Depression affects approximately 121 million people worldwide. The total cost of depression for Americans has risen to over 40 billion dollars each year for direct and indirect costs. Direct costs, such as hospitalization, outpatient care, and drug treatment, account for $12.4 billion, while indirect costs incurred by lost productivity, absenteeism, and suicide-related losses in productivity comprise the remainder.
When a person is depressed, it interferes with his or her daily life and routine, such as going to work or school, taking care of children, and relationships with family and friends. The illness causes pain for the person who has it and for those who care about him or her. Loss of a loved one, divorce, bereavement, social isolation, stress and hormonal changes, or traumatic events may trigger depression at any age.
Women are twice as likely to be diagnosed with Major Depressive Disorder as men. It occurs most often between the ages of 25 and 44. At any given time, up to 9 percent of women and 4 percent of men may have the disorder.
The clinical course of major depressive disorder is quite variable. The disorder typically has its onset when the patient is in his or her mid-20s or 30s, but a later onset is not uncommon.
Most patients who have major depressive disorder will eventually recover, but some patients will never have a remission (two months or more with no symptoms, or one or two symptoms to a mild degree) and others may have many years in which they have no signs and symptoms of depression.
Patients who have had severe depression or who have had an onset at a relatively young age are more likely to have recurrent depression, and depression accompanied with anxiety, personality disorders, or psychotic features has a poor prognosis for remission. Gender and age do not seem to affect the progression of major depressive disorder.
Major depressive disorder is associated with a high mortality risk and most of this risk is from suicide. Major depressive disorder is considered to be a significant risk factor for suicidal behavior, and suicide attempts or threats of suicide are considered to be consistent risk factors for suicide in patients who have major depressive disorder.
Major depressive disorder is a risk factor for the development of chronic diseases (and it negatively influences the progression of these diseases) such as cardiovascular diseases, diabetes, and neurological disorders.
People who have major depressive disorder are more likely to smoke, abuse alcohol and drugs, they report a lower quality of life, and this disorder has a profound effect on the patient’s family life, personal relationships, and professional and social life.