Approximately twelve percent of the patients seen by a primary care physician have major depression.  Recognizing that these patients-particularly male patients-have depression may be difficult as they usually describe symptoms such as fatigue, sleep problems, headaches, unspecified pain, or other vague symptoms. Other medical conditions may also be present and have similar symptoms, thus contributing to the failure to treat depression.  In addition, the rate of depression secondary to some other disorder is high.  Not only can depression co-occur with substance abuse, anxiety disorders or personality disorders, but is also seen with heart disease, diabetes, and many other illnesses.  Depression can be a risk factor for other illnesses, can impair the ability to participate in treatment, or can be stimulated by the stress of such illnesses.

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