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Major Depression Resource Center

Why Major Depression Can Go Undiagnosed

By Dr. Sanjay Gupta

Friends and family can help a loved one get diagnosed and treated for depression.

Major depressive disorder is a leading cause of disability in the United States,

affecting nearly 15 million adults each year. Studies have linked it to serious health
problems such as obesity, type 2 diabetes, cardiovascular disease, and cancer. A
recent study suggests depression can speed up the aging process by making our
cells age faster. Yet major depression often goes undiagnosed or untreated because
people wont address it or those around them dont recognize its signs.

Theres still a lot of stigma about mental illness, said Jon Lehrmann, MD, chairman
of the psychiatry department at the Medical College of Wisconsin. Its a lot less
than 10 or 20 years ago, but some people are just more reluctant to get help. Thats
where they need doctors or family to be looking out for them and helping with

Some symptoms of depression are not visible to others, such as feelings of

hopelessness, guilt, or sadness. Experts agree, however, that there are tell-tale
signs that friends, family, and co-workers can spot.

Family and friends have a big influence on getting the person help, said Kristin
Kuntz, PhD, an assistant professor of clinical psychiatry at The Ohio State University.
They cant make the diagnosis, but they can bring it to someones attention.

According to Robin Kerner, PhD, director of quality initiatives and outcomes in the
psychiatry department at St. Lukes-Roosevelt Hospital in New York City, one of the
most common indicators of depression is social withdrawal. A person may stop
responding to phone calls, emails, and texts; keep canceling plans to meet with
others; and start staying home all the time.

Other signs of depression to watch out for include:

Loss of interest in activities the person once enjoyed or did regularly.

Changes in sleep habits, such as sleeping too much or too little.

Changes in appetite, whether its eating too much or too little.

Anxiousness, irritability, and fatigue.

These symptoms are affecting their daily functioning and everyday life, said
Kerner. But since the behaviors may be attributed to day-to-day stress or personal
issues, people with major depression often dont get a formal diagnosis early on.
Usually by the time we see someone with depression, theyve been trying to cope
with these symptoms for a long time, said Kerner.

Even when signs of depression are spotted, getting a person to seek help can be
very challenging. People with depression typically dont want to think about
treatment, said Kuntz. The depression itself makes them less likely to get
treatment too.

If a depressed person wont respond to family and friends, it may be necessary to

get a primary care doctor to intervene. More family doctors are starting to screen
for depression at checkups, and they will refer patients to a therapist who can come
up with a treatment plan.

As Kuntz points out, theres more evidence out there that theres not overall health
without mental health.

For many patients, cognitive behavioral therapy (CBT) can help them understand
the way theyre thinking or perceiving themselves, and then change those thoughts
or behaviors, according to Kerner. CBT, which may be prescribed along with
medications or on its own, seeks to replace the patients false self-beliefs with
positive, self-affirming thoughts.

If you initiate treatment for depression, its not a lifelong sentence, said Kerner.
But if it goes untreated, quality of life is greatly affected.

Last Updated: 1/9/2014