329-336.

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