The Value of Depression Screening During Mental Illness Awareness Week
Since 1990 the first week in October has been dedicated to raising awareness of mental health problems across America and this year runs between October 5th and 11th. One aspect of this week-long awareness drive is National Depression Screening Day, which falls on October 9th. With evidence that as many as 10% of the US population suffers from depressive symptoms(1), this makes depression one of the most common conditions affecting our nation’s mental wellness. However, even cases of severe depression often go undiagnosed, which can have serious consequences when left untreated. Identifying individuals suffering from clinically low mood through screening events run in the community on this day can put them in touch with relevant support services, allowing people to access the treatment they need. What started out as a small scale project nearly 25 years ago, has grown annually and now reaches in excess of 85,000 people across 3000 sites countrywide each year.
What Are the Implications of Untreated Depression?
Serious depression is not just a major risk factor for suicide, but can also impact on other areas of your mental well-being, worsen your physical health and adversely affect family life(2), as shown below:
- People who are depressed have higher death rates across every age group and more than 15% of people with clinically low mood take their life. Rising depression rates mean that suicide is now the 11th most common cause of death in the United States, totaling around 30,000 deaths annually.
- You are more likely to suffer from depression if you have cardiovascular disease, diabetes, cancer, a neurological condition or your are HIV positive, and experiencing low mood can worsen your clinical outcome. For instance, if you have heart disease, a heart attack is more often fatal when you also have a depressed mood. One of the reasons for the link between depression and poorer prognosis is that when feeling low it is more difficult to comply with treatment and you are more likely to miss follow-up appointments.
- Rates of alcohol and drug abuse are higher among people with depression and by using these substances to escape your problems or self-medicate, your mental health may worsen further.
- You are more likely to take sick leave from work, and your absence rate and reduced productivity when at work may increase your risk of losing your job, placing a strain on your finances.
- Financial problems are not the only way in which depression can affect your family, as if a loved one is your carer, this can have a knock-on effect on their work. There is also evidence that maternal depression can adversely impact on child development and behavior.
Why Is Depression Screening Important?
Avoiding the negative consequences of untreated depression isn’t the only reason why screening for this mental illness is important(3). Screening is also vital because:
- It is a common misconception that feeling low is part of life and is something we need to get on with
- Depression can affect anyone, no matter what your gender, age, ethnicity or socioeconomic status
- Two-thirds of people who feel depressed do not seek help
- Screening is usually the first step to receiving help, with the vast majority of cases managed effectively through talking therapies and medication
Who Should Consider Getting Screened for Depression?
Although people often associate depression with the more severe feelings such hopelessness, that there is no reason to carry on and thoughts of suicide, depressed mood can show itself in many other ways. Common symptoms include(4):
- Unrelenting low mood and feeling pessimistic
- Poor appetite and weight loss, or comfort eating and weight gain
- Difficulty sleeping or wanting to sleep more than usual
- Reduced inclination to socialize and feeling isolated
- Struggling to concentrate, remember things and make decisions
- Feeling increasingly restless and irritable
- Losing interest in activities you used to enjoy
If you can identify with any of the above, it is a sign that you may have depression and you would benefit from taking a screening test.
Taking the Test
There are many tools that have been developed to identify someone who is likely suffering from depressed mood. The tool below is adapted from a patient health questionnaire used for screening in clinical practice(5) and is intended as a guide to alert you to the severity of any depressive symptoms you may have.
Answer each question with one of the following responses and score accordingly: Never = 0, Some days = 1, More than 50% of the days = 2, Almost daily = 3
In the last fortnight, how often were the following a problem:
- 1. I gained little pleasure from doing things
- 2. I felt low in spirits or hopeless
- 3. I struggled with one of the following sleep problems: a. difficulty getting to sleep b. difficulty staying asleep c. sleeping for longer
- 4. I felt lethargic or had little energy
- 5. I suffered from poor appetite or over ate
- 6. I felt I was a failure
- 7. I felt I had let myself or my family down
- 8. I struggled to concentrate with the following: a. reading the paper b. watching TV
- 9. I noticed my speech and movement have slowed down
- 10. I felt restless and fidgeted more than usual
- 11. I contemplated harming myself
- 12. I thought about ending my life
When you total up your score for this screening test, the severity of your symptoms are as follows:
- 0-4: No depression
- 5-9: Mild depression
- 10-14: Moderate depression
- 15-19: Moderate to severe depression
- 20+: Severe depression
Even if your score indicates you are suffering from mild depression, you should seek medical advice, as this is no substitute for an assessment by a doctor or mental health professional. Additionally, starting treatment early reduces the risk that your symptoms will worsen, so preserves your mental wellness for the future.