The percentage of Americans being treated for depression more than tripled between 1987 and 1997, according to a study published in the most recent issue of the Journal of the American Medical Association. The study points to the destigmatization of depression as one of the causes for the increase in people seeking treatment as well as the availability of drugs such as Prozac, which was made available in 1987. This increase shows a better willingness of people to seek out help, which is especially important to women’s health as more women suffer from depression than men. However, Harold Pincus, vice chairman for psychiatry at the University of Pittsburgh and one of the study’s authors, cautions, “What we don’t know about is the quality of the care people are getting.” Pincus continues, “There are reasons to suggest there are problems with quality.”
According to the study, medication is given to about 75 percent of patients suffering from depression, but patients are visiting their doctors for depression less and are using their primary care physicians for treatment instead of mental health professionals. Primary care doctors do not have an incentive for conducting long-term care and follow up for depression, which may undermine patient care. Managed-care companies also encourage drug use rather than psychotherapy for patients, even though psychotherapy has been shown to be as effective as medication alone and the combination of psychotherapy and medication has been found to be the most effective way of treating depression. The effect of managed-care companies on treatment is questionable as Geoffrey Reed, Assistant Executive Director for Professional Development at the American Psychological Association notes that “Survey after survey has shown that given a choice between psychotherapy and antidepressant medication, the majority of patients prefer psychotherapy.”
Psychologists also warn that medication alone is not as effective in preventing relapse, as it does not address the environmental factors triggering depression. These factors may be particularly important to women as research suggests that greater exposure to chronic negative circumstances, increased likelihood to ruminate, and social factors may all play a role in women’s greater likelihood of depression.