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Depression is common, affecting approximately 16 million, or almost 7%, of Americans each year.[1] People of any age, both adults and youth, may experience depression.  Depression is caused by a mix of genetic and environmental factors. 

Symptoms of depression include sadness, hopelessness or difficulty enjoying things that usually bring pleasure.  Young people with depression may have lasting irritability, rather than sadness.  Depression impacts sleep, energy, appetite and both focus and concentration.  If you notice these signs daily for at least two weeks and they harm function at work, school or in family life, then a person may be dealing with depression. 

Depression can have big effects on your employees’ health.  Many people with chronic health conditions, like diabetes and heart disease, also have depression.  When people have depression, diabetes can be harder to manage. It can also take longer to get well after a heart attack.  Depression can lead to hopelessness and self-harm.  In the United States, rates of suicide are rising. Suicide is the second leading cause of death in young people age 10-24 years.[2]

Perinatal depression may occur during pregnancy or after delivery, usually during the first 4-6 weeks after birth.  Look for signs such as severe sadness, worry and exhaustion.  These can interfere with a mother’s ability to care for herself or her baby.  Depression is not caused by anything that the mother did, and some new mothers may experience depression even though they have never had depression at other times in their lives.  A mix of physical and genetic causes, as well as changes in hormone levels due to pregnancy and delivery, contribute to perinatal depression. 

Depression – in all of its forms – is treatable. Talk therapy and/or antidepressant medications are the first-line treatments for depression for adults and youth.  Traditional talk therapy is delivered by a live therapist. Also, Telehealth and digital options are new and popular ways to be treated.  If you are concerned that you or an employee may have depression, it is important to seek treatment. You can direct your employees to the resources they need to get help. They can begin by finding a provider on Blue Connect, calling the Blue Cross and Blue Shield of North Carolina customer service line and/or talking with their primary care provider.  For thoughts of suicide, the National Suicide Prevention Lifeline is available 24/7 at 800.273.TALK, or call 911.

To address depression and other mental health conditions, Blue Cross NC is proud to offer Quartet Health.  Quartet Health helps primary care providers (PCPs) identify and evaluate their patients for depression and other mental health conditions.  With support from Quartet Health, PCPs can treat depression in consultation with psychiatrists and/or refer for in-person or online therapy.  Many people prefer to receive treatment for depression in primary care, and Quartet Health provides support to PCPs offering these services.


[1] https://www.nimh.nih.gov/health/statistics/major-depression.shtml

[2] https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_06.pdf

Kate Hobbs Knutson, MD, MPH

About Kate Hobbs Knutson, MD, MPH

Dr. Kate Hobbs Knutson is the Chief of Behavioral Health at Blue Cross and Blue Shield of North Carolina. She is an Adult and Child Psychiatrist and adjunct Assistant Professor at the Duke University School of Medicine, experienced in integrated care, alternative payment methods, innovative service delivery models, and State Medicaid administration.