Depression in United States

United States

Depression, also called major depressive disorder or clinical depression, is a common mood disorder. It is a complex disorder that is caused by a combination of genetic, biological, environmental and physiological factors. Commonly known risk factors for depression include chronic pain, major life changes or stressors, certain medications and family history of depression. The symptoms of depression — such as hopelessness, loss of interest and fatigue — can impact all aspects of a person’s life, including how they think, feel and handle daily activities. Around 80% of adults with depression report at least some difficulty performing work, home or social activities. Depression is a risk factor for attempting suicide. 

There are significant societal costs associated with depression. The economic burden of depression in the United States is estimated at $326.2 billion a year, including direct medical costs, loss of workplace productivity and loss of life due to suicide. 

According to America’s Health Rankings, populations of adults who have a higher prevalence of depression include: 

• Women compared with men.
• Adults ages 18-44 compared with those ages 45 and older.
• Multiracial and American Indian/Alaska Native adults compared with Asian adults.
• Adults with some post-high school education or less than a high school education compared with college graduates and those with a high school diploma or GED degree.
• Adults with an annual household income less than $25,000 compared with those with higher levels of income.
• Adults living in non-metropolitan areas compared with those in metropolitan areas.
• Adults who have difficulty with cognition compared with adults without a disability. 
• LGBQ+ adults compared with straight adults. 

Depressive disorders are common and treatable. Depression is most commonly treated with psychotherapy, medications or both. Talking with a primary care provider is a common first step to finding mental health care. Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers an online behavioral treatment locator. 

County Health Rankings & Roadmaps lists multiple evidence-based strategies for improving health outcomes for people who have depression, including: 

• Behavioral health primary care integration.
• Changes in mental health benefits legislation.
• Community-based social support for physical activity.

The National Institute of Mental Health provides a guide for how to help someone who is in emotional pain. In 2022, the 988 Suicide & Crisis Lifeline was launched to provide an easy-to-remember number and 24/7 confidential support for people in distress, as well as prevention and crisis resources, by call, text or online chat. The previous National Suicide Prevention Lifeline number (1-800-273-TALK(8255)) is also active and can still be used.

Healthy People 2030 has multiple goals pertaining to mental health, including:

• Increasing the proportion of primary care visits where adolescents and adults are screened for depression.
• Increasing the proportion of adults with depression who get treatment.

Brody, Debra J., Laura A. Pratt, and Jeffery P. Hughes. “Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016.” NCHS Data Brief No. 303. Hyattsville, MD: National Center for Health Statistics, February 2018. https://www.cdc.gov/nchs/products/databriefs/db303.htm.

Greenberg, Paul E., Andree-Anne Fournier, Tammy Sisitsky, Mark Simes, Richard Berman, Sarah H. Koenigsberg, and Ronald C. Kessler. “The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018).” PharmacoEconomics 39, no. 6 (June 2021): 653–65. https://doi.org/10.1007/s40273-021-01019-4.

van den Bosch, Matilda, and Andreas Meyer-Lindenberg. “Environmental Exposures and Depression: Biological Mechanisms and Epidemiological Evidence.” Annual Review of Public Health 40, no. 1 (April 1, 2019): 239–59. https://doi.org/10.1146/annurev-publhealth-040218-044106.