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Recognizing Symptoms in the U.S.
Recognizing Symptoms in the U.S.
Most American clinicians use the Diagnostic and Statistical Manual of Mental Disorders to identify symptoms of depression. A person must experience at least five of the nine DSM-V symptoms for a set number of days to be diagnosed with major depressive disorder (MDD). See #1 of this page for the full diagnostic criteria.
For countless Americans, depression is comorbid with other disorders. For instance, depression in its bipolar form typically involves hypomanic episodes characterized by racing thoughts and restlessness (DeRubeis et al. 2008). Also, almost half of Americans diagnosed with depression suffer from anxiety marked by excessive worry and fear (Anxiety and Depression Association of America).
Additionally, researchers have detected manifestations of depressive symptoms through social media activity. To illustrate, a recent study of U.S. Instagram users found that depressed individuals tend to post darker photos and fewer faces—signalling isolation—than healthy users (Reece and Danforth, 2017).
American Attitude Towards Depression
American Attitude Towards Depression
Public Stigma
Public Stigma
Stigma against people with depression has decreased in recent years, due in part to increased knowledge about the biological aspects of depression, but it still exists. For example, people with depression are seen as more dangerous, especially towards themselves. This is especially true of children. In addition, children are seen to be lazy troublemakers while adults are viewed as less competent. Children and adults alike tend to distance themselves from those with depression because of these stereotypes. Research also shows that children and non-white adults with depression face more stigma than white adults (Parcesepe, 2013).
Opinions on Treatment
Opinions on Treatment
The American public is increasingly supportive of professional help, including therapy and medication, to deal with depression. However Americans seem to believe more in treatment, especially medication, for adults than for children. Furthermore, attitudes towards treatment vary based on many social factors. Yet it does not appear as though one group has an overall more positive or more negative view of professional help (Parcesepe, 2013).
American Treatment Methods
American Treatment Methods
Therapy and medication are the two most common treatments for depression in America. Cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy have proven most effective in therapeutically treating depression in the U.S. (National Alliance on Mental Illness).
CBT - Reframing negative thoughts and practicing behaviors that contradict irrational beliefs.
IPT - Working to understand how interpersonal relationships contribute to depressive symptoms and trying to improve those relationships.
Approximately one in eight Americans over the age of 12 use antidepressants (CDC). The most widespread pharmacological treatment of depression is the consumption of SSRIs, which increase serotonin levels in the brain (Gelenberg and Hopkins, 2007). Although both appear to be effective treatments, cognitive therapy has shown lower rates of remission after stopped usage than has drug treatment in U.S. adults (DeRubeis et al. 2008).
Limitations of the American Model
Limitations of the American Model
Quality and availability of treatment varies by race and socioeconomic status (Alegría, 2008) (Lorant, 2003)
Mexican Americans and African Americans use depression therapies less than other ethnic groups despite similar depression severity ratings. Certain races may lack access to psychotherapy, or might avoid seeking it out (González et al. 2010)
Differences in display rules, or how acceptable it is to show one's emotions, might lead to under-diagnosis or over-diagnosis of depression for people of different cultural backgrounds
Many Americans take antidepressants without a depression diagnosis, while plenty of those with clinical depression do not receive psychiatric care (Olfson et al. 2016)
Over reliance on primary care physicians in diagnosing and treating mental illness leads to under diagnosis and insufficient treatment (Unützer, 2012)
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