Despite its huge impact on health and society, depression is still stigmatized and neglected worldwide, and it should receive far more attention, argues a new editorial in the Canadian Medical Association Journal (CMAJ).
“On a global scale, [the burden of depression] is greater than that of diabetes or tuberculosis,” writes Dr. Kirsten Patrick, Deputy Editor CMAJ. “TB and malaria, with lesser global burden, get official WHO [World Health Organization] global public health ‘days.’ Not depression. In high-income countries, only ischemic heart disease and stroke cause more disability than unipolar depression.”
Indeed, depression is the leading cause of disability worldwide, affecting more than 350 million people of all socioeconomic levels, in rich and poor countries. However, despite high-profile cases like the recent death of Robin Williams, depression does not seem to be a priority.
And although our culture has in recent years become increasingly sensitive around issues of mental illness, and depression in particular, the stigma of mental illness remains strong. It is telling that Robin Williams, who spoke openly for years about his substance abuse struggles, never said anything publicly about his battle with depression.
“We are not alone in asking why mental illness is such a low priority worldwide, in spite of coordinated efforts to destigmatize mental illness in recent years,” writes Dr. Patrick.
The high cost of depression
Depression, a disease that primarily affects people in their working years, often affects ability to function and can result in missed work days; it’s also linked to an increased risk of long-term physical conditions. The substantial negative social and health impact should not be ignored, the authors warm.
Although there are known, effective treatments for depression, fewer than half of those affected in the world (in some countries, fewer than 10%) receive such treatments. Even for those who do receive treatment, the shame and secrecy surrounding mental illness leads to pervasive delays in the onset of mental health care: the median across disorders is nearly a decade. As a result, mental illness often goes unrecognized and untreated — not only contributing to the severity and chronicity of the disorder, but also damaging physical health, relationships, school/career, and overall well-being.
Dr. Patrick urges that we need greater awareness overall of the devastating impact of depression on society and should make concerted investments to make it easier for people to be treated for depression. We also need to dedicate resources to finding better treatments, as many currently available treatments are limited in their effectiveness, says Dr. Patrick.
“… [W]e need to stop treating depression as a Cinderella disease. We need to fund research that can make a difference to people with depression. The federal government must make a commitment to improving mental-health infrastructure nationwide. Health practitioners ought to be able to connect patients identified as depressed with adequate support and appropriate treatment without delay,” she says.
“Although substantial resources are needed, the high cost of depression to individuals, families and society justifies the expense. But such resources will only receive priority if we all decide to pay more positive attention to depression,” Dr. Patrick concludes.
To learn more about the harmful effects of stigma, check out the following PublicHealthWatch articles: