What Is Depression?

Clinical depression should be distinguished from the low mood that all persons occasionally experience, particularly in response to loss, struggle, or emotional injury.  One may be depressed when a sense of helplessness, hopelessness, or worthlessness perseveres for more than two weeks.

A person who is clinically depressed experiences most of the following:

• Low mood, especially in mornings;
• Fatigue and low energy most days;
• Feelings of worthlessness or guilt most days;
• Reduced ability to concentrate and make decisions;
• Sleeping too little or too much;
• Loss of interest in normal activities most days;
• Persistent thoughts of death or suicide;
• Reduced ability to sit still or to start moving;
• Significant weight gain or loss (more than five percent of body weight).

Older persons frequently suffer depression.  They may be experiencing chronic illness, surgeries and attendant anesthesis, bereavement, loneliness or isolation, loss of purpose, financial stresses, long-term pain, cognitive decline, or fear.  Elder depression is often linked to physical illnesses.  Many medical conditions contribute to depression, as well as many prescription medications.  Alcohol may worsen depression.  Older persons may well be depressed without reporting that they feel sad or even feeling especially sad.

Losing one’s sense of joy in the world or one’s acute focus on life are not normal parts of aging.  Either may be caused by depression or dementia.  If suffering either depression or dementia, the elder needs to seek medical attention to relieve symptoms or slow the progression of symptoms.

If an elder is depressed, after seeing a doctor, try all of the following:  regular physical activity, and talking and doing things you enjoy with other people you enjoy.  Get a pet.  Learn a new skill.  Do things that challenge you mentally.  Laugh.  Eat well.

If depression still persists, consider informal talking groups with supportive friends or your co-religionists.  Professional therapy is a wonderful opportunity to express what is bothering you by talking about your world in a place where such self-focused talk is expected and the person listening is trained to support and understand you.  Also, consider peer counseling with friends or talented individuals in your life.  You will find that your experience of depression is shared by many.

Depression may be one part of a cycle of mood changes.  When conjoined with mania or hypomania (which are degrees of mood elation), a form of bipolar disorder may be diagnosed and treated.  If a person suffers only depression with no mania, that is called unipolar depression; it too is treatable.

A depressed person is at risk for suicide.  Any suicidal thoughts or intentions should be taken seriously, and that person should seek immediate psychiatric intervention.  Loved ones who learn of a depressed relative's suicidal thoughts should take that depressed relative to an emergency room for treatment.  Previous suicide attempts increase the risk of successful suicide, and so should increase the seriousness with which loved ones take the depressed person’s suicidal talk.

Depression is a treatable disease.  In our experience at Lancaster Law Office, about half of our clients, who are in the throes of some legal difficulty, experience some symptoms of depression.  The percentage is higher with our elder clients.  We encourage all people suffering depression to seek psychoactive medications prescribed by their doctor or a psychiatrist, and to seek talking therapy with a social worker or psychologist.  Both help.

Family members of elders should learn to identify depression.  At some point, your elder loved one is likely to experience depression.  You can help with prompt recognition and clear-headed intervention.