(Originally published on ATAI.life October 18, 2019)
Depression is today’s most prevalent mental health disorder and the leading cause of disability worldwide. However, the pain and burdens of depression are not limited to those diagnosed.
Depression profoundly impacts the lives of those close to the affected person, from friends and family to co-workers and acquaintances. With 322 million people (4.4% 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.
In recognition of World Mental Health Day, join us as we examine the impact of depression on both families and the wider community.
On the Family
Unlike other illnesses, depression is not always obvious to close friends and family — and even when it is, many feel at a loss about how to help. Some will respond to their loved one’s newly somber mood by denying there is an issue. Others may stigmatize the disease and look at it as a sign of weakness, while some may feel responsible and fight too forcefully alongside the sufferer. However someone chooses to react, the added confusion, stress, and/or frustration can take a serious toll on even the strongest of relationships.
When it comes to marriage, the likelihood of separation and divorce is significantly higher in couples with at least one depressed partner versus those in which no partner is suffering. Vice versa, not unexpectedly, divorce can often be a precursor to depression. A study that looked at the correlation between depression and the dissolution of marital relationships reported that for both sexes, the termination of a relationship was associated with 12% higher odds of a new depressive episode, compared with those who remained with their spouse over the two-year study period.
Children of depressed parents are also seriously affected by the disease. The prevalence of parent-child friction and low family cohesion is much higher in families with a distressed parent, and the presence of these factors is associated with higher rates of depression and antisocial behaviors in the children themselves.
Beyond issues related to the emotional stress of depression, a family can be negatively impacted by a loved one’s underperformance in the workplace, as this often leads to a decrease in salary or even job loss. A study that followed 2,334 full or part-time employees with an annual family income of $25,000 found a strong correlation between depression, a decrease in annual salary, and an increase in unemployment. During the five-year study, 33% of participants with depressive symptoms versus 21% of those without experienced unemployment at some point. Similarly, with regard to annual salary, 17% of participants with depressive symptoms versus only 7% of participants without saw their family income decrease below $25,000.
On the Community
People suffering from depression and those close to them may face the most obvious burdens of the disease, but even if not always apparent, this epidemic is also negatively impacting society at large. From early termination of education to negative impacts on child development to rising health care costs, this disorder has likely affected communities across the world in more ways than may be evident — for example:
- There is a strong association between depression in adolescents and early termination of education, with as much as a 60% higher likelihood of failing to complete secondary school when compared to otherwise similar youth.
- Depression in adolescents has also been linked to an increase in teenage pregnancy, with studies showing that teen mothers are three times more likely to be on taxpayer-supported government-benefits.
- Suicide is the second leading cause of death for adolescents 15 to 19 years old, with depression being a major suicide risk factor — an alarming and saddening statistic for myriad reasons, and a terrible loss of talent and productivity.
- Maternal depression affects the health and development of fetuses and newborns and is not uncommon. Prevalence rates have been reported to be 7.4%, 12.8%, and 12.0% for the first, second, and third trimesters, respectively, with studies finding that 10% to 16% of pregnant women meet the diagnostic criteria for depression, and that even more experience subsyndromal depressive symptoms. The associated risks include preterm delivery and low birth weights, compromised maternal-infant bonding, inadequate child development, behavioral and emotional issues, and maladaptive social behaviors.
- As previously mentioned, depression decreases an individual’s workplace productivity and can often lead to unemployment. While this has an obvious toll on the individual and his or her family, reduced workplace productivity and increased work absenteeism have been estimated to equate to a loss of $36.6 billion per year in the U.S. alone — a huge financial burden on employers and taxpayers.
- Finally, perhaps one of the most widely discussed burdens of depression on society — rising health care costs. In 2017, U.S. health care spending increased by 3.9% to reach $3.5 trillion, or nearly $10,740 per person. In 2018, that number rose to $3.6 trillion, is projected to be close to $3.8 trillion in 2019, and up to $6 trillion by 2027. What role does depression play in these rapidly rising costs? Data comparing the health care costs of people with depression to those without shows significantly higher utilization of health care services by depressed patients. In 2016, on average, patients diagnosed with depression had 163% more outpatient and emergency room visits, were written 214% more prescriptions, and had 227% more inpatient stays. This equated to a two-fold increase in average health care costs for those with depression at $10,673 versus $4,283 for others spending on health care services. These numbers are especially concerning when considering that the global rate of depression increased by 18.4% between 2005 and 2015 and continues to climb. Projections by the World Health Organization for the year 2030 have identified depression as the leading cause of disease burden in the world.
Lessening the Burdens of Depression
Growing bodies of evidence continually tell us that psychiatric disorders like depression are associated with a variety of adverse life consequences, and the list is only getting longer. Prevention and treatment of this disease must be seen as a priority in the modern world of science and medicine in order to enable people to live healthier and happier lives.