Marks Psychiatry

An article published in the October issue of the American Journal of Psychiatry (164:1539-1546) concluded that the earlier in life a person develops major depression, the more likely they are to have long term social and occupational problems. The authors studied a group of 4 thousand people ages 18-75 with major depression from both primary care and psychiatric offices. For each individual, they established the person’s age when they had their first depressive episode. The age groups were defined as childhood onset (age less than 12), adolescent onset (ages 12-17), early adult onset (ages 18-44), middle adult onset (ages 45-59) and late adult onset (age greater than 60).

The authors found that pre-adult onset (age less than 18) was associated with higher rates of never being married, impaired social functioning, more lifetime episodes and impaired occupational functioning. The people in this group also tended to have more medical problems and concurrent psychiatric illnesses in addition to depression. This is in contrast to those who developed their first episode in middle or late adulthood. These individuals experienced less comorbid psychiatric and medical illnesses and were overall higher functioning.

These aren’t encouraging findings, but it makes sense that the longer a person is depressed or struggles with depression on and off throughout their lifetime, the more opportunity for the illness to impair their quality of life.

Many people have difficulty with the idea of needing a medication “forever” and may spend years resisting treatment. We know that depression causes significant disability in some and rivals other illnesses such as heart disease in lost time from work and over decreased productivity. This study is another in the growing literature that describes the long term affects of having depression long term. Getting good, consistent treatment early can help one’s course so that developing depression early in life does not have to result in having your life permanently derailed.

[tag]depression, depression treatment, early depression[/tags]

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