What are the statistics of depression in adults in the US and the associated suicide risk?

Depression Statistics in the US and Associated Suicide Risk

Depression affects approximately 18.5% of US adults, with a significant association with suicide risk, particularly in young adults aged 18-29 years who are at increased risk for suicidal behaviors when taking antidepressants. 1

Prevalence of Depression in the US

• The age-standardized prevalence of depression among US adults was 18.5% in 2020, with state-level prevalence ranging from 12.7% to 27.5% 1
• Approximately 9% of US adults experience major depression each year, with a lifetime prevalence of approximately 17% for men and 30% for women 2
• Depression is more common among young adults aged 18-25 years (17.2%) and adolescents aged 12-17 years (16.9%) 3
• The prevalence of depression has been increasing most rapidly among adolescents and young adults 3
• In primary care settings specifically, the prevalence of major depressive disorder (MDD) ranges from 5% to 13% in adults and from 6% to 9% in older adults 4

Geographic Distribution

• Most states with the highest depression prevalence are in the Appalachian and southern Mississippi Valley regions 1
• At the county level, depression prevalence ranges from 10.7% to 31.9% (median = 21.8%) 1
• Counties with the highest prevalence are concentrated in the Appalachian region, southern Mississippi Valley, and states like Missouri, Oklahoma, and Washington 1

Risk Factors for Depression

• Groups at increased risk include:
  • Persons with other psychiatric disorders, including substance misuse 4
  • Persons with a family history of depression 4
  • Persons with chronic medical diseases 4
  • Persons who are unemployed or of lower socioeconomic status 4
  • Women (higher risk compared to men) 4
• In older adults, significant depressive symptoms are associated with medical illness, cognitive decline, bereavement, and institutional placement in residential or inpatient settings 4

Depression and Suicide Risk

• Depression is a major risk factor for suicide 4
• Suicide is a known risk of depression and certain psychiatric disorders are the strongest predictors of suicide 5, 6
• Antidepressants increase the risk of suicidal thinking and behavior in young adults (ages 18-24) with major depressive disorder and other psychiatric disorders 5, 6
• Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older 5, 6
• The risk differences for suicidality across different age groups when taking antidepressants compared to placebo are:
  • Ages 18-24: 5 additional cases of suicidality per 1000 patients treated 6
  • Ages 25-64: 1 fewer case per 1000 patients treated 6
  • Ages ≥65: 6 fewer cases per 1000 patients treated 6

Treatment Gap and Economic Impact

• Despite increasing prevalence, the prevalence of help-seeking has remained consistently low 3
• One third to one half of adults and nearly two thirds of older adults who receive treatment for depression receive it in a primary care setting 4
• The economic burden of depression is substantial for both individuals and society 4
• In 2000, the United States spent an estimated $83.1 billion in direct and indirect costs of depression 4
• Indirect costs include loss of life, reduced productivity (both diminished capacity while at work and absenteeism), and increased costs of mental health and medical care 4

Treatment Outcomes

• Large-scale studies show that approximately two-thirds of patients initiating depression treatment achieve remission within 1 year 4
• Despite fairly high rates of recovery from particular episodes, depression is highly recurrent 4
• About half of patients who achieve remission experience relapse during the subsequent year 4
• Effective treatments include specific forms of psychotherapy and more than 20 antidepressant medications 2
• Combined treatment with psychotherapy and medication may be preferred, especially for more severe or chronic depression 2

Screening and Monitoring Recommendations

• The US Preventive Services Task Force recommends screening for depression in adults when staff-assisted depression care supports are in place 4
• Simple screening can be done by asking two questions about mood and anhedonia over the past two weeks 4
• All patients being treated with antidepressants should be monitored closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of treatment or at times of dose changes 5, 6, 7