Everyone feels sad from time to time. We all face challenges as we get older and that can get us down. But how do we know when a low mood might mean something more serious? Depression is a treatable medical condition that can happen to anyone but it can be missed in older people who may feel reluctant to bring it up with their doctor. Depression is more than feeling sad. Common symptoms of depression include:
Low energy
Depressed mood most of the day
Poor sleep or too much sleep
Low appetite or overeating with weight changes
Feeling slowed down or restless
Little interest or pleasure in activities
Hopelessness about the future
A sense of guilt
Feelings of worthlessness or low self esteem
Trouble concentrating and poor attention
Wishing to die or suicidal thoughts
As we all get older it is common to have stressful events. Sometimes stressors like financial problems, medical illness or the death of a close friend or family member can trigger depression. Other times there may be no clear reason why depression begins. People who have had depression in the past or have a family history of depression are at increased risk of developing depression. Women, people who lack strong social support and those with a lot of medical problems or chronic pain may be more likely to have depression. Individuals with cognitive impairment or dementia are also at increased risk for depression. People with dementia may have to rely on caregivers to notice the symptoms of depression and advocate for their treatment.
Seniors may be concerned about seeking treatment for depression. In the past depression was not as well recognized by the medical field as it is now and patients felt a greater stigma about asking for help. Seniors may recall that early antidepressant medications had burdensome side effects or be worried about drug interactions with other medications they need to take.
We now know that depression is a common condition and it has a big impact on a person’s overall health and well-being. Untreated depression reduces self-care and functioning, which may be impacting the people around you. If the depression has worsened to the point you are having suicidal thoughts, it is an emergency and you should seek immediate treatment. Older people, especially men, are at an increased risk for suicide. People who are not suicidal can often access treatment through an appointment with their primary care physician.
The good news is that there are many ways to get help and feel better. Therapy can help you in coping with loss and stress. Therapy involves meeting regularly with a professional who is trained in listening to your problems and assisting you in better understanding what is going on with your thoughts and feelings. Medications are also available for treatment of depression. Medications can often be taken once a day along with other medications for chronic health issues. Your doctor will choose a medication that is safe to take with your other medications. If you have any side effects, let your physician know so they can be addressed. Most modern antidepressant medications are well tolerated and effective.
Therapy and medication treatments can be combined with lifestyle modifications such as improving sleep hygiene, increasing exercise and paying extra attention to a nutritious diet which will help both physical and mental health. Some people include a spiritual practice, such as yoga, meditation or prayer as a holistic addition to their depression treatment plan. Bright light therapy can improve mood if you notice a seasonal effect on your depression. If you need extra care, your primary care doctor may make a referral to a psychiatrist, who is a specialty physician trained in helping people recover from depression and other psychiatric illnesses.
Symptoms of depression can feel overwhelming but treatment is available and effective. The most important thing you can do is be open in discussing concerning symptoms with your doctor so together you can figure out the plan that puts you on the road to recovery.
Genevieve A. Henry, M.D., is a member of the medical staff of the Bristol Hospital Multi-Specialty Group and she is the medical director of Bristol Hospital’s Senior Behavioral Health Unit. Dr. Henry is a board-certified geriatric psychiatrist and completed her fellowship training in geriatric psychiatry and adult psychiatry at Yale University. She received her medical degree from the Medical College of Wisconsin. For more information on Bristol Hospital’s Senior Behavioral Health Unit, please call 860-585-3484 or visit www.bristolhospital.org