Senior Health: Depression in the elderly is not uncommon

Levenstein

Wintertime is often difficult for many individuals and a time of year when it’s not uncommon to feel a bit down.

The body’s daily rhythm can be thrown out of sync by the reduced sunlight we experience in the late fall and winter months. In fact, a condition known as Seasonal Affective Disorder affects about 3 percent of the country’s population. However, year-round depression is very common in the elderly and can be triggered by a variety of factors. It may worsen this time of year. When the sense of despair impacts a person’s ability to enjoy life and limits his or her daily activities, he or she often needs more help than can be offered by family and friends.

Is depression common among the elderly?

Depression can occur in people of all ages but may be more common in the elderly due to the impact of illness, medications, retirement, moving to a nursing home, death of family members and friends, and isolation from other people. The incidence of depression in older people is so common that the suicide rate for white males older than 65 is twice that of the general population.

How do you recognize depression?

When depression takes hold, most people know it. They feel sad, avoid others, lose interest in their usual activities, have a loss of self-worth, loss of appetite, have difficulty sleeping, cannot make decisions and may even have suicidal thoughts.

Depressed people may also be more uncomfortable, experiencing increased pain and feel physically unwell in a way they cannot explain. They may also be more forgetful, so it may seem like they have dementia. Depression may also increase anxiety and worry. Lastly, another common sign of depression is an increased consumption of alcohol, as people often use it to self-medicate or deaden the emotional pain of depression.

Can depression be a sign of illness?

Yes, people who are ill may have depression, and depression may make their illness worse. We know depression can be associated with heart disease, stroke, Parkinson’s disease, low thyroid function, cancer, rheumatologic disorders and viral infections. In addition, medications that many people take for medical conditions cause depression as a side effect. Of course, the elderly take more prescribed medications and thus are at a greater risk for this problem.

Is depression bad for your health?

Not only do depressed people feel bad, but they also are at greater risk of dying from life-threatening illnesses such as heart attacks and cancer. Depressed people are less motivated for rehabilitation after illness, injury or surgery and consequently their recovery can be limited or delayed.

What can be done to prevent depression?

As with one’s physical well-being, a healthy lifestyle also helps decrease the risk of depression. Regular exercise, eating a balanced diet, interacting regularly with other people, developing hobbies and participating in activities that challenge your thinking are all helpful. For many people, participating in local clubs, gyms or church groups are rewarding activities. Adult education classes and elder hostel programs, available both locally and around the country, can be stimulating and beneficial.

What are the treatments for depression?

The first step in treating depression is recognizing it and acknowledging that it is present. For some, this step is very difficult.

Once diagnosed, the treatment for mild depression is similar to its prevention — spending time others, participating in meaningful activities and exercise. More severe depression usually involves professional treatment. Your family doctor or general internist may provide this care or may refer you to a specialist. In our community, patients are often referred to counselors, psychologists or psychiatrists for specialty care.

Treatment for severe depression may involve psychotherapy, medication or electroconvulsive therapy.

Psychotherapy is a talking therapy useful in helping people gain insight into their problems and to help develop appropriate coping skills and solutions to these problems.

Antidepressant therapy is used to medically treat depression and often in conjunction with psychotherapy. There are many different medications available to treat depression. The various medications have different benefits and side effects. Therefore the prescribing doctor needs to review each patient to determine which treatment is most appropriate for his or her symptoms.

Electroconvulsive therapy is less commonly used than psychotherapy and antidepressants. In this treatment, patients are anesthetized then caused to have a seizure with an electric current. ECT tends to be recommended for patients who have not benefited from the other treatments.

Depression is a common problem that can affect people both physically and emotionally.

Recognizing the symptoms of depression can allow for early care and hopefully prevent the suffering that it can cause. If a family member or friend suggests you may have depression, think about it before you say “No way, not me.”

Dr. Michael Levenstein is a doctor of general internal medicine and geriatrics with the Bassett Healthcare Network in Oneonta.

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