If you're over 65 and feeling depressed ... treatment brings new hope.DEPRESSION IS A WHOLE BODY DISORDER Depression. The darkest moods. Feeling down, empty. Difficulty remembering. Many things just don't interest you you any more. Aches and pains that keep coming back. Depression that goes on and on and on for weeks and months is called clinical depression. Most people think of depression only as sadness and low mood, but clinical depression is far more than the ordinary "down" moods everyone experiences now and then, and which pass after a visit with a friend or a good movie. Depression is also more than a feeling of grief after losing someone you love. Following such a loss, for many people, a depressed mood is a normal reaction to grief. And these people may find it helpful to join a mutual support group, such as widowed-persons, to talk with others experiencing similar feelings. However, when a depressed mood continues for some time, whether following a particular event or for no apparent reason, the person May be suffering from clinical depression - an illness that can be treated effectively. Clinical depression is a whole body disorder. It can affect the way you think and the way you feel, both physically and emotionally. It isn't "normal" to feel depressed all the time when you get older, in fact, most older people feel satisfied with their lives. Nonetheless, among people 65 and over, as many as 3 out of 100 suffer from clinical depression. It can be serious and can even lead to suicide. But there is good news. Nearly 80 percent of people with clinical depression can be treated successfully with medications, psychotherapy psychotherapy, treatment of mental and emotional disorders using psychological methods. Psychotherapy, thus, does not include physiological interventions, such as drug therapy or electroconvulsive therapy, although it may be used in combination with such methods. , or a combination of both. Even the most serious depressions usually respond rapidly to the right treatment. But first, depression has to be recognized. TYPES OF CLINICAL DEPRESSION Two serious types of clinical depression are major depression and bipolar disorder bipolar disorder, formerly manic-depressive disorder or manic-depression, severe mental disorder involving manic episodes that are usually accompanied by episodes of depression. . Major Depression: Major depression makes it almost impossible to carry on usual activities, sleep, eat, or enjoy life. Pleasure seems a thing of the past. This type of depression can occur once in a lifetime or, for many people, it can recur several times. People with a major depression need professional treatment. Bipolar Disorder (Manic-Drpressive Illness). Another type of depression, bipolar disorder - or manic-depressive illness manic-depressive illness n. See bipolar disorder. manic-depressive illness Bipolar I disorder, see there - leads to severe mood swings, from extreme "lows" to excessive "highs." These states of extreme elation elation /ela·tion/ (e-la´shun) emotional excitement marked by acceleration of mental and bodily activity, with extreme joy and an overly optimistic attitude. and unbounded energy are called mania. This disorder usually starts when people are in their early twenties. Though unusual for this type of depression to start for the first time in later life, it requires medical treatment, whatever the person's age. A DEPRESSION CHECKLIST Check any symptoms experienced for more than two weeks. If four or more of the symptoms for depression or mania have been checked, physical and psychological evaluation by a physician and/or mental health specialist should be sought. Symptoms of Depression: * A persistent sad, anxious or "empty" mood * Loss of interest or pleasure in ordinary activities, including sex * Decreased energy, fatigue, feeling "slowed down" * Sleep problems (insomnia insomnia, abnormal wakefulness or inability to sleep. The condition may result from illness or physical discomfort, or it may be caused by stimulants such as coffee or drugs. However, frequently some psychological factor, such as worry or tension, is the cause. , oversleeping, early-morning waking) * Eating problems (loss of appetite loss of appetite Medtalk Anorexia, see there or weight, weight gain) * Difficulty concentrating, remembering or making decisions * Feelings of hopelessness or pessimism * Feelings of guilt, worthlessness or helplessness * Thoughts of death or suicide; a suicide attempt suicide attempt, suicide bid n → intento de suicidio suicide attempt, suicide bid n → tentative f de suicide * Irritability irritability /ir·ri·ta·bil·i·ty/ (ir?i-tah-bil´i-te) the quality of being irritable. myotatic irritability the ability of a muscle to contract in response to stretching. * Excessive crying * Recurring aches and pains that don't respond to treatment If someone has recently experienced a loss, these feelings may be part of a normal grief reaction. But, if the feelings persist with no lifting mood, the person may need professional treatment. Symptoms of Mania: These symptoms may range from moderate to severe. When mania is moderate, only people close to the affected person may be able to spot the symptoms. * Excessively "high" mood * Irritability * Decreased need for sleep * Increased energy * Increased talking, moving, and sexual activity * Racing thoughts * Disturbed ability to make decisions * Grandiose grandiose /gran·di·ose/ (gran´de-os?) in psychiatry, pertaining to exaggerated belief or claims of one's importance or identity, often manifested by delusions of great wealth, power, or fame. notions * Being easily distracted DEPRESSION AND OTHER ILLNESSES Sometimes clinical depression can look like other illnesses with symptoms such as headaches, backaches, joint pain, stomach problems, or other physical discomforts. Older people, when depressed, often speak of these problems rather than of feeling anxious, tired, or sad. Some signs of depression, such as memory lapses and difficulty concentrating, can mimic Alzheimer's disease Alzheimer's disease (ăls`hī'mərz, ôls–), degenerative disease of nerve cells in the cerebral cortex that leads to atrophy of the brain and senile dementia. or other medical disorders. Similar symptoms may also result from other physical problems or from medications commonly used by older people. Therefore, for a Proper diagnosis, it is important to have a thorough medical examination to rule out other disorders. If the symptoms are caused by depression, they will improve with the right treatment. Sometimes a person can have depression and another illness such as Alzheimers disease at the same time. Even in such a case, treating the depression can relieve unnecessary suffering. CAUSES OF DEPRESSION There are many causes of depression. Some people become depressed for a combination of reasons. For others, a single cause appears to trigger depression. Some become depressed for no apparent reason. Regardless of the cause, depression needs to be diagnosed and treated. Some of the causes that are particularly important among older people are: Other Illnesses Long-term or sudden illnesses can bring on or aggravate depression. Strokes, certain types of cancer, diabetes, Parkinson's disease Parkinson's disease or Parkinsonism, degenerative brain disorder first described by the English surgeon James Parkinson in 1817. When there is no known cause, the disease usually appears after age 40 and is referred to as Parkinson's disease. , and hormonal disorders are examples of illnesses that may be related to depressive disorders Depressive Disorders Definition Depression or depressive disorders (unipolar depression) are mental illnesses characterized by a profound and persistent feeling of sadness or despair and/or a loss of interest in things that once were pleasurable. . Medications Some medicines cause depressive de·pres·sive adj. 1. Tending to depress or lower. 2. Depressing; gloomy. 3. Of or relating to psychological depression. n. A person suffering from psychological depression. symptoms as side effects Side effects Effects of a proposed project on other parts of the firm. . Certain drugs used to treat high blood pressure and arthritis fall in this category. In addition, different drugs can interact in unforeseen ways when taken together. It is important that each doctor know all the different types and dosages of medicine being taken and discuss them with the patient. Genetics and Family History Depression runs in families. Children of depressed parents have a higher risk of being depressed themselves. Some people probably have a biological make-up that makes them particularly vulnerable. Personality Certain personalities-people with low self-esteem or who are very dependent on others-seem to be vulnerable to depression. Life Events The death of a loved one, divorce, moving to a new place, money problems, or any sort of loss have all been linked to depression. People without relatives or friends to help may have even more difficulty coping with The Coping With series of books is a series of books aimed at 11-16 year olds, written by Peter Corey and published by Scholastic Hippo. The first book, Coping with Parents, was released in 1989, and the series continued until the last book, Coping with Cash their losses. Sadness and grief are normal responses to loss, but if many symptoms of depression linger, professional help should be sought. HELP FOR DEPRESSION One of the biggest obstacles to getting help for clinical depression can be a person's attitude. Many people think that depression will go away by itself, or that they're too old to get help, or that getting help is a sign of weakness or moral failing. Such views are simply wrong. Depression is a treatable disorder. Even the most seriously depressed person can be treated successfully, often in a matter of weeks, and return to a happier and more fulfilling life. Such outcomes are a common story, even when people feel hopeless and helpless. There are three major types of treatment for clinical depression: psychotherapy, medication, and, in some cases, other biological treatments. At times, different treatments may be used in combination. Individuals respond differently to treatments. If after several weeks symptoms have not improved, the treatment plan should be reevaluated. Also, the procedures and possible side effects of all treatments should be fully discussed with the doctor. People may find that mutual support groups are helpful when combined with other treatments. Medication There are many very effective medications, but the three types of drugs most often used to treat depression are tricyclic antidepressants Antidepressants, Tricyclic Definition Tricyclic antidepressants are medicines that relieve mental depression. Purpose Since their discovery in the 1950s, tricyclic antidepressants have been used to treat mental depression. , monoamine oxidase inhibitors Monoamine Oxidase Inhibitors Definition Monoamine oxidase inhibitors (MAO inhibitors) are medicines that relieve certain types of mental depression. (MAOIs), and lithium. Lithium is very effective in the treatment of bipolar disorder
Bipolar disorder has not currently been cured but it can be managed. and is also sometimes used to treat major depression. * All medications alter the action of brain chemicals to improve mood, sleep, appetite, energy levels, and concentration. * Different people may need different medications, and sometimes more than one medication is needed to treat clinical depression. * Improvement usually occurs within weeks. Psychotherapy Talking with a trained therapist can also be effective in treating certain depressions, particularly those that are less severe. Short-term therapies (usually 12-20 sessions) developed to treat depression focus on the specific symptoms of depression. * Cognitive therapy cognitive therapy n. Any of a variety of techniques in psychotherapy that utilize guided self-discovery, imaging, self-instruction, and related forms of elicited cognitions as the principal mode of treatment. aims to help the patient recognize and change negative thinking patterns that contribute to depression. * Interpersonal therapy focuses on dealing more effectively with other people; improved relationships can reduce depressive symptoms. Biological treatments Some depressions may respond best to electro-convulsive therapy electro-convulsive therapy n → electroterapia electro-convulsive therapy n → électrochocs mpl electro-convulsive therapy n . ECT ECT electroconvulsive therapy. ECT abbr. electroconvulsive therapy ECT Electroconvulsive therapy sometimes is used to treat depression or mania when pharmaceutical treatment fails. is an effective treatment that is used in extremely severe cases of major depression when very rapid improvement is necessary, or when medications cannot be used or have not worked. Improved procedures make this treatment much safer than in previous years. During treatment, anesthesia and a muscle relaxant muscle relaxant an agent that specifically aids in reducing muscle tone. Most such agents inhibit the transmission of nerve impulses at the somatic neuromuscular junctions. They include tubocurarine, gallamine, pancuronium, succinylcholine and decamethonium bromide. protect patients from physical harm and pain. Research is also being done on the use of light for the treatment of depression. WHERE TO GET HELP Trained professionals in numerous settings diagnose and treat clinical depression: Family physicians, clinics, and health maintenance organizations can provide treatment or make referrals to mental health specialists. Mental health specialists include psychiatrists, psychologists, family therapists, and social workers. Psychiatrists can prescribe antidepressant drugs Antidepressant Drugs Definition Antidepressant drugs are medicines that relieve symptoms of depressive disorders. Purpose Depressive disorders may either be unipolar (depression alone) or bipolar (depression alternating with periods of because they are physicians. Other mental health specialists, however, often work with physicians to ensure that their patients receive the medications they need. Community mental health centers, which often provide treatment based on the patient's ability to pay, usually have a variety of mental health specialists. Hospitals and university medical schools may have research centers that study and treat depression. ADVOCACY ORGANIZATIONS National advocacy or consumer organizations provide information about depression, sources of treatment, and local community support groups: American Association of Retired Persons American Association of Retired Persons: see AARP. (AARP AARP, a nonprofit, nonpartisan national organization dedicated to "enriching the experience of aging"; membership is open to people age 50 or older. Founded in 1958 by Ethel Percy Andrus as American Association of Retired Persons, AARP now has over 30 million ) Widowed Persons Services Social Outreach and Support 1909 K Street, N.W. Washington, D.C. 20049 (202) 728-4370 National Alliance for the Mentally Ill 2101 Wilson Boulevard Suite 302 Arlington, VA 22201 (703) 524-7600 National Depressive and Manic man·ic adj. Relating to, affected by, or resembling mania. Depressive Association 53 W. Jackson Boulevard Suite 505 Chicago, IL 60604 (312) 939-2442 National Mental Health Association 1021 Prince Street Alexandria VA 22314-2971 (703) 684-7722 INFORMATION ON DEPRESSION For more information on depression, diagnosis, and treatments, write to the DEPRESSION Awareness, Recognition, and Treatment (D/ART) Program: D/ART Public Inquiries National Institute of Mental Health The National Institute of Mental Health (NIMH) is part of the federal government of the United States and the largest research organization in the world specializing in mental illness. 5600 Fishers Lane Room 15C-05 Rockville, MD 20857 Ann's daughter thought her 73-year-old widowed mother was getting senile senile /se·nile/ (se´nil) pertaining to old age; manifesting senility. se·nile adj. 1. Relating to, characteristic of, or resulting from old age. 2. because she was so confused and forgetful. Ann had seemed to recover well from the death of her husband three years before, but lately she cried about him almost every day. Her daughter arranged for Ann to see a geriatric specialist who diagnosed Ann's condition as depression, not senility senility (sənil`ətē), deterioration of body and mind associated with old age. Indications of old age vary in the time of their appearance. . He put her on medication and suggested that she join a widow-to-widow support group. Before long, Ann's memory improved along with her mood. For years, Tom had been looking forward to his retirement-with more time to fish. But after the first few months, not only had he stopped going fishing with his friends, he often did not go out of the house for days. Tom also complained to his wife about not sleeping well and about different aches and pains each day. Fortunately, his wife took him to a doctor who recognized Tom was depressed. After a few weeks of treatment, Tom began to enjoy his retirement as much as he had expected. |
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