Depression and Mental Health:

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Depression and Mental Health: A Psychiatrist s Perspective Peter M. Lake, MD Medical Director Rogers Memorial Hospital Oconomowoc Depression The Intersection of Hope, Medicine and Research Marquette University Community Forum September 17, 2012

Disclaimer Employed as a psychiatrist at Rogers Memorial Hospital Full-time Receive no pharmaceutical funding Not a Marquette graduate Education: Creighton University University of Iowa Vanderbilt

Three Quick Points to Cover 1. Mental health / psychiatric care issues National public health emergency Depression is a major example 2. These are biologically-based medical issues Warrants full range of services (evaluation and treatment) 3. Treatment works! Needs to be more comprehensive Needs to be more available Needs more advocates

Defining the problem About 26 percent that s about 1 in 4 adults have a diagnosable mental health disorder in any given year. Depression is the most common diagnosis. 1 out of every five people will have a major depressive disorder during their lifetime. Nearly 5 percent 2.7 million children are reported by their parents to have a definite or severe emotional illness. More children and adolescents have a diagnosable mental illness than diabetes, HIV and leukemia combined. Reference: National Institute of Mental Health

Depression: The Risk of Doing Nothing Annual death rate for suicide is higher than that for homicide The annual death rate for suicide is similar to that of breast cancer Death by suicide Second leading cause of death for college students Third leading cause of death for ages 15-24 Fourth leading cause of death for ages 24-65 30% of all disabilities is due to mental health Compared to 13% heart-related and 14% cancer

More about depression What it is NOT Myths about depression Behavior and/or attitude problem Weakness Something we have all experienced (the blues ) What it IS Common Severe Insidious (Often difficult to see in friends or self) Fatigue Side effects of treatments Being sick is depressing Under-diagnosed Medical offset Deadly

Depression is A neuropsychiatric, biologically-based brain disorder, as are: Schizophrenia Anxiety Disorders Obsessive-Compulsive Disorder (OCD) Social Anxiety Disorder Panic Disorder Generalized Anxiety Disorder Post-Traumatic Stress Disorder (PTSD) ADHD Bipolar Disorder

Causes of Depression Biologic / genetic vulnerability Developmental issues Brain growth plasticity (24 years) Psychosocial stress Case formulations involve: Precipitating Predisposing Perpetuating Analogies with many medical specialties: Heart Cancer Diabetes Asthma Epilepsy

$$ Medical Offset $$ There is a mind-body connection Depression impacts medical illness: Depression amplifies physical symptoms associated with medical illness (e.g. chronic pain; cardiac rehab; cancer) Depression decreases adherence to prescribed regimens Depression is associated with adverse health behaviors diet, exercise, smoking and these play an important role in immune functioning (and mortality risk) Obesity (70% of health care dollar spent)

About Treatment Medications: There is no magic pill! Medication enhances concentration, sleep, energy levels and other essential functions that are needed for patients to experience the full benefits of psychotherapies.

About Treatment Psychotherapies: Research is indicating there is a biological effect from psychotherapy interventions. Cognitive-Behavioral Therapy (CBT) is the best example

So: There is a knowledge gap The Reality Treatment is sought by less than 20% of adults and children with mental health concerns. Only one in ten children with a diagnosable illness are seen. The Hidden Truth Between 70 and 90% of individuals who get treatment have significant reduction of symptoms and improved quality of life with a combination of treatments and supports. The bottom line is: Treatment works! Reference: National Alliance for the Mentally Ill (NAMI)

Rogers Memorial Hospital Rogers treats children, adolescents and adults with: Anxiety disorders Mood disorders Eating disorders Substance-use disorders Rogers is a private, non-profit psychiatric hospital that is part of the Rogers Behavioral Health System, Inc.

Rogers has a long history of healing Established in Oconomowoc in 1907, Rogers Memorial Hospital has grown alongside the practice of behavioral health. Rogers is now the 7th largest behavioral health system in the nation, with five Wisconsin locations.

Residential Treatment Centers Obsessive-Compulsive Disorder Center Herrington Recovery Center Rogers is nationally known for it s one-of-a-kind residential treatment centers. Eating Disorder Center Child & Adolescent Center s

Thank you Peter M. Lake, MD Medical Director Rogers Memorial Hospital Oconomowoc 800-767-4411 rogershospital.org