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Depression

Depression is a very common and potentially debilitating condition. Some primary care settings estimate that 40% of their patients suffer from some degree of depression. Unfortunately only about one half of depressed patients receive adequate treatment. Aside from the impact of depression itself, depression can influence the outcomes of many common chronic conditions and co-morbidities. Risk factors for depression include alcohol or substance use, chronic medical conditions, female sex, personal or family history of depression and recent stressful events (including positive or desired events). The United States Preventive Services Task Force recommends screening all adults for depression provided adequate resources are in place should someone’s screening suggest depression. Symptoms of depression may include feeling down, little interest in activities, sleep disturbance, fatigue, appetite changes, trouble concentrating, moving or speaking slowly, feeling like you have let yourself or someone else down. Depression can also be associated with thoughts of self-harm and is a major risk factor for suicide. Notably, it is important to separate depression from bipolar disorder which is associated with periods of time that mimic depression but by contrast is also associated with periods of time that are associated with mania, increased energy, increased risky behavior and other symptoms. Depression is treatable, there are numerous medications as well as therapy strategies that can help. In some cases, it may be helpful to involve a therapist, psychologist, or psychiatrist.

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Reference:
McCarron RM, Vanderlip ER and Rado J. In The Clinic: Depression. Ann Intern Med. 2016. Oct 4; 165 (7)