Depression is a significant and pervasive problem across educational, socioeconomic, racial and ethnic groups. The Diagnostic and Statistical Manual Fourth Edition (DSM IV) has helped to standardize the definition of depression across practice disciplines such as medicine, psychiatry, nursing and social work. Depression is defined as a mood disorder or a sad affective state with loss of pleasure or interest in activities for a period of two weeks or more. This disorder is unrelated to the effects of a substance or bereavement and can manifest itself as a single or recurrent episode (American Psychiatric Association, 1994). To be diagnosed with depression, according to the DSM IV, the following five or more symptoms need to be present: persistent sadness, insomnia, irritability, low self-esteem, appetite changes, worthlessness, loss of interest, or thoughts of suicide.
Women, in particular, have diverse needs in relation to their emotional and mental health. Quite often women occupy various social roles such as wife, mother, caretaker and professional to name just a few. These roles can be complex and stressful as women are juggling multiple responsibilities among their own needs. This commonly results in women’s own needs being pushed aside to care for others and depression sets in.
Depression can lead to serious physical consequences for individuals affected by the disorder. The risk of death from heart disease, stroke or respiratory disorder is higher among people with depression as depressed people are more likely to engage in behaviors such as smoking, drug use, overuse of alcohol, limited or no exercise and poor nutrition (Sederer et al. 2007). In addition, depression can lead to lost worker productivity, disability, unemployment, poor physical health and suicide (Greenberg, Stiglin, Finkelstein & Berndt, 1993).
Suicide is another serous consequence of depression and it is one of the top ten leading causes of death in ages 10-64 years old in the United States (CDC, 2005). Approximately 50% of depressed persons report feelings of wanting to die, 33 % consider suicide and 8.8 % attempt suicide (Hasin, Goodwin, Stinson, & Grant, 2005). Approximately 90% of those who commit suicide are depressed (Gaynes et al. 2004).
According to World Health Organization (2000), depression is the fourth most disabling illness worldwide. The cost of depression to society is also quite substantial when factoring in increased use of expensive emergency services, inpatient care, high Medicaid utilization, unemployment, disability and low work performance in individuals who are depressed. People diagnosed with depression have general medical costs twice those of healthy individuals and visit hospital emergency rooms with significantly greater frequency (U.S. Department of Health & Human Services, 2001). According to the National Institute of Mental Health (2006), the cost of depression in the United States is estimated to be 83 billion dollars which has a tremendous economic impact to society.
Well-known Psychiatrist and Theorist Aaron T. Beck explains depression within the context of an affective state that can be regarded as the consequence which the individual views self, views the world and views the future. A negative view of oneself, the world and the future therefore, are the three components of the cognitive triad that lead to depression.
The gold standard therapy for depression is Beck’s Cognitive Behavioral Therapy which is touted to be effective and teachable with relative ease. The premise behind Cognitive Behavioral Therapy is to replace and/or reframe negatively biased or distorted views with more realistic, achievable, adaptive, and pleasure giving views. The goal is to help depressed individual feel less depressed as negative thoughts are reframed into more positive ones. This therapy, combined with antidepressant medications, has been proven to be effective in treating depression and restoring mental and emotional well-being, and as a result, physical health as well.
