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Senior Health Week: Depression
Health News You Can Use •

Latest Depression News:

Mild Depression Frequently Untreated in Seniors: Researchers say subthreshold depression in seniors frequently escapes diagnosis and therefore goes untreated.


Recent Depression News:

Primary Care Doctors Often Do Not Recognize Depression: Researchers say depression and anxiety are common in patients, but can be hard for doctors to recognize because of the patient's other medical issues.

Adults Suffering From Depression at High Risk of Heart Disease: Researchers say depressed adults are between one-and-a-half and four times as likely to develop heart disease as non-depressed adults.

Slowing of Speed of Blood Flow in Brain Linked to Depression: Researchers say a slowing of the speed of blood flow in the main arteries of the brain, caused by something other than arterial disease, appears linked to depression in older adults.

Brain Changes Can Predict Effectiveness of Antidepressant Drugs: Measurable changes in the front of the brain can predict the effectiveness of antidepressant medications within days of treatment, even before a patient starts to feel better, according to researchers at UCLA.

Most Elderly Who Commit Suicide Suffer From Depression: Researchers say many elderly people consult their physician shortly before taking their life, but fail to communicate their despair.

Depressed Patients Have Persistent Serotonin System Abnormality: Researchers say that even when they are well, the serotonin systems of depressed patients still do not work as efficiently.

Depression May Blunt Emotional Responses Like Crying: Researchers say people who are depressed are no more likely to cry than people who are not depressed.

Attitudes About Aging Keep Many From Seeking Treatment for Depression: Researchers say the belief that depression is a normal part of aging may contribute to inadequate treatment for a condition that affects people of all ages.

Sugar Pills Improve Mood of Depressed Patients: Researchers speculate that part of the benefit of a placebo may actually be from the care and concern shown to the patient during the course of the clinical trial, resulting in the patient having a greater sense of well-being.

Mildly Depressed Older Women Outlive Those Who Are Not Depressed: Researchers speculate that mild depression in older women could reflect a healthy coping mechanism linked with longevity and not a risk factor for early death, which has been seen in people with more severe depression.

Overcoming Depression Means Taking Pleasure Again in Activities: Researchers say a depressed person's ability to participate in and enjoy family, personal and community activities is critical to success in fully overcoming depression.

General Practitioners Need More Training to Help Depressed Patients: Researchers say family doctors require more than a few days of basic training on brief cognitive behavior theory if they are to better help their patients suffering from depression.

Project Seeks Better Communications Between Depressed Blacks and Doctors: A study that aims to improve the communication skills of primary care physicians in relating to African American patients suffering from depression is underway at the Johns Hopkins University School of Medicine.

Researchers Report St. John's Wort Ineffective for Moderate Depression: Based on a standard scale of depressive symptoms, patients taking St. John's wort showed no greater improvement in symptoms than those taking the placebo. .

Psychiatrist Terms Excessive Use of Pills to Treat Depression Dangerous: Treating depression, anxiety and other mental disorders through medication alone is irresponsible and dangerous, according to Dr. Charles Gant, a member of the American Academy of Psychiatrists in Addiction and Alcoholism.

Treatment of Depression in MS Patients May Impact MS Disease Progress: The treatment of depression in patients with multiple sclerosis may also modify the MS disease process, according to researchers at the University of California, San Francisco.


Depression Primer:

In any given 1-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from a depressive illness.

A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

Depressive disorders come in different forms.

  • Major depression is manifested by a combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
  • Dysthymia, a less severe type of depression, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
  • Bipolar disorder, another type of depression, is also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. Mania, left untreated, may worsen to a psychotic state.

Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time. Symptons include:

  • Persistent sad, anxious, or "empty" mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Decreased energy, fatigue, being "slowed down"
  • Difficulty concentrating, remembering, making decisions
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar disorder. In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function. People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder. Later episodes of illness typically are precipitated by only mild stresses, or none at all.

Women experience depression about twice as often as men.Many hormonal factors may contribute to the increased rate of depression in women-particularly such factors as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause. Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents.

Although men are less likely to suffer from depression than women, three to four million men in the United States are affected by the illness. Men are less likely to admit to depression, and doctors are less likely to suspect it. The rate of suicide in men is four times that of women, though more women attempt it. In fact, after age 70, the rate of men's suicide rises, reaching a peak after age 85. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men.

Some people have the mistaken idea that it is normal for the elderly to feel depressed. On the contrary, most older people feel satisfied with their lives. Sometimes, though, when depression develops, it may be dismissed as a normal part of aging. Depression in the elderly, undiagnosed and untreated, causes needless suffering for the family and for the individual who could otherwise live a fruitful life. When he or she does go to the doctor, the symptoms described are usually physical, for the older person is often reluctant to discuss feelings of hopelessness, sadness, loss of interest in normally pleasurable activities, or extremely prolonged grief after a loss.

There are a variety of antidepressant medications and psychotherapies that can be used to treat depressive disorders. Some people with milder forms may do well with psychotherapy alone. People with moderate to severe depression most often benefit from antidepressants. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life's problems, including depression.

Electroconvulsive therapy (ECT) is useful, particularly for individuals whose depression is severe or life threatening or who cannot take antidepressant medication.

There are several types of antidepressant medications used to treat depressive disorders. These include newer medications-chiefly the selective serotonin reuptake inhibitors (SSRIs)-the tricyclics, and the monoamine oxidase inhibitors (MAOIs). The SSRIs-and other newer medications that affect neurotransmitters such as dopamine or norepinephrine-generally have fewer side effects than tricyclics. Sometimes the doctor will try a variety of antidepressants before finding the most effective medication or combination of medications. Sometimes the dosage must be increased to be effective. Although some improvements may be seen in the first few weeks, antidepressant medications must be taken regularly for 3 to 4 weeks (in some cases, as many as 8 weeks) before the full therapeutic effect occurs.

Many forms of psychotherapy, including some short-term (10-20 week) therapies, can help depressed individuals. "Talking" therapies help patients gain insight into and resolve their problems through verbal exchange with the therapist, sometimes combined with "homework" assignments between sessions. "Behavioral" therapists help patients learn how to obtain more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to or result from their depression. Two of the short-term psychotherapies that research has shown helpful for some forms of depression are interpersonal and cognitive/behavioral therapies. Interpersonal therapists focus on the patient's disturbed personal relationships that both cause and exacerbate (or increase) the depression. Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving often associated with depression. Psychodynamic therapies, which are sometimes used to treat depressed persons, focus on resolving the patient's conflicted feelings.

Depressive disorders make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect.

Background information provided by: The National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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