Lifting late-life depression

August 20, 2010 By Michael Balkunas, M.D.

An estimated 7 million Americans over age 65 suffer from mild to severe depression, a medical illness that requires professional treatment. Depression isn't a sign of weakness and isn't an inevitable part of aging. In older adults, depression may be triggered by:

• illnesses such as heart disease, cancer and hypothyroidism

• drugs such as muscle relaxants, beta-blockers to control blood pressure and medications for ulcers and Parkinson's disease

• emotional stress, including grief

• functional difficulties such as vision loss or a decline in mobility

• sudden lack of independence

An occasional bout of the blues is normal. But persistent sadness or a loss of interest in people or activities once enjoyed can signal a more serious case of depression—a medical illness that's not normal. Fortunately, the symptoms of depression can be relieved with the right treatment. The first step toward healing is recognizing those symptoms, either in yourself or in someone you love.

The warning signs
Depression needs to be treated since it tends to get more serious over time and can lead to severe mental and physical problems, even suicide. In fact, one in five suicides in this country involves an adult over age 65, with most of those deaths attributable to untreated depression.

So how do you know whether you or someone you care for is suffering from late-life depression? See your doctor if you or a loved one has been suffering from any of these symptoms for longer than two weeks or if the symptoms are severe enough to interfere with daily routine:

• withdrawal from activities or social isolation

• lack of interest in physical appearance or health

• persistent sadness

• persistent fatigue or lethargy

• frequent tearfulness

• prolonged or excessive worries

• sleep irregularities, such as difficulty sleeping or sleeping too much

• concentration and memory difficulties

• weight changes

• unexplained physical pain

• feelings of hopelessness or worthlessness

• difficulty making decisions

• severe depression that lasts longer than two months after the loss of a loved one

A treatable condition

Whether late-life depression is caused by an outside source or appears suddenly for no apparent reason, the condition is highly treatable. After performing a complete medical checkup, a doctor may prescribe antidepressants, counseling or both. Regular exercise may also help relieve some symptoms of mild depression.

Most people who receive treatment eventually recover, sometimes within weeks. Sometimes the process can take longer while the doctor tries several different treatments to find one that works best for the patient.

The bottom line? Never accept persistent depression as a normal part of life.

Michael Balkunas, M.D., is chief of Psychiatry and Behavioral Health at The Hospital of Central Connecticut.