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Depression Co-Occurring
with General Medical
Disorders
Clinical depression commonly co-occurs with general medical illnesses, though it
often goes undetected and untreated. In fact, while the rate of major depression
among persons in the community is estimated to be between two to four percent,
among primary care patients it is between five and ten percent and among medical
inpatients it is between ten and fourteen percent. And an additional two to
three times as many persons in these groups experience depressive symptoms.
Research suggests that recognition and treatment of co-occurring depression may
unprove the outcome of the medical condition, enhance
quality of life, and reduce the degree of pain and disability experienced by the
medical patient.
What Is Depression?
Clinical depression is a common and highly treatable illness affecting over 17
million American adults with or without a co-occurring condition- each year.
Unfortunately, nearly two thirds of them do not get treatment, in part, because
the effects of depression are not understood to be symptoms of an illness. With
proper treatment, however, nearly 80% of those with depressive illness can feel
better, and most within a matter of weeks.
Depression: A Whole Body Illness
Depression affects mood, thought, body, and behavior. For some, it occurs in one
or more relatively severe episodes, known as major depression. Others have
ongoing, less severe but also debilitating symptoms, known as dysthymia. And
still others have bipolar disorder (also known as manic depressive illness),
with cycles of terrible "lows" and excessive "highs" If five or more symptoms
last for two weeks or longer, or are severe enough to interfere with normal
functioning, an evaluation for clinical depression by a qualified health or
mental health professional is recommended.
Accurate Diagnosis Is Important
Since some symptoms are common to both depression and certain medical disorders,
accurate diagnosis is critical to developing an effective plan for treatment.
For example, symptoms of depression such as weight loss, sleep disturbances, and
low energy, may also occur in diabetes, thyroid disorders, some neurologic
disorders, heart disease, cancer, and stroke. Other depressive symptoms, such as
loss of interest or memory, also occur early in the course of disorders such as
Parkinson's and Alzheimer's diseases. In addition, achiness or fatigue may be
present in many other conditions. In such cases, careful assessment of an
individual's emotional state, and personal and family histories can help
determine if one or two illnesses are present.
Other Diagnostic Concerns
The relationship of clinical depression to a medical illness can be varied.
Depression can occur as the biological result of a condition such as an
underactive thyroid, or can be the side-effect of one or a combination of
medications, including over-the-counter medications. In such cases, the
depression may be relieved by a change in dosage or type of treatment(s).
On the other hand, it is not unusual for a traumatic diagnosis, such as cancer,
to trigger a period of depressive symptomatology including sadness, poor
concentration, anxiety, or withdrawal. Careful monitoring of the length and
severity of depressive symptoms can determine if clinical depression is an
additional diagnosis.
A Message of Hope: Depression Is Treatable!
When depressive illness is a co-occurring condition, it should be treated. With
treatment, up to 80% of those with depression can show improvement, usually in a
matter of weeks. Common interventions include a range of antidepressant
medications, focused short-term psychotherapy, or a combination of the two. ln
addition, in special circumstances, electroconvulsive therapy (ECT), a safe and
effective treatment, may be considered as an option. Which treatment is
recommended depends on the severity of the depression, the type of co-occurring
illness and its treatment, and, to some degree, on individual preference. In
addition, maximizing the treatment of the medical disorder may also help to
diminish the depressive symptoms.
Wilmes-Reitz Psychological
23632 Calabasas Rd., Suite 202
Calabasas, California 91302
(818) 591-8270
wrpsych@aol.com
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