V E TE R AN S AFFAI R S & M I LITARY M E D I CI N E O UTLO O K
VA Research
DEPRESSION By Craig Collins
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The U.S. Army STARRS Study found major depression to be five times higher among active-duty service members compared to civilians.
DEVELOPING A “PICTURE OF DEPRESSION” Identifying risk factors for depression is more difficult than with most illnesses; depression weaves a tangled etiological web with other mental and physical health problems. It can occur along with literally all other psychiatric and physical diagnoses. Physical illness is known to increase the risk of developing depressive illness, though many of the cause-effect relationships – or whether cause-effect relationships are involved at all – remain unknown.
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n ACCORDING TO THE NATIONAL INSTITUTES OF MENTAL HEALTH, more than 15 million American adults suffer at least one major depressive episode in a given year – about 6.7 percent of the population. It’s a percentage that makes depression one of the nation’s most common and burdensome mental health disorders. Among active-duty service members and veterans, this rate is higher: The landmark Army STARRS Study, completed in 2014, found the incidence of major depression to be five times as high among active-duty soldiers as civilians. In 2008, the Department of Veterans Affairs (VA) estimated that about 1 out of every 3 veterans visiting a primary care facility displayed at least one symptom of depression, while 1 in 5 had serious symptoms suggesting the need for further evaluation. According to the National Alliance on Mental Illness, the diagnosis rate for major depression among veterans, requiring treatment with psychotherapy or antidepressants, is 14 percent. More than the occasional bout of melancholy or grief, depressive disorder is marked by sustained feelings of sadness or hopelessness that last for two weeks or longer, often accompanied by a loss of interest in activities once enjoyed. It can lead to other emotional and physical problems, and can be disabling, reducing a person’s ability to function at home and at work. Untreated depression is known to increase the risk for suicide, a cause of death that has been on the increase among veterans – particularly younger veterans – in recent years. Despite its often devastating effects, major depression is a treatable illness: About 8 out of 10 veterans receiving VA care are effectively treated. VA researchers aim to increase this percentage by developing models of intervention and social support to help veterans recover from depression and other mood disorders. Some investigators are exploring which risk factors – including brain chemistry, genetics, personality, and environmental factors such as stress or trauma – increase the likelihood of depression; others are evaluating the effectiveness of medications and other treatments.
