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Mindful : February 2018
This comes at a time when public health officials around the world struggle to get their hands around what is considered the leading cause of disability among adults, costing some $210 billion in medical and long-term care and lost productivity hours each year. “That depression has not been identified as our number-one health issue astounds me,” UCLA Chancellor Gene Block said in announcing the campus-screening program in September 2017. Unpacking the blues While mental health experts are cautious about calling depression an “epidemic”—citing better screening and greater understanding and accep- tance of the condition as possible reasons for increased diagnosis—the numbers are still star- tling: 350 million sufferers worldwide. Accord- ing to UCLA, if you haven’t experienced depres- sion yourself, you know someone who has. It is also now recognized as being at the core of numerous mental health conditions, from bipolar disorder (powerful swings between high and low mood) to postpartum depression, just to name a few. Many of the symptoms of depression are familiar: persistent low mood, exhaustion, loss of appetite and sex drive, an inability to enjoy life or cope with everyday activities—like socializing or even getting out of bed. But some may not be as obvious, such as disordered and distorted thinking, agitation, physical aches and pains, and insomnia. Yet despite how much we now know about what depression is, we still don’t really know what causes it. What we do know is that a vari- ety of wide-ranging factors seem to influence a person’s risk of developing depression, including childhood adversity; genetic make-up; chemical changes in the brain and body; certain unhelp- ful styles of thinking and relating; and social, economic, and cultural deprivation. The truth is, there are likely myriad interre- lating causes involved in each case. “ We’re all vulnerable in a sense because we all have factors that contribute to that vulnerability,” says Zindel Segal, a professor of psycholog y at the University of Toronto who specializes in depression. Further complicating matters, depression doesn’t always act the same way from individ- ual to individual, or from episode to episode, which can range from mild to severe. An epi- sode can last from a few days to weeks, months, or even years. → s nearly 10,000 freshmen and transfers arrived on campus at the University of California, Los Angeles, last fall, they were invited to try something never before offered during student orientation: depression screening. The hope, administrators explained, is that by identifying their risk for depression, students can get the support they need before they face the rigors of academia and the disorienting experience of living away at college. There’s reason for the concern. In 2016, a record high of almost 12% of UCLA freshman reported “fre- quently” feeling depressed in the past year. And a report from Penn State, drawing data from 139 university and college mental health services, found that in the 2015–2016 year, use of these services increased by 30%, although enrollment grew by just 5%. This included “a persistent increase in ‘threat-to-self ’ characteristics such as nonsuicidal self-injury and suicidal ideation.” The screening initiative—which will be extended to the entire student body eventu- ally—is part of the UCLA Depression Grand Challenge, a landmark effort to understand one of the most pervasive and debilitating health conditions in the world, one that affects an estimated 350 million people and contributes to the suicides of 800,000 people, including 40,000 Americans, every year. The university launched the challenge in 2015 as a multiyear, interdisciplinary study to develop better methods of understanding the genetic and environmental causes of depression and to improve detection, evaluation, and treatment. The goal is ambitious: to cut the global depres- sion rate in half by 2030. ABOUT THE AUTHOR Ed Halliwell is a mindfulness writer and teacher based in Sussex and London, UK. He is the author of Into the Heart of Mindfulness. If you experience depressive episodes, you’ll need to pay close attention to the types and doses of mindfulness practice you use and consider seeking the aid and advice of a therapist or psychiatrist who can assess your unique needs. Mindfulness-Based Cognitive Therapy (MBCT) has developed practices that have proved effective for some people with depression; however, mindfulness practice is not recommended during depressive episodes. If your depression is deeply interfering with your ability to live your life, it is best to consult a professional. GETTING HELP A 42 mindful February 2018 mental health