Understanding Depression in Veterinary Professionals
As part of Mental Health Awareness Month, we are going to discuss depression and how it affects veterinarians.
This article is for informational purposes only and is not intended to take the place of a medical diagnosis. If you think you are experiencing any of the symptoms of depression, seek out medical care through your primary care provider, mental health professional, or call the National Suicide Prevention Lifeline at: 1-800-273-8255.
Mood fluctuations, which many of us experience in our day-to-day lives, is not the same as having a diagnosis of depression. Depression is a serious health condition that affects how we function at work, school, and with our friends and families.
In this article, we will explore the symptoms of depression as well as what can be done to potentially treat and prevent depression in veterinarians.
What is depression?
Depression is classified into eight subtypes according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (2013), and in 2022, Prolonged Grief Disorder was added to the revised DSM-5. For the purposes of this article, we will be discussing Major Depressive Disorder (MDD), which is the most prevalent type of depression affecting approximately 7% of the adults in the U.S. (Boling & Smith, 2021).
What is the prevalence of depression?
Depression affects between 322—350 million people of all ages worldwide (Lim, et al., 2018 & WHO, 2017). To put into context, the U.S. population is approximately 330 million. In the U.S., the 12-month prevalence rate of depression is 17-18.5% of adults age 18 or higher (Boling & Smith, 2021 and Villarroel & Terlizzi, 2020) and the median age of onset is 30-35 (Kessler, et al., 2005 & Solmi, et al., 2022).
What are the symptoms of depression in veterinarians?
There are many signs that might indicate that a veterinarian has depression. The most common symptoms of depression include (Boling & Smith, 2021):
Depressed mood most of the day (nearly every day)
Significant loss of interest or pleasure almost every day for most of the day
Feelings of guilt (or low self-worth)
Changes in weight: reduced or increased appetite
Sleep disturbances: insomnia or sleeping too much
Feelings of tiredness, lethargy
Poor concentration
Unexplained physical problems
What are the risk factors for depression?
Depression can begin at any age, but the median age of onset is between 30-35 (Kessler, et al., 2005 & Solmi, et al., 2022). The risk factors for depression include (Boling & Smith, 2021):
Gender, with women being more likely than males to develop depression
Pregnancy or the postpartum period
A history of chronic illness or pain
Hormonal changes
A family history of mood disorders
History of trauma
Alcohol or substance use disorders
Unemployment
A spouse/partner with depression
How can veterinarians address depression?
If you are a veterinary professional who has symptoms of depression or you suspect that you might have depression, we recommend discussing this with a psychiatrist or a licensed mental health professional such as a psychologist, social worker, etc. These professionals will be able to provide you with individualized guidance on how to move forward with your mental health needs. There are several ways to treat depression, including psychotherapy, medication management, and Transcranial Magnetic Stimulation.
Psychotherapy
Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) involves working with a licensed mental health professional for the treatment of depression. Cognitive behavioral therapy (CBT) has been found to be effective for individuals living with depression as compared to other forms of therapy. The goal of CBT is to reduce depressive symptoms by challenging and reversing unhelpful beliefs as well as distortions in thinking.
Interpersonal therapy (IPT) has also been found to be effective in the treatment of depression. IPT focuses on improving interpersonal relationships, life challenges, including grief and loss. The goal of IPT is to identify the “trigger(s)” of the depressive episode and learn effective and healthy strategies for coping with life’s challenges. Like CBT, IPT is structured and time limited.
Medication Management
While there are several pharmacological interventions for the treatment of depression, all have potential side-effects and necessitate a conversation with your prescriber to see if the benefits outweigh the potential risks. There are several different classes of antidepressant medications:
Selective Serotonin Reuptake Inhibitors (e.g., Fluoxetine, Sertraline, etc.)
Tricyclic antidepressants (Amitriptyline, Desipramine, etc.)
Serotonin Norepinephrine Reuptake Inhibitors (Venlafaxine, Desvenlafaxinem, etc.)
Mood stabilizers (Lithium or Valproic Acid)
Treatment Resistant Depression
Transcranial Magnetic Stimulation or TMS is a U.S. Food and Drug Administration approved treatment for those individuals with treatment resistant depression. TMS is a time limited, noninvasive procedure that uses magnetic fields to stimulate regions of the brain to improve symptoms of mood and depression. Unlike Electric Convulsive therapy (ECT), TMS does not affect memory or cognition. Several studies have found TMS to be effective in the treatment of treatment resistant depression since its FDA approval in 2007 (Gaynes, et al., 2014).
Are there ways to prevent depression in veterinary professionals?
When we talk about prevention of certain behavioral health challenges such as depression, the first place to start is to assess your lifestyle and self-care.
A few lifestyle changes, such as diet and exercise, can go a long way in improving someone’s well-being. When looking for ways to help mitigate depression, we suggest the following strategies:
Exercise regularly, such as walking for 20 minutes a day a few times a week and maintain a healthy weight
Eat a well-balanced meal that eliminates or reduces processed foods
Limit or eliminate alcohol, tobacco, caffeine, and other mood-altering drugs
Establish a healthy sleep routine
Develop an individualized stress management plan
Make choices that reflect your goals
Establish a strong support network of friends, family, and veterinary mentors
Avoid toxic or negative people
Limit social media time
Attend to any chronic medical conditions
Practice self-compassion
If already being treated for depression, follow and maintain your treatment plan
Additional Resources
There may be additional resources at your state and community level, but here are some national resources, and their links provided below may serve as a starting point.
Anxiety & Depression Association of America- This website provides useful downloadable brochures on depression in several languages. You can find these resources by visiting ADAA’s website.
American Counseling Association- This is a website that provides resources for depression, including locating a counselor who treats depression as well as articles on depression. A subscription is needed to access some of their resources. To learn more, visit the American Counseling Association’s resources on depression.
National Association of Mental Illness (NAMI) National Help Line Resource Directory- The NAMI Help Line is an online directory for anyone interested in finding resources for depression and other behavioral health illnesses. The Help Line can be accessed via telephone at 800-950-NAMI (800-950-6264) or text “NAMI” to 741741. Access the online Resource Directory for additional resources.
National Institute of Mental Health- This is a resource that provides information about depression as well as a link to clinical trials and research. To learn more, visit the National Institute of Mental Health website.
Conclusion
Depression affects approximately 18% of adults in the U.S. with a median age of onset between 30-35. While many of us have experienced mood fluctuations in our day-today lives, depression can be a debilitating illness with negative consequences.
We’ve learned depression costs over $200 billion a year in lost wages and productivity as well as direct costs. Being a woman is one risk factor as well as histories of trauma, loss, chronic pain, alcohol and substance use disorders, and unemployment.
Having resources such as counseling and/or medication management that incorporate a prevention plan are vital in helping people cope and address their depression. With the advent of new technologies, such as smart phone apps and online HIPAA secure platforms for counseling, people can now have a counseling session from the comfort of their home.
The first step is to recognize the signs and symptoms of depression and then look for ways to help mitigate its impact whether through counseling or medication management. The overall goal of any behavioral health plan is to increase your well-being.
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.
Boling, B. and Smith, N. (2021, June 18). Depression: An overview. CINAHL Nursing Guide. https://eds-s-ebscohost-com.proxy.heal-wa.org/eds/pdfviewer/pdfviewer?vid=1&sid=54b6bbe4-3d72-410c-98b6-2e3bc2fe2d6e%40redis
Gaynes, B.N., Lloyd, S.W., Lux, L., Gartlehner, G., Hansen, R.A., Brode, S., Jonas, D.E., Evans, T.S., Viswanathan, M., and Lohr, K.N. (2014). Repetitive transcranial magnetic stimulation for treatment-resistant depression: A systematic review and meta-analysis. Journal Clinical Psychiatry, 75(5): 477-489. https://www.psychiatrist.com/read-pdf/29758/
Greenburg, P.E., Fournier, A.A., Koenigsberg, S.H., and Kessler, R.C. (2021). The economic burden of adults with Major Depressive Disorder in the United States (2010 and 2018). PharmacoEconomics, 39:653-665. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8097130/pdf/40273_2021_Article_1019.pdf
Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., and Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Achieves of General Psychiatry, 62:593-602. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/208678
Lim, G.Y., W.T., Wilson, Lu, Y., Ho, C.S., Zhang, M.W., and Ho, R.C. (2018). Prevalence of Depression in the Community from 30 Countries between 1994 and 2014. Nature. https://www.nature.com/articles/s41598-018-21243-x.pdf
Solmi, M., Rdua, J., Olivola, M., Croce, E., Soardo, L., Salazar de Pablo, G., Shin, J.I., Kirkbridge, J.B., Jone, P., Kim, J.H., Kim, J.Y., Carvalho, A.F., Seeman, M.V., Correll, C.C., and Fusar-Poli, P. (2022). Age at onset of mental disorders worldwide: Large-scale meta-analysis of 192 epidemiological studies. Molecular Psychiatry, 27: 281-295. https://www.nature.com/articles/s41380-021-01161-7.pdf
Villarroel, M.A., and Terlizzi, E.P. (2020). Symptoms of depression among adults: United States, 2019. NCHS Data Brief, No. 379, Sept. 2020. https://www.cdc.gov/nchs/data/databriefs/db379-H.pdf
World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf