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March 6, 2003

A rapidly growing health problem

“How many of you have a family member or a close friend who, at some point in the last 10 to 15 years, has suffered from depression?” David J. Kupfer asked Pitt trustees during their Feb. 20 meeting.

Nearly all of the 42 people at the meeting table raised their hands.

As recently as a decade or two ago, Kupfer suggested, his question might well have seemed provocative, and the show of hands tantamount to a public confession that trustees’ loved ones had a shameful condition they were too lazy to shake off.

Even today, “there is still a great deal of stigma attached to coming forward and saying, ‘I’m depressed, I need help, I’m not functioning as well as I can,’” said Kupfer, who is the Thomas Detre Professor and chair of Pitt’s psychiatry department.

That’s especially true among men (who are less prone to depression than are women) and in some minority communities, said Kupfer.

The National Institutes of Health is launching a campaign aimed at convincing men that seeking help for depression is not unmasculine or a sign of weakness, he noted. Psychiatry faculty are working with Pitt’s Center for Minority Health to raise awareness of depression among blacks. “If you are young, elderly or live in the African-American community, the likelihood is greater that you will be misdiagnosed and will not get treated” for depression, said Kupfer.

“We need to do a better job of recognizing different areas of society where it’s just not accepted to be depressed. Or, if you are depressed, it’s not accepted to get treatment. Or, even if you get treatment, it’s not accepted to continue to get treatment,” Kupfer said.

Seventy-five percent of major depressive disorders are recurrent, meaning that persons with the disorders will suffer two or more episodes in their lifetimes, studies show. The average number of episodes ranges between four and eight.

Until scientists find a cure, Kupfer said, depressed people and their families should view depression as an ongoing condition.

No one would advise a person with diabetes to stop taking insulin for a year “just to see how it works out,” he said. But too often, Kupfer said, people whose moods rebound following treatment for depression are reluctant to seek follow-up help when symptoms of depression return.

— Bruce Steele

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