Are we experiencing a depression epidemic?

Major depression is a common malady. Twenty percent or more of the population can expect to have at least one bout of depression in their lifetime. It is a disorder that is widely unrecognized, undiagnosed, untreated, and stigmatized. Depression is often trivialized, seen as a sign of "weakness" and self-indulgence that can be dissipated by will-power ("Snap out of it," "Keep busy"), even though this is not the case.

In recent years, a number of factors have somewhat increased the recognition and visibility of depression as a major health problem. There's more openness about a variety of personal problems and foibles in the talkshow, self-help culture of our times. Professional groups and public health authorities have tried to raise the level of public consciousness. New, better-tolerated treatments promoted by large pharmaceutical houses, along with attendant hoopla and controversy (such as the supposed link between Prozac and violent behavior), have caught public attention. Peter Kramer's book Listening to Prozac was a great success. As the newer drugs have gained currency, many people with mild depression are being treated with them, even though their effectiveness is less well-established in these milder conditions.

So we have a complex combination of an increase in recognition and treatment of depression; the extension of treatment to the less chartered waters of milder conditions (with perhaps an element of faddism and unrealistic expectations); and the persistence of depression as an underdiagnosed, undertreated, and misunderstood problem.