This article is the seventh in a series about depression.

Q: What are some negative effects and complications associated with depression?

A: The Centers for Disease Control and Prevention (CDC) consider depression both a serious medical illness and a major public health issue. Depression is associated with major healthcare needs, school problems, loss of work time, and earlier mortality.

Furthermore, depression is associated with a higher risk for mortality from suicide and from other causes, such as heart disease. Depression is associated with lower productivity in the workplace and with more absenteeism, which results in less income and higher unemployment. Depression is associated with higher risks for other behaviors and conditions, such as anxiety disorders, substance use disorders, and eating disorders. Depression is also associated with smoking, alcohol consumption, obesity and physical inactivity, sleep problems and epilepsy.

From Depression in Women on, there is information about how depression in mothers negatively affects their children. Depression can make a person irritable or critical. Or depression can cause someone to feel apathetic or empty which, in turn, results in neglect of one’s relationships. Studies have shown that being raised by mothers with untreated depression has a profoundly negative effect on children’s emotional, social and cognitive development.

Perhaps the most dramatic complication of depression is suicide. Thoughts or attempts of suicide are part of depression. Since these thoughts or impulses are part of depression, when depression is treated, they will go away. (From family

The following information is from the Mayo Clinic. There are many complications associated with depression. Obesity can lead to heart disease and/or diabetes. Obesity not associated with depression will also lead to heart disease and/or diabetes. Depression can intensify pain and physical illnesses. Some of the same neural pathways are activated by depression, pain and physical illness.

Another co-existing condition associated with depression is alcohol or substance abuse. Alcohol gives a person an initial high, but alcohol is a depressant. Therefore, drinking while depressed is counterproductive, especially when one considers hangovers. Other substance abuse can include opioids, sedatives, tranquilizers, and fentanyl, much stronger than heroin or morphine.

There are several anxiety conditions that are associated with depression. Panic disorders occur when a person experiences acute, extreme symptoms of anxiety, usually associated with chest pain and shortness of breath. Often someone in a panic attack thinks he/she is having a heart attack. A social phobia is an aversion to social contact or closeness to others. Such individuals avoid others and isolate themselves when they can. Going to the store or crowds in general are situations they avoid.

A Generalized Anxiety Disorder means a person feels apprehensive or restless or agitated. The situations that trigger anxiety differ from person to person based on their prior life experiences. A child who is very sensitive may be highly anxious in any new situation or when under pressure to perform, such as a school program or a recital. A child whose parent or parents are critical, demanding, and judgmental may well develop an anxious personality.

Additional complications associated with depression are family conflicts, relationship conflicts and problems at school or work. Depressed persons may be emotionally closed and difficult to reach or irritable and short-tempered. Sometimes persons in nonfamily situations, such as work or school, can mask their depressions. But sooner or later, untreated depression overcomes someone’s coping skills. The two most common reactions of a depressed person are either withdrawal and isolation or anger and hostility.

Social isolation is a complication of depression. Such persons have few friends and are distant from family members. Children come home and go to their rooms and stay there, usually with their electronics. Parents isolate themselves with cell phones, iPods, TV, or working on hobbies. Men may have workshops, watch sports on TV, or escape behind newspapers. Women escape into household chores, texting their friends, watching their favorite TV programs or Netflix movies.

Not all children who isolate themselves are depressed. If the school tells parents that a child is socially isolated at school, and the child’s behavior is normal from their viewpoint, parents should have a counselor evaluate the child, who may be shy and not especially uncomfortable. If a child is being bullied in person or online, parents need to work with the school, because that child needs support. If not already depressed, he/she will be eventually.

Another complication of depression is self-mutilation. Cutting oneself or hurting oneself physically, such as slamming one’s head against the wall, are forms of self-mutilation. Inflicting pain on oneself by mutilation is not the same as suicidal thoughts or attempts. The infliction of physical pain is a way to eliminate emotional pain for self-mutilators.

The last complication that the Mayo Clinic listed as a complication associated with depression is premature death from other medical conditions. Examples would include heart disease, diabetes, cancer, chronic pain.

The most important step to recovery from depression is to get started or get moving. Unfortunately, the first step is the most difficult because depression generally causes people to feel apathetic and immobilized and to lose interest in things they usually find pleasurable. Starting medication is an effective way to begin to counteract depression because antidepressants will start to work after two to three weeks. Then a person feels more motivated to follow through with self-help suggestions.

Next week’s article will discuss the relationships between depression and anxiety.

Judy Caprez is professor emeritus at Fort Hays State University