Depression Costs America as Much as the War in Afghanistan

Depression is a worldwide epidemic. According to the World Health Organization, it affects about 121 million people worldwide, and those numbers are increasing. Depressive disorders affect as many as 18.8 millio American adults or about 9.5 percent of the U.S. population age 18 and older in a given year, according to the National Institute of Mental Health. Depression is a lifelong vulnerability for millions of people. The cost of depression, including lost productivity and increased medical expenses, is estimated to be $83 billion each year, according to scientists at Harvard University and the University of Michigan. This number is about equal to the cost of the war in Afghanistan, which is approximately 84 billion dollars annually, as reported by the Pentagon. Depression is not a "limited engagement" with a fixed endpoint. The World Health Organization has reported that depression's financial burden globally ranked fourth in 2000, and will increase by 2020 to be the second most costly disease. Depression is an ongoing war that we know is winnable. However, most people do not seek treatment due to a wide range of reasons, including poverty, social stigma, and a lack of education about their condition and available resources. In the United Kingdom the National Health Service (NHS) has developed the largest mental health intervention program in history. The Improving Access to Psychological Treatments (IAPT) initiative mandates access to effective treatments for depression and other psychological problems. The argument behind this national initiative is largely economic - depressed people are less likely to work, have more disability days, and are less likely to be able to pay taxes. Simply from a practical point of view, effective treatment for depression makes economic sense. It's a good investment. If you effectively treat depression, people are more likely to work, require less disability coverage and, as cynical as it may sound, more likely to pay taxes. Treating depression pays. It's smart policy, and the right thing to do. Most adults suffering from depression or anxiety never get appropriate treatment, according to research from the Robert Woods Johnson Foundation, a private foundation dedicated to improving health and healthcare for Americans. Throughout the course of a year, researchers found that out of 83 percent of adults with depression or anxiety who saw a health care provider, only 30 percent received appropriate treatment. Most visited primary care physicians. Only 19 percent of this group received appropriate care. Of the individuals visiting mental health specialists, 90 percent received appropriate treatment, showing that people who see specialists in mental health are far more likely to receive effective treatment. According to scientists at Harvard Medical School and Yale University School of Medicine, 50 percent of children and adolescents and 20 percent of adults report some symptoms of depression. Even though many kids don't "qualify" for the clinical diagnosis of depression, they have some of the problems that depressed people have, such as sadness, self-criticism, and the inability to enjoy their lives. Depressed kids frequently become depressed adults. Kids born after 1960 were significantly more likely to suffer from depression in childhood or adolescence than kids born before 1960, according to a study from Cornell University Medical College. Depression is on the rise, and the costs are climbing. Depression has human costs that we all know: sadness, sense of isolation, feeling like a burden, and the inability to enjoy life. Each year, it is estimated that 35,000 people commit suicide, according to Dr. Thomas E. Joiner of Florida State University Department of Psychology in his book, Myths about Suicide. People who are depressed are 30 times more likely to commit suicide than people who are not depressed, according to studies from Oxford University. Depressed individuals are five times more likely to abuse drugs.

• Depression is the leading cause of medical disability for people aged 14 to 44, according to researchers at Boston College.
• Depressed people lose 5.6 hours of productive work every week when they are depressed, according to the journal of the American Medical Association.
• 80 percent of depressed people are impaired in their daily functioning, according to the Centers for Disease Control and Prevention (CDC).
• 50 percent of the loss of work productivity is due to absenteeism and short-term disability. In any 30 day period, depressed workers have 1.5 to 3.2 more short-term disability days, according to the American Psychiatric Association.

People with symptoms of depression are 2.17 times more likely to take sick days, according to the American College of Occupational and Environmental Medicine. And when they are at work their productivity is impaired, they are less able to concentrate, have lower efficiency and poor ability to organize work. In fact, absenteeism and work performance are directly related to how severe the depression is. Depressed people are seven times more likely to be unemployed, according to the American Psychiatric Association. In one of the largest studies of its nature, "The long-term economic costs of psychological problems during childhood", published in the journal Social Science & Medicine, children were followed for 40 years to determine the effects of illness and psychological problems on their life chances. This study found that:

• Children or adults who suffer from depression have lower incomes, lower educational attainment and fewer days working each year.
• Depressed people work seven fewer weeks per year, a loss of 20 percent in potential income, and a lifetime loss for each family who has a depressed family member of $300,000.
• People who suffer from depression end up with six-tenths of a year less schooling, an 11 percent decrease in the probability of getting married, and an average loss of $10,400 per year in income by age 50.
• There is a 35 percent decrease in lifetime income due to depression.
• The cost for the total group, over their lifetime, was estimated at 2.1 trillion dollars. And this does not include the increased cost of medical care.

With appropriate treatment, most people can effectively overcome depression. Even though there are effective treatments for depression, such as nutritional supplements, lifestyle and dietary changes, meditation, cognitive behavioral therapy, and as a last resort, prescribed medication, many depressed people often wait over 10 years on average to seek treatment. Depression costs as much as the war in Afghanistan. The good news is, depression is highly treatable. If more people seek treatment earlier, and get effective treatment, the human cost and the economic costs can be reversed. It is hard to imagine what could be a higher priority if we care about the well-being of our people and our nation.