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Massachusetts Medical Society's Physician Focus

February 2013

Understanding Depression


  • Depression is a chronic mental illness that affects about one in ten adults each year in the U.S.; it is a leading cause of disability for those 15-44 years of age.

  • Though women are more likely to experience depression, the illness can reach anyone, regardless of age or social, ethnic, or economic background.

  • Depression affects more than 6.5 million Americans 65 and older, and often goes untreated in the elderly because many think depression is a normal part of aging.

  • Depression is a very treatable illness, usually addressed with counseling or medication, or a combination of both.

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“Depression is not just having a bad day,” says psychiatrist Marie Hobart. It is really a serious medical illness that can be very debilitating and even life threatening. It really takes the life out of life.”

With that description, Marie Hobart, M.D. begins a discussion about the medical illness of depression on the February edition of Physician Focus with the Massachusetts Medical Society. Dr. Hobart, who is the chief medical officer of Community Healthlink, a part of UMass Memorial Health Care that provides psychiatric, mental health, and substance abuse services for families and individual patients in Central Massachusetts, joins program host John Fromson, M.D., a fellow psychiatrist and associate director of graduate medical education at Massachusetts General Hospital, in lifting some of the mystery surrounding this often-stigmatizing illness.

Dr. Hobart characterizes depression as a prolonged period of feeling extremely sad and irritable, affecting a person’s ability to enjoy the things he or she normally enjoys and making it difficult to function in one’s normal role, whether it be at work, at school, or at home. Among other symptoms are pronounced changes in sleep, appetite, and energy; and feelings of guilt, hopelessness, or suicide.

She cites a number of factors that contribute to the condition, including the experiences of major losses, such as the death of a loved one or the loss of a job or home. Genetic and environmental factors, along with a family history of the condition, can also raise a person’s predisposition to depression, and other chronic medical conditions, such as heart disease, diabetes, chronic pain, cancer or other life-threatening illnesses, can increase the risk of depression for patients as well.

“The condition impacts one’s ability to socialize, to work, and to carry out the normal activities of life; it can be remarkably impairing,” says Dr. Hobart, who is also a clinical associate professor of psychiatry at the University of Massachusetts Medical School.

Depression can also lead to physical problems, she says, such as alcohol or drug abuse, deterioration of eating and sleeping habits, and nonspecific aches and pains like stomach aches or headaches. And it can disrupt family and personal relationships.

It’s a condition that knows no age boundaries; it can affect any age group, from children to seniors. While it becomes more common as people get older, Dr. Hobart is quick to point out that “depression is not a normal part of aging.”

Recognizing the signs of depression is the first step to treating the condition, she says, and various therapies are available, including counseling and medication.

But on a positive note, and reflecting the growing idea in medicine that ‘what’s good for the body is good for the mind,’ Dr. Hobart urges people to take preventive steps for their mental health by focusing on their physical health.

“It’s important to be proactive about your mental health,” she advises, and that includes paying attention to physical health. “Having a healthy body helps to decrease your anxiety level and your risk of depression. A healthy diet and especially physical activity can have huge benefits.”

She also has a hopeful message for those with the condition: that depression need not be a lifelong condition. “Seeking treatment is very important,” she cautions, and “the good news is that depression is very treatable.”

Watch the accompanying program for the full discussion, including conversation on how depression is an illness that affects the brain, how isolation plays a dual role in the illness, how medications work on the brain, and how other treatment options such as electro convulsive therapy work as therapies for the illness.

MMS/Richard Gulla

National Alliance on Mental Illness

National Institute of Mental Health

American Academy of Child and Adolescent Psychiatry

American Psychiatric Association

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"Understanding Depression" PSA

From left, John Fromson, M.D., Marie Hobart, M.D.
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