Depression

Most of us feel a little down lately from time to time, but when feelings of sadness interfere with your daily life and make it hard to function, you may be suffering from depression.

Symptoms

Depression symptoms may include:

• Often feeling sad, empty or lonely
• Feeling hopeless or expecting the worst
• Feeling guilty, worthless or helpless
• Being irritable or restless
• Loss of interest in things you used to like
• Feeling tired, fatigued or run down
• Inability to concentrate or make decisions
• Forgetting details
• Problems sleeping
• Eating too much or having no appetite
• Persistent aches, pains, headaches, cramps and stomach disorders that don’t go away with treatment
• Thoughts of suicide or suicide attempts

Causes

Causes may include:

• Genetics
• Biochemical imbalances
• Psychological factors
• Environmental factors, such as the loss of a loved one or major life changes

Depression can affect people of all ages. Here are some general facts about depression:

• It’s more common in women.
• Men who are depressed may be tired, irritable or angry. They may use alcohol or drugs to cope.
• Depression in seniors may be overlooked because their symptoms are less obvious.
• Children may pretend to be sick, refuse to go to school, cling to parents or worry about death.

Common Causes of Depression

Depression is more than a blue day or feeling in a slump. It’s a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms too. Sometimes it’s called major depression, major depressive disorder and clinical depression. It affects how one feels, thinks and behaves.

Depression isn’t a weakness, nor is it something someone can just “snap out” of. Depression is a chronic illness that usually requires long-term treatment. However, this shouldn’t discourage someone with depression, because after counseling or other treatments most people see an improvement.

The exact cause of depression isn’t known, but as with many mental illnesses, it appears to be a variety of factors including:

• Biological differences
• Faulty neurotransmitters
• Hormones
• Inherited traits
• Traumatic life events

Untreated depression can take a terrible toll on individuals and families, resulting in emotional, behavioral and health problems that affect all areas of life. Complications can include:

• Alcohol abuse
• Substance abuse
• Anxiety
• Work or school problems
• Family conflicts
• Relationship difficulties
• Social isolation
• Suicide
• Self-mutilation
• Premature death from other medical conditions

To be diagnosed with depression, an individual must meet five or more of the symptom criteria established by the Diagnostic and Statistical Manual of Mental Disorders. At least one of the symptoms must be either a depressed mood or loss of interest of pleasure.

These include:

• Depressed mood most of the day, nearly every day, such as feeling sad, empty or tearful (in children and adolescents, depressed mood can appear as constant irritability)
• Diminished interest or feeling no pleasure in all — or almost all — activities most of the day, nearly every day
• Significant weight loss when not dieting, weight gain, or decrease or increase in appetite nearly every day (in children, failure to gain weight as expected can be a sign of depression)
• Insomnia or increased desire to sleep nearly every day
• Noticeable restlessness or slowed behavior
• Fatigue or loss of energy nearly every day
• Feelings of worthlessness, or excessive or inappropriate guilt nearly every day
• Trouble making decisions, or trouble thinking or concentrating nearly every day
• Recurrent thoughts of death or suicide, or a suicide attempt

With treatment, depression can be controlled. Because it’s often undiagnosed, a doctor may ask questions to create an assessment that can rule out other problems, pinpoint a diagnosis and check for related complications.

This may include a physical exam, laboratory tests (blood test to check complete blood count to test thyroid functioning) and a psychological evaluation. In some instances, a doctor will prescribe medications to relieve depression symptoms.

Depression can seriously impair a person's ability to function in everyday situations, but it is possible to recover.

For a free physician referral, call (866) 236-5933.

Depression in seniors

The golden years are supposed to be a time to rest, relax and enjoy the fruits of a lifetime of labor. Following retirement, many seniors have the opportunity to spend quality time with family and friends, take up a new hobby, travel or even start a fun part-time job.

But aging also can bring apprehension about health and well-being, and stress caused by social and emotional changes. Seniors may be faced with the loss of loved ones, isolation after retirement or boredom. Dealing with these new events and significant changes can lead to anxiety, loneliness or depression.

Depression can be caused by a number of factors. Some people become depressed following a single illness. For others, the condition may be brought about by a serious illness, such as cancer, diabetes, Parkinson’s disease or stroke.

Certain medications for arthritis, high blood pressure or heart disease may cause mood changes and signs of depression. The condition also may be hereditary, or it can be the result of alcohol or drug abuse. People who have been depressed in the past run a higher risk of developing depression.

Depression is more than just feeling sad, “blue” or “down in the dumps.” It is a medical illness. Some steps can be taken to lower the risk of depression:

• Maintain friendships and family ties to help ease the loss of a spouse.
• Develop a hobby to keep the mind and body active.
• Exercise to gain mental and physical benefits.

Older people usually can regain emotional balance after being unhappy for a period of time. But if symptoms of depression last all day, every day, for more than two weeks, professional help may be necessary. The first step to getting help is to recognize the symptoms of depression.

Symptoms of depression include lack of interest in everyday activities, trouble sleeping, fatigue, change in eating habits, excessive crying, difficulty concentrating or making decisions, feeling of worthlessness or guilt, headaches or backaches or suicidal thoughts.

Depression can be treated with medication, counseling or a combination of both. Antidepressant drugs are often used to correct the chemical imbalance in the brain that causes depression. Some drugs may have side effects and could take up to two months to improve mood, sleep, appetite and concentration.

All medications should be taken in the proper dosage amount, on the right schedule and for the duration of time prescribed by the physician.

Counseling in the form of support groups may be recommended to help seniors develop new coping skills or provide social support. Psychotherapy offers the opportunity to talk with specially trained professionals who can help the elderly deal with depression, suicidal thoughts or other problems.

Persistent depression that interferes with day-to-day activities is not a normal part of the aging process and should not be suffered in silence. Getting better will take time, but with the support of professionals, family and friends, seniors can enjoy their later years and live life to the fullest.

If you know someone who may have depression, call the Institute for Mental Health at St. Mary’s Medical Center for more information or to schedule an appointment.

For a free physician referral, call (866) 236-5933.

Facts about antidepressants

Antidepressants are a form of medication that may be used in conjunction with psychological therapy to treat depression. There are several different classifications of antidepressants.

The most common are:

• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin and Norepinephrine Reuptake Inhibitors (SSNIs)
• Tricyclic antidepressants (TCAs)
• Monoamine Oxidase Inhibitors (MAOIs)

Each classification of antidepressant regulates neurotransmitters (naturally occurring brain chemicals) in a unique way.

Who needs them?

Antidepressants are prescribed to individuals showing signs of depression ranging from minor depression (less severe symptoms for a limited amount of time) to dysthymia (less severe symptoms but lasting for more than two years) to major depression (severe symptoms that interfere with day-to-day life).

Depression has many causes but the main factors include genetics, brain chemistry and exposure to increased amounts of stress.

Several different symptoms signal depression. Some of these symptoms include feeling “empty,” fatigue or constant exhaustion, insomnia, lack of interest in favorite activities, and constant aches and pains such as headaches and cramps.

How antidepressants should be taken

The Food and Drug Administration estimates that roughly 60 to 70 percent of patients respond to the first form of antidepressant prescribed. However, it may take up to three or four weeks before effects of the medication are realized.

Your doctor will tell you when and how to take any prescribed antidepressants. You should follow those instructions very carefully to get the most benefit from the medication.

Even if the symptoms of depression begin to disappear, you should not stop taking the medication as it could result in withdrawal symptoms such as anxiety, irritability or a reoccurrence of the original depression.

Risks and side effects

Antidepressants may cause one or more mild side effects. These side effects can include sleeplessness, agitation, dry mouth, bladder problems, sexual problems, agitation and nausea. Many of these pass very quickly but still represent an important reaction that should be reported to your doctor as soon as possible.

For a free physician referral, call (866) 236-5933.