Co-occurring Disorders and Depression

Clinical depression is a common and serious medical illness that can be effectively treated. The risk of clinical depression is often higher in individuals with serious medical illnesses, such as heart disease, stroke, cancer and diabetes. However, the warning signs are frequently discounted by patients and family members, who mistakenly assume feeling depressed is normal for people struggling with serious health conditions. In addition, the symptoms of depression are frequently masked by these other medical illnesses, resulting in treatment that addresses the symptoms but not the underlying depression. It is a myth that depression is a “normal” emotional response to another illness; it’s extremely important to simultaneously treat both medical illnesses.
Impact of Depression in Primary Care Settings
- Nearly 74 percent of Americans who seek help for depression or symptoms of depression will go to a primary care physician rather than a mental health professional.[1]
- The rate of depression among those with medical illnesses in primary care settings is estimated at five to 10 percent. Among those hospitalized, the rate is estimated at 10 to 14 percent.[2]
- The more severe the medical condition, the more likely that patient will experience clinical depression.[2]
- People with depression experience greater distress, an increase in impaired functioning and less ability to follow medical regimens, thus hindering the treatment of any other medical conditions.[2]
- Unfortunately, the diagnosis of depression is missed 50 percent of the time in primary care settings.[1]
Why Depression and Medical Illnesses Often Occur Together
- Medical disorders may contribute biologically to depression.[3]
- Medically ill people may become clinically depressed as a psychological reaction to the prognosis, the pain and/or incapacity caused by the illness or its treatment.[3]
- Though occurring together, depression and a general medical disorder may be unrelated.[3]
Prevalence of Depression Co-occurring with Other Medical Illnesses
Heart Disease and Depression
- Depression occurs in 40 to 65 percent of patients who have experienced a heart attack, and in 18 to 20 percent of people who have coronary heart disease, but who have not had a heart attack.[4]
- After a heart attack, patients with clinical depression have a three to four times greater chance of death within the next six months.[4]
- Men and women with depression are at increased risk for coronary artery disease but only men are at greater risk for dying.[5]
Stroke and Depression
- Depression occurs in 10 to 27 percent of stroke survivors and usually lasts about one year.[6]
- An additional 15-40 percent of stroke survivors experience some symptoms of depression within two months after the stroke.[6]
- Individuals reporting five or more depressive symptoms have more than a 50 percent risk of mortality due to stroke in the subsequent 29 years.[7]
Cancer and Depression
- One in four people with cancer also suffer from clinical depression. [8]
- Depression is sometimes mistaken as a side effect of corticosteroids or chemotherapy, both treatments for cancer. [8]
- Depressive symptoms can be mistakenly attributed to the cancer itself, which can also cause appetite and weight loss, insomnia and loss of energy. [8]
Diabetes and Depression
- People with adult onset diabetes have a 25 percent chance of having depression.[9]
- Depression also affects as many as 70 percent of patients with diabetic complications.[9]
Eating Disorders and Depression
- Research shows a strong relationship between depression and eating disorders (anorexia and bulimia nervosa) in women.[10]
Alcohol/Drugs and Depression
- Research shows that one in three depressed people also suffer from some form of substance abuse or dependence.[1]
Common Symptoms of Depression and Other Medical Disorders
- Weight loss, sleep disturbances, and low energy may occur in people with diabetes, thyroid disorders, some neurological disorders, heart disease, cancer and stroke –and also are common symptoms of depression.
- Apathy, poor concentration and memory loss can occur in individuals with Parkinson’s disease and Alzheimer’s disease – and also are common symptoms of depression.
- Medications for high blood pressure, Parkinson’s disease, and other medical problems can produce side effects similar to the symptoms of depression.
Importance of Treatment
- People who get treatment for co-occurring depression often experience an improvement in their overall medical condition, better compliance with general medical care and a better quality of life.[9]
- More than 80 percent of people with depression can be treated successfully with medication, psychotherapy or a combination of both.[2]
- Early diagnosis and treatment can reduce patient discomfort and morbidity, and can also reduce the costs associated with misdiagnosis, and the risks and costs associated with suicide.[1]
References:
[1] Montano B: “Recognition and Treatment of Depression in a Primary Care Setting ,” Journal of Clinical Psychiatry 1994; 55(12):18-33.
[2] National Institute of Mental Health, “Co-occurrence of Depression with Medical, Psychiatric and Substance Abuse Disorders,”
[3] National Institute of Mental Health, “Depression Co-occurring with General Medical Disorders,”
[4] National Institute of Mental Health, “Co-occurrence of Depression with Heart Disease,”
[5] Ferketich, A, Schwartzbaum, J, Frid, D, Moeschberger, M. Depression as an Antecedent to Heart Disease Among Women and Men in the NHANES I Study. Archives of Internal Medicine 2000; 160:1261-1268.
[6] National Institute of Mental Health, “Co-occurrence of Depression with Stroke,” .
[7] Everson SA, Roberts RE, Goldberg DE, Kaplan GA: “Depressive Symptoms and Increased Risk of Stroke Mortality Over a 29-Year Period,” Archives of Internal Medicine 1998; 158:1133-1138.
[8] National Institute of Mental Health, “Co-occurrence of Depression with Cancer,”
[9] Lamberg L: “Treating Depression in Medical Conditions May Improve Quality of Life.” JAMA 1996; 276(Dec. 18):857-858.
[10] Willcox M, Sattler DN: “The Relationship Between Eating Disorders and Depression,” Journal of Social Psychology 1996; 136:269-271
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Support Groups for Depression, Substance Abuse, Co Occuring
Last Modified On: 12-02-2018 6:24 pm
This group provides support for family and friends of individuals with mental illness.
St. Joseph's Hospital/Breese
9515 Holy Cross Lane
Breese, IL 62230
Contact Information:
618-882-3306
sharon206@prodigy.net
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Meets: 2nd and 4th Mondays, 7:00 p.m.
Location: Breese-Mater Dei Library, 900 Mater Dei Drive, Breese, IL 62230
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City Hope Bible Church
5868 West Florissant Avenue
St. Louis, MO 63120
Contact Information:
Phyllis
314-385-9129
314-383-7771 church
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Call for more information, if needed.
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Last Modified On: 12-13-2019 6:14 pm
Depression Bipolar Support Alliance
907 Dock St
St Louis, MO 63147
Contact Information:
Helen or Sarah
314-652-6100
866-525-1442 Friendship Line
hminth@sbcglobal.net
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Last Modified On: 12-02-2018 6:02 pm
Emotions Anonymous International Headquarters
P.O. Box 4245
St. Paul, MN 55104
Contact Information:
651-647-9712
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Last Modified On: 10-21-2021 8:13 pm
Karla Smith Behavioral Health offers this support group for individuals and/or family members whose loved one experiences a mental health diagnosis.
Karla Smith Behavioral Health
200 North Lincoln
O'Fallon, IL 62269
Contact Information:
618-624-5771
Meeting Details
Meets: 1st Thursday of the month; 7:00 - 8:30 p.m.
Call or visit https://karlasmithbehavioralhealth.org/support-groups for additional information.
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NAMI St. Louis
1810 Craig Road #124
St. Louis, MO 63146
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HELP Line
314-962-4670
800-950-NAMI
info@namistl.org
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Last Modified On: 12-02-2018 6:43 pm
A Christian support group committed to ministering to the spiritual, emotional, and physical needs of individuals and families affected by mental illness. Within an atmosphere of acceptance, compassion, and empathy we offer relevant information, and trustworthy resources related to issues commonly associated with and experienced by those who have a loved one affected by a neurological disorder or a chemical imbalance. We provide a place to share one’s faith in God and one’s personal experiences as we walk a similar path alongside a family member, friend, or loved one living with a serious mental illness.
Central Presbyterian Church
7700 Davis Drive
St. Louis, MO 63105
Contact Information:
Pat Grace
grace1pat@sbcglobal.net
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Last Modified On: 12-13-2019 6:18 pm
Recovery, International
Contact Information:
312-337-5661
866-221-0302
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Email Chuck at johnbeerg13@gmail.com for info about group meetings in St. Louis, Union and Ste. Genevieve, MO.
Visit recoveryinternational.org/meetings/find-a-meeting to locate groups and coordinators anywhere in the country.
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Last Modified On: 01-16-2020 4:57 pm
CenterPointe Hospital
4801 Weldon Spring Pkwy
St Charles, MO 63304
Contact Information:
Gregg Sansone
636-236-2267
greggsansone@hotmail.com