PITTSBURGH (KDKA) — A government screening advisory panel is recommending that as part of routine health care – all adults be screened for depression, which is a big public health problem.

“If the predictions are correct, major depression will be the third largest cause of lost productivity, work time, and shortened life behind cardiovascular disease and cancer in the next 10 years,” says Allegheny General Hospital psychiatrist Dr. P.V. Nickell.

Depression is not just sadness, but a group of symptoms including feeling down and hopeless, trouble sleeping or eating, poor concentration, loss of interest or motivation, and thoughts of harming oneself or others.

Sometimes a stressful event will trigger depression, but not necessarily. It’s thought to be a disturbance in how brain cells interact. Risk factors include family history, chronic pain, substance abuse, and being female.

In fact, screening of pregnant women is also emphasized in the recommendations.

“During pregnancy, after pregnancy, for the year after. About 16 percent, according to most studies. A pretty high rate,” Dr. Nickell points out.

One in 14 people have an episode of major depression each year.

The guidelines issued by the panel do not specify how often screening is to take place, but once a year at your primary care checkup would be reasonable.

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One of the issues with screening everybody is catching more cases. People would have to be referred for treatment, and enough psychologists and psychiatrists will have to be in place.

“There’s a huge shortage of psychiatrists, and to a lesser degree, psychologists in the nation, so if you do screen positive, what do you do with it? It’s hard to refer somebody easily and quickly,” Dr. Nickell says.

Dr. Nickell says primary care will have to play a role.

“Primary care colleagues to kind of up their game, their comfort level and their skill and their prescribing practices,” Dr. Nickell says.

Symptoms improve with psychotherapy, medicine, or other treatments. Insurance coverage has improved in recent years.

“All treatment does not have to be medicine,” says Dr. Nickell.

Dr. Maria Simbra