Nearly
2 million Americans aged 65 and older suffer from some form of depression.
It is a widely under-recognized and under-treated medical condition.
It isn't "normal" to feel depressed all the time especially when you
get older; in fact, most older people feel satisfied with their lives.
Most people think of depression only as sadness and low mood, but
clinical depression is far more than the ordinary "down" moods that
everyone experiences now and then, which often disappear after a visit
with a friend or a good movie.
Depression is also more than a feeling of grief after losing someone
you love. Following such a loss, for many people, a depressed mood
is a normal reaction to grief. However, when a depressed mood continues
for some time, whether following a particular event or for no apparent
reason, the person may be suffering from clinical depression--an illness
that can be treated effectively. Clinical depression is a whole body
disorder. It can last for months, affecting the way you think and
the way you feel, both physically and emotionally.
But there is good news. Nearly 80 percent of people with clinical
depression can be treated successfully with medications, psychotherapy,
or a combination of both. Even the most serious depressions usually
respond to the right treatment. But first, depression has to be recognized.
Both the family and doctors may have trouble recognizing depression
in the elderly. Some symptoms of depression also occur in other medical
conditions. For example, weight loss, sleep disturbance, diabetes
and heart disease; poor concentration and memory loss are also found
in Parkinson and Alzheimer's diseases. Fatigue may be present in numerous
other conditions. In addition, fatigue, sleepiness, and difficulty
with memory or concentration can also occur as side effects of medication.
To determine the proper diagnosis, a physician must conduct a thorough
evaluation, keeping in mind that depressed older people are more likely
to complain of such physical problems rather than expressing sad,
anxious, or hopeless feelings.
Treatment Options
Current research has revealed that in depression, neural circuits
responsible for the regulation of moods, thinking, sleep, appetite,
and behavior fail to function properly and that critical neurotransmitters-chemicals
used by nerve cells to communicate-are usually out of balance. Genetics
research indicates that vulnerability to depression results from the
influence of multiple genes acting together with environmental factors.
Antidepressant medications are widely used as an effective treatment
for depression. Antidepressant drugs influence the functioning of
certain neurotransmitters in the brain, primarily serotonin and nor-epinephrine,
known as monoamines. Newer medications, such as the selective serotonin
reuptake inhibitors, have fewer side effects than the older drugs,
making it easier to adhere to treatment. Sometimes the doctor will
try a variety of antidepressants before finding the most effective
medication or combination of medications. Although some improvements
may be seen in the first few weeks, antidepressant medications must
be taken regularly for 3 to 4 weeks (in some cases, as many as 8 weeks)
before the full therapeutic effect occurs.
Psychotherapy is also an effective treatment for depression. Certain
types of psychotherapy, cognitive-behavioral therapy and interpersonal
therapy, can be very useful. Most people with depression improve when
they receive appropriate treatment with medication, psychotherapy
or the combination.
How Family And Friends Can Help
One of the biggest obstacles to get help for clinical depression can
be a person's attitude. Many people think that depression will go
away by itself, or that they're too old to get help, or that getting
help is a sign of weakness or moral failing. Such views are simply
wrong. Family members are the key in getting seniors into treatment,
because most often seniors don't recognize they are suffering from
depression. Warning signs of depression, which family members should
look for, include sleep problems, excessive worrying, increasing dependency,
withdrawal from friends, and signs of hopelessness. In addition, many
senior citizens will not discuss problems with their doctors because
they don't want the term "depression" associated with them. Improved
recognition and treatment of depression in late life will make those
years more enjoyable and fulfilling. With treatment, even the most
seriously depressed person can start to feel better, often in a matter
of weeks, and return to a happier and more fulfilling life.
Feature Archives