The editors note: Season 8 of the podcastChasing Life with Dr. Sanjay Guptagoes back to basics by in-depth examination of the brain in various states. Each episode will focus on one of those states, distracted brain, scared brain, fed brain, etc. to focus on what goes on in our heads and how it affects our bodies.
(CNN) Depression is on the rise in the US. Chances are if you don’t struggle with the condition, you almost certainly know someone who does.
Nearly 18% of U.S. adults, more than 1 in 6, said they were currently depressed or receiving treatment for depression, according to a 2023 Gallup poll. In 2015, when Gallup first began collecting information on the topic, the number was under 11%.
Gallup’s data shows that clinical depression was rising slowly in the country before the pandemic, but grew faster in its aftermath, with social isolation, loneliness, fear of infection, psychological exhaustion, substance abuse and disruption in mental health care. Rates among women, young adults, and black and Hispanic adults are rising the fastest.
For adolescents, ages 12 to 17, the statistics are also dire: According to the US Centers for Disease Control and Prevention, of the 5 million children in that age group, just over 20% experienced an episode of major depression in 2021 ( the most recent year with available data), with 3.7 million facing severe impairment.
Psychiatrist Charles Raison, a professor of human ecology and psychiatry at the University of Wisconsin-Madison, said he has struggled with depression himself. Raison, who is also director of the Vail Health Behavioral Health Innovation Center and former mental health expert for CNN Health, described the state of mental health in the United States in one word: bad.
“There’s no doubt that depression and anxiety and suicide and substance abuse have been on the rise in the United States for probably 20, 25 years, maybe longer,” Raison told CNN Chief Medical Correspondent Dr. Sanjay Gupta recently on the “Changing Life” podcast. But they’ve really been on the rise over the last 10 years, and the data is really consistent.
The increase is not equal among all age groups, Raison said. The people who really suffer are young people. So people between the ages of 15 and 35, that’s where you’re seeing this really, really disturbing increase.
While the rise in depression among Americans is alarming, what is also troubling is the difficulty in pinpointing the cause. We can’t see it on a brain scan. We don’t have a blood test for that. We cannot accurately measure its severity.
Raison compared depression to dropsy, an old-fashioned term for edema that can be caused by a variety of underlying conditions or factors. It could be heart failure. It could be pneumonia. It could be cancer. There are (are) different reasons for those symptoms to occur, he said.
Will we ever find a test to diagnose depression? No, because depression is like drops, he said, pointing to a variety of possible underlying causes. Depression is not the only thing that will yield to a test.
And that may be one of the reasons why depression is so challenging to treat.
Take antidepressants such as Prozac, also known by the generic name fluoxetine. It was launched in the country 35 years ago as the first in a new class of drugs called selective serotonin reuptake inhibitors, or SSRIs. The idea was that depression was the result of a chemical imbalance in the brain, and the imbalance could be corrected by targeting the neurotransmitter serotonin. Serotonin reuptake inhibitors, or SNRIs, followed in 1993, which target two neurotransmitters.
But antidepressants it doesn’t work for everyone.
The issue of the use of antidepressants, which are the first line of treatment for depression in the United States, is incredibly complex, Raison said, noting that they are lifesavers for some people.
But as we’ve gone on over the last 20 years, we’ve had to digest, as a field, a number of very hard truths about antidepressants and their effectiveness, he said. One hard truth, and the most obvious, is that they don’t work nearly as well as we thought 30 years ago, estimating that only 30% of patients get a complete response.
To hear what promising new treatments are being tried for depression, listen to the full episode of Chasing Life here:
Ryson admitted that trying to do something when you’re depressed is an uphill battle. He offered these five tips for self-care.
Make an appointment with a mental health professional.
If you feel down all the time, if you’ve lost interest in life, if your sleep and your appetite have changed, if you feel hopeless, if you have thoughts of hurting yourself, things like this, that’s what depression is. eh, Raison said. Getting help is especially important if you have had these symptoms for several months.
All of us who struggle with depression know that having a clinician can help you with either psychotherapy or medication or both, he said.
It turns out that what’s good for the body is good for the brain.
Really try to do the things you would do for your physical health, Raison said. I often tell people, think about what you would do if you wanted to manage your heart health and do the same. All of those things are also antidepressants. So, weight management, eating healthy foods, getting enough sleep, getting enough exercise, getting sunlight.
Try to maintain a close relationship.
(Council) No. 3 is sometimes very difficult when you are depressed. But it’s probably the single most important thing, which is trying to maximize our interpersonal connections with other people, Raison said.
If you have caring, smaller, supportive relationships with other people, that’s a big protective factor against being depressed. It is also a factor that can really help you overcome depression.
Be persistent in seeking help.
The way people, especially in the United States, respond to antidepressants tends to be very divided, Raison said. There is a small group of people who just start an antidepressant, and within a few weeks feel better and the depression goes away, while others struggle with chronic depression.
So if one antidepressant doesn’t work, he said, try another.
But don’t be afraid to move on. For example, we’ve long known that people who don’t respond to a stack of antidepressants in a row are less likely to respond to the next one, but not less likely to respond to psychotherapy, he said.
Create a state of gratitude.
Work on developing an attitude of gratitude, Raison said.
Raison admits it’s not always easy when you’re depressed. If you can make it a habit, it can be very powerful in both preventing depression and making you feel better if you’re depressed, he said.
We hope these five tips help you take better care of your depressed brain. Listen the full episode here. And join us next week onChasing Life Podcast when we explore dating and the brain, and what all that scrolling is doing to us.
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