Stress leads to depression and anxiety: facts and figures

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What is Stress?
Stress is our
RESPONSE
To Life’s Pressures

Stress Triggers Disease
Heart Disease
Asthma
Diabetes
High Blood Pressure
Ulcers
Cancer
Common Cold & Flu
and…
Mental Illness (Depression & Anxiety)

Stress Triggers Disease
Each year, ONE in every FIVE adults around the
world suffer from depression or anxiety.
Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014). The global prevalence of common
mental disorders: a systematic review and meta-analysis 1980–2013. International Journal of Epidemiology, 43(2), 476–493.

Depression & Anxiety
Those who
suffer from
depression
often also
suffer from
anxiety
Overlap is
50-70%

What is Anxiety?
Anxiety Disorders* involve excessive fear and anxiety:
*The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, published by the American Psychiatric Association in 2013
FEAR: emotional
reaction to either a real
or perceived imminent
threat
ANXIETY: anticipation
and fear of future
threats

600
million
Anxiety Disorders
Alonso, J., Liu, Z., Evans-Lacko, S., Sadikova, E., Sampson, N., Chatterji, S., Abdulmalik, J., Aguilar-Gaxiola, S., Al-Hamzawi, A., Andrade, L. H.,
Bruffaerts, R., Cardoso, G., Cia, A., Florescu, S., de Girolamo, G., Gureje, O., Haro, J. M., He, Y., de Jonge, P., Karam, E. G., Kawakami, N., Kovess-
Masfety, V., Lee, S., Levinson, D., Medina-Mora, M. E., Navarro-Mateu, F., Pennell, B. E., Piazza, M., Posada-Villa, J., Ten Have, M., Zarkov, Z.,
Kessler, R. C., Thornicroft, G., WHO World Mental Health Survey Collaborators (2018). Treatment gap for anxiety disorders is global: Results of the
World Mental Health Surveys in 21 countries. Depression and anxiety, 35(3), 195-208.
1 out of every
10

What is Depression?
Major Depressive Disorder* occurs when you have at least 5
of the following 9 symptoms daily for 2+ weeks:
*The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, published by the American Psychiatric Association in 2013
Anxiety symptoms (irrational worry; fear that something
terrible will happen) may also accompany depression
• A depressed mood during most of the day, particularly in the morning
• Diminished interest or pleasure in almost all activities
• Significant weight loss or gain (more than 5% in a month)
• Insomnia (lack of sleep) or hypersomnia (excessive sleeping)
• Feeling restless, agitated or slowed down
• Fatigue or loss of energy
• Impaired concentration, indecisiveness
• Feelings of worthlessness or guilt
• Recurring thoughts of death or suicide (not just fearing death)

300
million
Major Depressive Disorder
Thornicroft, G., Chatterji, S., Evans-lacko, S., Gruber, M., Sampson, N., Aguilar-gaxiola, S., … & Bruffaerts, R. (2017).
Undertreatment of people with major depressive disorder in 21 countries. The British journal of psychiatry, 210(2),
119-124.
1 out of
every 22

300
million
To put that # into
perspective:
U.S. population =
327 million
119-124.

*The Diagnostic and Statistical Manual of Mental Disorders,5th edition,published by the American Psychological Association in 2013
23
million
1 out of
every 15

Cost of Depression
FINANCIAL
Greenberg, P. E., Fournier,A. A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015). The economic burden of adults with major depressivedisorder in the United States(2005 and
2010). The Journal of clinical psychiatry, 76(2), 155-162.
Direct costs: $30 billion
Indirect costs: $210 billion
✓Other physical problems
✓Workplace (absenteeism, low work
performance)
✓Loss of lifetime earnings

Cost of Depression
FINANCIAL
Chisholm,Dan, et al. "Scaling-up treatment of depressionand anxiety: a globalreturn on investment analysis." The Lancet Psychiatry 3.5 (2016): 415-424.
World Health Organization. (2017). Depression and other common mental disorders:global health estimates.
• Global economic burden is $1 trillion
• 12 billion days of lost productivity
• Largest contributor to medical disability
• Causes more “days out of role” than any
other mental disorder (massive loss of
human potential)

Cost of Depression
HUMAN LIFE
Center for Disease Control’s and Prevention (CDC) Data & Statistics Fatal Injury Report for 2015
Möller, H. J. (2003). Suicide,suicidality and suicide prevention in affective disorders.Acta Psychiatrica Scandinavica, 108(s418), 73-80.
Nock, M. K., Hwang, I., Sampson, N., Kessler, R. C., Angermeyer, M., Beautrais, A., ... & De Graaf, R. (2009). Cross-national analysis of the associations among mental
disordersand suicidal behavior:findingsfrom the WHO World Mental Health Surveys. PLoS medicine, 6(8), e1000123.
World Health Organization. (2017). Depression and other common mental disorders:global health estimates.
• MDD is the strongest predictor of suicide
attempts around the world
• 60-70% of depressed individuals have suicidal
thoughts; 10-15% commit suicide
• In the U.S., suicide is in the top 10 leading causes
of death (65,000/yr)
• In the world, it is in the top 20 (800,000/yr)

119-124.
TREATMENT RATES
BY INCOME:
POOR COUNTRIES:
4 IN 100 received
adequate treatment
4%

119-124.
TREATMENT RATES
BY INCOME:
RICH COUNTRIES:
LESS THAN 1 IN 4
received adequate
treatment22%

Suicide: Global Rates & Risk Factors
Center for disease control’s and prevention (CDC) data & statistics fatal injury report,
World health organization. (2017). Depression and other common mental disorders: global health estimates.
Cavanagh, j. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: a systematic
review. Psychological medicine, 33(3), 395-405.
40seconds
800,000
65,000

Suicide: Global Rates & Risk Factors
Center for disease control’s and prevention (CDC) data & statistics fatal injury report,
World health organization. (2017). Depression and other common mental disorders: global health estimates.
Cavanagh, j. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: a systematic
review. Psychological medicine, 33(3), 395-405.
• Social Isolation
• Stress
• Previous Suicide
Attempts
• Family History
• Mental Illness
RISK FACTORS:
90%
are related
to mental
illness.

Cost of Depression
HEALTH
Scott, K. M., Bruffaerts, R., Tsang, A., Ormel, J., Alonso,J., Angermeyer,M. C., ... & Gasquet, I. (2007). Depression–anxietyrelationshipswith chronic physical conditions:results
from the World Mental Health Surveys. Journal of affective disorders, 103(1), 113-120.
Scott KM, Lim C, Al-Hamzawi A, et al. Association of Mental DisordersWith SubsequentChronic Physical Conditions:World Mental Health Surveys From 17 Countries. JAMA
psychiatry. 2016;73(2):150-158. doi:10.1001/jamapsychiatry.2015.2688.
DEPRESSION ILLNESS
ILLNESS DEPRESSION

DEATH
Negative lifestyle choices
Loss of control
Non-compliance with treatment
Despair
ILLNESS
Self-neglect
or harm
DEPRESSION

Cost of Depression
HEALTH
• Stroke
• Chronic pain
• Ulcers
• Chronic lung
disease
Scott, K. M., Bruffaerts, R., Tsang, A., Ormel, J., Alonso,J., Angermeyer,M. C., ... & Gasquet, I. (2007). Depression–anxietyrelationshipswith chronic physical conditions:results
from the World Mental Health Surveys. Journal of affective disorders, 103(1), 113-120.
Scott KM, Lim C, Al-Hamzawi A, et al. Association of Mental DisordersWith SubsequentChronic Physical Conditions:World Mental Health Surveys From 17 Countries. JAMA
psychiatry. 2016;73(2):150-158. doi:10.1001/jamapsychiatry.2015.2688.
DEPRESSION
• Cancer
• Diabetes
• Asthma
• Cardiovascular disease
• Hypertension
increases later
risk of:

Stress leads to depression and anxiety: facts and figures

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