Barry Bittman - depression-part 2

Depression: key insights for the elderly –part II

by Barry Bittman, MD

It’s time we realized “depression” isn’t a 4-letter word.

Yet it seems to be shunned and more often than not covered up in our society. People, especially older folks, generally don’t talk about being depressed. Perhaps that’s one of the main reasons depression is so poorly diagnosed by healthcare professionals these days.

If you’re reading column as a follow-up to filling out last week’s depression checklist, I’m glad you returned for more information. If you just found this column and missed that overview, I’m certain you’ll discover some rather important insights that can help you or a loved-one discover a renewed sense of meaning and purpose in life.

It is important to realize that symptoms of depression vary considerably. Characterized by a wide constellation of symptoms, no two people suffer from depression in exactly the same way.

A depressed person often experiences a persistent sad or “empty” mood, loss of interest or pleasure in ordinary activities, eating and sleeping disturbances, restlessness, decreased energy, and feelings of guilt, worthlessness, or helplessness. Additionally some people note difficulty concentrating, remembering, or making decisions. Severe depression often leads to thoughts or attempts at suicide.

Depression can be especially challenging to diagnose in older people. I suppose in part, this is based on a pervasive attitude centered around lowering our expectations for living life to the fullest as we age. Perhaps our concept of the “aging process” itself is the real culprit. Growing older for some seems to imply that many of the symptoms listed above are bound to occur naturally.

To complicate matters further, depression often coexists with other illnesses that become more prevalent as we age. Who wouldn’t be depressed by the compromises that often occur in the context of illness or disability? When we compound the effects of chronic illness with related financial issues, loss of control, loneliness, social disruption and a change in one’s support system, depression becomes predictable. Sometimes reactive depression is inevitable

What makes matters worse, however, is the fact that amidst the sea of depression in which the victim is progressively drowning, rarely does the medical profession recognize one’s failure to tread water. In fact, few depression prevention measures are ever in place for people with obvious situations, predilections or family histories.

Yet when depression finally rears its ugly head in the case of a suicide attempt, medical professionals seem startled by the lack of apparent warning. I suppose it’s difficult at best to uncover what one has not been searching for even when the warning signs are omnipresent.

Ultimately the responsibility and the opportunity for uncovering depression rests with all of us. If you, a loved-one, a co-worker or a friend is suffering from depression, there is help. If thoughts of impending doom or suicide exist, you must seek professional assistance immediately. If a family member or loved-one is reticent to discuss the problem with a physician, contact that practitioner yourself or accompany the person to the next appointment. If embarrassment is what’s holding you back, realize you can deal with that issue after a path toward health is reestablished. If respect for confidentiality is preventing you from seeking help, know that your action could alter the balance of life and death.

Even after reporting depression to your physician, your job isn’t over. Do not simply accept a prescription for an antidepressant without a referral for counseling. Research has substantiated the combined advantage of counseling and medication together versus medication alone. Realize the cure is rarely in the bottle, and know that your commitment toward reestablishing the gift of mental or physical health requires a real investment of time and effort.

And don’t stop once counseling commences or medication is prescribed. Consider rebuilding an important relationship that seems to have chilled lately. You might be surprised by the people you’ve already pushed away who really continue to care about you. The shortest path to recovery just might be a phone call away. Always remember what Mother Theresa one said, “the shortest distance between two people is a smile.” Nurturing is a powerful elixir.

And speaking of short paths, take a hike! Staying at home, staring at the four walls and watching the tube are bound to deepen depression. Well established, successful programs are available for seniors through the Office of the Aging and other centers that focus on rebuilding self-worth through camaraderie, support, nurturing and a variety of enjoyable activities. Call your local Aging Office or long-term care facility and discover the opportunities that exist in your area that can enable you to regain meaning and purpose in your life.

And finally, consider a healthy prescription of laughter and music. Even if you’re not in the mood, I guarantee you’ll find these activities far more uplifting than the world news. Remember, regardless of the challenge, depression is not inevitable! Realize you can change your mind. Let’s begin to recognize the symptoms of depression early and do not hesitate to take appropriate action that can make living worthwhile¾ Mind Over Matter!