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Essays About Depression

Depression essay topic examples.

Explore topics like the impact of stigma on depression, compare it across age groups or in literature and media, describe the emotional journey of depression, discuss how education can help, and share personal stories related to it. These essay ideas offer a broad perspective on depression, making it easier to understand and engage with this important subject.

Argumentative Essays

Argumentative essays require you to analyze and present arguments related to depression. Here are some topic examples:

• 1. Argue whether mental health stigma contributes to the prevalence of depression in society.
• 2. Analyze the effectiveness of different treatment approaches for depression, such as therapy versus medication.

Example Introduction Paragraph for an Argumentative Essay: Depression is a pervasive mental health issue that affects millions of individuals worldwide. This essay delves into the complex relationship between mental health stigma and the prevalence of depression in society, examining the barriers to seeking help and the consequences of this stigma.

Example Conclusion Paragraph for an Argumentative Essay: In conclusion, the analysis of mental health stigma's impact on depression underscores the urgent need to challenge and dismantle the stereotypes surrounding mental health. As we reflect on the far-reaching consequences of stigma, we are called to create a society that fosters empathy, understanding, and open dialogue about mental health.

Compare and Contrast Essays

Compare and contrast essays enable you to examine similarities and differences within the context of depression. Consider these topics:

• 1. Compare and contrast the symptoms and risk factors of depression in adolescents and adults.
• 2. Analyze the similarities and differences between the portrayal of depression in literature and its depiction in modern media.

Example Introduction Paragraph for a Compare and Contrast Essay: Depression manifests differently in various age groups and mediums of expression. This essay embarks on a journey to compare and contrast the symptoms and risk factors of depression in adolescents and adults, shedding light on the unique challenges faced by each demographic.

Example Conclusion Paragraph for a Compare and Contrast Essay: In conclusion, the comparison and contrast of depression in adolescents and adults highlight the importance of tailored interventions and support systems. As we contemplate the distinct challenges faced by these age groups, we are reminded of the need for age-appropriate mental health resources and strategies.

Descriptive Essays

Descriptive essays allow you to vividly depict aspects of depression, whether it's the experience of the individual or the societal impact. Here are some topic ideas:

• 1. Describe the emotional rollercoaster of living with depression, highlighting the highs and lows of the experience.
• 2. Paint a detailed portrait of the consequences of untreated depression on an individual's personal and professional life.

Example Introduction Paragraph for a Descriptive Essay: Depression is a complex emotional journey that defies easy characterization. This essay embarks on a descriptive exploration of the emotional rollercoaster that individuals with depression experience, delving into the profound impact it has on their daily lives.

Example Conclusion Paragraph for a Descriptive Essay: In conclusion, the descriptive portrayal of the emotional rollercoaster of depression underscores the need for empathy and support for those grappling with this condition. Through this exploration, we are reminded of the resilience of the human spirit and the importance of compassionate understanding.

Persuasive Essays

Persuasive essays involve arguing a point of view related to depression. Consider these persuasive topics:

• 1. Persuade your readers that incorporating mental health education into the school curriculum can reduce the prevalence of depression among students.
• 2. Argue for or against the idea that employers should prioritize the mental well-being of their employees to combat workplace depression.

Example Introduction Paragraph for a Persuasive Essay: The prevalence of depression underscores the urgent need for proactive measures to address mental health. This persuasive essay asserts that integrating mental health education into the school curriculum can significantly reduce the prevalence of depression among students, offering them the tools to navigate emotional challenges.

Example Conclusion Paragraph for a Persuasive Essay: In conclusion, the persuasive argument for mental health education in schools highlights the potential for early intervention and prevention. As we consider the well-being of future generations, we are called to prioritize mental health education as an essential component of a holistic education system.

Narrative Essays

Narrative essays offer you the opportunity to tell a story or share personal experiences related to depression. Explore these narrative essay topics:

• 1. Narrate a personal experience of overcoming depression or supporting a loved one through their journey.
• 2. Imagine yourself in a fictional scenario where you advocate for mental health awareness and destigmatization on a global scale.

Example Introduction Paragraph for a Narrative Essay: Personal experiences with depression can be transformative and enlightening. This narrative essay delves into a personal journey of overcoming depression, highlighting the challenges faced, the support received, and the lessons learned along the way.

Example Conclusion Paragraph for a Narrative Essay: In conclusion, the narrative of my personal journey through depression reminds us of the resilience of the human spirit and the power of compassion and understanding. As we reflect on our own experiences, we are encouraged to share our stories and contribute to the ongoing conversation about mental health.

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Overview of Biological Predispositions and Risk Factors Associated with Depression

How to overcome depression and anxiety, depression: definition, risks, symptoms and treatment, the best way to help someone who is depressed, get a personalized essay in under 3 hours.

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The Issue of Depression: Mental Battle

What is a depression, living in depression: a firsthand account, teen depression - symptoms and causes, adolescent depression and its contribution to teenage suicides, the issue of depression and its affect in an emerging adulthood, depression: definition and ways of resolving caused problems, depression in teenagers: causes and ways to overcome, depression and its main causes, genetic disorder report: clinical depression, the way teachers can help their students to overcome anxiety and depression, depression and its effects of mind and body, the effectiveness of cognitive behavioural therapy (cbt) for treating individuals with depression and anxiety, how to overcome teenage depression, depression as the reason of serious health problems and suicide, a depressing world with different obstacles, the link between self-esteem and adolescent depression, darwinian psychology and depression: the gender differential hypothesis, prevention of depression, anxiety and burnout in resident doctors – a systematic review, dysregulated processing of negative and positive responses in depression.

Depression, known as major depressive disorder or clinical depression, is a psychological condition characterized by enduring feelings of sadness and a significant loss of interest in activities. It is a mood disorder that affects a person's emotional state, thoughts, behaviors, and overall well-being.

Its origin can be traced back to ancient civilizations, where melancholia was described as a state of sadness and melancholy. In the 19th century, depression began to be studied more systematically, and terms such as "melancholic depression" and "nervous breakdown" emerged. The understanding and classification of depression have evolved over time. In the early 20th century, Sigmund Freud and other psychoanalysts explored the role of unconscious conflicts in the development of depression. In the mid-20th century, the Diagnostic and Statistical Manual of Mental Disorders (DSM) was established, providing a standardized criteria for diagnosing depressive disorders.

Biological Factors: Genetic predisposition plays a role in depression, as individuals with a family history of the disorder are at a higher risk. Psychological Factors: These may include a history of trauma or abuse, low self-esteem, pessimistic thinking patterns, and a tendency to ruminate on negative thoughts. Environmental Factors: Adverse life events, such as the loss of a loved one, financial difficulties, relationship problems, or chronic stress, can increase the risk of depression. Additionally, living in a socioeconomically disadvantaged area or lacking access to social support can be contributing factors. Health-related Factors: Chronic illnesses, such as cardiovascular disease, diabetes, and chronic pain, are associated with a higher risk of depression. Substance abuse and certain medications can also increase vulnerability to depression. Developmental Factors: Certain life stages, including adolescence and the postpartum period, bring about unique challenges and changes that can contribute to the development of depression.

Depression is characterized by a range of symptoms that affect an individual's emotional, cognitive, and physical well-being. These characteristics can vary in intensity and duration but generally include persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities once enjoyed. One prominent characteristic of depression is a noticeable change in mood, which can manifest as a constant feeling of sadness or emptiness. Individuals may also experience a significant decrease or increase in appetite, leading to weight loss or gain. Sleep disturbances, such as insomnia or excessive sleepiness, are common as well. Depression can impact cognitive functioning, causing difficulties in concentration, decision-making, and memory recall. Negative thoughts, self-criticism, and feelings of guilt or worthlessness are also common cognitive symptoms. Furthermore, physical symptoms may arise, including fatigue, low energy levels, and a general lack of motivation. Physical aches and pains, without an apparent medical cause, may also be present.

The treatment of depression typically involves a comprehensive approach that addresses both the physical and psychological aspects of the condition. It is important to note that the most effective treatment may vary for each individual, and a personalized approach is often necessary. One common form of treatment is psychotherapy, which involves talking to a mental health professional to explore and address the underlying causes and triggers of depression. Cognitive-behavioral therapy (CBT) is a widely used approach that helps individuals identify and change negative thought patterns and behaviors associated with depression. In some cases, medication may be prescribed to help manage depressive symptoms. Antidepressant medications work by balancing neurotransmitters in the brain that are associated with mood regulation. It is crucial to work closely with a healthcare provider to find the right medication and dosage that suits an individual's needs. Additionally, lifestyle changes can play a significant role in managing depression. Regular exercise, a balanced diet, sufficient sleep, and stress reduction techniques can all contribute to improving mood and overall well-being. In severe cases of depression, when other treatments have not been effective, electroconvulsive therapy (ECT) may be considered. ECT involves administering controlled electric currents to the brain to induce a brief seizure, which can have a positive impact on depressive symptoms.

1. According to the World Health Organization (WHO), over 264 million people worldwide suffer from depression, making it one of the leading causes of disability globally. 2. Depression can affect people of all ages, including children and adolescents. In fact, the prevalence of depression in young people is increasing, with an estimated 3.3 million adolescents in the United States experiencing at least one major depressive episode in a year. 3. Research has shown that there is a strong link between depression and other physical health conditions. People with depression are more likely to experience chronic pain, cardiovascular diseases, and autoimmune disorders, among other medical conditions.

The topic of depression holds immense significance and should be explored through essays due to its widespread impact on individuals and society as a whole. Understanding and raising awareness about depression is crucial for several reasons. Firstly, depression affects a significant portion of the global population, making it a pressing public health issue. Exploring its causes, symptoms, and treatment options can contribute to better mental health outcomes and improved quality of life for individuals affected by this condition. Additionally, writing an essay about depression can help combat the stigma surrounding mental health. By promoting open discussions and providing accurate information, essays can challenge misconceptions and foster empathy and support for those experiencing depression. Furthermore, studying depression allows for a deeper examination of its complex nature, including its psychological, biological, and sociocultural factors. Lastly, essays on depression can highlight the importance of early detection and intervention, promoting timely help-seeking behaviors and reducing the burden of the condition on individuals and healthcare systems. By shedding light on this critical topic, essays have the potential to educate, inspire action, and contribute to the overall well-being of individuals and society.

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. 2. World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. World Health Organization. 3. Kessler, R. C., Bromet, E. J., & Quinlan, J. (2013). The burden of mental disorders: Global perspectives from the WHO World Mental Health Surveys. Cambridge University Press. 4. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press. 5. Nierenberg, A. A., & DeCecco, L. M. (2001). Definitions and diagnosis of depression. The Journal of Clinical Psychiatry, 62(Suppl 22), 5-9. 6. Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). Journal of Clinical Psychiatry, 76(2), 155-162. 7. Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry, 58(7), 376-385. 8. Hirschfeld, R. M. A. (2014). The comorbidity of major depression and anxiety disorders: Recognition and management in primary care. Primary Care Companion for CNS Disorders, 16(2), PCC.13r01611. 9. Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Nierenberg, A. A., Stewart, J. W., Warden, D., ... & Fava, M. (2006). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. American Journal of Psychiatry, 163(11), 1905-1917. 10. Kendler, K. S., Kessler, R. C., Walters, E. E., MacLean, C., Neale, M. C., Heath, A. C., & Eaves, L. J. (1995). Stressful life events, genetic liability, and onset of an episode of major depression in women. American Journal of Psychiatry, 152(6), 833-842.

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Conclusion depression.

Depression is one of the most common conditions in primary care, but is often unrecognized, undiagnosed, and untreated. Depression has a high rate of morbidity and mortality when left untreated. Most patients suffering from depression do not complain of feeling depressed, but rather anhedonia or vague unexplained symptoms. All physicians should remain alert to effectively screen for depression in their patients. There are several screening tools for depression that are effective and feasible in primary care settings. An appropriate history, physical, initial basic lab evaluation, and mental status examination can assist the physician in diagnosing the patient with the correct depressive spectrum disorder (including bipolar disorder). Primary care physicians should carefully assess depressed patients for suicide. Depression in the elderly is not part of the normal aging process. Patients who are elderly when they have their first episode of depression have a relatively higher likelihood of developing chronic and recurring depression. The prognosis for recovery is equal in young and old patients, although remission may take longer to achieve in older patients. Elderly patients usually start antidepressants at lower doses than their younger counterparts.

Most primary care physician can successfully treat uncomplicated mild or moderate forms of major depression in their settings with careful psychiatric management (e.g., close monitoring of symptoms, side effects, etc.); maintaining a therapeutic alliance with their patient; pharmacotherapy (acute, continuation, and maintenance phases); and / or referral for psychotherapy. The following situations require referral to psychiatrist: suicide risk, bipolar disorder or a manic episode, psychotic symptoms, severe decrease in level of functioning, recurrent depression and chronic depression, depression that is refractory to treatment, cardiac disease that requires tricyclic antidepressants treatment, need for electroconvulsive therapy (ECT), lack of available support system, and any diagnostic or treatment questions.

Antidepressant medications’ effectiveness is generally comparable across classes and within classes of medications.  The medications differ in side effect profiles, drug-drug interactions, and cost.  The history of a positive response to a particular drug for an individual or a family member, as well as patient preferences, should also be taken into account.  Most psychiatrists agree that an SSRI should be the first line choice.  The dual action reuptake inhibitors venlafaxine and bupropion are generally regarded as second line agents.  Tricyclics and other mixed or dual action inhibitors are third line, and MAOI’s (monoamine oxidase inhibitors) are usually medications of last resort for patients who have not responded to other medications, due to their low tolerability, dietary restrictions, and drug-drug interactions.  Most primary care physicians would prefer that a psychiatrist manage patients requiring MAOI’s.

Psychotherapy may be a first line therapy choice for mild depression particularly when associated with psychosocial stress, interpersonal problems, or with concurrent developmental or personality disorders. Psychotherapy in mild to moderate depression is most effective in the acute phase, and in preventing relapse during continuation phase treatment. Psychotherapy is not appropriate alone for severe depression, psychosis, and bipolar disorders. For more severe depression, psychotherapy may be appropriate in combination with the use of medications. The most effective forms of psychotherapy are those with structured and brief approaches such as cognitive behavioral therapy, interpersonal therapy, and certain problem solving therapies. Regardless of the psychotherapy initiated, “psychiatric management” must be integrated at the same time.

Patients, who live with depression, and their family and friends, have enormous challenges to overcome. Primary care physicians can provide compassionate care, important education, psychiatric monitoring, social support, reassurance, and advocacy for these patients and their loved ones.

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Essays About Depression: Top 8 Examples Plus Prompts

Many people deal with mental health issues throughout their lives; if you are writing essays about depression, you can read essay examples to get started.

An occasional feeling of sadness is something that everyone experiences from time to time. Still, a persistent loss of interest, depressed mood, changes in energy levels, and sleeping problems can indicate mental illness. Thankfully, antidepressant medications, therapy, and other types of treatment can be largely helpful for people living with depression.

People suffering from depression or other mood disorders must work closely with a mental health professional to get the support they need to recover. While family members and other loved ones can help move forward after a depressive episode, it’s also important that people who have suffered from major depressive disorder work with a medical professional to get treatment for both the mental and physical problems that can accompany depression.

If you are writing an essay about depression, here are 8 essay examples to help you write an insightful essay. For help with your essays, check out our round-up of the best essay checkers .

• 1. My Best Friend Saved Me When I Attempted Suicide, But I Didn’t Save Her by Drusilla Moorhouse
• 2. How can I complain? by James Blake
• 3. What it’s like living with depression: A personal essay by Nadine Dirks
• 4. I Have Depression, and I’m Proof that You Never Know the Battle Someone is Waging Inside by Jac Gochoco
• 5. Essay: How I Survived Depression by Cameron Stout
• 6. I Can’t Get Out of My Sweat Pants: An Essay on Depression by Marisa McPeck-Stringham
• 7. This is what depression feels like by Courtenay Harris Bond

8. Opening Up About My Struggle with Recurring Depression by Nora Super

1. what is depression, 2. how is depression diagnosed, 3. causes of depression, 4. different types of depression, 5. who is at risk of depression, 6. can social media cause depression, 7. can anyone experience depression, the final word on essays about depression, is depression common, what are the most effective treatments for depression, top 8 examples, 1.  my best friend saved me when i attempted suicide, but i didn’t save her  by drusilla moorhouse.

“Just three months earlier, I had been a patient in another medical facility: a mental hospital. My best friend, Denise, had killed herself on Christmas, and days after the funeral, I told my mom that I wanted to die. I couldn’t forgive myself for the role I’d played in Denise’s death: Not only did I fail to save her, but I’m fairly certain I gave her the idea.”

Moorhouse makes painstaking personal confessions throughout this essay on depression, taking the reader along on the roller coaster of ups and downs that come with suicide attempts, dealing with the death of a loved one, and the difficulty of making it through major depressive disorder.

2.  How can I complain?  by James Blake

“I wanted people to know how I felt, but I didn’t have the vocabulary to tell them. I have gone into a bit of detail here not to make anyone feel sorry for me but to show how a privileged, relatively rich-and-famous-enough-for-zero-pity white man could become depressed against all societal expectations and allowances. If I can be writing this, clearly it isn’t only oppression that causes depression; for me it was largely repression.”

Musician James Blake shares his experience with depression and talks about his struggles with trying to grow up while dealing with existential crises just as he began to hit the peak of his fame. Blake talks about how he experienced guilt and shame around the idea that he had it all on the outside—and so many people deal with issues that he felt were larger than his.

3.  What it’s like living with depression: A personal essay   by Nadine Dirks

“In my early adulthood, I started to feel withdrawn, down, unmotivated, and constantly sad. What initially seemed like an off-day turned into weeks of painful feelings that seemed they would never let up. It was difficult to enjoy life with other people my age. Depression made typical, everyday tasks—like brushing my teeth—seem monumental. It felt like an invisible chain, keeping me in bed.”

Dirks shares her experience with depression and the struggle she faced to find treatment for mental health issues as a Black woman. Dirks discusses how even though she knew something about her mental health wasn’t quite right, she still struggled to get the diagnosis she needed to move forward and receive proper medical and psychological care.

4.  I Have Depression, and I’m Proof that You Never Know the Battle Someone is Waging Inside  by Jac Gochoco

“A few years later, at the age of 20, my smile had fallen, and I had given up. The thought of waking up the next morning was too much for me to handle. I was no longer anxious or sad; instead, I felt numb, and that’s when things took a turn for the worse. I called my dad, who lived across the country, and for the first time in my life, I told him everything. It was too late, though. I was not calling for help. I was calling to say goodbye.”

Gochoco describes the war that so many people with depression go through—trying to put on a brave face and a positive public persona while battling demons on the inside. The Olympic weightlifting coach and yoga instructor now work to share the importance of mental health with others.

5.  Essay: How I Survived Depression   by Cameron Stout

“In 1993, I saw a psychiatrist who prescribed an antidepressant. Within two months, the medication slowly gained traction. As the gray sludge of sadness and apathy washed away, I emerged from a spiral of impending tragedy. I helped raise two wonderful children, built a successful securities-litigation practice, and became an accomplished cyclist. I began to take my mental wellness for granted. “

Princeton alum Cameron Stout shared his experience with depression with his fellow Tigers in Princeton’s alumni magazine, proving that even the most brilliant and successful among us can be rendered powerless by a chemical imbalance. Stout shares his experience with treatment and how working with mental health professionals helped him to come out on the other side of depression.

6.  I Can’t Get Out of My Sweat Pants: An Essay on Depression  by Marisa McPeck-Stringham

“Sometimes, when the depression got really bad in junior high, I would come straight home from school and change into my pajamas. My dad caught on, and he said something to me at dinner time about being in my pajamas several days in a row way before bedtime. I learned it was better not to change into my pajamas until bedtime. People who are depressed like to hide their problematic behaviors because they are so ashamed of the way they feel. I was very ashamed and yet I didn’t have the words or life experience to voice what I was going through.”

McPeck-Stringham discusses her experience with depression and an eating disorder at a young age; both brought on by struggles to adjust to major life changes. The author experienced depression again in her adult life, and thankfully, she was able to fight through the illness using tried-and-true methods until she regained her mental health.

7.  This is what depression feels like  by Courtenay Harris Bond

“The smallest tasks seem insurmountable: paying a cell phone bill, lining up a household repair. Sometimes just taking a shower or arranging a play date feels like more than I can manage. My children’s squabbles make me want to scratch the walls. I want to claw out of my own skin. I feel like the light at the end of the tunnel is a solitary candle about to blow out at any moment. At the same time, I feel like the pain will never end.”

Bond does an excellent job of helping readers understand just how difficult depression can be, even for people who have never been through the difficulty of mental illness. Bond states that no matter what people believe the cause to be—chemical imbalance, childhood issues, a combination of the two—depression can make it nearly impossible to function.

“Once again, I spiraled downward. I couldn’t get out of bed. I couldn’t work. I had thoughts of harming myself. This time, my husband urged me to start ECT much sooner in the cycle, and once again, it worked. Within a matter of weeks I was back at work, pretending nothing had happened. I kept pushing myself harder to show everyone that I was “normal.” I thought I had a pattern: I would function at a high level for many years, and then my depression would be triggered by a significant event. I thought I’d be healthy for another ten years.”

Super shares her experience with electroconvulsive therapy and how her depression recurred with a major life event despite several years of solid mental health. Thankfully, Super was able to recognize her symptoms and get help sooner rather than later.

7 Writing Prompts on Essays About Depression

When writing essays on depression, it can be challenging to think of essay ideas and questions. Here are six essay topics about depression that you can use in your essay.

Depression can be difficult to define and understand. Discuss the definition of depression, and delve into the signs, symptoms, and possible causes of this mental illness. Depression can result from trauma or personal circumstances, but it can also be a health condition due to genetics. In your essay, look at how depression can be spotted and how it can affect your day-to-day life. 

Depression diagnosis can be complicated; this essay topic will be interesting as you can look at the different aspects considered in a diagnosis. While a certain lab test can be conducted, depression can also be diagnosed by a psychiatrist. Research the different ways depression can be diagnosed and discuss the benefits of receiving a diagnosis in this essay.

There are many possible causes of depression; this essay discusses how depression can occur. Possible causes of depression can include trauma, grief, anxiety disorders, and some physical health conditions. Look at each cause and discuss how they can manifest as depression.

There are many different types of depression. This essay topic will investigate each type of depression and its symptoms and causes. Depression symptoms can vary in severity, depending on what is causing it. For example, depression can be linked to medical conditions such as bipolar disorder. This is a different type of depression than depression caused by grief. Discuss the details of the different types of depression and draw comparisons and similarities between them.

Certain genetic traits, socio-economic circumstances, or age can make people more prone to experiencing symptoms of depression. Depression is becoming more and more common amongst young adults and teenagers. Discuss the different groups at risk of experiencing depression and how their circumstances contribute to this risk.

Social media poses many challenges to today’s youth, such as unrealistic beauty standards, cyber-bullying, and only seeing the “highlights” of someone’s life. Can social media cause depression in teens? Delve into the negative impacts of social media when writing this essay. You could compare the positive and negative sides of social media and discuss whether social media causes mental health issues amongst young adults and teenagers.

This essay question poses the question, “can anyone experience depression?” Although those in lower-income households may be prone to experiencing depression, can the rich and famous also experience depression? This essay discusses whether the privileged and wealthy can experience their possible causes. This is a great argumentative essay topic, discuss both sides of this question and draw a conclusion with your final thoughts.

When writing about depression, it is important to study examples of essays to make a compelling essay. You can also use your own research by conducting interviews or pulling information from other sources. As this is a sensitive topic, it is important to approach it with care; you can also write about your own experiences with mental health issues.

Tip: If writing an essay sounds like a lot of work, simplify it. Write a simple 5 paragraph essay instead.

FAQs On Essays About Depression

According to the World Health Organization, about 5% of people under 60 live with depression. The rate is slightly higher—around 6%—for people over 60. Depression can strike at any age, and it’s important that people who are experiencing symptoms of depression receive treatment, no matter their age. 

Suppose you’re living with depression or are experiencing some of the symptoms of depression. In that case, it’s important to work closely with your doctor or another healthcare professional to develop a treatment plan that works for you. A combination of antidepressant medication and cognitive behavioral therapy is a good fit for many people, but this isn’t necessarily the case for everyone who suffers from depression. Be sure to check in with your doctor regularly to ensure that you’re making progress toward improving your mental health.

If you’re still stuck, check out our general resource of essay writing topics .

Amanda has an M.S.Ed degree from the University of Pennsylvania in School and Mental Health Counseling and is a National Academy of Sports Medicine Certified Personal Trainer. She has experience writing magazine articles, newspaper articles, SEO-friendly web copy, and blog posts.

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A major aim of this course was to shed some light on the aetiology of depression and anxiety. At the end of it you should have some idea of the complexity of this enterprise. We have focused on one of the best-studied and hence best-understood contributors to psychopathology – stress. This has biological, social and psychological significance, and its operation can be studied and understood at all these levels.

The clear message you should take away is that interaction between these levels is enormously important in aetiology. Biological factors, such as dysregulation of the HPA axis and its consequences, possible abnormalities in brain neurotransmitter systems, the effects of stress on the developing brain at different ages, and the kinds of genes that an individual carries, appear to play an important part in the development and maintenance of emotional disorders such as depression and anxiety. However, these biological factors cannot be divorced from factors that are thought of as psychosocial, such as abuse in childhood, or stressful events and how we perceive them. This is very evident from the most recent developments in genetics, which show how, via epigenetic processes, experiences are translated into the activity (or expression) of genes, which then modify the workings of the brain in ways that affect mood.

Research into epigenetic influences on mental health and ill-health is burgeoning and is likely to make a very significant contribution to our understanding of aetiology in the years to come. If so, it should also help clarify how existing treatments, both pharmacological and psychotherapeutic, for emotional disorders work, or suggest new approaches that would work more effectively.

The HPA axis is overactive in those with depression and anxiety, suggesting a role for chronic stress. Elevated levels of glucocorticoids such as cortisol and corticosterone, resulting from chronic stress, have toxic effects in some areas of the brain and promote neurogenesis in others.

The monoamine hypothesis of mood disorders has been influential in trying to explain the causes of depression. However the picture is now more complex and the view of a simple chemical imbalance as a cause of depression is outdated.

Hypotheses such as the neurotrophic hypothesis and the network hypothesis have been developed to try to account for the complex effects of antidepressant treatments on the brain.

The life-cycle model of stress links brain development with stress effects over the lifetime.

The cognitive approach concentrates on particular ways of thinking and how these cause and sustain depression.

Genetic and other vulnerabilities (also called predispositions or diatheses) can interact with environmental factors, which include psychosocial stressors such as stressful life events and early life stress (including child abuse) to cause emotional disorders such as depression.

Epigenetic processes add another layer of complexity to the interaction between genes and environment. There is increasingly evidence of the importance of epigenetic processes in the aetiology of mood disorders.

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How To Write A Strong Essay On Depression?

Table of Contents

Looking for useful information that will help you write a powerful essay on depression? You’ve come to the right place, then!

Depression is a worldwide spread disease that negatively affects how people feel, the way they think, and how they act. It is also the leading cause of disability. There are estimates that more than 300 million people are affected by depression globally, and this condition is also one of the most common mental disorders in the USA.

No wonder depression essay is a typical assignment for high school and college students. The goal of writing about this mental condition is to increase awareness among young people about mental health and help them find solutions to this problem.

In this guide, you will find all the necessary information for writing the best essays on this topic.

Depression essay: what’s the deal?

At some point in our lives, we all may experience symptoms like sadness, loss of interest, lack of pleasure from performing daily activities, etc.

For most people, these symptoms are a completely normal response to unpleasant or stressful events that they experience, for example, romantic relationships failures or financial issues.

Negative feelings are usually painful and overwhelming, but as time goes by, they become less intense and disappear.

But if these feelings persist, they may affect people’s life substantially and result in depression.

In recent decades, clinical depression has reached epidemic proportions and is widespread in the suburbs inner cities, farms, refugee camps, boardrooms, and classrooms, and women are more likely to be depressed than man.

Recent research reveals that the United States is the most depressed country in the world.

When writing an essay about this mental illness, you need to examine different aspects. For example, you may write a postpartum depression essay or explore how this mental condition affects the brain, personality, and physical health.

The choice of topics is endless, but you should follow standard writing requirements when working on your projects. Let’s discuss some important steps of writing an essay about mental disorders in detail.

Depression research paper outline: a brief how-to

Many students skip this stage in the writing process and as a result, may waste a lot of time when doing research and actually writing.

Creating a working outline for your project is an essential step that will help you stay focused and increase your overall productivity. Never skip this crucial step if you want to succeed.

Here are some tips on how you can do it right.

• Choose a topic for your research and do some preliminary reading. Search for some interesting facts and try to think about new ways to address your topic. Scan some articles and look for knowledge gaps.
• Take notes when you see an interesting quote and create a list of your sources. You can use them as references in your essay. Keep all the information you have gathered in one place.
• Write down the objective of your essay in one sentence. Think about the outcome you want to achieve when other people read your essay.
• Look through your notes and make a list of all the important points you want to make. Use brainstorming techniques and write down all ideas that pop into your head.
• Review the points and create a thesis statement for depression research paper or essay.
• Organize the list of points to create a structure of your essay . Put the points in a logical order. Check all aspects to make sure that each of them is relevant to your objective.
• Revise all your points and try to put your outline in a standard format: numbered or bulleted list.

Depression essay introduction: how to start?

The introduction of your essay should provide some context and prepare your readers for the arguments you would present next.

Start your introduction with an attention grabber to engage your audience. It can be a provocative question, statistics, an anecdote, an interesting fact, etc.

Introduce your specific topic and provide some context to help your readers understand your paper. For example, you can define some key terms.

Finish your introduction with a strong thesis statement that clearly and concisely states the central argument or the purpose of your paper.

e.g., Students who drop out of a high school before graduation are more susceptible to depression and anxiety and have a higher risk of facing mental and physical health problems later in life.

You may also briefly outline the major points of your paper to help your audience follow your argument.

Depression essay conclusion: what should be included?

The conclusion is the last chance to impress your readers so it can be the most challenging part of an essay to write.

It should give your paper a sense of completeness and answer the question, “so what?”

You need to restate your main claim and tie that claim to a larger discussion. Don’t introduce any new ideas or subtopics here.

You can conclude your paper using one of the following strategies:

• Call for a specific action.
• Outline next steps for other researchers.
• Speak about future implications.
• Compare different situations or issues.
• Use a quotation.
• Ask a provocative question.

The use of depression essay example

A good essay example may help you understand how your project must be written. You can find a lot of essay examples online or order a well-written example from a professional writer.

You should read it and analyze what strategies and techniques are used to convey the main ideas and make an impression on readers.

Besides, you can get a better understanding of how you can structure your paper and what transitions you can use to ensure a logical flow of ideas.

Essay on depression: what to cover?

Writing about depression in college essay can involve a lot of different topics, especially those connected with the epidemic of mental disorders in teens.

For example, you may write causes of teenage depression essay and discuss multiple factors that create chemical imbalances in the human brain which may result in mental disorders and lead to such symptoms like anger, irritability, and agitation:

• Biological factors – family history of mental disorders.
• Social factors – loneliness and isolation, lack of meaningful relationships with family or peers.
• Behavioral factors – alcohol or drug abuse.
• Psychological factors – early childhood trauma, recent stressful experiences like a death in the family.

TOP-10 depression essay topics

• Effects of mood disorders on physical health.
• Causes of depression among teens.
• Compare depression and bipolar disorder.
• Neurodegenerative effects of long-term depression.
• Mental disorders and personality changes in adults.
• Impact of psychological stress on mental disorders.
• Teen depression and suicide.
• Depression symptoms in children and adults.
• Are we witnessing an epidemic of serious mood disorders?
• Digital media and mental disorders in children.

Argumentative essay on depression: how to prove you’re right?

Argumentative essay on depression is a more complex task because you need to take a stance and create a convincing argument to persuade your readers and make them accept your point of view or take a specific action.

You need compelling evidence to support your claims and main points.

Consult credible online sources, for example, a website of the American Psychiatric Association, to find some facts or statistics about mental disorders or news about current research on the topic.

Review some statistics which you can use to support your argument.

• According to estimates, about 15% of adults experience depressive episodes in their lifetime.
• About 5% of the US population experience seasonal depression every year.
• The most “depressed” countries in the world are the USA, France, the Netherlands, Ukraine, and Colombia.
• Japan has one of the lowest depression rates in the world, but it has one of the highest suicide rates, which is one of the leading causes of death among Japanese teens.
• 4.8% of men and 8.5% of women suffer from depression in the USA.
• The median age of people experiencing a major depressive episode is 32.
• More than 44,000 American commit suicide each year and it’s the 2nd leading cause of death for young people aged from 15 to 24.

Argumentative essay topics about depression

• Is there any correlation between burnout, depression, and anxiety?
• How to deal with a crisis when living with mental disorders?
• Is it common to have both anxiety and depression at the same time?
• Can sleep deprivation cause mental disorders?
• Is there any relationship between the consumption of certain food and mental disorders?
• Can food help with overcoming anxiety?
• Social media obsession and mental health issues.
• Why do a lot of teens struggle with mental disorders?
• Can exercise treat mental health issues?
• How can we tell the difference between grief and depression?

Feel free to choose any of these interesting topics and write your own depression essay.

Although mental disorders are a complicated thing to write about, you are much likely to successfully cope with this challenging task if you follow our easy guidelines.

Depressed with the task to write depression? Forget the anxiety! Order your paper within three clicks and enjoy the bright side of life!

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This is what depression feels like

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• v.14(9); 1999 Sep

Awareness, Diagnosis, and Treatment of Depression

Larry s goldman.

1 Council on Scientific Affairs, American Medical Association Council on Scientific Affairs, American Medical Association, Chicago, Ill

Nancy H Nielsen

Hunter c champion.

To review recent findings on the epidemiology, burden, diagnosis, comorbidity, and treatment of depression, particularly in general medical settings; to delineate barriers to the recognition, diagnosis, and optimal management of depression in general medical settings; and to summarize efforts under way to reduce some of these barriers.

M edline searches were conducted to identify scientific articles published during the previous 10 years addressing depression in general medical settings and epidemiology, co-occurring conditions, diagnosis, costs, outcomes, and treatment. Articles relevant to the objective were selected and summarized.

CONCLUSIONS

Depression occurs commonly, causing suffering, functional impairment, increased risk of suicide, added health care costs, and productivity losses. Effective treatments are available both when depression occurs alone and when it co-occurs with general medical illnesses. Many cases of depression seen in general medical settings are suitable for treatment within those settings. About half of all cases of depression in primary care settings are recognized, although subsequent treatments often fall short of existing practice guidelines. When treatments of documented efficacy are used, short-term patient outcomes are generally good. Barriers to diagnosing and treating depression include stigma; patient somatization and denial; physician knowledge and skill deficits; limited time; lack of availability of providers and treatments; limitations of third-party coverage; and restrictions on specialist, drug, and psychotherapeutic care. Public and professional education efforts, destigmatization, and improvement in access to mental health care are all needed to reduce these barriers.

This report reviews recent findings on the epidemiology, burden, diagnosis, comorbidity, and treatment of depression, particularly in general medical settings; describes barriers to the recognition, diagnosis, and optimal management of depression in general medical settings; and summarizes efforts under way to reduce these barriers. The American Medical Association's Council on Scientific Affairs produced a series of reports on depression in 1991. 1

Major depression is the depressive disorder on which most research has been conducted. Other depressive disorders, such as dysthmyic disorder (“chronic” depression) and mixed depressive-anxiety states, are also common in general medical settings but have been studied far less. Similarly, most research has been done in adult populations; this report notes a few instances of information about children. Except for comoribidity, most of the research in this area has been in primary care settings rather than in more specialized medical environments; most research on treatment has been conducted in specialty mental health settings.

EPIDEMIOLOGY IN GENERAL MEDICAL SETTINGS

Depressive disorders are common in the general population, with a point prevalence of about 2% to 4% for major depressions 2 and about a 20% lifetime risk for the development of major depression or dysthymic disorder. 3 , 4 The rate of depression among women is 2 to 3 times that of men. 5 These findings are based on large community surveys using structured interviews. Of those seeking help for depression in the United States, nearly three fourths go to a primary care physician rather than to a mental health professional. The most common presentation in primary care is not dysphoria but rather complaints of sleep disturbance, fatigue, or pain. 6 Overall, 5% to 10% of ambulatory primary care patients and 10% to 14% of medical inpatients suffer from major depression. 7 One study in a general internal medicine practice treating a diverse population found that 10% of the patients had diagnosable depressive disorders, while 11% had a disorder with depressive symptoms that did not fit into any standard diagnostic categories 8 ; this underscores the high prevalence of depressive complaints that do not fit into current diagnostic schemes.

Another study examined more than 1,000 primary care patients whose diagnostic screen was positive for major depression and who then underwent a psychiatric evaluation. 9 Seventy percent of these patients were suffering from major depression that could be treated in a primary care setting, 13% had major depression but required specialty sector care, and 17% had conditions other than major depression. Of those with major depression suitable for primary care treatment, nearly 75% had suffered at some time during their life from an additional Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) axis I disorder (most commonly generalized anxiety or panic disorder), 10 and 68% were felt to have an axis II (personality) disorder. A high percentage had experienced episodes of major depression prior to the study episode. This study illustrates both benefits and limitations of screening, the predominance of cases suitable for primary care setting treatment, the need to inquire about past history of depression, and the high rates at which other psychiatric disorders co-occur with depression.

Among the well-known burdens caused by depression are patient suffering, family distress and conflict, impaired cognitive development of young children in cases of postpartum depression, 11 and the strikingly increased risk of suicide. More recent studies have examined the impact on functioning and the economic burdens. The Medical Outcomes Study looked at patient physical functioning in several chronic diseases. Patients with depression had functioning scores about the same as those with advanced coronary artery disease, scores that were in turn lower than all other conditions studied, including hypertension, diabetes mellitus, and arthritis. 12 This impairment in functioning, when coupled with the high prevalence, chronic or relapsing course, and frequent early onset, led a group of World Health Organization researchers to conclude that unipolar major depression is the leading cause of disability worldwide. 13 Functional improvement occurs with effective treatment.

Costs of depression in the United States have been estimated at $43 billion per year. 14 Only 30% of the cost is from direct medical care; the remainder is from premature death and impaired workplace productivity. The economic cost to employers is estimated at $6,000 per depressed worker per year. 15

The effects of depression on consumption of medical care are striking. When the diagnosis of depression is missed, the search for physical explanations of symptoms causes unnecessary increases in medical utilization rates. When depression co-occurs with other general medical conditions, patient adherence to treatment is worsened, chances for improvement or recovery from the other condition are lessened, and health care costs are further increased. 16 One study in a large group HMO compared two groups of “high utilizers” (i.e., patients whose annual medical expenses were above the HMO median). Costs for high utilizers who were depressed were $1,500 higher per year than for those who were not depressed. 17 Health care costs in patients with depression and co-occurring medical illness are increased even when the nature and severity of the medical condition are controlled. 18 , 19

The diagnosis of major depression is fundamentally clinical. As with most psychiatric disorders, it is made on the basis of a careful clinical interview and mental status examination. Considerable evidence suggests that such an interview is comparable in sensitivity and specificity to many radiologic and laboratory tests commonly used in medicine. The criteria in the DSM-IV ( Table 1 ) are generally considered the standard diagnostic approach. Major depression is a syndromal diagnosis: on the basis of the patient's medical history and physical examination, it may be appropriate to consider other psychiatric disorders (obsessive-compulsive disorder, panic disorder, bulimia nervosa, dementia), general medical conditions, medications, or a substance use disorder as etiologic and to pursue relevant diagnostic investigations.

Criteria for Major Depressive Episode *

A number of screening tools are available to help physicians identify patients most likely to be depressed. As with most screening instruments, they tend to be fairly sensitive but not too specific for identifying depression. Most authors suggest screening when the physician has some a priori suspicion of depression, typically a specific depressive symptom, unexplained physical symptoms, impaired functioning, or subjective distress out of proportion to a known general medical condition, or another psychiatric disorder. Physicians must interpret specific screening results correctly and appreciate the need to carry out further clinical assessment. No preventive service guide calls for depression screening in asymptomatic individuals. 20 , 21

Long-established, symptom-oriented patient self-report screens include the General Health Questionnaire, 22 the Beck Depression Inventory, 23 the Symptom Checklist, 24 the Inventory of Depressive Symptoms, 25 and the Zung Depression Scale. 26 Scores above a predetermined cutoff suggest the need to perform a more comprehensive evaluation for depression. These screens have sensitivities of 70% to 85% and specificities of about 80%. The Center for Epidemiologic Studies Depression scale 27 and the shortened Geriatric Depression Scale 28 have been proposed as particularly valuable in the elderly. 29 These tools are designed simply to produce a depression rating (severity) score; however, two more recent instruments, the Symptom-Driven Diagnostic System for Primary Care 30 and the Primary Care Evaluation of Mental Disorders, 31 are diagnosis-oriented, patient-administered screens that are supplemented by a clinician-driven diagnostic module if any of the patient screens are positive. These instruments probe for several different psychiatric disorders, including major depression. There also are other symptom checklists or inventories. All screens require diagnostic confirmation by a careful clinical interview.

The primary care version of DSM-IV provides in abbreviated form the DSM-IV diagnostic criteria of the mental disorders most commonly seen in primary care settings, including depression. 32 It also contains symptom-driven algorithms to move from a patient's complaint to a specific diagnosis. A pediatric version has been developed by the American Academy of Pediatrics. 33 The World Health Organization has developed a primary health care version of the International Classification of Diseases dealing with mental disorders (ICD-10 PHC, chapter 5) that contains cards with information about the common complaints, diagnosis, and management of 24 common psychiatric disorders. 34

Several aspects of the DSM approach may be problematic in a medical setting. A number of the symptoms are somatic. Although the diagnostic criteria give equal weighting to all nine symptoms, clinicians often fail to consider depression as part of a differential diagnosis of the patient's chief complaint unless the complaint itself is of dysphoria or the patient is observably and notably sad. Patients may tend to emphasize physical symptoms because these are most troubling, because they are reluctant to disclose emotional distress, or because they believe the physician will be most interested in or helpful for those symptoms. At times, it may be difficult to determine whether any particular symptom is caused by a depression or by another medical disorder.

COMORBIDITY

Depression occurs frequently with anxiety disorders and with substance use disorders, including alcoholism. More recent research highlights the relation between nicotine addiction and depression. 35 Diagnosis of co-occurring depression and substance abuse is complicated, as either condition may overshadow the other. A number of recent textbooks and review articles are devoted to issues of diagnosing and treating depression and other psychiatric disorders in general medical populations. 36 – 38

Recent studies and reviews confirm the high rates of depression and its morbidity seen in many general medical conditions, especially those that affect the central nervous system. Table 2 summarizes some of the studies examining the rates of depression in various medical conditions.

Rates of Depression Co-Occurring with Other Medical Conditions.

Advanced age also may be an important factor that exists concurrently with depression. Depression in the elderly may be particularly hazardous and costly if untreated, and it also may be more complicated to treat. 39 – 41 Finally, untreated depression in the presence of terminal medical illness is one of several psychosocial factors associated with patient requests for physician assistance in dying. 42

TRENDS IN TREATMENT

Recent trends in the treatment of depression have been driven by scientific advances as well as changes in the practice environment. Over the past 10 years, nine newly marketed antidepressants (fluoxetine [Prozac], sertraline [Zoloft], paroxitene [Paxil], bupropion [Wellbutrin], venlafaxine [Effexor], fluvoxamine [Lu-vox], nefazodone [Serzone], mirtazapine [Remeron], and citalopram [Celexa]) were released in the United States. These drugs are structurally and pharmacologically quite different from the older tricyclic and monoamine oxidase inhibitor agents. For the most part, these drugs exhibit a more benign side effect profile, a simplified dosing strategy, better patient adherence, and a lower risk of death in overdose situations compared with the older drugs. As a result, they have quickly been adopted in medical settings, and several are among the most commonly prescribed drugs in all of medicine. These newer drugs do, however, continue to demonstrate the delay in full therapeutic action (several or more weeks) seen with older drugs, they generally lack a clear relation between serum drug level and therapeutic response, and some pose risks of significant drug-drug interactions with other medications. 43

Parallel advances in the development and testing of psychotherapies have occurred as well. Cognitive behavioral and interpersonal psychotherapy, which are both structured and time-limited in nature, have been shown to be equal in efficacy to antidepressant medication for mild-to-moderate, nonbipolar, nonpsychotic major depression, the type seen most commonly in general medical settings. 44 Such therapies offer a genuine alternative to patients intolerant of or averse to using antidepressant medications, to those who prefer psychotherapy, and to pregnant or nursing women. It is still uncertain whether combining pharmacotherapy and psychotherapy yields better outcomes than either form of treatment alone. 45 , 46 The exact role of other forms of psychotherapy (e.g., behavioral, marital/family, group, psychodynamic) in depression also remains unclear.

These specific therapies for major depression are different from the general supportive care offered by many physicians. Although such support may be vital to the doctor-patient relationship, may encourage medication adherence, and can be helpful to the patient, there is no empirical evidence of its efficacy as a specific treatment modality. Few nonpsychiatrist physicians are trained in cognitive-behavioral or interpersonal psychotherapy, although other specific forms of counseling by the primary care physician may also improve outcomes. 47 , 48 Primary care physicians most commonly prescribe medications themselves as a sole treatment modality, offer a few sessions of supportive psychotherapy, or refer patients to mental health practitioners for psychotherapy (either as sole therapy or in conjunction with primary care antidepressant prescribing, so-called split treatments). The impact on outcomes of these different provider approaches is not well understood. 49

A further development in depression treatment is the growing appreciation of depression as a chronic, often recurrent illness. At least 50% of those who experience an episode of major depression without a co-occurrent general medical condition will go on to have another, and after several such episodes the risk of future recurrences probably exceeds 90%. In addition, while most patients make a full recovery from any particular episode (with or without treatment), about one fifth to one third have a residual persistence of symptoms or impairment in functioning or both. 50 Thus, interest has increased in using medications prophylactically (after a likely episode recovery but in anticipation of a subsequent one), particularly after the patient has experienced several episodes. In addition, studies have sought to clarify whether any specific psychotherapeutic interventions afford a protective effect against future episodes (i.e., after cessation of psychotherapy or when it is provided at infrequent intervals). 51 Much of the information on illness prevalence, course, and treatment efficacy was reviewed, synthesized, and published as a set of treatment guidelines on depression for primary care settings by the Agency for Health Care Policy and Research (AHCPR). 52

Several trends also have emerged as a result of changes in health care delivery systems. There is growing appreciation of the important role of the primary care sector in caring for those with a variety of psychiatric illnesses. 53 The “gatekeeper” role has come to include an increased pressure on primary care physicians to diagnose and treat depression themselves. This pressure is both clinical (they can provide more integrated care) and economic (to limit more costly specialty sector referrals). As with other illnesses, patients with uncomplicated depression are likely to receive care from their primary care physician, while those with complex (e.g., bipolar, psychotic, suicidal, other co-occurrent psychiatric disorders such as substance use disorders) or treatment-refractory illnesses, or those requiring specialized treatments (e.g., electroconvulsive therapy, light therapy, cognitive-behavioral psychotherapy) may be followed in the specialty mental health sector.

There has been a dramatic rise in recent years of mental or behavioral health “carve outs,” where an organizational entity contracts with a managed care organization or other general health provider to provide all services for patients identified as in need of mental health services. This entity may be clinically or geographically distinct from the primary medical care setting. The proposed advantage of this approach is to guarantee an expert set of specialized clinicians and services that can care for all of a patient's mental health problems (e.g., depression, substance abuse, personality disorders) and provide an optimal level of access and treatment setting (e.g., outpatient office, partial hospital, detoxification setting, inpatient hospital). Potential disadvantages center on the fact that such care is not integrated into the patient's general medical care. Thus, the patient may need to utilize different facilities, the record-keeping system is separate, and the feedback loop between referring and treating clinician is stretched or nonexistent. Unlike traditional practice in which the referring physician selects the consultant (often based on previous shared experiences), carved-out care seldom allows the primary care physician to decide to whom he or she is sending the patient or even which type of mental health professional the patient will see. However, to date there has been little research to inform this debate.

MANAGEMENT IN GENERAL MEDICAL SETTINGS

A number of studies indicate that about half of those with psychiatric disorders (including depression) are detected in primary care settings. 54 Only about half of these receive any treatment, and that occurs largely (50% to 75% of the time) in the primary care setting rather than in the mental health care system.

A multisite outpatient study of health care system factors in the recognition and care of depressed patients found that 46% to 51% of these patients were recognized by medical clinicians, while 78% to 87% were recognized by mental health specialists. 55 Among the medical clinicians, depression was less likely to be recognized or treated under a prepaid system than under fee-for-service care. Nonetheless, depression outcomes in the general medical sector were similar under prepaid and fee-for-service care (because rates of treatment were similarly low to moderate in both payment systems). 56

Several studies have examined physician factors that may influence recognition of depression. In one study, high physician interest in psychosocial issues did not correlate with the type of interviewing behaviors necessary to diagnose depression. Several specific interviewing behaviors did, however, lead to great recognition of depression, including open-ended questioning, periodically summarizing the patient's information, and responding to nonverbal and emotional patient cues. 57 Robbins and colleagues found that primary care physicians who were more sensitive to affective and nonverbal patient cues made more psychiatric diagnoses, and physicians who tended to blame patients for their depression made fewer and less accurate diagnoses. 58 Overall, these authors found that false-positive psychiatric diagnoses were uncommon.

A few studies have examined the impact of recognition on patient outcomes. Simon and VonKorff screened patients attending a primary care clinic and interviewed those with positive depression screens: they found that unrecognized and untreated cases had a milder self-limited illness. 59 As a result, they concluded that a focus on increased recognition might not improve overall outcomes significantly. The Groningen Primary Care Study also found that recognition of psychological disorders by primary care physicians was not associated with better patient outcomes, and concluded that recognition was necessary but not sufficient unless primary care physicians had the skills or resources to provide appropriate treatments after making a diagnosis. 60

Katon and Gonzales reviewed all randomized trials of mental health interventions in primary care settings developed by consultation-liaison psychiatrists. 61 They too concluded that screening interventions and feedback to the primary care physician somewhat increased recognition and treatment of depression, but that the effect on patient outcomes was unclear. In general, although the link between diagnosis and treatment of depression may seem conceptually clear, in practice these tasks are not invariably linked. 62

A recent review of studies of unrecognized psychiatric illnesses in general medical outpatient settings found that: (1) half of the disorders were unrecognized; (2) the natural history of unrecognized depression suggested no worsening of course; and (3) interventions to teach physicians led to greater recognition and treatment but had little short-term effect on symptoms or health care use. 63 The review concluded that efforts to increase recognition alone that are not connected to strategies to improve management may not reduce patient suffering or decrease health care costs. Nonetheless, this conclusion may be less applicable over a longer period of time, as some milder depressions may worsen slowly over time.

Four studies have examined the rates of recognition of psychiatric disorders in children in primary care settings: the percentage of cases recognized ranged from 17% to 59%. 64 – 67 Insufficient data exist to reach any conclusions about the clinical or economic significance of such nonrecognition in children.

Even when patients' depression is recognized, treatment provided is highly variable. One study on high utilizers of one HMO's primary care medical services (a patient group known to be at high risk of depression) found that half of these patients were clinically depressed, yet only 45% of the depressed high utilizers had received an antidepressant during the preceding year. 68 Only one fourth of those receiving an antidepressant received a dose or duration of treatment that would be considered adequate by relevant practice parameters.

Another study that looked at depression treatment in a variety of different primary care settings found that only 11% of mildly and 29% of markedly depressed patients received any antidepressant. 69 In that same study, only about one third of all of the patients cared for by psychiatrists received any antidepressant, and only 41% received an adequate dose. In another study in a group of academically affiliated primary care offices, physicians were explicitly informed by investigators of patients with major depression and urged to provide treatment. 70 Only about three fourths of the patients were treated, 60% of them with antidepressants; only 43% of those prescribed antidepressants received them in amounts consistent with AHCPR guidelines.

Psychotherapy or counseling is even scarcer in primary care settings. In the Medical Outcomes Study conducted at multiple sites, less than half of depressed patients in the general medical sector settings received 3 minutes or more of counseling from their primary care physicians. 71 Counseling rates were lower under prepaid than fee-for-service plans.

A limited number of studies have examined the effect of increasing treatment to depressed patients by various methods. One small uncontrolled study examined high utilizers who were depressed and who were treated by the primary care physician with antidepressants following a study protocol. There were significant reductions in symptoms, improvements in quality-of-life measures, and increases in work performance. Overall general medical costs fell by 50%, and even when depression treatment costs were figured in, there remained a modest cost saving. 72

Sturm and Wells estimated the effects of restricting access to specialty care and predicted that shifting patients away from mental health specialists decreased costs but worsened patients' functional outcomes. 73 They suggested that there should be quality improvement in the general medical sector rather than changing the primary care–specialty care mix. Schulberg and colleagues attempted to have primary care physicians follow AHCPR guidelines for treatment of depression. 74 They found that doing so is feasible but challenging, that keeping patients in treatment is problematic (only 33% completed a full treatment regimen per the guidelines), and that physicians need to be more flexible than the guide regimens suggest. 75 There was a 70% recovery at 8 months when AHCPR guidelines were adhered to versus a 20% recovery among patients receiving usual care, suggesting high effectiveness of the guidelines. In those recovering, functional improvements occurred across a broad range of domains in addition to symptomatic improvement. 76

Two recent studies looked at a multifaceted intervention that integrated a psychiatrist or psychologist into the primary care area. The intervention consisted of a structured program of patient education, behavioral counseling, improved psychopharmacologic management, drug refill tracking, and physician education. This approach led to significant improvement in depression, patient satisfaction, medication adherence, and cost-effectiveness when compared with usual care, but only for those with major depression and not for those with minor (milder) depression. 77 – 79

BARRIERS TO OPTIMAL MANAGEMENT

Recognition barriers.

Because of the stigma still attached to psychiatric illnesses, many patients are reluctant to acknowledge to themselves or their physicians that they are experiencing emotional distress. Patients may deny or minimize symptoms, rationalize them as expectable because of life stresses or as due to other general medical problems, believe them to be failures of will or moral shortcomings, or not see them as within the physician's purview or capabilities. These attitudes may be reinforced by familial or cultural beliefs. Similarly, patients may be reluctant to disclose information they fear could be included in insurance or employment records; they may be especially concerned about having a psychiatric diagnosis recorded. 80

Attention also has been called to physician deficits in this area. 81 , 82 Some physicians harbor the belief that depression is not a “real” illness. Some believe that depression reflects a personal shortcoming or laziness and is thus something the patient could improve with more effort, willpower, or “positive thinking.” Others are doubtful about the existence of depression as a clinical entity because of the absence of confirmatory laboratory or radiologic studies. These doubts may take different forms, from simply never inquiring about depressive symptoms to having an unduly high threshold for considering depression in the differential diagnosis of a patient's chief complaint.

Even when attitudes are appropriate, some physicians lack the requisite skills to properly elicit the relevant history. 83 Many adopt a highly focused closed-ended interviewing technique that may prevent patients from bringing up affectively laden or psychosocial material. Failure to recognize nonverbal cues and to ask follow-up questions in response to indications of distress are also potential impediments to obtaining an appropriate history. Some physicians fail to offer empathic, supportive comments during the interview, cues that patients may interpret as lack of interest or unwillingness to discuss these concerns. Finally, some physicians, uncomfortable with displays of affect, may consciously or unwittingly steer the interview toward less difficult areas.

Differences in age, gender, or cultural background may result in barriers in the interaction between patient and physician. One of the most common interactional barriers is the medicalization of presenting complaints. 84 As discussed above, 50% to 70% of depressed patients will present with somatic rather than psychological complaints. 85 Patients may believe or hope that something physical is wrong, the cause will be found, and they will be healed. Because of stigma issues, there may be a potent investment on the part of the patient in keeping the focus on the somatic complaints. The physician, too, may feel more comfortable in the physical realm, and the assessment will emphasize these complaints. This focus in medical training, which covertly reinforces a more limited biomedical rather than biopsychosocial model, has been referred to as the “hidden medical curriculum.” 86 Symptoms that are not physical in nature (e.g., sadness, guilt, hopelessness) may not be asked about or voiced by the patient, and the recognition that the patient has a psychiatric disorder eludes both patient and physician. This appears to be especially the case among older patients.

Medicalization and other barriers may be compounded by the increasing time demands of an office visit. Physicians may be reluctant to elicit affectively laden information that can require more time to explore and to reach closure. Patients also may be reluctant to discuss topics for which they know insufficient time may be available. In addition, physicians often have a multiplicity of tasks during an office visit, such as assessment and ongoing management of known general medical problems, prevention and health maintenance, and paperwork. Limited remuneration for the time spent on assessing depression may influence the outcome.

In addition, the lack of appropriate performance standards for depression in managed care and other medical settings limits knowledge of actual practice and impedes feedback to clinicians, administrators, consumers, and purchasers of health care.

Diagnostic Barriers

One group of barriers concerns physician appraisal of the patient's willingness to consider having a psychiatric disorder. Physicians may not wish to compromise patient confidentiality or may fear offending patients or families by making a psychiatric diagnosis. At times, physicians may accurately assess that a patient is simply not ready to accept a diagnosis (e.g., by observing defensiveness during relevant inquiries), so they defer a full assessment decision about the diagnosis.

Other barriers pertain to appropriate diagnostic criteria. The DSM-IV criteria were developed largely in psychiatric settings, and some have questioned their applicability to primary care and other medical situations. One controversy concerns patients who meet some but not all criteria for major depression, a group encountered far more often in primary care than psychiatric settings. Another problematic group are those with mixed symptoms of depression and anxiety that fall short of DSM-IV thresholds for a disorder. Patients in either of these groups may be symptomatic and have functional impairment but, because they fail to meet full diagnostic criteria, may not be appropriately diagnosed or treated.

A third set of factors relates to inadequate physician knowledge about depression. Physicians may be unfamiliar with the diagnostic criteria and thus may not appreciate the differences between transient sadness, bereavement, and a clinical illness. Others understand the diagnostic criteria but fail to appreciate the import of the illness: they may believe it will remit spontaneously, that it is understandable in the context of the patient's life, or that it does not cause much suffering or dysfunction. Thus, they may not perform a careful diagnostic assessment because they would not be inclined to treat anyway.

The complexities of some clinical situations also may impede an accurate diagnosis. Symptoms of certain concurrent general medical conditions may overlap those of depression and may be attributed to the concurrent condition. A similar attribution problem may occur when a patient is taking medications that can cause depressive symptoms. When patients have another psychiatric disorder in addition to depression (e.g., panic disorder), that condition's symptoms might overshadow the depression and cause a missed diagnosis. Finally, depression may simulate other psychiatric disorders (e.g., dementia) and thus confound the diagnostic process. One study found that recognition of depression by primary care physicians was only 29% in patients with comorbid general medical illness versus 67% in those without comorbidity. 87

Financial considerations also may intrude: for example, reluctance to diagnose depression in a patient with little or no mental health third-party coverage because the patient may be unable to obtain care once the diagnosis is made. The physician may find it necessary to treat specific physical symptoms (e.g., insomnia, pain, fatigue) because these nonpsychiatric disorders will be covered. Rost and colleagues describe some of the reasons that physicians deliberately miscode diagnoses. 80

Treatment Barriers

Some patients may be unwilling to accept a diagnosis of depression and thus will not accept any treatment. Others may be hesitant about beginning specific treatments. Some patients are reluctant to take antidepressants for fear of “becoming addicted,”“needing a crutch,” taking “mind-control drugs,” or for other reasons; some may then be prone to mislabel pretreatment symptoms as drug-related after beginning on antidepressants. 88 Other patients will avoid psychotherapy, fearing it to be too intrusive, complicated, lengthy, expensive, or overly focused on childhood experiences. Patients who begin treatment may be dissuaded by unexpected or unpleasant side effects of medications, delay in sufficient improvement, or difficulty in forming an alliance with a psychotherapist. Patients also may be reluctant to see a mental health specialist even if such services are available.

Even if patients initially agree to treatment, they must adhere to enough of a treatment plan to make it likely that outcomes will be improved. Many patients discontinue their medications within the first month. 89 Patient education improves adherence for those with depression in almost all studies in which it has been examined, as it does for many other medical conditions. The difference between outcomes of adherent and nonadherent patients may be considerable, equivalent to the difference between active antidepressant use and a placebo. 90

Several physician-related barriers exist as well. As noted above, too many physicians interpret a depression as “appropriate” for the patient's circumstances and thus not in need of treatment. At other times, physicians will fail to appreciate the duration or severity of a depression and take an inappropriately expectant approach, withholding treatment for a certain time or unless certain conditions are met.

Even when the physician decides that treatment is warranted, the treatment offered may be suboptimal. Antidepressants may be prescribed in inadequate doses or for periods too short to be effective. A common problem is that a physician reacts to reports of side effects that occur shortly after starting an antidepressant by discontinuing the drug, lowering the dose below the therapeutic range, or switching to another drug. This may lead to a series of inadequate drug trials, resulting in multiple side effects but no improvement. Not uncommonly, the patient may decide to forgo further treatment.

Similar problems may occur with psychotherapy. Because few physicians are trained in the empirically proven effective psychotherapies, brief office counseling may be offered. This results in psychotherapy of inadequate intensity or duration. Even if referral is made to a mental health practitioner, that clinician too may undertake a form of psychotherapy (most commonly psychodynamic psychotherapy) that has not been proved to be efficacious for depression.

A number of health care system factors also serve as barriers to treatments. Third-party coverage for mental health care may be limited or nonexistent. Thus, patients may be covered for only a certain number, duration, or frequency of psychotherapy sessions. Even though the empirically validated psychotherapies generally require only 12 to 20 sessions, this often exceeds a health care plan's limits for psychotherapy. Visits for medication checks, even if provided by the primary care physician, may be considered part of the mental health benefit, so the lowered limits on visits, percentage of reimbursement, or total costs covered and any higher copayments may apply. In some settings in which mental health care is carved out, primary care physicians may not be reimbursed for any treatment of depression they provide.

In many areas (particularly rural), availability of mental health professionals may be limited, and patients must make do with whatever care the primary care physician or a limited mental health clinician community can provide. Patients who are covered by mental health carve outs must accept the care provided through that system, even if it is difficult to access or limited in provision.

It is likely that the use of newer antidepressants, despite being more expensive than older agents, results in equal or lower total costs overall by reducing adverse drug reactions, drug monitoring, and hospitalizations for worsened depression or other adverse events (e.g., severe side effects, suicide attempts). 91 , 92 Nonetheless, some managed care organizations continue to influence treatment by formulary restrictions of antidepressant drugs, often in favor of older, less expensive, and less safe choices. Managed care organizations also may influence physician behavior by discouraging appropriate specialty referrals, thus reducing access of depressed patients in need of specific psychotherapies or more expert psychopharmacologic care.

Barriers to recognition, diagnosis, and optimal treatment are summarized in Table 3 .

Some Barriers to Recognition, Diagnosis, and Optimal Treatment of Depression *

ACTIVITIES TO REDUCE BARRIERS

Many professional organizations and advocacy groups have drawn attention to the undertreatment of depression and the need to increase public and professional awareness. For example, a consensus panel sponsored by the National Depression and Manic-Depressive Association issued a report on undertreatment of depression, 93 proposing five immediate steps to reduce the gap between knowledge about depression and actual treatment received: enhancing the role of patients and families, developing performance standards for behavioral health care, increasing provider knowledge and awareness, enhancing collaboration among providers for disease management, and conducting research for new treatments.

Many attempts have been made to identify critical skills and knowledge for primary care physicians. A model curriculum for physicians to diagnose and treat the most common mental and behavioral disorders seen in primary care settings has been developed by a task force of the Society for General Internal Medicine, with input from the American College of Physicians, the American Academy of Physician and Patient, the American Association of Medicine and Psychiatry, and the American Psychiatric Association. 94 Major depression and dysthymia are included among the “mental disorders of central importance in primary care.”

The importance of family physicians has been highlighted by publications such as a White paper of the American Academy of Family Physicians that referred to mental health services as “an essential component of comprehensive primary medical care.” 95 A model curriculum for the psychiatric training of family practitioners also has been developed. 96

The primary care version of DSM-IV is designed to assist in the recognition and diagnosis of depression; practice guidelines for treating major depression in adults in primary care settings have been developed by the AHCPR. The American Psychiatric Association, with input from many medical organizations, also has developed treatment guidelines for major depression in adults, which are primarily directed at psychiatrists, but may be helpful to primary care physicians as well. 97

An example of an approach to teaching the interviewing skills needed to increase recognition of depression is McWhinney's “patient-centered” and “problem-based” approach to interviewing, which has been extensively tested in Great Britain. 98 These techniques may be taught to trainees or self-taught by practicing physicians. Evidence suggests that depression-recognition skills are improved and that the patients of physicians using these techniques have better clinical outcomes. 99

Once the diagnosis is made and treatment initiated, so-called disease management programs may assist with clinical monitoring and patient adherence. Several pharmaceutical manufacturers and managed care entities have developed proprietary programs to help educate patients about depression, assist physicians in tracking the course of a patient's illness, and increase treatment adherence. The effectiveness of such programs is not currently known. Model programs such as those of Schulberg et al., 74 Katon et al., 77 and others, which have been or are being rigorously studied, provide additional, on-site staff for treatment as well as physician education and guideline utilization.

For the past 10 years, the National Institute of Mental Health has operated the Depression Awareness, Recognition, and Treatment program, 100 which includes educational components directed to the public, professionals, and employers. More recently, it has emphasized the importance of recognizing and treating depression when it co-occurs with other general medical disorders. A similar, nongovernmental approach was the Defeat Depression Campaign, a public and professional education campaign undertaken jointly by the Royal College of Psychiatrists and the Royal College of General Practitioners that ran in the United Kingdom from 1992 through l996. The effects of the campaign are currently being evaluated. 101

Other campaigns that emphasize public awareness include National Depression Screening Day (part of National Mental Illness Awareness Week) each October and the National Public Education Campaign on Clinical Depression, a public service campaign launched in 1993. The latter is sponsored by the National Mental Health Association and cosponsored by more than 100 professional groups and advocacy groups. The National Association for Research on Schizophrenia and Affective Disorders (NARSAD) also has a public education campaign on depression, whose slogan is “depression is a flaw in chemistry, not character.”

The American Medical Association has adopted policies that emphasize physician and public education, the need for outcomes research, and the importance of equivalent third-party coverage for psychiatric disorders. The following statements, recommended by the Council on Scientific Affairs, were adopted as AMA Policy at the AMA Interim Meeting in December 1997: (1) The AMA encourages medical schools, primary care residencies, and other training programs as appropriate to include the appropriate knowledge and skills to enable graduates to recognize, diagnose, and treat depression, both when it occurs by itself and when it occurs with another general medical condition. (2) The AMA also encourages all physicians providing clinical care to acquire the same knowledge and skills. (3) The AMA encourages additional research into the course and outcomes of patients with depression who are seen in general medical settings and into the development of clinical and systems approaches designed to improve patient outcomes. Furthermore, any approaches designed to manage care by reduction in the demand for services should be based on scientifically sound outcomes research findings. (4) The AMA fully supports equivalent third-party coverage for all psychiatric disorders, including depression, with that for other medical disorders, and it strongly opposes any arbitrary restrictions or limitations on the provision of mental health services. (5) The AMA will work with the National Institute on Mental Health and appropriate medical specialty and mental health advocacy groups to increase public awareness about depression, to reduce the stigma associated with depression, and to increase patient access to quality care for depression.

Depression, a commonly occurring disorder in the general population, is seen even more frequently in general medical settings and is associated with marked individual and family suffering, an elevated risk of suicide, functional impairment, and a high economic toll in health care costs and lost productivity. Diagnostic criteria are well established, and a number of screening tools exist for use in symptomatic patients. Highly effective psychopharmacologic and psychotherapeutic treatments are available. Most cases of depression seen in general medical settings are milder forms of the illness than are typically seen in specialty settings, and they are frequently amenable to treatment in the primary care setting by those with appropriate expertise.

Depression frequently co-occurs with a number of chronic general medical illnesses, and such comorbidity may complicate the recognition of a depressive illness. Co-occurring depression often impairs patient adherence to medical care and may seriously worsen the course and prognosis of both conditions. Therefore, it is essential to diagnose and treat such co-occurring depression.

Only about half of all cases of depression are recognized and diagnosed in primary care settings, although such unrecognized cases generally are milder and more self-limited in nature. Improved recognition by physicians is largely associated with attitudes about depression and the use of certain specific interviewing skills. Even when cases are recognized, both pharmacologic and psychotherapeutic treatments provided often fall short of existing practice guidelines. When practice guidelines are followed, patient outcomes are quite good.

Barriers to diagnosing and treating depression in general medical settings include those related to stigma; patient somatization and denial; time; patient adherence to treatment; physician knowledge and skill deficits; lack of availability of providers and specific treatments; limitations of third-party coverage; and restrictions on specialist, drug, and psychotherapeutic care. A number of programs are under way to reduce these barriers, but undertreatment remains a serious problem.

Acknowledgments

Members and staff of the Council on Scientific Affairs at the time this report was prepared: Ronald M. Davis, MD, Detroit, Mich (Chair); Joseph A. Riggs, MD, Haddon Fields, NJ (Chair-Elect); Roy D. Altman, MD, Miami, Fla; Hunter C. Champion, New Orleans, La; Scott D. Deitchman, MD, MPH, Decatur, Ga; Myron Genel, MD, New Haven, Conn; John P. Howe III, MD, San Antonio, Tex; Mitchell S. Karlan, MD, Los Angeles, Calif; Mohamed Khaleem Khan, MD, PhD, Boston, Mass; Nancy H. Nielsen, MD, PhD, Buffalo, NY; Michael A. Williams, MD, Baltimore, Md; Donald C. Young, MD, Iowa City, Iowa; Linda B. Bresolin, PhD (CSA Secretary), Barry D. Dickinson, PhD (CSA Assistant Secretary), Chicago, Ill; Larry S. Goldman, MD (Department of Psychiatry, University of Chicago).

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7 Depression Research Paper Topic Ideas

Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.

Cara Lustik is a fact-checker and copywriter.

In psychology classes, it's common for students to write a depression research paper. Researching depression may be beneficial if you have a personal interest in this topic and want to learn more, or if you're simply passionate about this mental health issue. However, since depression is a very complex subject, it offers many possible topics to focus on, which may leave you wondering where to begin.

If this is how you feel, here are a few research titles about depression to help inspire your topic choice. You can use these suggestions as actual research titles about depression, or you can use them to lead you to other more in-depth topics that you can look into further for your depression research paper.

What Is Depression?

Everyone experiences times when they feel a little bit blue or sad. This is a normal part of being human. Depression, however, is a medical condition that is quite different from everyday moodiness.

Your depression research paper may explore the basics, or it might delve deeper into the  definition of clinical depression  or the  difference between clinical depression and sadness .

What Research Says About the Psychology of Depression

Studies suggest that there are biological, psychological, and social aspects to depression, giving you many different areas to consider for your research title about depression.

Types of Depression

There are several different types of depression  that are dependent on how an individual's depression symptoms manifest themselves. Depression symptoms may vary in severity or in what is causing them. For instance, major depressive disorder (MDD) may have no identifiable cause, while postpartum depression is typically linked to pregnancy and childbirth.

Depressive symptoms may also be part of an illness called bipolar disorder. This includes fluctuations between depressive episodes and a state of extreme elation called mania. Bipolar disorder is a topic that offers many research opportunities, from its definition and its causes to associated risks, symptoms, and treatment.

Causes of Depression

The possible causes of depression are many and not yet well understood. However, it most likely results from an interplay of genetic vulnerability  and environmental factors. Your depression research paper could explore one or more of these causes and reference the latest research on the topic.

For instance, how does an imbalance in brain chemistry or poor nutrition relate to depression? Is there a relationship between the stressful, busier lives of today's society and the rise of depression? How can grief or a major medical condition lead to overwhelming sadness and depression?

Who Is at Risk for Depression?

This is a good research question about depression as certain risk factors may make a person more prone to developing this mental health condition, such as a family history of depression, adverse childhood experiences, stress , illness, and gender . This is not a complete list of all risk factors, however, it's a good place to start.

The growing rate of depression in children, teenagers, and young adults is an interesting subtopic you can focus on as well. Whether you dive into the reasons behind the increase in rates of depression or discuss the treatment options that are safe for young people, there is a lot of research available in this area and many unanswered questions to consider.

Depression Signs and Symptoms

The signs of depression are those outward manifestations of the illness that a doctor can observe when they examine a patient. For example, a lack of emotional responsiveness is a visible sign. On the other hand, symptoms are subjective things about the illness that only the patient can observe, such as feelings of guilt or sadness.

An illness such as depression is often invisible to the outside observer. That is why it is very important for patients to make an accurate accounting of all of their symptoms so their doctor can diagnose them properly. In your depression research paper, you may explore these "invisible" symptoms of depression in adults or explore how depression symptoms can be different in children .

How Is Depression Diagnosed?

This is another good depression research topic because, in some ways, the diagnosis of depression is more of an art than a science. Doctors must generally rely upon the patient's set of symptoms and what they can observe about them during their examination to make a diagnosis. 

While there are certain  laboratory tests that can be performed to rule out other medical illnesses as a cause of depression, there is not yet a definitive test for depression itself.

If you'd like to pursue this topic, you may want to start with the Diagnostic and Statistical Manual of Mental Disorders (DSM). The fifth edition, known as DSM-5, offers a very detailed explanation that guides doctors to a diagnosis. You can also compare the current model of diagnosing depression to historical methods of diagnosis—how have these updates improved the way depression is treated?

Treatment Options for Depression

The first choice for depression treatment is generally an antidepressant medication. Selective serotonin reuptake inhibitors (SSRIs) are the most popular choice because they can be quite effective and tend to have fewer side effects than other types of antidepressants.

Psychotherapy, or talk therapy, is another effective and common choice. It is especially efficacious when combined with antidepressant therapy. Certain other treatments, such as electroconvulsive therapy (ECT) or vagus nerve stimulation (VNS), are most commonly used for patients who do not respond to more common forms of treatment.

Focusing on one of these treatments is an option for your depression research paper. Comparing and contrasting several different types of treatment can also make a good research title about depression.

A Word From Verywell

The topic of depression really can take you down many different roads. When making your final decision on which to pursue in your depression research paper, it's often helpful to start by listing a few areas that pique your interest.

From there, consider doing a little preliminary research. You may come across something that grabs your attention like a new study, a controversial topic you didn't know about, or something that hits a personal note. This will help you narrow your focus, giving you your final research title about depression.

Remes O, Mendes JF, Templeton P. Biological, psychological, and social determinants of depression: A review of recent literature . Brain Sci . 2021;11(12):1633. doi:10.3390/brainsci11121633

National Institute of Mental Health. Depression .

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition . American Psychiatric Association.

National Institute of Mental Health. Mental health medications .

Ferri, F. F. (2019). Ferri's Clinical Advisor 2020 E-Book: 5 Books in 1 . Netherlands: Elsevier Health Sciences.

By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.  

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Personal Health

The Devastating Ways Depression and Anxiety Impact the Body

Mind and body form a two-way street.

By Jane E. Brody

It’s no surprise that when a person gets a diagnosis of heart disease, cancer or some other life-limiting or life-threatening physical ailment, they become anxious or depressed. But the reverse can also be true: Undue anxiety or depression can foster the development of a serious physical disease, and even impede the ability to withstand or recover from one. The potential consequences are particularly timely, as the ongoing stress and disruptions of the pandemic continue to take a toll on mental health .

The human organism does not recognize the medical profession’s artificial separation of mental and physical ills. Rather, mind and body form a two-way street. What happens inside a person’s head can have damaging effects throughout the body, as well as the other way around. An untreated mental illness can significantly increase the risk of becoming physically ill, and physical disorders may result in behaviors that make mental conditions worse.

In studies that tracked how patients with breast cancer fared, for example, Dr. David Spiegel and his colleagues at Stanford University School of Medicine showed decades ago that women whose depression was easing lived longer than those whose depression was getting worse. His research and other studies have clearly shown that “the brain is intimately connected to the body and the body to the brain,” Dr. Spiegel said in an interview. “The body tends to react to mental stress as if it was a physical stress.”

Despite such evidence, he and other experts say, chronic emotional distress is too often overlooked by doctors. Commonly, a physician will prescribe a therapy for physical ailments like heart disease or diabetes, only to wonder why some patients get worse instead of better.

Many people are reluctant to seek treatment for emotional ills. Some people with anxiety or depression may fear being stigmatized, even if they recognize they have a serious psychological problem. Many attempt to self-treat their emotional distress by adopting behaviors like drinking too much or abusing drugs, which only adds insult to their pre-existing injury.

And sometimes, family and friends inadvertently reinforce a person’s denial of mental distress by labeling it as “that’s just the way he is” and do nothing to encourage them to seek professional help.

How common are anxiety and depression?

Anxiety disorders affect nearly 20 percent of American adults . That means millions are beset by an overabundance of the fight-or-flight response that primes the body for action. When you’re stressed, the brain responds by prompting the release of cortisol, nature’s built-in alarm system. It evolved to help animals facing physical threats by increasing respiration, raising the heart rate and redirecting blood flow from abdominal organs to muscles that assist in confronting or escaping danger.

These protective actions stem from the neurotransmitters epinephrine and norepinephrine, which stimulate the sympathetic nervous system and put the body on high alert. But when they are invoked too often and indiscriminately, the chronic overstimulation can result in all manner of physical ills, including digestive symptoms like indigestion, cramps, diarrhea or constipation, and an increased risk of heart attack or stroke.

Depression, while less common than chronic anxiety, can have even more devastating effects on physical health. While it’s normal to feel depressed from time to time, more than 6 percent of adults have such persistent feelings of depression that it disrupts personal relationships, interferes with work and play, and impairs their ability to cope with the challenges of daily life. Persistent depression can also exacerbate a person’s perception of pain and increase their chances of developing chronic pain.

“Depression diminishes a person’s capacity to analyze and respond rationally to stress,” Dr. Spiegel said. “They end up on a vicious cycle with limited capacity to get out of a negative mental state.”

Potentially making matters worse, undue anxiety and depression often coexist, leaving people vulnerable to a panoply of physical ailments and an inability to adopt and stick with needed therapy.

A study of 1,204 elderly Korean men and women initially evaluated for depression and anxiety found that two years later, these emotional disorders increased their risk of physical disorders and disability. Anxiety alone was linked with heart disease, depression alone was linked with asthma, and the two together were linked with eyesight problems, persistent cough, asthma, hypertension, heart disease and gastrointestinal problems.

Treatment can counter emotional tolls

Although persistent anxiety and depression are highly treatable with medications, cognitive behavioral therapy and talk therapy, without treatment these conditions tend to get worse. According to Dr. John Frownfelter, treatment for any condition works better when doctors understand “the pressures patients face that affect their behavior and result in clinical harm.”

Dr. Frownfelter is an internist and chief medical officer of a start-up called Jvion. The organization uses artificial intelligence to identify not just medical factors but psychological, social and behavioral ones as well that can impact the effectiveness of treatment on patients’ health. Its aim is to foster more holistic approaches to treatment that address the whole patient, body and mind combined.

The analyses used by Jvion, a Hindi word meaning life-giving, could alert a doctor when underlying depression might be hindering the effectiveness of prescribed treatments for another condition. For example, patients being treated for diabetes who are feeling hopeless may fail to improve because they take their prescribed medication only sporadically and don’t follow a proper diet, Dr. Frownfelter said.

“We often talk about depression as a complication of chronic illness,” Dr. Frownfelter wrote in Medpage Today in July . “But what we don’t talk about enough is how depression can lead to chronic disease. Patients with depression may not have the motivation to exercise regularly or cook healthy meals. Many also have trouble getting adequate sleep.”

Some changes to medical care during the pandemic have greatly increased patient access to depression and anxiety treatment. The expansion of telehealth has enabled patients to access treatment by psychotherapists who may be as far as a continent away.

Patients may also be able to treat themselves without the direct help of a therapist. For example, Dr. Spiegel and his co-workers created an app called Reveri that teaches people self-hypnosis techniques designed to help reduce stress and anxiety, improve sleep, reduce pain and suppress or quit smoking.

Improving sleep is especially helpful, Dr. Spiegel said, because “it enhances a person’s ability to regulate the stress response system and not get stuck in a mental rut.” Data demonstrating the effectiveness of the Reveri app has been collected but not yet published, he said.

Jane Brody is the Personal Health columnist, a position she has held since 1976. She has written more than a dozen books including the best sellers “Jane Brody’s Nutrition Book” and “Jane Brody’s Good Food Book.” More about Jane E. Brody

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about Depression - Free Essay Samples And Topic Ideas

Depression, a common mental health disorder, can severely impact an individual’s quality of life. Essays on depression could delve into its symptoms, causes, and various treatment approaches including psychotherapy, medication, and lifestyle modifications. Furthermore, discussions might extend to the societal stigma surrounding depression, the importance of mental health awareness, and the socio-economic impact of depression on individuals and communities. We have collected a large number of free essay examples about Depression you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Depression and Anxiety in Teenagers

More than 1 in 20 US children and teens have anxiety or depression (Wolters Kluwer Health). Teenage depression and anxiety are one of America’s most prevalent issues that parents can’t seem to get a hold of. Students all over the nation are struggling day to day with this mental illness. Given how common this issue is, many students do not seek the help that they need out of fear of judgment or ridicule from fellow peers. However, many parents can […]

Jane’s Depression in the Yellow Wallpaper

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Stress at Workplace

Stress is something which occurs or disturbs someone's mind whether we are rich or poor it doesn't matter the person is having wealth so it's free from stress. Stress is a thing which takes place when others demands exceed our limitations when someone expects something favourable or of some high expectations within a short period of time and putting pressure to complete or touch their limitations than its harmful for our physical as well for our mental health too. It's […]

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About Postpartum Depression in the Yellow Wallpaper

Charlotte Perkins Gilman's The Yellow Wallpaper does not, in my opinion, reflect contemporary concerns of women. Gilman's short story focuses on the idea that men control the lives of women in essentially every aspect. The narrator's husband tells her not to do anything to stimulate her brain. He asks her not to write, think about her condition, or to talk to anyone in a stimulating fashion. Her whole life at this point is decided by her husband and brother, who […]

Postpartum Depression

Postpartum depression is a severe mood disorder one in ten women experiences following childbirth. It is caused by chemicals produced in the brain going haywire after the hormones are thrown off balanced by pregnancy. Postpartum depression's effects vary for each woman, symptoms often include mood swings, anger, anxiety, panic attacks, weight loss/gain, insomnia, etc. Postpartum depression is very common but often goes undiagnosed and treated. Women feel ashamed and embarrassed by these feelings, thus they keep their feelings to themselves, […]

Effects of Helicopter Parenting on College Students

The term “helicopter parenting” has recently become a reoccurring term used, especially in media and schools (Van Ingen et al., 2015, p. 8). Universities have brought helicopter parenting to the attention of many as the reason for college students having a difficult time transitioning into college. Practitioners, college administrators, and professors have become very concerned about this generation of college students (Reed, Duncan, Lucier-Greer, Fixelle, & Ferraro, 2016, p. 3136). This generation is considered to be the “Millennial” generation. This […]

What was the Great Depression and why did it Start in the USA

There are many significant events that have shaped America’s history. Some were infamous, some scandalous and some we choose to overlook..According to the PBS film “The Great Depression”, The Great Depression was one of the most traumatic and gut wrenching event throughout history. This film outline the events leading up to the great depression and highlights some of the significant events during this time period. The Great Depression was an economic downturn that began in 1929 while president Herbert Hoover […]

Rise in Depression and Anxiety

Social media is a whole bunch of websites where many people seem to have an addiction for; whether it's Facebook, Instagram, Snapchat, Twitter etc. Many people can't seem to go a minute or not even a day without posting a picture for likes. They post their personal thoughts or even use it to vent. Why not call up a friend and have a real conversation with them about your problem? Kids these days don't know what fun is. They rather […]

In the Modern World

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Why are teenagers suffering from anxiety and depression leading to suicide? In this paper in will be researching teenage depression and what causes it. I will be researching what to look for and what is normal and what is not. When to see a doctor and when to get immediate emergency help. Although depression among teenagers is high, we now have to look at the different causes. There is no exact known cause but here are the ones I came across: Early childhood trauma which something tragic happened in their life directly to them whether it is a family member sexually assaulted and abused them, or a misunderstanding with their parents as in a Rose for Emily essay . It also could be by inherited or learned from other relatives. One may ask what depression is. Well, teen depression is a very serious mental health problem that is continuously spread among teenagers. It is the after effect from something happening to them that was very traumatic, whether it was present or in the past. It affects the thoughts, feelings and behavior and can cause emotional and even physical problems. Depression can occur at any time in life and the symptoms will vary from person to person. Some of the causes are certain expectation from their parents, peer pressure in school, being bullied and the list goes on. Identifying the signs of a depressed teenager is the a changing attitude and behavior. Many teenagers who think they are so depressed and considering suicide will talk about it before doing anything. Sometimes they don’t say anything and just do it.. Teenage suicide can be detected at an early point if one is educated to recognize and understand the signs of suicide. It almost always start with depression. But if the person noticing this does not know any of the signs, they could end up losing someone close when they could have helped prevent the suicide. By knowing the signs and symptoms associated with suicide is a start to preventing teen suicide; however, taking action is equally as important. One action that could be helpful is to take the potentially suicidal teenager to a doctor if it appears that the teenager is pondering suicide. Another action is to communicate with the suicidal teenager. This is probably the easiest initial action to attempt. If the teenager is contemplating suicide and a person communicates with them, two things can happen. First, the person may find out more information about what is bothering the teenager. Second, the teenager may be talked out of committing suicide in the near term. Talking may be easy and helpful to solve this horrific tragedy; but the teenager may commit suicide if a person does not act immediately. The main key to helping a suicidal teenager is to act immediately. According to Sylvia Cochran, “If you have reason to believe your child may, on whatever level, be contemplating suicide, you must take action immediately. Do not leave her/him alone until help is available. Do not adopt a wait and see attitude.” (Cochran). If a parent, friend, teacher, etc., is able to act quickly, then they may be able to prevent a possibly suicidal teenager from committing suicide. Teenagers committing suicide during depression is clearly one of the more rapidly growing causes of death for young people today. It is not an infrequent occurrence and can definitely be prevented with the help of proper treatment and action. Depression, pressures in life in general, and the greater access to lethal weapons and drugs are some of the major causes and reasons of suicide. They are all preventable however, in more ways than one. Greta was a firm believer in the age-old saying that sometimes the best way to overcome something is to understand it.

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“15% of people with major depressive disorder die by suicide” (Major). Major depressive disorder or the common term depression is a medical illness that involves the mind and body. Major depressive disorder and clinical depression, it affects how you feel, think and behave. Depression can lead to a variety of emotional and physical problems. mental disorder Depression is usually characterized by low mood, accompanied with low self-esteem and by the loss of interest or pleasure in normal activities.

First, to be diagnosed with depression the person has to have five or more symptoms of depression for at least two weeks. Some symptoms include feeling sad, hopeless, worthless, fatigue or lack of interest, thoughts of suicide, withdrawal from usual activities or even pessimistic. Also, if the person has been experience signs of insomnia, in which the person has sleep problems.

Also, the exact cause of depression is unknown but researchers believe it is caused by a chemical imbalance in the brain, which may be heredity or caused by events a person’s life. Some types of depression seem to run in the family, but depression can occur for people who do not have a family. Also, stressful life changes or events can cause depression. Men and women of all races, ages and economic levels can have depression.

Furthermore, Depression is a chronic illness that usually requires long-term treatment, like diabetes or high blood pressure. Most people with depression feel better with medication, psychological counseling or other treatment. Depression can be treated in variety of ways but usually with the help of medications and counseling. Studies show that it is better for a person suffering from depression to combine antidepressant drug therapy with psychotherapy. Another treatment is called Electroconvulsive is a treatment that causes seizures by means of an electric current. Electroconvulsive may improve the mood of severely depressed or suicidal people who do not respond to other treatments. Also, research is now being conducted on transcranial magnetic stimulation (TMS), which alters brain function in a way similar to ECT, but with fewer side effects. Use of light therapy for depressive symptoms in the winter months and interventions to restore a normal sleep cycle may be effective for relieving depression. It is important for the depressed person to live a healthy lifestyle while undergoing treatment. This includes avoiding drugs and alcohol, which makes depression worse. Also, eat well-balance meals, get regular exercise and sleep and even seek supportive relationships.

In conclusion, depression can affect anyone at any age. If a person with depression does not seek medical help then the mental disorder might become worse and make the person commit suicide.

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• Published: 25 May 2024

Eye-tracking evidence of a relationship between attentional bias for emotional faces and depression severity in patients with treatment-resistant depression

• Laetitia Imbert 1 ,
• Cécilia Neige 1 , 2 ,
• Rémi Moirand 2 ,
• Giulia Piva 2 ,
• Benoit Bediou 3 ,
• William Vallet 1 , 2 &
• Jerome Brunelin 1 , 2  

Scientific Reports volume  14 , Article number:  12000 ( 2024 ) Cite this article

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In a retrospective study, 54 patients with treatment-resistant major depressive disorder (TRD) completed a free-viewing task in which they had to freely explore pairs of faces (an emotional face (happy or sad) opposite to a neutral face). Attentional bias to emotional faces was calculated for early and sustained attention. We observed a significant negative correlation between depression severity as measured by the 10-item Montgomery-Åsberg Depression Rating Scale (MADRS) and sustained attention to happy faces. In addition, we observed a positive correlation between depression severity and sustained attention to sad faces. No significant correlation between depression severity and early attention was found for either happy or sad faces. Although conclusions from the current study are limited by the lack of comparison with a control group, the eye-tracking free-viewing task appears to be a relevant, accessible and easy-to-use tool for measuring depression severity through emotional attentional biases in TRD.

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Introduction.

Major depressive disorder (MDD) is one of the most common mental health disorders, affecting 4.4% of the world’s population 1 . In addition to the classic clinical symptoms (e.g., feelings of guilt, sadness), MDD is also characterized by cognitive impairments that contribute to the overall burden of the illness. Among these, deficits in emotional processing have attracted a particular interest because of their hypothesized role in the onset and maintenance of depressive symptoms 2 . Several studies have shown that, compared to healthy controls, people with MDD exhibit a bias toward negative stimuli over positive or neutral information 3 , and conversely, tend to neglect positive information 4 .

Interestingly, significant relationships were observed between depression severity and the intensity of emotional biases. One study using different types of stimuli (e.g., emotional words, scenes, and faces) found an association between depression severity and attention to negative information 5 , while another study using only emotional words found no relationship 6 , calling for further research on this topic.

Better characterizing attentional biases to emotional stimuli in MDD patients is crucial, as they have been shown to be a stable vulnerability factor for depression 2 , to persist in remitted depression and to predict future depressive symptomatology 7 .

It is worth noting that the mentioned studies investigating attentional biases in MDD have primarily used motor reaction time tasks and indirect measures of attention such as the stroop, dot-probe or cueing tasks. However, these tasks primarily assess early attention allocation (direction bias) which is thought to be less impaired in MDD than sustained attention allocation (duration bias) 8 , 9 . In addition, reaction time measures used to assess attentional processes have extremely low reliability 10 and do not accurately capture emotional processing in patients who have difficulty responding by pressing a keyboard, due to psychomotor retardation or catatonic symptoms. Eye-tracking can overcome these limitations by providing a direct and objective measure of sustained and early attention through the recording of eye movement.

Free-viewing eye-tracking meta-analysis and review have reported that patients with MDD show a robust attentional bias away from positive stimuli and a less robust bias toward negative stimuli, compared to controls 9 , 11 . Importantly, patients with MDD show a more pronounced attentional bias toward negative stimuli than participants with subclinical depression 11 . Several studies have examined the relationship between depression severity and attentional bias toward emotional faces using eye-tracking in patients with MDD, but have yielded inconsistent conclusions. Some have focused solely on investigating the relationship between symptom severity and sustained attentional bias for both positive and negative information 12 , 13 , 14 revealing no significant correlation. Conversely, other studies have used a free-viewing task to examine both early and sustained attention, leading to conflicting results. For instance, Duque and Vázquez 15 identified a significant correlation only between the depression severity and the sustained attentional bias for sad faces, whereas Bodenschatz et al. 16 reported no such correlation.

To address these discrepancies presumed to stem from methodological differences, the present study aims to investigate the relationship between both sustained and early attentional biases for emotional faces (happy and sad) and depression severity in patients with moderate to severe treatment-resistant MDD (TRD) with stable medication for 4 weeks. In this study, we hypothesized that there would be inverse correlations between attentional bias to positive and negative emotions and the severity of depression. The ultimate goal of this study is to establish eye tracking in a free-viewing task as a reliable tool for assessing the severity of depression.

Clinical and sociodemographic characteristics

Clinical and sociodemographic characteristics are detailed in Table 1 .

Relationship between depression severity and sustained emotional attentional bias

A significant negative correlation between depression severity and sustained attention bias for happy faces ( p corr  < 0.01; r  = -0.40; IC 95%  = [− 0.61; − 0.15]) was observed with strong evidence in favor of H 1 (BF 10  = 14.77; Fig.  1 A). There was also a significant positive correlation between depression severity and sustained attention bias for sad faces ( p corr  < 0.001; r  = 0.51; IC 95%  = [0.28; 0.68]) with decisive evidence in favor of H 1 (BF 10  = 281.8; Fig.  1 B). Multiple linear regression analyses showed no effect of age or sex on sustained attentional bias (see Table 2 ).

Correlation between depression severity and emotional bias for sustained attention. ( A ) Significant negative correlation between depression severity and sustained attention bias for happy faces (r = − 0.40; p corr  < 0.01; BF 10  = 14.77). ( B ) Significant positive correlation between depression severity and sustained attention bias for sad faces (r = 0.51; p corr  < 0.001; BF 10  = 281.8).

For sustained attentional bias toward happy faces, the multiple linear regression model accounted for 19.7% of the variation in the attentional bias to happy faces and reached statistical significance ( F (3,50)  = 4.088, p = 0.011; R = 0.444; adj. R square = 0.149). The results show that only the MADRS score was statistically significant in predicting the attentional bias to happy faces while sex and age were not. For sustained attentional bias to sad face, the overall model explained 26.8% of the variation in the attentional bias to sad faces and was significant ( F (3,50)  = 6.093, p = 0.001; R = 0.517; adj. R square = 0.224). Again, the results show that only the MADRS score was statistically significant in predicting the attentional bias to sad faces while sex and age were not (Table 2 ).

Relationship between depression severity and early emotional attentional bias

Analyses revealed no significant correlation between the depression severity and the laterality quotient for either happy faces ( p corr  = 0.052; r  = 0.34; IC 95%  = [0.08; 0.56]; substantial evidence in favor of H 1 : BF 10  = 6.846, n = 53) or sad faces ( p corr  = 0.90; r  = -0.17; IC 95%  = [− 0.11; 0.42]; anecdotal evidence in favor of H 0 : BF 10  = 0.35).

We aimed to characterize the relationship between depression severity and emotional bias using a straightforward measure of sustained and early attention in patients with TRD.

Regarding sustained attention, the analyses showed strong evidence for a negative correlation between emotional bias to happy faces and the depression severity, and decisive evidence for a positive correlation between emotional bias to sad faces and the depression severity. This suggests that the more severe the depression, the more time participants spent looking at sad faces and the less time they spent looking at happy faces compared to neutral faces. Strengthening this robust association between depression severity and attentional bias, multiple linear regression analyses show that only the MADRS score is a predictor of sustained attentional bias, while gender and age do not contribute significantly to the prediction. Some of these findings are supported by previous eye-tracking studies, which have reported a more pronounced attentional bias in patients diagnosed with MDD compare to participants with subclinical depression 11 , a positive correlation between depression severity and sustained attentional bias to sad faces 15 , a longer DTs to sad faces, and a lack of bias to happy faces compared to controls 17 , 18 .

Regarding early attentional biases, no significant relationships were observed between the orientation of the first saccade to sad and happy faces and the depression severity. These findings are consistent with several previous eye-tracking studies showing that people with MDD do not show an initial orientation bias to emotional stimuli 8 , 9 .

The current study replicates and extends previous findings by showing in the same FVT study that there is an association between sustained emotional bias for both positive and negative stimuli and depression severity, but not with early emotional attentional bias. Although these results are encouraging some limitations that curtail the generalization of the results must be noted. First, our statistical model only controls for the effect of MADRS score, age and sex on cognitive bias, but it is known that other variables could have an impact on this cognitive function, such as treatments or disease characteristics (course of the disease, duration of episode, number of relapses, etc.). Second, it should be noted that results were obtained in patients with TRD, a specific subgroup of patients that may present differences from a clinical 19 and neurobiological point of view 20 . However, the inclusion of treatment-resistant patients with stable antidepressant treatment for at least 4 weeks allowed us to control for the potential beneficial effect of medication on emotional processing, including FVT 21 . Third, the study suffers from lack of a comparison group (either healthy volunteers or people with subclinical depression). Finally, the number of face pairs presented may seem small, but this allows us to propose a task that can be completed quickly and integrated into the patient's examination routine (< 5 min). Then, because we only included ‘sad’ and ‘happy’ faces, the generalization of the current conclusions to other emotions is limited.

Finally, using a task that is accessible and easy to integrate into patients' assessment routines, we showed that sustained attentional bias toward sad and away from happy faces increases with depression severity. The FVT may be a useful tool for objective assessment of depression severity in clinical settings.

Material and method

This retrospective study was approved by a local ethics committee (Comité d’Ethique de la REcherche du VInatier—CEREVI, id number #2023/006, on April 24th, 2023), was performed in accordance with relevant French guidelines and regulations using data from an authorized anonymized database (Commission Nationale de l’Informatique et des Libertés CNIL, MR-003-2017-002), and in accordance with the Declaration of Helsinki. All participants (and/or their legal guardians when applicable) gave written informed consent for participation and for publication of the study. This retrospective study was not registered in a public database prior to its execution.

We reviewed data from patients who attended our clinical unit for treatment-resistant depression between December 2018 and December 2022. Treatment-resistant depression was defined as a failure to respond to two or more antidepressant regimens despite adequate dose and duration and adherence to treatment 22 . The 10-item Montgomery-Asberg Depression Rating Scale (MADRS 10 ) 23 was used to assess depression severity. It is a clinician-rated questionnaire known for its validity and inter-rater reliability 24 . It is designed to assess depression severity through 10 items that focuses on the symptoms of depression (e.g., sadness, tension, and pessimistic thoughts).

Patients were eligible if they had a DSM-5 diagnosis of MDD, have moderate to severe depression as indicated by a MADRS 10 score ≥ 20 even on stable medication (dosage and molecule) for 4 weeks, and have completed the free viewing task (FVT) on the day of their first visit to our clinical unit. Exclusion criteria included neurological (e.g., dementia) or psychiatric comorbidities, unanalyzable eye-tracking data, incomplete clinical information, or withdrawal of consent. Of the 61 eligible patients, 7 patients were not included due to unprocessable eye-tracking data, resulting in a final analyzed sample of 54 participants with moderate to severe depression.

Eye tracking free-viewing task

The FVT consisted of showing pairs of faces: one emotional (happy or sad) and one neutral, presented randomly for 3500 ms to the right and left of a fixation cross lasting 1500 ms. We presented 23 pairs of stimuli: 11 happy-neutral and 12 sad-neutral pairs, with 12 different identities (6 males, 6 females). The faces were extracted from the Ekman and Friesen open set 25 . Throughout the task, gaze position and eye movements were recorded with an eye-tracking system (SMI SensoMotoric Instruments with BeGaze 3.6.52, Teltow, Germany).

Eye tracking measurement analysis

Early (direction bias) and sustained (duration bias) attention allocation was assessed per participant based on eye-movements recording 26 .

Dwell time (DT), the total time (ms) of all fixations on the faces, was used to measure sustained attention allocation (duration bias). The difference between emotional and neutral DTs was used to calculate an emotional bias score.

The orientation of the first saccade, corresponding to the first face the participant looked at, was used to measure early attention allocation (direction bias). A laterality quotient was calculated as the difference between the number of times the participant made a first saccade to the emotional face and the number of times where the first saccades were to the neutral face, divided by the total number of trials.

For both measures, a positive value indicates a bias toward emotional faces, while a negative value indicates a bias toward neutral faces.

Statistical analysis

We used Pearson’s correlations with Bonferroni adjustment ( p corr ) to examine the relationship between sustained and early emotional attentional biases and depression severity (MADRS 10 scores). To complement the frequentist statistics, we also performed Bayesian analyses using BF 10 , which provided us with a likelihood ratio of the alternative hypothesis (i.e., H 1 : correlation between variables) to the null hypothesis (i.e., H 0 : no correlation). Finally, to provide a more comprehensive understanding of the findings, multiple linear regression analyses were conducted to assess the predictive significance of the MADRS score, age, and sex on sustained attentional bias to happy faces and sustained attentional bias to sad faces. All statistical analyses were performed using Rstudio version 2021.09.2+382 (Richmond Hill, Canada).

Data availability

The data that support the findings of this study are available on request from the corresponding author, [J.B.]. The data are not publicly available due to local restrictions (e.g., their containing information that could compromise the privacy of research participants).

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Acknowledgements

The authors thank the study nurses of the PSYR2 team and the Ugo Cerletti Unit. This research was funded by the joint Scientific council of CH Le Vinatier with the University Lumière Lyon 2 (#CSLV 09, RM).

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Imbert, L., Neige, C., Moirand, R. et al. Eye-tracking evidence of a relationship between attentional bias for emotional faces and depression severity in patients with treatment-resistant depression. Sci Rep 14 , 12000 (2024). https://doi.org/10.1038/s41598-024-62251-4

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Forgotten Spaces: Ecocriticism Social Justice, and the U.S. South (Collection of Essays)

The U.S. South is often a forgotten space within ecocritical discussions, yet it provides fruitful ground for thinking about environmental issues. In 2019, in the first edited collection of essays on the topic, Zachary Vernon notes that focusing attention on this bioregion might help “provide a way out of the limitations of thinking too locally or too globally,” and it might inspire a group of stakeholders to come to the table as well (7). One problem with ecocritical approaches is the long history of representing the U.S. South as an “internal other in the national imagination: colonized, subordinate, primitive, developmentally arrested, or even regressive” (Watson 254). Another issue is that both the environmental humanities and Southern studies have frequently been white spaces. This proposed anthology convenes a conversation about the U.S. South and environmental issues with an eye towards social justice. We seek theoretically-sophisticated essays attentive to intersections between race, class, gender, and sexuality within the U.S. South to round out our proposed collection.  Interdisciplinary environmental research from a variety of frameworks and disciplines is welcome, including literature, film, art, history, popular culture, public memory, sociology, political science, and geography. 

Questions to consider:

• Why does the U.S. South seem like a forgotten space within ecocritical discussions?
• How do we reach across entrenched divides and academic silos to engage in cross-disciplinary engagement with ecocritical concerns about the South?
• What entanglements might we find between race, environment, gender, sexuality, class, and social justice?
• How have artists, writers, activists, and cultural workers of color engaged with representing the environment, and what might their creative labor contribute to wider discussions beyond the academy?
• How are rural and urban environments represented in the U.S. South? How are they represented from outside?
• What constitutes the commons in the South? Was there ever really a Southern commons?
• How are public parks, museums, and recreation areas curated in the South, and what might we learn about entanglements between race and the environment through attending to these spaces?
• What is the history of traveling southward or leaving the South? What kinds of cultural constructions represent the region as a place to return to or escape from?
• How might we interrogate Donna Haraway’s phrase “the plantationocene” to consider the vexed history of work, nature, and captivity in Southern spaces? 
• How might we consider Settler colonialism, genocide, and Indian Removal within an ecocritical framework? How has a legacy of Settler colonialist violence in the South impacted the environment?
• Can indigenous practices, beliefs, and cultural production be mobilized towards a Southern ecocriticism?
• What are the many varieties of experience within different souths?

Other possible topics:

• Climate change and its impact on southern spaces. Southern climate diaspora.
• Hurricanes, floods, tornados. Natural disasters and social justice.
• Disaster capitalism and southern spaces.
• Sacrifice zones. Industrial pollution.
• Carceral, military, and/or institutional Southern spaces.
• Queer ecology and queer ecological souths.
• Global approaches to environment and the U.S. South.
• Animals and animality in southern cultural productions. Domestic/wild/wilding.
• Southern megacities and the built environment in the U.S. South.
• Race and nature in the South.
• White supremacy and public spaces.

We seek MLA-formatted essays from 4,000-7,000 words. Please submit abstracts of 250-500 words by July 15, 2024. Notification of acceptance will be made by Aug. 1, 2024. And final essays will be due October 15, 2024. We will be submitting the proposal, table of contents, and sample essays to academic presses by Aug. 1, 2024.

Send abstracts and questions to: Katie Simon, Georgia College and State University,  [email protected]  and Catherine Bowlin, Elon University,  [email protected]

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Essays on art and science.

Eric R. Kandel

Columbia University Press

Pub Date: March 2024

ISBN: 9780231212564

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Anything Eric R. Kandel says about neuroscience or the relationship between art and neuroscience is noteworthy. He is not only brilliant at explaining difficult and complex scientific ideas and data in simple language but also well-informed about—and sympathetic to—twentieth-century art, and avails himself of an impressive range of art-historical literature. Nancy Princenthal, author of Unspeakable Acts: Women, Art, and Sexual Violence in the 1970s, and Joseph E. LeDoux, Henry And Lucy Moses Professor of Science, New York University

A lively, erudite inquiry into the experience of art. Kirkus Reviews

Eric R. Kandel’s ‘Essays on Art and Science’ is a fascinating, thought-provoking read that beautifully articulates the complex interplay between our brain’s inner workings and our emotional responses to art. It’s a testament to Kandel’s expertise and ability to make science approachable and relevant to our everyday experiences with art. This book is a must-read for anyone interested in the profound ways in which art and science intersect to define our perception of the world. Mental Health Affairs

• Read an excerpt in Book Post
• Read an excerpt "The Creative Brain" from as published in The Transmitter

About the Author

• Neuroscience and Biopsychology
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• Fine Arts and Art History

Substance Abuse: Case Study Analysis Essay

Introduction.

Andrew, a Hispanic man of 26, lives with his mother and elder sister. He works part-time since he is currently enrolled at a nearby community college. Andrew was suspended from school and placed on academic probation for his involvement with marijuana. In addition, he was doing a number of part-time gigs, all of which ended in his dismissal after a few months of bad performance. One of Andrew’s four siblings, a brother, lost his life in a terrible childhood drowning. He has not sought either therapy or a solid support network. Andrew, though, has admitted to consuming marijuana and drinking alcohol and has sought professional help.

A decade of fighting Major Depression, it is finally revealed after he attends many therapy sessions. Andrew says he can drink heavily without becoming drunk. He freely admits to having tried and failed on several occasions to kick his weed and alcohol habits. Andrew has a higher chance of being fired again since he keeps skipping work. Multiple prescriptions for antidepressants were written for Andrew’s mum by her Physician. In addition, her sister gives off a gloomy vibe but insists she is well. To this end, the self-medication model will be applied to Andrew’s case to establish the root of her addiction and the best means of treating it.

Treatment Model and Conceptualization

Under the self-medication theory, drug use is a symptom of a deeper problem. For some people, drug abuse is a means of coping with difficult feelings, mental health issues, and stressful situations. Drug use is a coping mechanism for the distress of mental illness (Parvinro et al., 2022, p.20). Individuals may feel better in the short term, but the underlying substance misuse problem remains. Substance addiction problems are strongly linked to self-medication, suggesting that people engage in this approach because they believe it would cure their underlying disease. The use of substances provides a means for those who have suffered trauma to divert their focus away from their feelings and toward something else, which is why addiction and trauma occur together. In addition, drug use is perpetuated because it provides users with temporary relief from unpleasant experiences.

Pain, whether mental or physical, that persists over a long period of time is a major factor in the development of drug misuse disorders. Self-medication is a coping mechanism used to alleviate both emotional and physical suffering (Hawn et al., 2020, p.5). Relaxation and pain reduction from any source are two of the many benefits of using marijuana or opioids. The paradigm of self-medication is crucial to understand because it may lead to improved methods of treating substance abuse problems(Hawn et al., 2020, p.8). Substance misuse typically manifests as a symptom of a more severe problem. Substance addiction treatment often ends in relapse since so many things might trigger an individual to start abusing drugs or alcohol in the first place.

Andrew’s been using marijuana and alcohol as a kind of self-medication for his mental health issues. Over the past decade, Andrew has been medicating his significant depressive disorder using it. This suggests that Andrew’s decision to self-medicate in order to deal with his grief is a symptom of a deeper mental health issue. Since Andrew’s mom used antidepressants and her sister seems down in the dumps, it is possible that Andrew has a family history of depression. Andrew’s mental difficulties run in the family; both his sister and her mother suffer from depression. Even more importantly, Andrew is hiding his feelings of despair by consuming drugs. From Andrews’s case, it is evident that people turn to drugs as a means of relieving tension and gaining security against the unknown.

DSM5 Diagnosis

Andrew suffers from significant depression and addiction. A person with symptoms consistent with DSM-F33, IV’s major depressive disorder, recurrent episode, typically has recurring episodes of depression without a concurrent history of periods of increased activity or improved mood (Jongsma, 2022, p.6). A recurrence after two months should have been expected, and the last episode ought to have been two weeks. A lack of previous mania or hypomania is a common feature of this condition. Andrew has admitted to having serious depression for the past decade but insists he does not require treatment. The relationship he shares with his brothers is strained, but he is happy with his fiancée.

Andrew has been allowed a number of part-time positions owing to subpar performance. His lack of focus shows in his inconsistent performance at work and subsequent terminations. Despite his lack of a pre-existing depressive disorder, Andrew satisfies the diagnostic criteria for severe depression. He admits he does not need aid since Andrew thinks he is OK on his own. Andrew claims he has tried and failed to give up both alcohol and marijuana. Andrew’s drinking has been worse recently, and he brags about being able to consume large quantities of alcohol without seeing any effects.

It is clear that Andrew has a drug use disorder according to the DSM-IV criteria. Due of his dependency and abuse, he describes the experience of cravings. Andrew has a severe craving for both weed and alcohol. He freely admits to having tried and failed to kick his nicotine and alcohol habits. Because he does not seem to cut down on his drinking, Andrew also satisfies the requirements for dependency. Fearing he may fail in his job as a result of his absences, he is unable to take any significant action. He fits the abuse criteria since he has been using drugs and alcohol to cope with his major depressive disorder for a decade.

Treatment Plan

Problem presentation.

Andrew suffers from significant depression and addiction, he opens out about his heavy use of both marijuana and alcohol. His girlfriend had been encouraging him to see a counselor, and he finally did. A decade of significant depression and alcohol abuse were revealed after he attended numerous sessions. Recently, Andrew has been bragging about drinking excessively without becoming drunk. Andrew’s drinking has gotten out of hand, and he is tried several times to cut back without success.

Treatment Goal

Long-term planning for Andrew should focus on improving both the quality and the duration of his life. Goals include relieving Andrew’s severe depressive symptoms and helping him give up drinking. Andrew is depressed and uses marijuana and liquor to self-medicate. Evidence of extreme reliance and misuse is his recent pattern of drinking heavily without becoming intoxicated. Andrew has tried several times to cut back on his drinking but to no avail. Short-term targets for Andrew include cutting back on drinking and consuming marijuana and increasing his attendance at work.

Therapeutic Intervention

In order to alleviate Andrew’s substantial depressive symptoms, cognitive-behavioral therapy (CBT) should be suggested. Zayfert & Becker (2019, p.5) found that clients suffering from both depression and substance misuse responded positively to CBT. In comparison to other types of psychiatric drugs or psychological therapy, the therapy has proven to be more effective. That is why CBT is the best option for helping Andrew overcome his significant depression since he will have access to new and healthier coping mechanisms. The reduction of his depressive symptoms should help him become more productive. Andrew will be better able to handle difficult situations after doing CBT since he will have acquired the necessary problem-solving abilities. Behavioral modifications are the focus of treatment in CBT.

The second strategy is connecting Andrew with abuse support groups. The support group will assist him in giving up alcohol and drugs as coping mechanisms. In these gatherings, Andrew may hear from others and gain insight into how they have dealt with similar situations. Those who take part in support groups have less cause for worry, anxiety, and despair (Shaari, & Waller, 2022, p.10). A common theme in the group’s communication is honesty and openness about members’ internal experiences. Therefore, Andrew will be able to stick with the different treatment options that have been proposed to him and maintain his motivation to quit drinking and smoking.

Andrew suffers from serious depression, which has led him down the path of substance misuse. Andrew’s drinking and smoking habit is best explained by the self-medication theory. Upon participating in therapy, he said that he had suffered from serious depression for the previous decade, which had led him to turn to alcohol and marijuana for relief. Andrew will be able to overcome his alcohol and drug addiction with the aid of cognitive behavior therapy and connection to substance abuse support groups.

Abu Hassan Shaari, A., & Waller, B. (2022). Self-help group experiences among members recovering from substance use disorder in Kuantan, Malaysia . Social Work with Groups , 1-17. Web.

Hawn, S. E., Bountress, K. E., Sheerin, C. M., Dick, D. M., & Amstadter, A. B. (2020). Trauma-related drinking to cope: A novel approach to the self-medication model . Psychology of addictive behaviors , 34 (3), 465. Web.

Jongsma Jr, A. E. (2022). The addiction treatment planner . John Wiley & Sons.

Parvinroo, S., Rouhi Khalkhali Pargam, H., Hosseinzadeh Asli, R., Rafiei, E., & Nemati, S. (2022). Frequency and causes of self-medication in patients with chronic rhinosinusitis, North of Iran, 2018–2019. European Archives of Oto-Rhino-Laryngology , 279 (8), 3973-3980.

Zayfert, C., & Becker, C. B. (2019). Cognitive-behavioral therapy for PTSD: A case formulation approach . Guilford Publications.

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