That’s because depression is disabling. Among mental and behavioral disorders, depression is responsible worldwide for 1.84 percent of all DALYs, or disability-adjusted life years, according to 2016 data from the Global Burden of Disease (GBD) study.
DALYs account for years of life lost to illness, disability or premature death.
To put this in context: DALYs for depression are comparable to those for chronic kidney disease, tuberculosis and falls, and higher than those for Alzheimer’s disease and many types of cancer.
Barriers to treatment
Though depression is common and treatment effective, access to care presents a problem for many people. There are several reasons for this. Psychiatrists can be hard to find especially in rural areas, and primary care doctors may not have the capacity to provide the focused care that depression requires, says Marc Avery, M.D., a psychiatrist and director of the University of Washington School of Medicine’s telepsychiatry program.
In a standard primary care visit, someone who is feeling depressed and brings it up will likely be treated in one of two ways, Avery says. They will either be prescribed an antidepressant medication on the spot or will be referred to a psychiatrist.
Those approaches may or may not work for that particular patient, Avery says, for a variety of reasons. The first or even second medication prescribed might not work. The psychiatrist might be located too far away from the patient or may not be covered by their insurance. All of these factors may seem small but are very real reasons people don’t get the care they need, Avery says.
Adding yet another layer of complexity is the fact that some depression symptoms—such as reduced self-esteem, energy levels and motivation—can prevent people from seeking care as well, as can the erroneous idea that they don’t need to.