Depression was already consistently among the most common mental health disorders, both in the United States and globally, before the pandemic — but a new study published in JAMA Network Open revealed that depression rates in US adults have tripled since COVID-19.
Now, an estimated and frankly, despite the fact that we all know the world is in turmoil still quite shocking, 27.8 percent are depressed.
Unsurprisingly, people facing more financial insecurity and those who lost loved ones to COVID-19 were more vulnerable to depression. Those two risk factors apply to a a whole lot of people, while those with other risk factors or no obvious "reasons" to be depressed can also very much fall into despair.
Why you might be clinically depressed and not know it
Many people seem to see depression as a state of mind in which someone actively feels sad, tearful, and hopeless pretty much all the time — but although all those symptoms do indeed feature in the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), that's not at all the whole story.
Depression may also show up with different dominating symptoms.
All of these factors can make it harder to recognize that you're depressed, but even if you do know that you're feeling down, you can easily brush it off as a natural result of stress, rather than a treatable medical condition. You may be in denial about the possibility that you suffer from major depressive disorder or one of the other diagnoses that fall under the depressive umbrella, or the idea that you could be clinically depressed may simply never have crossed your mind.
Why screening tests matter, and you should screen yourself for depression once in a while
Think of screening as a prediagnosis evaluation tool that can help catch people who have an increased risk of a medical condition — so that they can then move on to more thorough diagnostic testing. In other words, screening programs are like the first round of job interviews, in which employers narrow down the people they want to see again.
Screening matters because it catches diseases earlier, even when patients don't have symptoms or dismiss them, allowing them to access sometimes life-saving treatment.
When left untreated, depression (obviously) leads to a greatly reduced quality of life. Depression is associated with a loss of income, which is itself a risk factor for depression. It also has the potential to negatively impact your physical health by increasing your risk of cardiovascular disease, stoke, and suicide.
How to self-screen for depression
To self-screen for clinical depression, you can use the the Patient Health Questionnaire (PHQ) — a questionnaire to screen for some of the most common mental health disorders that's scientifically been proven to provide rather accurate insights into the probability that a person has any of the disorders it targets, as well as the severity of the disorder. The PHQ-9 is the portion of this questionnaire that specifically targets major depressive disorder. It's designed for people aged 16 and over.
In the PHQ-9, you'll think about how often and how severely you have, over the last two weeks, been dealing with certain emotions and symptoms. You answer the questions on a scale, from "not at all" to "nearly every day", and it targets all the key symptoms of major depression.
How often have you...
- Had little interest or pleasure in doing things over the last couple of weeks?
- Felt down, depressed, or hopeless?
- Had trouble fallen asleep or staying asleep, or overslept or stayed in bed?
- Been plagued by feelings of fatigue and low energy?
- Had no appetite, a low appetite, or felt like overeating or binge eating?
- Felt, over the last two weeks, that you are a failure, have let yourself or your family down, or are somehow bad?
- Had issues focusing on everyday, normal, things?
- Been physically lethargic, with people perhaps commenting that you're slower than usual, or on the opposite side, been especially fidgety and restless?
- Had thoughts that you'd be better off dead?
And then finally — to what extent have these symptoms and feelings interfered with your ability to take care of your normal obligations, or interact with the people in your life?
These questions are a bit more concrete and practical than the diagnostic list for major depressive disorder as it appears in the DSM-5 — and the good news is that you don't even have to score the PHQ-9 screening test for depression yourself. Online versions that score it for you are all over the internet. Take this version of the PHQ-9 from the British NHS, for instance — and don't be confused by the fact that it's labeled a mood self-assessment.
Scores of 5, 10, 15, and 20 respectively give a good indication that you may be living with mild, moderate, moderately severe, or severe depression — and anything over 5 is good reason to make an appointment with your family doctor for further diagnosis. If, like me, you're not a fan of numbers, simply recognizing that you're facing a good deal of depressive symptoms a good deal of the time is also reason enough to do the same.