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Is it Just the “Getting Older Blues?”
Or Something More?
By Shannon Leonard-Boone
An older loved one complains of persistent body
aches and pains, that they have trouble
remembering things, lack energy, and may say either
they sleep too much or can’t get to sleep at all.
The problem may not be the aches, pains and
fatigue one might assume comes with the territory
while growing older — it may be depression, a
medical illness that occurs when the brain’s chemistry
is out of balance. It’s more than a brief period of
feeling sad, which we all experience from time to time,
and it can drastically and negatively impact one’s ability to function and enjoy life.
“Depression can be difficult to discern sometimes in older adults,” says Dr. Steve Burton,
lead psychiatrist at Louisville Veteran’s Administration Medical Center. “A lot of times it
gets missed.”
A December 2006 poll by Mental Health America revealed 59 percent of those polled felt
depression was a normal part of aging — not so.
CAUSES AND SYMPTOMS
Depression in the older segment of the population may have slightly different root
causes and symptoms than other age groups, Dr. Burton added. For instance, older
people are more likely to feel irritable and withdraw from social situations instead of
feeling sad or “blue,” and that change in personality may be more apparent to family and
friends than the person themself may realize, he said. Other symptoms often associated
with depression include loss of appetite and feelings of helplessness and hopelessness,
worthlessness and guilt.
According to the American Psychiatric Association (APA), depression can also be genetic
and runs in families. People with low self-esteem, those who are easily overwhelmed by
stress, or are pessimistic in nature can be particularly vulnerable. Other environmental
and social factors like exposure to violence, neglect, abuse, or poverty can also lead to
depression, Association information shows.
A 2004 study by University of Rochester Medical Center researchers revealed
transportation can be an issue for many older Americans, hindering them from seeking
medical care. The same study showed that poor health, money worries, and family
conflict exacerbated the severity of depression.
And the National Institute of Mental Health (NIMH) said that declining health also plays a
strong role in depression among older Americans — 13.5 percent among those who
require home health care and 11 percent of those who are hospitalized. The American
Psychological Association says 20 percent of older adults living independently and as
many as half of nursing home residents have depression.
TREATMENT
Dr. Burton said usually a visit to the family doctor is the first step in treating depression,
and thorough physical and psychological assessments should be performed, including a
review of the patient’s medical history, personal history (past depressive episodes for
instance), family and social history, along with any drug and alcohol use and a review of
medications being taken and their current medical condition.
Some diseases like Parkinson’s, stroke, lupus, rheumatoid arthritis, and some cancers
can cause an onset of depression, as can the side effects of some medications and
upsetting life events like being widowed, separated, or divorced, Dr. Burton said.
A family doctor will also want to know if the depression is severe enough that the patient
has had suicidal thoughts. Although adults 65 and older make up 12 percent of the
general population, they account for 16 percent of all suicides, according to the NIMH.
Treatment options for mild to moderate depression usually include psychotherapy, a type
of specialized counseling performed by a trained and licensed psychiatrist, psychologist
or clinical social worker, Burton said, as well as prescription antidepressants.
“The bottom line is that treatment works,” Burton said.
APA data shows antidepressants are not habit forming and usually take from a few
weeks to a few months to fully take effect, with medication typically taken for six or more
months after symptoms have begun to improve. NIMH cites a study that shows 80
percent of older adults with depression recovered with a combination treatment of
psychotherapy and antidepressant medication rather than one or the other alone.
There are other things people can do on their own to help stave off depression, including
regularly exercising and maintaining social contacts to avoid feelings of isolation and
boredom, Dr. Burton said. Pursuing enjoyable hobbies, joining clubs and social
organizations and keeping in touch with friends can really minimize depression, he said.
“Anything you can do to stay active I’d say is particularly important,” Dr. Burton said.
Also having a well-balanced diet and keeping regular checkups with a physician is key,
Dr. Burton said, as is keeping an open, honest relationship with your medical
practitioners.
Becky Goin is a clinical social worker who also has a master’s of science degree in social
work and works in geriatric psychiatry at Our Lady of Peace Hospital in Louisville. Goin
said depression can be successfully treated just like many other ailments like diabetes or
high blood pressure.
Even so, Goin said older people are often hesitant to reveal their feelings of depression,
because of the tremendous social stigma that is still associated with mental illness, and
because they think it’s a normal part of growing older. In past generations, children were
raised to be seen and not heard and men were often taught not to share their emotions.
“All those things just kind of fester over the years and really impair their ability to share
their feelings later in life,” Goin said.
Older people sometimes begin feeling depressed when they have to leave their home
due to illness or other circumstances, or have begun losing close friends, siblings and
others to old age, Goin said.
Keeping a sense of one’s self and self-worth and sharing life experience with younger
generations helps older people feel useful and vital and shows them they still have
something to offer society, Goin said.
“Helping people redefine what it is they have of value is what we do a lot,” she said.
For more information about depression in older Americans and how to help, visit the
National Alliance on Mental Illness at www.nami.org, the Geriatric Mental Health
Foundation at www.gmhf.org and the American Psychiatric Association at www.psych.org.
Or Something More?
By Shannon Leonard-Boone
An older loved one complains of persistent body
aches and pains, that they have trouble
remembering things, lack energy, and may say either
they sleep too much or can’t get to sleep at all.
The problem may not be the aches, pains and
fatigue one might assume comes with the territory
while growing older — it may be depression, a
medical illness that occurs when the brain’s chemistry
is out of balance. It’s more than a brief period of
feeling sad, which we all experience from time to time,
and it can drastically and negatively impact one’s ability to function and enjoy life.
“Depression can be difficult to discern sometimes in older adults,” says Dr. Steve Burton,
lead psychiatrist at Louisville Veteran’s Administration Medical Center. “A lot of times it
gets missed.”
A December 2006 poll by Mental Health America revealed 59 percent of those polled felt
depression was a normal part of aging — not so.
CAUSES AND SYMPTOMS
Depression in the older segment of the population may have slightly different root
causes and symptoms than other age groups, Dr. Burton added. For instance, older
people are more likely to feel irritable and withdraw from social situations instead of
feeling sad or “blue,” and that change in personality may be more apparent to family and
friends than the person themself may realize, he said. Other symptoms often associated
with depression include loss of appetite and feelings of helplessness and hopelessness,
worthlessness and guilt.
According to the American Psychiatric Association (APA), depression can also be genetic
and runs in families. People with low self-esteem, those who are easily overwhelmed by
stress, or are pessimistic in nature can be particularly vulnerable. Other environmental
and social factors like exposure to violence, neglect, abuse, or poverty can also lead to
depression, Association information shows.
A 2004 study by University of Rochester Medical Center researchers revealed
transportation can be an issue for many older Americans, hindering them from seeking
medical care. The same study showed that poor health, money worries, and family
conflict exacerbated the severity of depression.
And the National Institute of Mental Health (NIMH) said that declining health also plays a
strong role in depression among older Americans — 13.5 percent among those who
require home health care and 11 percent of those who are hospitalized. The American
Psychological Association says 20 percent of older adults living independently and as
many as half of nursing home residents have depression.
TREATMENT
Dr. Burton said usually a visit to the family doctor is the first step in treating depression,
and thorough physical and psychological assessments should be performed, including a
review of the patient’s medical history, personal history (past depressive episodes for
instance), family and social history, along with any drug and alcohol use and a review of
medications being taken and their current medical condition.
Some diseases like Parkinson’s, stroke, lupus, rheumatoid arthritis, and some cancers
can cause an onset of depression, as can the side effects of some medications and
upsetting life events like being widowed, separated, or divorced, Dr. Burton said.
A family doctor will also want to know if the depression is severe enough that the patient
has had suicidal thoughts. Although adults 65 and older make up 12 percent of the
general population, they account for 16 percent of all suicides, according to the NIMH.
Treatment options for mild to moderate depression usually include psychotherapy, a type
of specialized counseling performed by a trained and licensed psychiatrist, psychologist
or clinical social worker, Burton said, as well as prescription antidepressants.
“The bottom line is that treatment works,” Burton said.
APA data shows antidepressants are not habit forming and usually take from a few
weeks to a few months to fully take effect, with medication typically taken for six or more
months after symptoms have begun to improve. NIMH cites a study that shows 80
percent of older adults with depression recovered with a combination treatment of
psychotherapy and antidepressant medication rather than one or the other alone.
There are other things people can do on their own to help stave off depression, including
regularly exercising and maintaining social contacts to avoid feelings of isolation and
boredom, Dr. Burton said. Pursuing enjoyable hobbies, joining clubs and social
organizations and keeping in touch with friends can really minimize depression, he said.
“Anything you can do to stay active I’d say is particularly important,” Dr. Burton said.
Also having a well-balanced diet and keeping regular checkups with a physician is key,
Dr. Burton said, as is keeping an open, honest relationship with your medical
practitioners.
Becky Goin is a clinical social worker who also has a master’s of science degree in social
work and works in geriatric psychiatry at Our Lady of Peace Hospital in Louisville. Goin
said depression can be successfully treated just like many other ailments like diabetes or
high blood pressure.
Even so, Goin said older people are often hesitant to reveal their feelings of depression,
because of the tremendous social stigma that is still associated with mental illness, and
because they think it’s a normal part of growing older. In past generations, children were
raised to be seen and not heard and men were often taught not to share their emotions.
“All those things just kind of fester over the years and really impair their ability to share
their feelings later in life,” Goin said.
Older people sometimes begin feeling depressed when they have to leave their home
due to illness or other circumstances, or have begun losing close friends, siblings and
others to old age, Goin said.
Keeping a sense of one’s self and self-worth and sharing life experience with younger
generations helps older people feel useful and vital and shows them they still have
something to offer society, Goin said.
“Helping people redefine what it is they have of value is what we do a lot,” she said.
For more information about depression in older Americans and how to help, visit the
National Alliance on Mental Illness at www.nami.org, the Geriatric Mental Health
Foundation at www.gmhf.org and the American Psychiatric Association at www.psych.org.