While everyone feels sad or low from time to time, most people find that they can work through those feelings within a few days.
Sometimes, however, those feelings don't ease. Life doesn't return to "normal," and feeling down becomes a persistent state. Activities that were once pleasurable no longer provide satisfaction. Even starting the day can seem to be an overwhelming task.
Such feelings may be more than just sadness or a normal part of aging. They could be symptoms of depression. Among people aged 65 and older, nearly three out of 100 are diagnosed with clinical depression. The rates of mild depression may be much higher. Unfortunately, the disease can be difficult to recognize and is frequently not diagnosed or properly treated. This can be especially true in older Americans, since the symptoms may be overlooked or attributed to other causes.
Some of the signs associated with depression -- including irritability, anxiety, sleep disruptions, changes in appetite, decreased interest in sex, increase in complaints of pain, or a withdrawal from usual socializing -- are mistakenly considered to be a normal part of aging. Likewise, confusion or lethargy may be incorrectly associated with early signs of Alzheimer's or other diseases, or as a reaction to medication. In some cases, a person's pride may prevent him or her from admitting to feeling depressed.
Reasons for Depression
There are many reasons for the development of depression. Some are medical or biological, while others are situational. Depressive symptoms can be a side effect of some medications, particularly those taken for high blood pressure and arthritis. Since many older adults take medications for multiple reasons, drug interactions may cause a depressive state.
Genetics may also be a factor. Studies show that children of parents with depression may be at higher risk for the disease. Major life changes such as the death of a family member or friend, retirement, moving from the family home to a retirement community, and physical limitations as a result of injury or disease can be traumatic. Consequently, a person may feel a loss of identity or control, which can precipitate depression.
The diagnosis of a serious illness, a debilitating injury such as a hip fracture, or any condition causing chronic pain may also initiate depression in a patient. The occurrence of depression in conjunction with illnesses such as cancer, heart disease, Parkinson's disease, stroke, substance abuse disorders and other psychiatric illnesses is common and can exacerbate the existing illness. It can also be extremely difficult to recognize, especially among Parkinson's and Alzheimer's disease patients, because the symptoms of depression are mistakenly attributed to symptoms of the other diseases. Untreated depression can hinder the patient's ability to follow a treatment regimen or participate effectively in rehabilitation programs.
Of the nearly 600,000 Americans who suffer from a stroke, an estimated 10 to 27 percent experience major depression, while an additional 15 to 40 percent experience some symptoms of depression. Among the more than 500,000 Americans affected by Parkinson's disease, nearly half are estimated to have depression.
Likewise, research has shown that roughly one in three people who have suffered a heart attack also suffers from depression, and those diagnosed with both heart disease and depression are at greater risk for worsening their illness or death following a heart attack.
Fortunately, proper treatment can result in significant improvements. Treating depression can help to speed the recovery process, reduce pain, decrease time spent in rehabilitation, make it easier for the patient to manage both diseases, and ultimately enhance his or her quality of life.
Getting the Help That's Needed
Once the symptoms of depression are recognized, the next step is to talk to a doctor. It is important to realize that not every doctor is capable of treating depression. A family doctor should be able to assess the symptoms and provide guidance for the best treatment, which may mean seeing another physician or psychiatrist or other mental health care provider. There are several different types of treatment for depression. One of these treatments may work effectively, or a combination may be necessary.
Talk and other behavioral therapies are also options in coping with depression. Talking to a therapist or joining a support group can enable the patient to express his or her feelings in an objective and supportive environment.
Lifestyle changes, including diet and exercise, can have an impact on managing depression, although this is not a substitute for seeing a medical or mental health professional.
Antidepressant medications alter the chemicals in the brain and thus improve mood, sleep patterns, appetite, energy levels and concentration. It is important to note that these drugs may produce unwanted side effects when taken in combination with other medications. Since many older patients see several doctors for treatment of multiple disorders, it is imperative that the physician who is treating the depression knows about the use of all other pharmaceuticals, including over-the-counter drugs.
A Brighter Future
There is no question that the multitude of life changes we experience as we age can produce a profound sense of sadness or hopelessness. Depression is a debilitating disease, but fortunately there are ways to treat it. Recognizing the symptoms of depression in oneself or a loved one and seeking help are critical to recovery. The diagnosis and treatment for depression can significantly improve a person's well-being and enable him or her to continue to live a productive and fulfilling life.
For more on depression information and resources, click here.
Alliance for Aging Research Advisory Panel
Source: Health & Wellness
