Ask the Doctor: My Mother is Depressed

We asked Dr. Barbara Lock about what to do when one's mother is suffering from depression.

Q: My mother who is in her 80's seems depressed all the time. Is it just aging or is there something that can be done?

A: Oh ho, the "just aging" trap. It turns out that the concept that any disease or health disorder can be due to "just aging" is kind of a fallacy. Yes, it is true that many diseases, such as dementia and osteoporosis, are more common among older adults, but aging in and of itself is neither necessary or sufficient for the presence of most diseases associated with aging. Depression is no exception.

Depression is also a tricky diagnosis; it's not really correct to use the term "just depression" either. Depression, usually associated with a feeling of frequent sadness, lack of ability to feel pleasure, lack of energy, sleep disturbances, or lack of appetite, each lasting more than two weeks, can have many different triggers. Life events, such as the death of a spouse or retiring from full time work, can trigger depression, but depression can also be mimicked or triggered by a medical disease, such as cancer, hypothyroidism or nutritional deficiency, or by prolonged hospitalization with slow recovery, as from pneumonia or stroke. And depression can also be a side effect of certain types of medications, particularly certain beta-blockers, which are frequently used to treat hypertension.

The first thing you should do if you suspect your mother is depressed is to bring her to the doctor to screen her for signs or thoughts of self-harm. Her doctor can also look for the presence of medical problems that may be contributing to or confounding her condition. This is the time for you to have a private conversation with the doctor if you think your mother is not being candid about her symptoms. If you've noticed that all she eats is tea and toast, by all means make that fact known to her doctor. If you've noticed that she has started taking extra sleeping pills at night, or drinks a few too many martinis starting a bit too early in the evening, don't keep it a secret. If your mother avoids people, avoids exercise, avoids sunlight, and avoids any food that is green, prompt your doctor to consider your mother's health and depression symptoms from a "whole health" perspective. If, after careful evaluation, quite possibly over more than one visit, the doctor thinks that he has a handle on any medical, nutritional, or lifestyle conditions that could be contributing to depression-like symptoms, it may be time to engage the help of a mental health professional.

There has been much speculation in the medical community recently about whether depression can be helpful and even healthy for a person. If there ever were a health topic laden with land mines, this would be it. I'll try to tread carefully. The theory goes something like this: depression, when it is a reaction to stressful life events, may be a healthy and normal reaction, allowing the affected person to conserve energy and 'hunker down' while they get their bearings in their new reality. It can lead to a burst of creativity, empathy, or new direction in one's career or romantic life. Certainly, depression associated with suicidality or impulsive thoughts of harm to self or others is never healthy. Whether or not an antidepressant medication, hospitalization, or other specific depression treatment may be helpful for an individual patient is a complex decision that must be considered by each patient and their doctor.

Barbara Lock is a practicing emergency physician and is a founding partner of MedPie.com.

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