Gail Gilman, Family Life Consultant, M.Ed., C.F.C.S. and Professor Emeritus, University of Minnesota
Depression is a serious medical illness. It is not the feeling of being “down” or “low” which we experience occasionally at all ages. Feeling depressed, sad, and irritable for short periods of time are normal responses to the stresses of life. Regardless of our age, the loss of a loved one or troubles at home are examples of situations that often are painful and stressful. However, when feelings of sadness, hopelessness, and despair increase in intensity or last for an extended period of time and interfere with daily functioning, clinical depression may have set in.
Depression is clearly not a personal weakness. It is a common, diagnosable, and treatable medical illness that should not be ignored. Its symptoms can range from mild to severe.
Mental health professionals typically diagnose depression in later life when the following first two symptoms are present, along with four or more other symptoms, for at least two weeks and generally daily:
· Feeling sad or irritable throughout the day
· Loss of interest or pleasure in activities once enjoyed
· Changes in weight or appetite
· Changes in normal sleep patterns (such as difficulty falling asleep, early morning awakening or increase in sleep)
· Fatigue or loss of energy
· Feeling worthless, hopeless, or unreasonably guilty
· Inability to concentrate, remember things or make decisions
· Restlessness or decreased activity
· Complaints of physical aches and pains for which no medical causes can be attributed
· Recurrent thoughts of suicide or death (not just a fear of dying)
Men and women do not experience depression at the same rate. Twice as many women as men experience the illness. So, it appears females are much more vulnerable to depression than males. Studies have shown that men are more likely than women to ignore their symptoms of depression and try to cope with emotional pain by turning to alcohol or drugs.
Depression is not a normal result of growing older. It is not normal to be depressed in later life, than it is normal to experience heart disease or cancer. Life for older adults should continue to be fulfilling.
This does not mean older adults do not get depressed. They do. It means that depression should not be accepted as a normal part of the aging process. And suffering in quiet desperation is not wise or necessary.
Multiple factors may contribute to depression, or a single factor may trigger onset of the illness. People can even become depressed for no apparent reason. Regardless, depression is an illness that, once accurately diagnosed, is extremely treatable. Depression is often related to the following factors:
· An imbalance of brain chemicals called neurotransmitters
· Negative thinking patterns
· A family history of clinical depression
· Difficult life events
· Certain medications
· Frequent and excessive alcohol consumption
· Certain illnesses or diseases
The loss of a long-term partner or a friend is a frequent occurrence in later life and it is normal to grieve after such a loss. But it may be depression rather than bereavement if the normal period of grief leads to a prolonged, intense grief and loss of interest or pleasure in activities previously enjoyed. Normal grief usually resolves in about one year.
Those grieving often find it helpful to join a mutual support group, such as a widowed persons group, to talk with others who share similar experiences. If prolonged grief is accompanied by any of the following symptoms the individual should seek medical attention:
· Guilt unconnected with the loved one’s death
· Inability or refusal to acknowledge the reality of the death
· Intense emotion at the mention of the deceased, years after the death
· Inability to function at one’s usual level
· Recurrent thoughts of one’s own death (not just a fear of dying)
· Persistent feelings of worthlessness
· Difficulty sleeping
· Weight loss
Some older people believe they are “too old” to get help for depression or are reluctant to talk about their feelings. Others believe depression will go away on its own and that they should just “tough it out.” Or some think depression is a sign of weakness or associate it with being “crazy.” Such views are simply wrong. Depression is no different than any other medical illness and requires the proper professional treatment.
It is true that talking with friends, family and clergy can often give people the support needed to make it through life’s difficult times. However, for those with depression, such support is no substitute for a health professional. Depression left untreated can:
· Lead to disability
· Lead to premature death
· Worsen symptoms of other illnesses · Result in suicide
Remember, depression is a serious medical illness that is best treated by a doctor and/or a qualified mental health professional.
Personal psychology, that very individual thing we call our personalities, also appears to play a role in depression. People with low self-esteem, pessimism, or those easily overwhelmed by stress are more vulnerable to depression.
Environmental factors in our society appear to play a role, as you might expect. Changes in an older adult’s environmental can often contribute to the development of depression.
Such changes often include moving from the family home, neighborhood changes or being admitted to a nursing home facility.
More than 80 percent of people who seek treatment for depression recover to live fuller, more productive lives. Depression is unlikely to go away if you just give it enough time or try to ignore it.
The first step to treatment is recognizing that something is not right and talking with your doctor or a mental health professional about the symptoms you have been experiencing. If depression is diagnosed, it is important that all treatment options be discussed. Your physician and other health resources can make referrals, as needed, to a mental health specialist who has experience working with older adults.
Suicide is more common in older adults than any other age group. Fifteen percent of all severely depressed individuals end up committing suicide. And the population over age 65 accounts for about 20 percent of our nation’s suicides, with older white males especially at risk. Attempts or thoughts of suicide by older adults must always be taken very seriously.
If you would like more information on “Answers to Depression Questions” contact Gail Gilman, Family Life Consultant, M.Ed., C.F.C.S. and Emeritus University of Minnesota at waldn001@umn.edu. Be sure to watch for more Family Living Focus™ information in next week’s paper.
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