DEPRESSION IN LATE LIFE

People of all ages suffer from sever depression, but older adults are twice as likely as the general population to experience this illness.

Depression is best described as a "physical illness" comparable in some ways to diabetes or heart disease. It is serious health problem affecting 15 percent of persons over age 65. Compare this to Alzheimer's which affects about 1 percent of the older population.

The economic cost of depressive disorders is measured at $16 billion annually but the emotional costs to the lives of those affected and to their families and friends cannot be measured.

Those who have a depressive illness and those who love them must realize:

• Depression is no one's fault.
  
• It's not due to spiritual or moral weakness.
  
• It is a serious but treatable illness

What is depression?

• Depression is a severe, persistent "down" mood in which, along with other symptoms, a person loses interest or pleasure in the usual activities of life. It is not the holiday blues or the sad feeling everyone experience after a loss.
  
• The symptoms of depression may last from a few weeks to months or even years.
  
• Depression can change, disable or even kill those that have it. The highest suicide rate is in the elderly white male population.

Serious depressions that need treatment are usually called depressive disorders or clinical depression.

What causes clinical depression?

We do not know all the causes of depression but a combination of biological, emotional and environmental factors seems to increase a person's likelihood of developing a depression.

Each person responds to these factors differently. Some individuals can handle a great deal of stress with no problems, others very little.

Research over the past decade strongly suggests a genetic link in depressive disorders. Depression can run in families.

Symptoms of depression:

Some of the common symptoms of depression are:

• Impaired concentration, slowed thinking, forgetfulness, being more accident prone.
  
• Lack of energy and motivation.
  
• Drastic changes in sleeping or eating habits.
  
• Increased complaints about physical problems such as headaches, digestive disorders or chronic pain.
  
• Feelings of worthlessness or guilt.
  
• Recurrent thoughts about death or suicide.
  
• Inability to experience pleasure or express feeling.
  
• Indecisiveness; inability to take action.
  
• Wanting to avoid people; always wanting to be alone.

These symptoms can be obvious and apparent or secret and hidden. But usually our bodies let us know when we have to take care of ourselves; when something is wrong.

Why is there a higher incidence of depression in older adults?

Older adults experience depression in greater numbers than other age groups. Some of the reasons are:

• Normal aging causes changes in the chemical functioning of the brain.
  
• Older adults experience increased social and economic pressures over which they have little control.
  
• In later life multiple losses (spouse, friends, home, work) often occur all at once.
  
• An older person's support network of family and friends may be very fragile or nonexistent.
  
• As people get older they are less able to tolerate certain medications. This can lead to depressive symptoms.

If you're depressed, why should you seek help?

At least 80 percent of people with a depressive disorder can be treated effectively and their symptoms relieved within weeks.

Proper diagnosis is very important. Often depression can be mistaken for many other diseases including stomach problems. Delays in proper treatment may cause the depression to continue or worsen for months and even years until it is a disabling, chronic problem.

Why do people avoid treatment?

There are many bad reasons why people fail to seek help for depression.

• Some individuals don't or won't acknowledge they're depressed.
  
• Some are so disabled that they cannot reach out for help, or are concerned that people will think they're crazy. Others don't realize that treatment is available.
  
• Some blame personal weakness for the problem and are too proud to ask for help.

How is depression treated?

Medications and psychotherapy or counseling are the most common choices for treatment. They can be used separately or in combination. Medication gives quick symptom relief. Therapy or counseling helps in learning to deal with life's changes.

It is important to remember:

• The response to treatment is very individual; no two people are alike.
  
• Medication side effects are more common as people age so their use must be closely monitored.

Who will pay for treatment?

Medicare, Medicaid and most health insurances cover the cost of treating depression.

Where can you get help?

The most common resource is your family doctor. He/she will either initiate treatment or refer you to another mental health specialist for help as needed.

Other resources available to you are:

• Community hospitals
  
• Senior mental health programs
  
• Mental health specialist
  
• Community mental health centers
  
• Family service/social agencies

When you contact a mental health specialist or clinic for information or help, you can expect that the information you give will be kept confidential. You will be treated with respect and dignity. You will not be forced to receive any services you do not want.