Women and Depression

suffering is incalculable. In addition to the despair and loss of pleasure suffered by depressed individuals (and their families), two thirds of the 30, 000 reported suicides in this country each year may be linked to clinical depression. The economic expense to American society in lost productivity and health care is stag gering. Annual costs for ill ness exceeded 129 billion in 1988. Depression and the affective disorders are recurrent and consti tute a major public and mental health problem. Still, they are often unrecognized, undiagnosed, and untreated. The predominant affective disor ders are major depressive disorder, affecting some 3% of our adult pop ulation; dysthymia, affecting an other 3%; and bipolar disorder (manic-depression), which affects about 1% of our citizens. Depres sion also often accompanies physi cal illness and may be a response to high-stress and disruptive life events. No sex diff? rences are found for bi