Teens, Millennials Hardest Hit by Surge in Depression

Trent Haywood, MD, JD

Major depression diagnoses soared by a third from 2013 through 2016, with adolescents and millennials the hardest hit, a review of medical claims by the Blue Cross Blue Shield Association (BCBSA) shows.

Overall, major depression in the US affects more than 9 million commercially insured Americans, according to the analysis.

“Major depression is the second most impactful health condition despite relatively low prevalence compared to other top conditions like hypertension, high cholesterol, coronary artery disease, and diabetes,” Trent Haywood, MD, JD, senior vice president and chief medical officer for BCBSA, told MD Magazine. “It is crucial to effectively treat and manage this condition when it begins in order to improve the health of millions of Americans.”

BCBSA, a federation of 36 independent Blue Cross and Blue Shield companies, based its analysis on a review of medical claims from more than 41 million members. The data underpin a health index that considers more than 200 conditions and covers almost every US county. The index was refreshed in March.

The recent findings show that adolescents had the biggest jump in major depression diagnoses. Adolescent girls saw a surge of 65% while boys’ diagnoses climbed 47%. Millennials, those born from 1981-1996, also experienced a 47% increase in diagnoses.

“The high rates for adolescents and millennials could have a substantial health impact for decades to come,” Haywood said.

Women had double the major depression diagnoses compared to men, at 6% versus 3%, the review found. Among states, Rhode Island had the highest rate in 2016 at 6.4%; Hawaii had the lowest at 2.1%.

Chronic health conditions are strongly linked to depression, the analysis showed. Some 85% of people who are diagnosed with depression also have one or more serious ailments. Nearly 30% of these BCBS members have 4 or more other health conditions, the data show.

Overall, those diagnosed with major depression are almost 30% less healthy on average than those without major depression. This translates to almost a decade of healthy life lost for both men and women, according to the analysis.

“There are studies that show physical ailments can cause major depression, and that major depression can cause physical ailments,” Haywood noted. “Both mind and body are equally important when it comes to one’s health.”

Haywood said he couldn’t speculate on why depression diagnoses are increasing or why there are wide geographical and generational variations.

“The BCBS Health Index uses medical claims data, which cannot determine the causes of diagnosed conditions,” he said. “Nor can medical claims determine local practice patterns or the availability of mental health practitioners in a geographic area.”

Asked whether the findings are indicative of depression in the US as a whole, Haywood noted that the study focuses on diagnosis rates for commercially insured BCBS members.

This means that a medical professional had to actively apply the diagnosis code for major depression for the claim to be counted in the review.

“Unfortunately, there are people with private insurance that suffer from major depression, but have not sought treatment and will not be counted using our methodology,” he said. “Other studies may be survey-based, focused on a smaller amount of people in a clinical setting and may include Medicare and Medicaid beneficiaries.”

One important takeaway from the analysis is that major depression is a complex condition with vast impacts on overall health and wellness. People need to address the issue as quickly as possible.

“We hope these findings will shed light on the subject and inform local medical professionals and policymakers, so they can help people get the care they need,” Haywood said. He added that members should schedule and attend their annual checkups — and seek additional care, if needed.

“Further education and research is needed to identify methods for both physicians and patients to effectively treat major depression and begin a path to recovery and better overall health,’’ he said.

The study, “Major Depression: The Impact on Overall Health,” was published by Blue Cross Blue Shield Association’s Health of America Report.