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Co-Occurring Disorders And Depression

Co-occurrence of Depression with Medical, Psychiatric, and Substance Use Disorders

Clinical depression is a common and serious medical illness that can be effectively treated. The risk of clinical depression is often higher in individuals with serious medical illnesses, such as heart disease, stroke, cancer, and diabetes. However, the warning signs are frequently discounted by patients and family members, who mistakenly assume feeling depressed is normal for people struggling with serious health conditions. In addition, the symptoms of depression are frequently masked by these other medical illnesses, resulting in treatment that addresses the symptoms but not the underlying depression. It is a myth that depression is a “normal” emotional response to another illness; it’s extremely important to simultaneously treat both medical illnesses.

If you are struggling with your mental health and want to check if you may be experiencing symptoms of depression, take an online mental health screen.

Impact of depression in primary care settings

The majority of mental health services for people with depression are (link is external)provided in the primary care setting. Yet depression in primary care clinics is only (link is external)correctly identified in 50% of patients. It is especially important for primary care settings to screen people with medical illness for depression. This is because (link is external)people with depression experience greater distress, which may result in an increase in impaired and difficulty following medical regimens for patients with medical conditions.

Why depression and medical illnesses often occur together

Genetic, biological, social and lifestyle factors (link is external)can all contribute to comorbid depression. Treatments of medical disorders can also interfere with the treatment of depression. People with medical illnesses can experience clinical depression as a response to their prognosis or the pain and/or incapacity caused by the illness.

Prevalence of depression co-occurring wiht other medical illnesses

Up to (link is external)30% of cardiac patients have depression. The prevalence of depression in females with coronary heart disease is (link is external)twice as high as males. Depression is one of the main causes of (link is external)death and hospitalization for cardiac patients.

Between (link is external)18-30% of patients will experience depression after a stroke. Some risk factors for post-stroke depression include: a history of mental health conditions, poor social support, and the occurrence of multiple strokes. Post-stroke depression can (link is external)significantly increase the risk of mortality in post-stroke patients.

(link is external)Twenty-three percent of all cancer patients also have depression. There is a high prevalence of depression symptoms in the inpatient setting and advanced disease stages. Depression may be under-diagnosed in cancer patients because (link is external)symptoms like weight loss and insomnia may be mistakenly attributed to cancer itself.

People with diabetes are (link is external)2 to 3 times more likely to have depression than people without diabetes. People with diabetes are also (link is external)20% more likely to have anxiety than those without diabetes. Depression in diabetes is (link is external)associated with less effective self-management, a higher risk of diabetes complications, and higher mortality rates.

Female patients with major depressive disorder have (link is external)higher rates of eating disorders than the general population. The opposite is also true: female patients with eating disorders have higher rates of major depressive disorder than the general population. Research also shows that female adolescents with low self-esteem, a high amount of perfectionistic tendencies, and mood regulation challenges were (link is external)more likely to develop an eating disorder.

In one study, (link is external)93% of people with a substance use disorder also experienced depression symptoms. Many people in recovery also report (link is external)depression as a symptom of withdrawal.

  • Weight loss, sleep disturbances, and low energy may occur in people with diabetes, thyroid disorders, some neurological disorders, heart disease, cancer and stroke –and also are common symptoms of depression.
  • Apathy, poor concentration and memory loss can occur in individuals with Parkinson’s disease and Alzheimer’s disease – and also are common symptoms of depression.
  • Medications for high blood pressure, Parkinson’s disease, and other medical problems can produce side effects similar to the symptoms of depression.

Importance of treatment

It is important to receive treatment for depression when living with a co-occurring medical disorder. Depression affects (link is external)both the brain and the body, which is why depression symptoms can make it (link is external)more difficult to recover from medical illnesses. But depression is highly treatable. Fifty-four percent of adults with depression (link is external)show an improvement in symptoms after taking antidepressant medication. Sixty-two percent of adults with depression (link is external)show improvement in symptoms after receiving psychotherapy.

Increased (link is external)stress can affect the immune system, making people with mental health conditions more susceptible to physical illness. People with mental health conditions are also (link is external)more likely to smoke and (link is external)have lung conditions, making respiratory illnesses more difficult to fight off. Respiratory viruses such as (link is external)COVID-19 and the flu mutate quickly. For this reason, it is important for people living with depression and co-occurring medical disorders to get updated vaccines on a regular basis.