Depression in Los Angeles

Depression is one of the most prevalent mental health disorders in the world. According to the World Health Organization, 300 million people across the globe suffer from depression. The highest rates of depression amongst adults are in Brazil, with an estimated 10% of the population affected, and in the United States, with an estimated 8.3% of the people suffering from depression. Statistics show that wealthier countries have higher rates of the disorder.

While it can be argued that it’s because those more affluent nations have the resources to track depression rates accurately, that argument falls apart when one investigates rates across provinces, states, and cities in a particular country.

What is depression?

Clinical depression is a common mood disorder, broken into several different subtypes. They include:

• Major depressive disorder
• Postpartum depression
• Seasonal Affective Disorder
• PMDD
• Bipolar depression
• Psychotic depression
• Dysthymia
• Atypical depression

Depression affects every aspect of a person’s life and is incredibly disruptive. It can derail a person’s relationships, career, and physical health. Often, people with undiagnosed or untreated depression will self-medicate with drugs and alcohol. Close to 50% of people who enter drug rehabilitation and detox facilities are diagnosed with depression and anxiety. Furthermore, alcohol is implicated in 40% of all suicide attempts with a firearm.

The symptoms of depression vary by subtype, and also by the individual. There are emotional, physical, and behavioral changes in a person who is suffering from the disease.

Left untreated, depression can lead to suicide, self-harm, and substance abuse. People with depression also suffer unseen consequences of their disease. They may be unable to finish school, keep or get a job, or focus on their future. This can lead them to a life of poverty and hardship. In Los Angeles County reports of depression have increased 50% since 1999. In tandem, the homeless population and drug abuse prevalence rates have also skyrocketed within that time frame.

Southern California has some of the highest per capita rates of drug rehabilitation and detox centers in the country. Addiction treatment centers usually also treat comorbid depression and anxiety, as there is a growing need for these services in the Los Angeles County and the Southern California area.

What are the treatment methods for depression?

Depression is a whole-body disease and requires managed, nuanced care that is tailored to the individual. There are several different drug classes which, along with therapy, are incredibly effective at controlling the symptoms of depression. Unfortunately, there is no cure for the disease, but with help from trained doctors and therapists, people can live a life free from depressive symptoms and the disruption and pain they cause.

Depression is caused by a unique mix of faulty brain chemistry signaling, genetics, and in some cases, a convergence of adverse life events and stressful or traumatic situations. SSRIs, SNRIs, and in some instances MAOIs, are effective at balancing the chemical signals in the brain that can cause depression. Sometimes, people will not respond well to drug medication and will need deep brain stimulation techniques to treat their depressive symptoms. These include things like ECT, Vagus nerve stimulation, and transcranial magnetic stimulation, a new and highly effective way to treat the disease.

The disorder isn’t just a matter of neurotransmitter imbalances. Depression also requires talk therapy to work through the emotional and situational aspects of the disorder. Cognitive behavioral therapy and talk therapy are both highly effective means for working through the disease and also preventing a relapse.

What is the statistical prevalence of depression in Los Angeles, California?

Depression rates in LA county have risen in recent decades, and the rate of depression amongst adults in LA is higher than the national average. In 1999, 9% of Los Angeles County adults actively had the disorder or had been diagnosed at some point in their lives. By 2011, that number rose to 14% of the adult population of Los Angeles County.

Who is most affected by depression in Los Angeles?

Depression can happen to anyone, regardless of their gender, age, race, or socioeconomic status. But specific demographics are at higher risk of contracting the disorder.

Women have much higher rates of diagnosed depression than men. Between 1999 and 2011, depression diagnoses rates rose, but the prevalence of the disorder was still higher for women than men. In 2007, women accounted for 17% of depressed patients, and men for 10%.

Racially, pacific islanders and those of Asian descent have the lowest rates of depression, 4%, amongst the residents of Los Angeles. Whites have the highest rates, at 12%, followed by African Americans at 9%, and Latinos at 7%.

Age wise, people between the ages of 40 and 59 have the highest rates, at 13% of the population.

Socioeconomically, people within 100 to 200% of the federal poverty level have the highest rates of depression, at 11%. This is an especially curious finding. Those closer to the national poverty level and those farthest away have lower rates of depression, at 9 and 8 percent, respectively. As far as employment status goes, people who are unemployed or entirely out of the workforce are more likely to have depression than those who are employed.

Different areas of Los Angeles have different rates of depression, as well. Antelope Valley, San Fernando, the Metro area, and South Bay all have rates at 10%

Why do people in different parts of Los Angeles County have different rates of depression?

Research shows, across the state of California and not in Los Angeles County alone, that regions with more stratified neighborhoods report higher rates of depression, anxiety, drug abuse, and suicide. Areas with very high-income residents living alongside those who are impoverished will experience higher rates of mental health distress and substance abuse. It’s possible that areas with higher rates of poverty have less access to mental health services. Also, there is a stigma associated with mental health and drug abuse disorders. People who suffer from these conditions who live alongside the very wealthy may feel this stigma more acutely, hampering their ability to seek help for their issues.

It should also be noted that across the United States, the southern states and Appalachia have some of the highest rates of mental health issues and drug abuse in the country. These regions also have higher poverty levels, and they are much more rural and isolated than other areas. People in Appalachia in particular simply do not have access to mental health resources.

Studies on impoverished regions such as Appalachia indicate that it isn’t poverty that is the cause of depression, it is the fact that these people do not have easy access to mental health services.

Are depression rates different for people who move to LA versus LA natives?

Research conducted on brain imaging results show that people who live in rural areas and suburban areas have lower rates of depression than city dwellers. Scientists have studied the amygdala, a region of the brain responsible for assessing threats and generating fear, in people who live in different settings. The results of the studies indicated that city dwellers do not respond to stress as well as rural and suburban inhabitants.

In addition, it’s been found that people who move from rural or suburban areas to big cities can develop depression. Moving, and the sudden change of pace in living and culture can stress out a vulnerable individual and trigger a depressive episode.

A populated, diverse city like Los Angeles has higher crime rates, and people who live in the city will be busier assessing threats. This is especially true for women and could explain why city dwellers and inhabitants of Los Angeles have high rates of depression.

When has depression been recorded at its lowest and highest in Los Angeles?

Over time, depression, suicide, anxiety, and drug abuse rates have risen across the country, not only in Los Angeles and the surrounding counties. Unfortunately, these conditions are profoundly related and play upon each other. Also, sometimes it is difficult for healthcare professionals, social workers, and therapists to determine which disorder came first and how to treat it.

Often, people will experience anxiety and panic disorders before developing depression. It’s also common for people to treat undiagnosed depression with drugs and alcohol. And yet, drugs and alcohol can trigger anxiety and depression. Each disorder is highly nuanced and every individual who presents with these conditions, either alone or in tandem, requires individualized and ongoing care and post-treatment support plans.

Historically, depression has not been as adequately and scientifically measured as it has been since the 1990s. But, depression has been recognized and recorded since ancient Greece. During the Victorian era in the United States, depression was romanticized as ‘melancholy,’ and immortalized in poetry and popular fiction novels at the time. Abraham Lincoln, F. Scott Fitzgerald, Emily Dickinson, and Ernest Hemingway all were reported to suffer bouts of melancholy.

During the Great Depression and the WWII era, Americans reported higher rates of sadness, dissatisfaction, stress and anxiety than at earlier times. Also, even though prohibition made alcohol illegal, rates of heavy drinking, alcoholism, and related accidents and crime rose significantly. Suicide rates also rose during this dark time in American history.

Before the market crash of 1929, suicide rates hovered around 12.1 for every 100,000 people. After the market crash and during the ensuing Great Depression, suicide rates skyrocketed to more than 18 for every 100,000 people. The numbers didn’t fall until the start of WWII, before stabilizing once the war ended.

In Los Angeles, the Pasadena Bridge has a morbid history. Jumping is so prevalent, and rates of suicides on this bridge have risen sharply in recent years that there is a sign for a suicide hotline attached to the bridge, urging people not to jump. Since the 1930s, the bridge has been given the moniker, ‘suicide bridge.’

In 1998, depression was the third leading cause of premature death and disability.

Rising rates of depression indicate that by 2020, depression will be the leading cause of premature death and disability worldwide based on the measurement of DALYs. DALYs stands for Disability-Adjusted Life Years. DALYs measures the number of years lost to early death and disability for many conditions.

How do depression and suicide rates in Los Angeles compare to the rest of the country and other major cities?

Depression and suicide are on the rise across the globe. Statistically, though, Los Angeles and the surrounding Southern California counties have much higher rates of the disorder than the rest of the state. Northern California counties report overall lower rates of adverse mental health conditions. Alameda and San Francisco have the worst rates of depression and mental health. These areas boast higher populations and more diverse inhabitants than the northern counties, which could contribute to their higher rates.

Depression rates compared to other major U.S. cities New York, Chicago, Denver, and Miami:

• Entire United States: 8.3%
• Los Angeles: 14%
• New York: 8%
• Chicago: 11%
• Miami: 26%
• Denver: 14%