Depression is on the rise in the United States. Chances are, if you don’t struggle with the condition, you almost certainly know someone who does.
Nearly 18 percent of American adults — more than one in six — said they did currently depressed or receiving treatment for depressionaccording to a 2023 Gallup poll. In 2015, when Gallup first began collecting information on the topic, the figure was under 11 percent.
Gallup’s data shows that clinical depression was rising slowly in the country before the pandemic, but rose faster in the post-pandemic period, with social isolation, loneliness, fear of infection, mental exhaustion, substance abuse and disruptions in mental health care taking their toll. Rates among women, young adults, and black and Hispanic adults are rising the fastest.
For adolescents, between the ages of 12 and 17, the statistics are also terrible: according to US Centers for Disease Control and Prevention5 million children in that age group – just over 20 percent – experienced an episode of major depression in 2021 (the latest year with available data), and 3.7 million experienced 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. Reason, which is also director of the Vail Health Behavioral Health Innovation Center and train a mental health specialist 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’s chief medical correspondent Dr. Sanjay Gupta on a recent podcast. Chasing life. “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 are really suffering are young people. So people between the ages of 15 and 35, that’s where you see this really, really disturbing increase.”
While the rise in depression among Americans is alarming, what is also disturbing 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 weight.
Reason likened depression to “watering down” – an old-fashioned term for edema – which may be caused by different underlying conditions or factors. “It could be … heart failure. It could be pneumonia. It could be cancer. There (are) different reasons for producing those symptoms,” he said.
“Will we ever find a test to diagnose depression? No, because depression is like dropsy…” he said, pointing to possible different underlying causes. “Depression is not the only thing that will undergo just one test.”
And this could be one of the reasons why depression is so difficult 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 and norepinephrine reuptake inhibitorsor SNRIs, which target two neurotransmitters, followed in 1993.
But antidepressants don’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 through the last 20 years, we’ve had to metabolize, as a field, a number of very hard truths about antidepressants and their effectiveness,” he said. “One hard truth, and the most obvious one, is that they don’t work nearly as well as we thought 30 years ago,” estimating that only 30 percent of patients “get a full response.”
To hear what promising new treatments are being tried for depression, listen to the full episode Chasing life here.
Raison admitted that trying to do anything when you’re depressed is an uphill battle. He offered these five tips for self-care.
Commit to seeking help
Make an appointment with a mental health professional.
“If you feel constantly depressed, if you’ve lost interest in life, if your sleep and appetite have changed, if you feel hopeless, if you have thoughts of self-harm, things like that — that’s depression,” Reason said. Getting help is especially important. if you have experienced these symptoms for several months.
“All of us who struggle with depression know that a clinician … can help you — either with psychotherapy or medication … or both,” he said.
Lifestyle interventions can help
It turns out that what’s good for the body is also 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 address your heart health and do the same thing.’ All of those things are also antidepressants. So weight management, healthy food, enough sleep, enough exercise, sunlight.”
Be with people
Try to maintain close relationships.
“(Tip) No. 3 is sometimes very difficult when you’re depressed. … But that’s probably the most important thing, and that’s trying to maximize our interpersonal connections with other people,” Raison said.
“If you have caring, less supportive relationships with other people, that’s a huge protective factor against depression. It’s also a factor that can really help you get over depression.”
do not give up
Be persistent in seeking help.
“The way people, especially in the United States, respond to antidepressants tends to be very twofold,” Raison said. “There is a small group of people who just start taking an antidepressant, and within a few weeks they feel better and … 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. “We’ve known for a long time, for example, 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.
Reason admits that this is not always easy when you are depressed. “If you make it a habit, it can be very powerful in both preventing depression and making you feel better if you’re depressed,” he said.