Burdens of Depression: The Individual

Depression is today’s most prevalent mental health disorder and the leading cause of disability worldwide. Painful both mentally and physically, the onset of the disease is slow and gradual, with highly variable symptoms that manifest differently from person to person, making it a challenge to identify for both medical practitioners and those close to the individual.

Symptoms often seep into every corner of the lives of those suffering. While mild forms of the disease may impair the ability to focus, feel motivated, and maintain social relationships, more severe forms often leave the patient unable to function normally, and in some cases, lead to the ultimate cost — the patient’s life.

Importantly, this pain is not solely limited to those diagnosed. On a micro-level, depression also profoundly impacts the lives of those close to the affected person, from friends and family to co-workers and acquaintances. On a macro-level, with 4.4% (322 million people) of the global population suffering across the world, even if an individual is not being directly affected by a friend or loved one’s illness, he or she is indirectly impacted by society at large.

On the Patient

For those suffering, depression often feels all-consuming, making normal, everyday functioning difficult if not impossible to achieve. From a constantly somber mood to nagging feelings of guilt, hopelessness, and worthlessness, living with depression not only feels crippling but also comes with a wide array of mental and physical complications and consequences far beyond a pessimistic outlook. These may include:

– Feelings of chronic fatigue and decreased energy levels, making things like exercising, socializing, and pursuing personal hobbies less likely to occur.
– Changes in appetite and eating habits that may lead to weight loss or weight gain.
– Decreased libido and sexual performance.
– Problems with sleep, such as insomnia or hypersomnia.
– Restlessness and irritability.
– Difficulty focusing and making decisions.
– Treatment-resistant physical issues including digestive problems, headaches, and chronic pain.
– Increased risk of cardiovascular death and death from cancer stemming from psychological stress.
– Suicidal thoughts or attempts.

Whether suffering from one or several of these symptoms, each can lead to consequences that intensify negative feelings and create vicious cycles that propel the patient deeper into the disorder. A lack of motivation and decreased ability to concentrate often impairs performance at work, leading to reduced productivity and ultimately an increased risk of losing the employment altogether. Complications with and worsening of physical health issues — both pre-existing and those caused by the disease — may shorten the patient’s life expectancy. A loss of interest in spending time with close friends and family may lead the individual to feel isolated, misunderstood, and hopeless that anyone can help. These feelings are often further exacerbated by both public and self stigmas about depression (e.g. that depression only affects people with a weak personality). In a survey of 3,047 adults, 47.2 % of men and 39.2% of women felt that “weakness of character” was a probable trigger for depression. Of the 360 respondents who indicated having direct personal experience with depression, there was substantial evidence of stigmatizing attitudes toward one’s self when it came to the disease — over three-quarters of respondents said that they would feel disappointed in themselves (77.9 %), inadequate around other people (77.7 %), and like a burden to others (76.1 %) if they became depressed. These stigmas serve as great barriers to diagnosing and managing depression, and can easily lead to further isolation.

Finally, there is the ultimate cost to the patient. Every year, there are 800,000 deaths from suicide worldwide — approximately 2,200 each day, with more than 95% attributable to depression. Estimates suggest an additional 30–40 attempts for each completed suicide, translating to more than 20 million attempted suicides annually. Hence, the probability of a patient choosing to end his or her own life is a constant threat and concern.

Even if remission is achieved through standard treatment methods, residual symptoms such as cognitive impairment and social dysfunction may remain a significant burden to the patient, continuing to reduce performance and cause considerable stress and anxiety — coupled with the looming risk of relapse, this often weighs heavily on the patient and reduces quality of life.

Join us next week as we take a closer look at the burdens of depression on families and communities. To stay up to date on the latest in mental health innovation and alternative treatments of depression, check back regularly and sign up for ATAI’s weekly #InsightNetwork.