Most people feel down and out at times and experience periods of generalized sadness. However, that is not the same thing as experiencing a mood disorder.
The mental and physical consequences of mood disorders can be unbearable and overwhelming to those suffering with a true diagnosis of depression. Some 6.5 million people suffer from some degree of depression, and the disease has no prejudice when being diagnosed. Adults, children, women and men are all candidates.
Every year, at least some life insurance applicants are so affected. Fortunately, many such cases are insurable. Advisors who know something about the disease and how to prepare client information for the underwriter will be better able to submit a strong case. That is the focus here.
Bipolar Disorder (manic depressive disorder), major depression, anxiety disorder and dysthymia fall into the overall classification of mood disorders. They are all debilitating illnesses in their own respect, and each diagnosis may affect individuals differently, from mild to life threatening. But it is an illness that definitely needs treatment for, without it, depression can cause permanent disability. Treatments can range from simple counseling to medicinal therapies to short- or even long-term hospitalizations.
Certain groups of individuals have an increased vulnerability to depression. Women, as an example, experience depression twice as often as men. Stress factors such as premenstrual syndrome, single parenthood, responsibilities both at home and at work, and caring for aging parents all play a part.
More recently, the incidence of depression has increased in men. Men often can feel as though they are not “stacking up” and shift toward feeling their lives lack meaning or importance.
Children, especially those entering adolescence, tend to experience a great deal of competition in their lives due to pressures to keep up with styles, sports and academics. Parental divorce, death of a loved one, moving and changing schools are additional factors that can lead to childhood depression.
Although “situations” such as those mentioned above can produce depression, mood disorders also are caused by chemical abnormalities or imbalances and by the irregular pattern of neurotransmitters such as dopamine, acetylcholine or serotonin. The inability of these neurotransmitters to travel the junction between two neurons interrupts the ability of the first neuron to excite the impulse of the second neuron, causing an imbalance.
Most individuals diagnosed with a mood disorder have one parent who has been diagnosed with the same disorder.
If a client has been diagnosed with a mood disorder, consideration for life insurance depends on several factors.
Bipolar: People having bipolar disorder usually suffer from both depression and mania. Although pure mania is rare, it usually occurs in a person who has a history of major depression. Psychotherapists understanding of patients with this condition has improved tremendously over the past 10-15 years, as has the availability of effective antidepressant and antipsychotic drug therapies. Therefore, a combination of antidepressant medications and psychotherapy are the most common treatments and, in most cases, when used in combination, these approaches are quite effective.
Anxiety: Anxiety disorders, which include generalized anxiety and panic disorders, phobias, and obsessive-compulsive disorder, are most commonly treated with anti-anxiety sedatives. These provide a quieting agent with a soothing or tranquilizing effect.
Dysthymia. Dysthymia is a less severe form of depression and may not need both medication and therapy. So, for some individuals who are diagnosed with this condition, simply obtaining psychotherapy treatment may be the answer.
As with any medical impairment, psychiatric disease needs to be controlled effectively and monitored by a health professional. Underwriting consideration will depend on the diagnosed mood disorder and how treatment is maintained.
Individuals must conform suitably to the impairment and not have any significant intervention with daily activities. Factors such as working full time, social activities and continuation of a stable lifestyle are positive attributes that show whether an individual has adjusted well to the diagnosis and subsequent treatment.
If abuse of antidepressant medications is suspected, or an increase in dosage is discovered, then a less favorable rating may be applied.
An increase in alcohol consumption also will play a negative role by increasing the severity of the disease and possibly causing hospitalization. This indicates a worsening condition, resulting in a declination.
On the other hand, those disorders that are situational in nature, tend to be resolved after the disturbing factor has subsided or settled, making insurability less severe, and therefore, may not require any type of insurable rating.
Mood disorders fall into 3 categories, mild, moderate or severe. A thorough inquiry by the broker or field underwriter is necessary to help the home office underwriter fully understand the degree of impairment upon initial inquiry. Type of treatment and amount of medication should be provided, along with onset of the disease, any past hospitalizations and current status of activities of daily living.
This subject is sometimes uncomfortable for the affected individual to discuss. However, clients who are receiving effective treatment and therapy have adjusted well to the impairment and are more than happy to reveal their history and successes of beating the disease and moving forward with their lives and continued stability.
This disease is manageable, and the majority of affected individuals respond well to treatment, hence making insurability an easily obtainable goal for most.
Elizabeth V. Cammarota is vice president at Brokerage Professionals Inc., Phoenix, Ariz. Her e-mail is [email protected]
Reproduced from National Underwriter Edition, November 11, 2004. Copyright 2004 by The National Underwriter Company in the serial publication. All rights reserved.Copyright in this article as an independent work may be held by the author.