The expected answer for many participants here would be "never." Lifetime incidence of at least one period of depressed mood is fairly high across humankind, but that's over the course of a whole lifetime. If a young person is depressed for days at a time a few times a year, that young person has a clinical case of depression and is well advised to seek medical advice about what to do about. Both medicine and cognitive talk therapy can be helpful, often most helpful as a both-and combination.
If a young person is depressed for days at a time a few times a year, that young person has a clinical case of depression
That is far from obvious.
The medicalization of depression is itself questionable. There are eloquent dissents by informed critics. It's certainly the majority view right now, but is more a paradigm than a proven truth, and these things are notorious for being subject to fashion. It wouldn't be surprising if, in a decade or two, the pendulum swung the other way.
I agree with you about the medicalization of depression. The unspoken boogey man behind this is that the professionals say this kind of thing in the belief that medicalization is a lesser evil than the prospect of young people killing themselves. Its the old problem of whats good for society isn't necessarily good for the individuals. Wide spread medicalization of depression saves lives, but the cost is that individuals offen get medicalized for things they don't need.
professionals say this kind of thing in the belief that medicalization is a lesser evil than the prospect of young people killing themselves
Yes. Untreated depression is a huge cause of mortality among young people. Young people in developed countries don't die of much else besides traffic accidents (and at least some deaths of young people that are reported as traffic accidents may be misreported suicides).
There is also the issue of subsequent degradation of a person's quality of life if depression is not treated when the person is young. Most twenty-somethings are resilient enough to get through quite a few episodes of depression and to stay employed and to stay in romantic relationships, but each depressive episode tends to cost a patient work productivity, intimacy with significant others, and other sources of personal reserves for the next episode. It is UNUSUAL for young people to have prolonged (days-long) episodes of depressed mood if they haven't had a parent die or something like that. That's an issue that should be looked into. Perhaps part of what is going on in this thread is that people are applying different criteria for using the term "depressed." Physicians have taken care in multiple research projects to develop diagnostic screening tools that standardize how much by way of depressive symptoms is enough to be of concern. If you have a concern, get the opinion of someone with clinical experience and see if you can go through life without repeated episodes of feeling worse (and doing worse) than you need to.
the professionals say this kind of thing in the belief that medicalization is a lesser evil than the prospect of young people killing themselves
Interesting. I hadn't heard that before. How do you know this?
Have suicides really gone down with the advent of antidepressants? I remember lawsuits about increased rates of suicides among adolescents prescribed some of them. It would be interesting to know the overall rates.
I don't know how the participant to whom you are replying knows what his post reported, but concern about suicide is definitely one of the motivations for urging more treatment for depression. An organization for suicide prevention
puts up billboards in my town to remind family members to have their depressed relatives treated for depression, saying that untreated depression is the main risk factor for suicide. That factual statement is correct, as I can verify from having read many books by psychologists or medical doctors about mood disorders. I got into this reading back in the 1990s as part of studying suicide risk in different cultures,
and research on this issue continues to be replicated across many studies with different investigators in different places.
You ask about one category of medicines, the SSRI medicines commonly prescribed as antidepressants. They do have a genuine risk of INCREASING rather than decreasing suicidal behavior in some patients, now recognized in their prescriber labeling. The Goodwin and Jamison textbook
details the research on this issue over many pages with lots of footnotes to primary research papers in peer-reviewed journals. My overall impression of the mechanism for increased suicide risk upon SSRI treatment for depression is that some depressed patients go from thinking that there is nothing they can do to thinking that the one thing they can do is to harm themselves. That's why I follow Goodwin and Jamison in thinking that for most depressed patients whose history of mood variation is poorly known, the best initial treatment is a mood-stabilizing medicine (such as lithium, carbamazepine, divalproex, or lamotrigine) rather than an SSRI medicine. But I am not a physician, and I urge persons who are concerned about their depressed moods to check with a physician who has clinical experience with depressed patients to be evaluated for what might or might not be at issue.
Very common. Around one million Australian adults and 100,000 young people live with depression each year. On average, one in five people will experience depression in their lifetime - one in four females and one in six males.
