Depression diagnosis rates are increasing in Blue Cross and Blue Shield of Nebraska (BCBSNE) members – up 18.9 percent since 2014. Young people had the most dramatic rise, a 37.3 percent increase for members ages 15 to 20 and a 40 percent increases for members ages 21 to 30.

“The Blue Cross and Blue Shield Health of America study shows that we are diagnosing depression more frequently,” said Dr. Debra Esser, chief medical officer. “Which I think is a good thing. It’s not unusual for you to get a depression screen when you go to the doctor now. Just a few questions can help determine if further evaluation should be done.”

Diagnosis rates vary by as much as 300 percent by state from a high of 6.4 percent in Rhode Island to lows of 2.1 in Hawaii and 3.2 percent in Nevada. Nebraska ranks in the middle at a 4 percent prevalence.

The Blue Cross and Blue Shield Association Health of America study on depression also shows that women are diagnosed with depression at higher rates, twice as much as men. Men over age 30 are being diagnosed more frequently over the past four years, but are still consistently at half the rate of women.

Nationally, 85 percent of the Blue Plans members diagnosed with depression also had one or more other serious chronic health conditions. Nearly 30 percent of them had four or more other health conditions.

“Chronic conditions change your lifestyle; it may disrupt your sleep, and if you have rheumatoid arthritis for example, you’re not exercising like you used to. It hurts a lot, you’re not feeling well,” Esser said. “You have to grieve for the loss of that lifestyle.”

Members diagnosed with major depression use health care services more, too. The average cost for BCBSNE members with depression was $10,458 in 2017, compared to $4,320 for all other types of claims.

“We have to reach out through providers and case management to make sure patients are adhering to their medications, that they’re exercising, eating and sleeping properly to minimize expenses,” Esser said. “We want them to have a care plan in place so they know what is expected and what the next steps are. It is so important that they have a support system around them.”

Clearly major depression is a complex condition that has a substantial impact on overall health and wellness. It is crucial that it is effectively addressed and managed to improve the health of all.