Rosmann: Understanding, managing depression critical for farmers

Depression is not as common as anxiety disorders for farmers and others in the agricultural population, but it has key importance because of its propensity to incline farmers to purposefully end their lives.
Newly reported research on the topic offer additional understanding about this behavioral health disorder and beneficial information about factors that precipitate depression, its prevention and treatment.
Depression erodes the confidence, hope and clear thinking of those dealing with the disorder. It drags people down and reduces motivation and the capacity to work effectively.
Depressed people tend to be negative, unable to move ahead with tasks, withdrawn and sometimes unpredictably volatile. Children especially may exhibit volatile moods and intentions, as many of the recent school shootings bear witness.
Family and others who associate with depressed people want to help them. Despite their good intentions, they often are shut out and feel helpless to assist the depressed person.
About 17 percent of all Americans experience some form of depression each year, according to an October report of the federal Centers for Disease Control and Prevention.
Most studies that compare the incidence of depression among farm people to non-farm people in the United States report higher depression levels among those in ag-related fields, but the incidence varies across the studies. The same is true of studies in other countries: Most point to a higher incidence of depression in their agricultural population than their non-agricultural population; their findings also vary.
Researchers have identified a number of reasons for the inconsistent findings, such as unwillingness by farm people to admit to personal trouble and differing ways of measuring depression.
One of the most scientifically sound studies of the causes of farmer depression appeared in the May 2013 issue of Annals of Clinical Psychiatry. Two hundred fifty-seven farmers who were enrolled in the Certified Safe Farm program in a nine-county area of northwest Iowa participated in the study.
All the CSF farmers completed extensive questionnaires or interviews for 10 successive yearly quarters. Sixty-two people (24.1 percent) reported a high or very high depressed mood score during one or more quarters. A 2002 study of Iowa farm women reported an almost identical rate (24 percent) of depression.
Four main factors distinguished the 62 depressed farmers from the 195 CSF farmers who reported a low, very low or average depressed-mood score.
The depressed farmers were significantly more likely to hold an off-farm job; they reported significantly more stress; they were significantly more likely to have experienced a pesticide exposure, and they were significantly more likely to have suffered a farming-related injury.
These findings are consistent with earlier conclusions of an extensive literature review in a chapter entitled “Agricultural Behavioral Health: In Critical Need,” in Partners in Agricultural Health (2003).
The average suicide rate of farmers is about 60 percent higher than by those who are not farmers. The farming-related suicide rate in the United States and in agricultural areas of other countries varies from about equal to as much as 10 times greater during episodes of severe stress, like the outbreaks of foot and mouth disease and bovine spongiform encephalopathy in Great Britain during the early part of the last decade.
Many British farmers couldn’t bear to see their animals destroyed, even if incineration prevented the spread of these dangerous diseases. In the U.S., farmer deaths by suicide rose to as much as four times the usual rate during the Farm Crisis of the 1980s.
An off-farm job, high stress, farming-related injuries and exposures to pesticides all are associated with heightened risk for suicide among farmers. And, as the CSF study suggested, all four factors involve modifiable behaviors.
My columns during the next two weeks will look further at reducing depressive symptoms or preventing them. We will also examine a fifth factor that helps explain the higher rates of depression and death by suicide in the farm population, the intense drive to farm successfully – called the agrarian imperative.
Like the other factors associated with self-imposed death by farmers this inherited drive must be understood so its associated behaviors can be modified.
The diagnosis of depression is not an “end-all” determination. Depression is usually successfully treated by the combination of medications with behavior management therapy.
Seriously depressed people and their families should seek professional help. They should contact their personal or family physician, a psychiatrist or other behavioral health professionals about how to manage their illness and behaviors. To be most helpful, the professionals assisting depressed farmers should be familiar with agricultural behavioral health and agricultural medicine.

Mike Rosmann is a Harlan, Iowa, psychologist and farmer. To contact Rosmann go online to: www.agbehavioralhealth.com .