Jan. 28, 2005 — “You have depression” can be hard words for young adults to accept — even if the news comes from their doctor. As a result, many settle for diminished lives, refusing to get the help they need.

By age 24, one out of every four people in the U.S. has experienced depression. That can lead to substance abuse, problems at work and in relationships, and a host of other woes.

But only 20% of depressed young adults get high-quality treatment, say Benjamin Van Voorhees, MD, MPH, and colleagues. To find out why, they conducted an Internet survey of nearly 11,000 people aged 16 to 29. All participants showed signs of depression in an online screening test.

The study posed a provocative question — could participants accept a depression diagnosis from their doctor? For 26%, the answer was no.

That includes those who said they neither agreed nor disagreed with the statement, “If my doctor told me I had depression, I could accept that.” Such people are unlikely to take action and accept treatment, say the researchers.

Much of the resistance — 84% — stemmed from three causes:

• Negative beliefs and attitudes about depression (48%)
• Social stigma (18%)
• A lack of helpful treatment experiences in the past (18%)

Negative beliefs and attitudes were common. For instance, nearly 39% disagreed, strongly disagreed, or weren’t sure if biological changes in the brain cause depression. About 30% agreed or strongly agreed that depression medications are addictive.

Shame was also a factor. Many participants wouldn’t want friends, employers, or family to know if they got treatment.

Nearly half — 46% — agreed or strongly agreed that they would be embarrassed for their friends to know that they were being treated for depression. About 67% agreed or strongly agreed that employers shouldn’t know about treatment. Almost 30% agreed or strongly agreed that their families would be disappointed to know they were getting depression treatment.

Participants were also asked about past depression treatment. Those who said medications or counseling hadn’t helped in the past were more reluctant to consider trying those treatments again.

Participants with milder symptoms were also less willing to accept a depression diagnosis, say the researchers.