100 Questions and Answers About Depression, Second Edition by Ava T. Albrecht, Charles Herrick

By Ava T. Albrecht, Charles Herrick

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Sometimes the accumulation of several mild stressors triggers a depressive episode. At one time it was assumed that there were two types of depression: endogenous (triggered from within, or “biologic”) or exogenous (triggered from environmental circumstances). Such a distinction is generally not considered applicable anymore, because most depressions are triggered by environmental circumstances and are likely dependent on the person’s genetic vulnerability. A comprehensive mental health evaluation typically identifies social stressors associated with the depression.

Close to 25% of persons seeking medical treatment in their primary care doctor’s office suffer from depression. Not only does depression have a personal cost on individuals and their families, it has a significant cost on society. Because many people who are depressed do not seek treatment, the cost of untreated depression to society runs into tens of billions of dollars, in part because of decreased productivity at work and overuse of primary healthcare services. Only approximately half of people with major depression ever receive specific treatment, because symptoms of depression may be inappropriately dismissed as understandable reactions to stress, evidence of personal weakness, or an attempt to receive secondary gain (such as attention from others or disability payments).

Indd 24 1/23/10 1:40:30 AM 100 QUESTIONS & ANSWERS ABOUT DEPRESSION The Basics system where physicians took responsibility for the general health care of the mentally ill who were confined to asylums. Psychiatrists begin studies in human anatomy and physiology as medical students. Graduating with a medical degree and the same educational background as all physicians, psychiatrists spend a year in an internship that may include psychiatry but must include medicine or some other medical rotation and neurology.

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