Depression Frequently Untreated in Seniors:
Researchers say subthreshold
depression in seniors frequently escapes diagnosis and therefore
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.
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.
of Speed of Blood Flow in Brain Linked to Depression:
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.
Changes Can Predict Effectiveness of Antidepressant Drugs:
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.
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.
Patients Have Persistent Serotonin System Abnormality:
say that even when they are well, the serotonin systems of depressed
patients still do not work as efficiently.
May Blunt Emotional Responses Like Crying:
say people who are depressed are no more likely to cry than people
who are not depressed.
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.
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.
Depressed Older Women Outlive Those Who Are Not Depressed:
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.
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
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.
Seeks Better Communications Between Depressed Blacks and Doctors:
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
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. .
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
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.
In any given
1-year period, 9.5 percent of the population, or about 18.8 million
American adults, suffer from a depressive illness.
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.
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.
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.
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:
sad, anxious, or "empty" mood
of hopelessness, pessimism
of guilt, worthlessness, helplessness
- Loss of interest
or pleasure in hobbies and activities that were once enjoyed,
energy, fatigue, being "slowed down"
concentrating, remembering, making decisions
early-morning awakening, or oversleeping
and/or weight loss or overeating and weight gain
of death or suicide; suicide attempts
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.
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.
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.
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.
therapy (ECT) is useful, particularly for individuals whose depression
is severe or life threatening or who cannot take antidepressant
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.
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
provided by: The National Institute of Mental Health, National Institutes
of Health, Bethesda, MD 20892