Older Adults and Depression (Part 1)

Do you feel very tired, helpless and hopeless?

Have you lost interest in many of the activities and interests you previously enjoyed? Are you having trouble working, sleeping, eating and functioning? Have you felt this way day after day? If you answered yes, you may be experiencing depression.

As you get older, you may go through a lot of changes — death of loved ones, retirement, stressful life events or medical problems. It's normal to feel uneasy, stressed or sad about these changes. After adjusting, however, many older adults feel well again.

Depression is different. It is a medical condition that interferes with daily life and normal functioning. It is not a normal part of aging, a sign of weakness or a character flaw. Many older adults with depression need treatment to feel better.

Types of Depression

There are several types of depression. The most common include:

• Major depression — severe symptoms that interfere with your ability to work, sleep, concentrate, eat and enjoy life. Some people may experience only a single episode within their lifetime, but more often, a person may experience multiple episodes.
• Persistent depressive disorder (dysthymia) — depression symptoms that are less severe than those of major depression, but last a long time (at least two years).
• Minor depression — depression symptoms that are less severe than those of major depression and dysthymia, and do not last long.

Do you know the signs?

Depression may sometimes be undiagnosed or misdiagnosed in some older adults because sadness is not their main symptom. They may have other, less obvious symptoms of depression, or they may not be willing to talk about their feelings. It is important to know the signs and seek help if you are concerned.

Depression has many symptoms, including physical ones. If you have been experiencing several of the following symptoms for at least two weeks, you may be suffering from depression:

• Persistent sad, anxious or "empty" mood.
• Loss of interest or pleasure in hobbies and activities.
• Feelings of hopelessness, pessimism.
• Feelings of guilt, worthlessness, helplessness.
• Decreased energy, fatigue, being "slowed down."
• Difficulty concentrating, remembering, making decisions.
• Difficulty sleeping, early-morning awakening or oversleeping.
• Appetite or unintended weight changes.
• Thoughts of death or suicide, or suicide attempts.
• Restlessness, irritability.
• Aches or pains, headaches, cramps or digestive problems without a clear physical cause or that do not ease even with treatment.

Is it grief or depression?

Grief after loss of a loved one is a normal reaction to loss and generally does not require mental health treatment. However, grief that lasts a very long time or is unusually severe following a loss may require treatment.

Risk Factors

Although most cases of depression are diagnosed in young adults, depression can occur at any age. Certain people are at a higher risk for developing depression. If you are an older adult, you may be at a higher risk if you:

• Are female.
• Have a chronic medical illness, such as cancer, diabetes or heart disease.
• Have a disability.
• Sleep poorly.
• Are lonely or socially isolated.

You may also be at a higher risk if you:

• Have a personal or family history of depression.
• Use certain medications.
• Suffer from a brain disease.
• Misuse alcohol or drugs.
• Have experienced stressful life events such as loss of a spouse, divorce or taking care of someone with a chronic illness.

How do I get help?

If you think that you or a loved one may have depression, it is important to seek treatment. A person with depression cannot simply "snap out of it" — it is a medical condition that affects your quality of life. Depression can also lead to suicide, particularly if left untreated, and you are more likely to develop a physical illness if you have depression.

The good news is that, in most cases, depression is treatable in older adults. The right treatment may help improve your overall health and quality of life. With the right treatment, you may begin to see improvements as early as two weeks from the start of your therapy. Some symptoms may start to improve within a week or two, but it may be several weeks before you feel the full effect.

Talking to Your Doctor

If you think you have depression, the first step is to talk to your doctor or health care provider. Your doctor will review your medical history and do a physical exam to rule out other conditions that may be causing or contributing to your depression symptoms. He or she may also ask you a series of questions about how you're feeling. It is important to be open and honest about your symptoms, even if you feel embarrassed or shy.

If other factors can be ruled out, the doctor may refer you to a mental health professional, such as a psychologist, counselor, social worker or psychiatrist. Some providers are specially trained to treat depression and other emotional problems in older adults.