Part 3 increase in Depression and Anxiety disorders

Part 3 Depression and Anxiety Disorders and the role of managed care.

Isn't anyone just sad anymore? Why does everybody seem to have depression or some disorder?


Remember diagnosis is not a label that defines a person, it just suggest a course of treatment. So if you just happen to be really sad, not depressed, and you go to a therapist you are going to leave with some sort of diagnosis because your insurance company wants to know what they are paying for.


A disorder just means that part of you is not functioning at the optimal level. When you seek
treatment for that issue the professional you are working with picks the type of treatment they are likely to provide.

The problem comes in when a person needs a level of treatment that the insurance company will not pay for if they have a certain diagnosis. Lets say a person moves to a new town to live with his girlfriend, then they break up and he feels alone and stranded. He isn't suicidal but his level of functioning is so low that he is not grooming himself very regularly and he may loose his job soon. He has been in counseling with a diagnosis of adjustment (to the move) disorder with depressed mood. He and his therapist feel he needs to be in the hospital while proper medication is determined. Insurance might not pay for that without a shift in diagnosis to major depression or bi-polar because those disorders suggests a level of danger that can lead to law suits if service is denied.

So while it is in an ethical gray area I feel that there are many people get a diagnosis that sounds more severe than what they are actually dealing with so that insurance will pay.


As I said in an earlier post, however, I think more people than ever are anxious and depressed because of all of our freedom and options. Horatio Alger and Barack Obama are conspiring against us. People like the president, Steve Jobs, and Bill Gates have “made it”. Because we live in a free society where everyone could be the next Bill Clinton and go from a trailer park in Arkansas to the White House, everyone of us who isn't can feel like we have failed.

The thing about depression is most people who have it will survive it without any medication or counseling. This leads to the false notion that because they CAN suffer and merely survive that they SHOULD. (note I believe "should" is a dirty word and I will not allow people to use it in my office without a a solid nagging)

America believes in rugged individualism and that those who seek help are weak. What a load of crap! None of us make it on our own and you don't get extra points for suffering.
Depression and anxiety disorder respond very well to treatment. The fact that the shame and stigma for getting help are starting to lift a little might mean a reduction in suicides, and addictions for future generations.

Even with the complications of insurance, based on my experience I would say that 95% of people diagnosed with a mood disorder or an anxiety disorder are diagnosed correctly. I would say that less than 1/10th of the people who need treatment are getting it and I think every person could benefit from counseling/life coaching/ or therapy at some point in their lives.

The sooner we can change the question from “Do I need help?” to “Could my life be better with help?” the healthier our society will be.