By Aminah Cherry, MD
According to various reports, depression affects 1 in 10 people throughout the United States. This condition, and other diseases affecting mental health affect women and low-income individuals at a higher rate than others.
This is a particular item of interest to me, as an African American woman practicing medicine in a community clinic. A large percentage of my patients that are ailed with pain, decreased energy, and poor sleep, I find, have an untreated mental health disease.
The reasons their mental health disease remains untreated is likely multifactorial – they do not believe medicine or therapy will help, they don’t want to talk about their lives with strangers, or they don’t want to be viewed as ‘crazy’.
And sometimes, in my rush to manage their diabetes and high blood pressure and meet the new patient satisfaction quality metrics, I simply do not see the positive screen for depression until I am completing charts after the clinic has closed and the patient is long gone. Still, given the huge physical and economic costs of untreated mental health disease, burying our collective heads in the sand is not an option.
Depression can be categorized in several ways. Clinical depression is a very specific diagnosis, however, many of the symptoms can be easily recognized by lay persons: changes in sleep patterns, loss of interest in activities previously enjoyed, excessive guilt, loss of energy, difficulty concentrating, changes in appetite, physically moving slower, and suicidality.
Many people in fact present physical manifestations of the disease. We call this somatic complaints.
Depression can manifest as pain, constipation, or nausea, etc. These symptoms, left untreated, are a part of the reason that by 2020, depression is estimated to become the largest cause of disability in the U.S.
‘Depression hurts’ and we can help.
The collective ‘we’ extends outside the boundaries and limitations of the physician’s office. It extends to community outreach programs, the patients’ own social support system, faith-based organizations, and alternative medicine professionals.
However, despite the multitude of treatment options and attempts historically to educate low-income and minority communities about the prevalence of mental health disease, a pervasive stigma remains. This stigma is not treatable in the physician’s office.
There is a large body of evidence that agrees that where there is stigma regarding disease, the disease remains untreated. Given that depression is linked to shorter life spans, and an increase in cardio-vascular disease, both ailments that disproportionately affect minorities and low-income communities, this is a stigma that we cannot allow to continue.
I hope that bringing attention to this disease, and talking about it publicly, will alter our discourse regarding mental health and encourage those who need it to seek treatment.
If you know someone, or if you are experiencing some of the symptoms listed above, talk to someone. There are people in your community who would help you. I am one of them.
Aminah Cherry, MD, is a USC-CHMC Chief Resident in the Family Medicine Department at The James A. Watson Wellness Center.