Let me start today with a few questions for you...
Since the first pandemic shutdowns started in March in the U.S., have you struggled with any of the following:
- Feeling tired or having little energy?
- Poor appetite or overeating?
- Trouble falling or staying asleep, or sleeping too much?
- Little interest or pleasure in doing things?
- Trouble concentrating on things, such as reading the newspaper or watching television?
If you're like millions of Americans, you probably answered yes to a few of these. And you might shrug it off as just another part of the stress of living through a pandemic. But the symptoms could be a sign of something much more serious... clinical depression.
These questions come straight from a standard diagnostic tool called the Patient Health Questionnaire-9 (PHQ-9). It also includes questions about feeling sad, worthless, or suicidal. Depending on your answers over a two-week span of time, you could find yourself with a depression diagnosis.
And you wouldn't be alone.
For months, I've written about the second crisis triggered by COVID-19: a rise in mental illness. More specifically, I've said that Americans are more depressed now than before the pandemic. I based it on rising unemployment rates and reports from mental health providers about increasing caseloads.
But we didn't have the numbers back in May when I last wrote about it. We didn't have a way to measure just how much the pandemic has affected us. No studies had used tools like the PHQ-9 to calculate the change in depression symptoms before and after lockdown started.
Last week, a paper published in JAMA Network Open (an open-source arm of the Journal of the American Medical Association) gave us those answers.
Researchers from Boston University and Brown University looked at PHQ-9 scores for folks both prior to the pandemic and after. They also asked about COVID-19 stressors like job loss, financial hardship, and the death of a loved one from COVID-19.
They found that symptoms of depression have risen three-fold since mid-March. About 28% of us now report feeling sad, hopeless, tired, or other symptoms of depression. That's up from 8.5% before the pandemic. That means roughly 92 million people in this country are likely suffering from depression.
Even worse: the increase happened regardless of factors like age, gender, or income level. That means we've all suffered together.
But as I've written before, too few people who have depression receive a diagnosis. Even fewer seek treatment. Folks 65 and older have higher rates too, with only about 10% of seniors with depression receiving treatment.
If you suspect you or someone you love has depression, getting help is easier than you think. Here are a few of the best suggestions I've shared over the years:
1. Talk about it.
We understand the stigma surrounding mental health. We also know how many folks think they're weak if they talk about it or ask for help. But you don't have to go right to a white-coated psychiatrist. Try talking to someone you know first. It should be someone you trust who will really listen to you, like a loved one, a close friend, or a religious leader.
If you're concerned about someone else, be the person who can have these conversations with them. Make sure you ask the hard questions about feelings of sadness, worthlessness, and hopelessness.
Part of fighting the risk factors like isolation and loneliness involves regular check-ins. Try setting up a time and date every week to talk with friends and family. Making it a part of a regular routine will keep everyone accountable. My researcher has a group like this every Wednesday, and it's helped her and her friends talk about difficult topics and gain the support they need.
2. Manage stress.
Two years ago, we shared a study from Hong Kong about meditation. The researchers set up two treatment groups for folks with low-grade depression. One received regular educational materials about depression and the other participated in meditation practices.
One year later, those who had participated in the meditation workshops were far less likely to develop major depression – 10.8% for those in workshops versus 26.8% in the non-intervention group.
We love meditation for the ability to trigger the relaxation response. It's good for our blood pressure, pain responses, and anxiety. The brain chemicals released during mediation boost our feelings of happiness and contentment.
3. If you're a caregiver, get the support you need.
We've written before about caregiver stress. But we didn't mention that about 58% of all caregivers suffer from symptoms of clinical depression. They may feel like they're complaining if they seek treatment. But that's simply not true. If you're caring for a parent or loved one, take care of yourself – including your mental state. Manage your stress as well. And join a support group for other caregivers.
You don't have to face depression alone. Have the hard conversations. Check in on each other. Manage your stress. And above all, get the support you need.
What We're Reading...
- It's World Suicide Prevention Day. Read our issue on suicide prevention here.
- You can read the whole JAMA paper right here.
- Something different: Do mutations in the coronavirus matter?
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
September 10, 2020