Depression is massively, frighteningly increasing

Some frightening news last week, according to health insurance data from Blue Cross Blue Shield:

  • Major depression has a diagnosis rate of 4.4 percent in the United States, affecting more than 9 million commercially insured Americans.

  • Diagnoses of major depression have risen dramatically by 33 percent since 2013. This rate is rising even faster among millennials (up 47 percent) and adolescents (up 47 percent for boys and 65 percent for girls).

  • Women are diagnosed with major depression at higher rates than men (6 percent and nearly 3 percent, respectively).

The report also found that younger generations are seeing the largest increase ind depression rates:

Image: Major depression report

By the way, keep in mind that this data is from among those who have health insurance – and we know that there are millions of Americans who do not, and those in poverty are more likely to be depressed…so this is an underestimation.

This is a genuinely terrifying. We should all be deeply, deeply worried about the findings of this report, findings that, unfortunately, ring true.

Also worth noting: Rates of major depression vary significantly on a state by state basis:

Image: Major depression report

The NBC article on the subject referred to a variety of potential causes for the increase, including:

  • An increasing sense of business in our day to day lives and a loss of community that comes with it.
  • Overall world events and our increasing awareness of the trauma that exists…everywhere.
  • Social media.
  • Overdependance on smart phones.

We’re going to have to start treating depression for what it is: A major public health crisis. I won’t pretend to be fully capable of developing every solution – and certainly not solutions which are politically viable (treating mental health for everyone requires infusing billions of dollars into the mental health system, and we’re not doing that anytime soon, sadly). And I’ll add this: Many of the items which would really reduce depression are societal and cultural changes that are largely beyond the reach of government. They include things like slowing own our daily lives, increasing family and community bonds, and taking our phones and throwing them out the window.

But the fact is this: We have to do better. As I write this entry I am staring at my children and I worry, given this world and their genetic predisposition, that this will be them one day. Families have to now constantly be on the lookout for potential mental health problems. They have to teach coping skills and resilience, and they have to be willing to seek treatment when symptoms of mental illness/depression begin to display themselves. I wish I’d realized this when I was younger – early treatment for mental illness – like for most illnesses – is critical.

My mission with this blog is largely to discuss mental health and raise awareness. It’s becoming apparent that this awareness is more needed now than ever.

Why talking about mental illness helps

I’d almost make the argument that the thing that makes the most sense about depression is that it doesn’t make any sense at all.

Like, none.

Understand that this is just my perspective, but hear me out on this one.  Depression, anxiety, mental illness, the works, they make no damn sense.  I mean, isn’t one of the things that makes us human the ability to control our own thoughts and act independently?  “I think, therefore, I am?” and all that?

Which is why having a mind that works against you so darn frustrating.

Call me crazy here…okay, don’t, I do that enough on my own…but I think that one of the reasons that depression is so frustrating, confusing and mystifying is that it goes against the very thing that makes us human: Our ability to think.  Humans are fundamentally logical and emotional creatures, right?  I firmly believe that there is a piece of our own minds will always believe that it is in control.

Of course, that isn’t the case.

Even now, even as someone who has been living with depression for years and doing so in a very public forum – it still makes no sense to me.  How is it that people who are so successful, loved and popular can still suffer so?  And I ask myself this question despite the fact that I am someone who has depression.

So, that brings me back to the crux of this blog entry: Why I think that talking about depression/mental illness in an open, honest and public manner helps, and why I always encourage others to do the same.

I think it helps us make sense.

I firmly believe that the idea that we aren’t in complete control of our emotions and thoughts is a truly alien one, something that most of us struggle with on some base level.  To that extent, I think that talking about mental illness helps.  It helps us process what’s going on in our brain and make sense of the thoughts and feelings that we are experiencing.

I obviously don’t have all the answers to mental illness – if I did, I’d be a lot richer, and at least a little bit happier.  But I would suggest this: If you are one of the people suffering in silence, do what you can to change that perspective.  Talk about it.  You may not have access to a supportive network of family or friends, but I think you’d be surprised at the amount of online support groups that you can participate in – anonymously or not.  Even the act of sitting there, and formulating your feelings, can help process your emotions and make a positive difference in your life.

And, on a personal note: I’ve found that this blog has helped my advocacy tremendously, and not just because it gives someone else a chance to read my thoughts.  By putting “pen to paper,” so to speak, it gives me a chance to organize my thoughts, examine my feelings and reevaluate the way I handle my own recovery.  It’s also helped me to rethink some of my public advocacy, in particular the portions related to stigma – it’s not just stigma that matters, but self-stigma.  

As always, I’d love to hear your thoughts.  Am I onto something here?  Let us know in the comments, and have a wonderful day!

A shameful disparity: Minorities & Mental Illness

Earlier this week, I had the good fortune to attend Pride in the Park, the Lehigh Valley’s annual LGBT festival.  I always bring the family and it’s a blast; it’s interesting, has great vendors, good food and is a great time for the kids.

On our way out, I commented to my wife that everyone at the event always seemed so happy, and how relaxing it must be to attendees to be in a place where you know no one cares who you are.  My wife corrected me: Everyone cares.  Period.

This reminded me of a tragic reality about mental illness in America: If you are a minority, you are more likely to be mentally ill, and less likely to be treated.

Before I go into the statistics, one caviet: “Minorities” is a broader term than you think.

African-Americans make up 13.2% of the U.S. population, and 16% of those have a diagnosable mental illness.  However, the disparity is striking.  African-Americans are 20% more likely than whites to say they suffer from serious psychological issues.  They also feel worse, in terms of sadness, hopelessness and worthlessness, than whites. Stigma-related attitudes are more likely to be held by African-Americans than whites, and cultural competency amoung mental health providers remain a real issue.  Perhaps most significant: 15.9% of all African-Americans are uninsured, compared to 11.1% of whites.

LGBT Americans
LGBT Americans are three times as likely to suffer from mental health conditions than the rest of the general population.  According to the National Alliance on Mental Illness, much of this is due to “minority stress,” including, “social stigma, discrimination, prejudice, denial of civil and human rights, abuse, harassment, victimization, social exclusion and family rejection.”  Suicide is also a major issue within this community, with suicide for LGBTQ Americans aged 10-24 being described as “one of the leading causes of death.”  LGBTQ individuals are four times as likely to attempt suicide than the general population, and 38-65% of transgender individuals experience suicidal ideation.

Rural Americans
Clearly, rural Americans are different than some of the other groups here.  But, that doesn’t change a central fact: They have similar challenges when it comes to mental health than many other groups.  Rural Americans have roughly the same rate of mental illness as the rest of the population.  However, poverty is higher in many sections of rural American, and stigma presents a huge cultural barrier to seeking care. Additionally, rural Americans have problems with accessing care due to practitioner shortages and transportation issues.

American Indians
This is astonishing: The suicide rate among males, aged 15-24, who are American Indian or Alaskan Native, are 2-3 times greater than the suicide rate for whites.  Additionally, 21% of all Native Americans had a mental illness over the past year, and they experience psychological distress at a rate 1.5 times more than the general population.  High levels of poverty, a rural location, poor transportation and low rates of health insurance (33%!!) all lead to low treatment usage.

There is more, but these were just some of the low lights.

I don’t want to necessary explore this from a policy perspective – at least, in this entry.  I’d rather approach this from the personal perspective.  In this sense, I suppose I am lucky; I’m a white, male, young adult, whose only claim to any sort of minority status is that I am Jewish.  That being said, I cannot imagine how difficult it must be – to be a member of one of these communities and have your ability to get and receive care be compounded by factors beyond your control and things that shouldn’t make a difference anyway.

Now, to ignore what I just said: Speaking a a policymaker, it’s pretty clear that there is no one size fits all approach to ending mental health disparities.  A ton of factors play a part, including access to care, stigma, availability of practitioners, cultural competency, discrimination and more.  Mental illness is a huge problem, and an under discussed one.  I suppose that’s why I’m blogging and lending my name to this effort.

We have to do better.