Depression is on the Rise and Linked with Other Chronic Conditions

A new report finds that people diagnosed with major depression are almost 30 percent less healthy on average, translating to a loss of almost 10 years of healthy life.

The number of commercially insured Americans diagnosed with major depression increased by about 33 percent from 2013 to 2016, surpassing 9 million people, according to a new analysis of health insurance claims by the Blue Cross and Blue Shield Association.

The increase was even larger among young adults (up 47 percent) and teenagers (up 65 percent for girls and 47 percent for boys), according to the Association’s latest Health of America report, which is based on the Blue Cross Blue Shield Health Index, an annual look at the health of people in nearly every U.S. county.

The Index reflects an analysis of 200 health conditions using anonymous claims data from more than 41 million commercially insured members of Blue Cross and Blue Shield companies.

Major depression — defined as persistent feelings of sadness, hopelessness or other symptoms that last most of the day, almost every day, for two weeks — is second only to high blood pressure as having the most impact on the overall health of the population in the analysis.

On average, according to the report, depressed people are almost 30 percent less healthy than people who have not been diagnosed with major depression, translating to almost 10 years of healthy life lost for both men and women. This is in part because major depression often is not the only health issue affecting patients.

One of the most common symptoms of depression is apathy.

The report found that 85 percent of people diagnosed with major depression have at least one other serious chronic health condition, and almost 30 percent have four or more. It defined common chronic conditions as high cholesterol, hypertension, diabetes, coronary artery disease, obesity and chronic obstructive pulmonary disease.

[Related: The Intersection of Physical and Behavioral Health Care]

However, the report notes that the data does not determine if the depression preceded or followed the other health issues, nor to what degree major depression may cause, or be caused by, these other health conditions.

“Depression has a significant impact on your health,” says Dr. Ben Kurian, a psychiatrist and a medical director for Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas. “For example, one of the most common symptoms of depression is apathy, which is the inability to want to get up and do things. That means if someone has both diabetes and depression, they may be less likely to be compliant with the full regimen to take care of the diabetes because they have low energy from the depression.”

The report also notes that depressed patients use health care services more than other patients, pushing their annual health care spending to about twice that of non-depressed patients — $10,673 compared with $4,283, according to the report. One reason for this is that when a person is diagnosed with major depression, the cost of treating other conditions is higher. The report notes, for example, that treating substance abuse costs nearly twice as much when the person also suffers from depression.

Other findings from the report:

  • Women are diagnosed with major depression at higher rates than men (6 percent vs. nearly 3 percent).
  • Rhode Island has the highest prevalence of major depression (6 percent), while Hawaii has the lowest (about 2 percent). All states, except Hawaii, had rising rates of major depression from 2013 to 2016.
  • It costs $920 on average per person, per year to treat only major depression, although this number can vary widely.
  • People with depression are three times as likely to suffer from pain-related disorders such as spine, neck and back pain and migraine headaches. They are seven times more likely to have alcohol or substance-use disorders than people who do not have major depression.

Kurian says numbers like these aren’t likely to change dramatically over the next few years. But he also finds hope in a few recent developments.

One is that the social stigma around depression is waning, allowing more people to feel comfortable seeking help instead of suffering in silence.

Another is that new technologies, such as virtual visits between therapists and patients, and new areas of research, such as biological markers in depressed patients, may lead to better management of depression.

[Related: Telehealth Brings Behavioral Health Care to People in Need]

“People are looking into areas we haven’t looked into before,” Kurian says. “We used to have difficulties reaching people in rural areas because you couldn’t get psychiatrists to them. Today, with mobile devices, we are moving into that space and can treat people regardless of where they live.”

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