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Lindsay Royer Robin Kramer 04-17-2012 LA 101H The Dangers of Underestimating Depression

Depression. The English language only sanctions one word, three syllables, and ten letters for this extremely complex and misunderstood disease. When typed into Google, it takes twenty-three seconds for 265,000,000 hits to appear on this one word, yet, when said aloud, this one word oftentimes breaks all conversation. Depression has been a taboo topic for generations in America, and the nations perception of this disease bears witness to this fact. There are many false perceptions of depression. Some believe depression is a part of life. Others believe that a person who is depressed can simply work their way out of it alone, or even that depression is state of mind. For every wrong perception of depression, there are equal amounts of false cures. Eating certain foods, exercising certain exercises, even breathing a certain way can cure depression according to some. People have recognized depression as a problem dating back to the ancient Greeks. Similar to today, most ancient Greeks did not consider depression as seriously as they did other non-mental illnesses. By the end of the 18th century, nerve doctors such as Pierre Pomme, physician to the French King, were subscribing chicken soup and a cold bath for symptoms of fatigue, sadness, melancholy and a sense of dullness. The first anti-depressant medication for the treatment of depression was given in 1955, and the 1960s saw the early development of todays most common anti-depressant, Prozac. By 1987, the drug was being prescribed to patients and by 1994 it was the number two best-selling drug in the world (Sharma).

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Despite all of this research, the medications created in hopes of a cure, and the tests to diagnose the disease, there is still no single accepted explanation for the biological and chemical causes of depression (Sharma). While there have been many scientific advances in the study of depression, the way we react to this disease has still not changed. With better information circulating to the general public, specifically, students through a High School Depression Awareness program, Americas perception of depression can change, and the individuals who are suffering from this disease will better know how to approach the necessary people in order to receive the appropriate help. Americas perception of depression is skewed at a time when knowledge could potentially help those in need. Fifty-four percent of people believe depression is a personal weakness, 41% of depressed women are too embarrassed to seek help, and 92% of AfricanAmerican males do not seek treatment due to the negative and oftentimes false stigmas associated with depression (Murray, Fortinberry). These figures are alarming, especially when considering depressive disorders affect approximately 18.8 million American adults age 18 and older in a given year. Of this 9.5% of the population, approximately 80% are not seeking treatment that could help them lead a more successfully productive and happy lifestyle (Murray, Fortinberry). Instead, the average American believes that depression is a character flaw instead of a treatable psychoneurotic or psychotic disorder that affects a relatively large faction of our population (Nordenberg). Depression affects not only the home, but the workplace as well. Every year, an increasing number of people are diagnosed with depression, posing a significant detriment to the productivity of US workers. People who are depressed but remain untreated often call off of work, or are less productive than their healthier co-workers due to their mental illness. In 2007,

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21 million Americans ages 15 to 44 were affected by depression (Mark et. al.). That same year, a study by Mental Health America estimated the lost productive time due to depression from U.S. workers was upwards $31 billion per year (Mark et. al.). Not only are the numbers increasing, but the number of people living with depression and not seeking treatment is growing as well. On average, people living with depression wait a decade before receiving treatment, and less than one-third of people who seek help receive minimally adequate care (Mark et. al.). Students are not exempt from these harrowing figures. School-aged children are the fastest growing age-group to be diagnosed with depression in America. The 11th leading cause of death in the United States overall, suicide due to depression is the third cause of death among individuals ages 15 to 24 (Mark et. al). On the collegiate level, depression is increasing every year. A 2009 nationwide survey of college students at 2 to 4 year institutions implemented through the American College Health Association National College Health Assessment found that more than 30 percent of college students reported feeling so depressed that it was difficult to function at some time in the past year. The college years can be a time when depression either develops, or gets systematically worse. Though some people carry genes that increase the risk of depression, not all people who are depressed do, and ones surroundings and life experiences can cause depression. The stress of college increases the risk of depression for college students, with experts saying the stress of living away from family for the first time, feeling alone or isolated, facing new and sometimes difficult school work and worrying about finances can be overwhelming (U.S. Department of Health and Human Services). In an effort to prevent more people going through life with untreated depression, the Adolescent Depression Awareness Program (ADAP) began in 1999 in response to a string of adolescent suicides in Baltimore. Designed to educate high school students, teachers, and parents

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about adolescent depression, ADAPs central message is that depression is a treatable medical illness, and should be treated accordingly. ADAP includes a school-based curriculum that not only educates the students about depression and bipolar disorder (stressing the need for evaluation and treatment) but also helps to disprove the negative stigma associated with mental disorders (ADAP). In order to see how effective the ADAP program is, the Society for Public Health Education (SPHE) conducted a study in 2007. The purpose of the study was to assess the effectiveness of the ADAP curriculum in improving students knowledge of depression. From 2001 to 2005, 3,538 students were surveyed twice about their knowledge on depression, once before and once after the completion of the ADAP curriculum. The number of students scoring 80% or higher on the assessment more than tripled from pretest to posttest (701 to 2,180), suggesting the effectiveness of the ADAP curriculum. While compiling the data, the SPHE noticed that though a large majority of students knew before the curriculum that drug and alcohol abuse can be signs of depression, that depression is not a normal part of adolescence, and that depression can run in families, the scores improved after the ADAP curriculum. suggesting that learning occurred during the program. After completing the ADAP curriculum, more students understood that people who are depressed arent necessarily always sad as well as the fact that depression cannot be controlled simply by willpower (showed a 17.9% improvement). This knowledge is essential for anyone dealing with depression; the understanding that willpower alone is not enough to treat depression, just as it takes more than simple willpower to cure asthma or diabetes (ADAP). There was a 17.2 percent increase in the understanding that depression is a curable disease; another key fact that students should know when learning about

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depression. Overall, the study on The Effectiveness of a School-Based Adolescent Depression Education Program (ADAP) concluded that, The increased knowledge in the students might decrease the stigma associated with depression in that school Furthermore, the benefit of depression education is not limited to the time of the intervention, as the participants may later use this information to identify mood disorder symptoms in themselves, friends, family, or coworkers. Finally, psychiatric clinicians and school personnel have a common goal in mind, to support and guide adolescents as they transition through the high school years to adulthood. By working collaboratively to provide accurate information about depression, as is done with other health concerns, adolescent depression as an important topic for discussion is underscored.

The success the ADAP has had in high schools is the reason why I believe the program should be initiated in all states, starting with the areas of most need. The ADAP curriculum has been implemented in 7 states, with programs starting in the next few years for 7 more states (see figure 1)(ADAP). While it is excellent that ADAP has branched out of Baltimore, the program is not in the places where the need is most apparent. According to a study done by Mental Health America, formerly known as the National Mental Health Association, there are states that have higher rates of depression than others (see Table 1)(Mental Health America) with more at-risk children. Co-researched and written by Mental Health America and Thomson Healthcare, Ranking the States: An Analysis of Depression Across the States compiled data from 2002 to 2006 to compare depression levels of all 50 states and the District of Columbia, as well as gathered information to highlight solutions to improve the mental health status of individual states (Mental Health America). Of the ten states with the highest rates of depression, ADAP programs have been implemented in three of them; a step in the right direction, but we need to do more. Ideally, the ADAP program would be available in every state so that no child has to suffer through depression without the facts. This is what is happening all around the world,

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however, with no other program that has been implemented reaching the same success level as the ADAP program. There are virtually no other programs that try to educate the populace about depression in order to give people the tools necessary to fight it, with the exception of many suicide/depression education programs high schools and even some middle schools use which focus on suicide prevention. Fifteen percent of depressed people commit suicide each year, however, the dangers of suicide are covered in the ADAP program along with important facts about depression that might not be covered in suicide prevention programs. The ADAP program would not only help prevent suicide from depression, but also the other 85% of people suffering from depression who might not be flagged as depressed because they are not suicidal (Murray, Fortinberry). If the Adolescent Depression Awareness Program were adopted by every state, then high school students would be able to better identify depression and know what to do when/if they encounter a situation dealing with depression in their present situation, or in their future. We need to act now, to educate high school students about these dangers so they are prepared for whatever kind of depression affects their live, whether through a family member, a friend, or if they are suffering from it themselves. Depression is a serious problem, and has been pushed aside for too long; chicken soup and a cold bath will not solve the problem anymore than it did 300 years ago. Education clarifying all of the implications of depression is the best way to help ameliorate this growing epidemic, and the ADAP is the solution. The states with the highest depression rates should act quickly, and enact this program to help their youth comprehend this misunderstood disease, and stop this upward trend in depression. Let us not let this one word silence us anymore. We have the tools necessary to win this battle. We need to enact this policy to help us win.

Royer 7 Figure 1: Map of ADAP Expansion (ADAP)

Royer 8 Table 1: Depression Ranks for the US (Mark et. al.)

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Works Cited Adolescent Depression Awareness Program. "A Decade of Raising Awareness One Classroom at a Time." Hopkinsmedicine.org. Adolescent Depression Awareness Program, 2010. Web. 12Apr.2012.<http://www.hopkinsmedicine.org/psychiatry/specialty_areas/moods/ADAP /images/ADAP_Program_Summary.pdf>. Borchard, Therese J. "Statistics About College Depression | World of Psychology." Psych Central. World of Psychology, 02 Sept. 2009. Web. 12 Apr. 2012. <http://psychcentral.com/blog/archives/2010/09/02/statistics-about-college-depression/>. Nordenberg, Liora. "Dealing with the Depths of Depression." Dealing with the Depths of Depression. HealingWell.com, 2009. Web. 12 Apr. 2012. <http://www.healingwell.com/library/depression/nordenberg1.asp>. Mark, Tami L., David L. Shern, Jill E. Bagalman, and Zhun Cao. "RANKING AMERICA'S MENTAL HEALTH: AN ANALYSIS OF DEPRESSION ACROSS THE STATES." Mental Health America. Mental Health America, 2012. Web. 12 Apr. 2012. <http://www.mentalhealthamerica.net/go/state-ranking>. Mental Health America. "Ranking America's Mental Health: An Analysis of Depression Across the States." Mental Health America:. Mental Health America, 2012. Web. 12 Apr. 2012. <http://www.mentalhealthamerica.net/go/state-ranking>. Murray, Bob, and Alicia Fortinberry. Depression Facts and Stats. Uplift Program, 27 Mar. 2012. Web. 11 Apr. 2012. <http://www.upliftprogram.com/depression_stats.html>. Sharma, Tonmoy. "A Brief History of Depression." Mental Health Matters. The Psychmed Group, 2001. Web. 12 Apr. 2012. <http://www.emental-health.com/depr_history.htm>. U.S. Department of Health and Human Services. "Depression and College Students."National Institute of Mental Health. U.S. Department of Health and Human Services, 02 Mar. 2012. Web. 12 Apr. 2012. <http://www.nimh.nih.gov/health/publications/depression-andcollege-students/complete-index.shtml>.