Depression is a state of persistent and ongoing unhappiness, and is more than an 'attack of the blues' or being 'in the doldrums' for a short while. Early diagnosis and treatment increase chances of recovery; however, most depression goes undetected and untreated.
If you have ongoing feelings of sadness and hopelessness talk to your doctor. The sooner you get help, the sooner you will start to feel better.
- Causes of depression vary and may be due to a range of factors.
- Grief and depression can have similar symptoms, but grief usually lessens over time.
- Treatment options for depression include counselling and medication.
- Lifestyle measures are also beneficial, such as regular exercise (eg, gardening, walking), contact with friends and family, pursuing hobbies or voluntary work.
- Talk to your doctor if feelings of low mood persist.
What causes depression?
Grief, loss, change, loneliness, poverty, illness, reaction to medication and many other factors may contribute to depression. Often it is due to a combination of factors. Sometimes depression just seems to come 'out of the blue'.
What about grief?
The signs of depression and grief can be similar, although people who have experienced both, talk about the sadness of grief compared with the numbness or almost non-feeling state of major depression.
Grieving is a natural process. After a period it usually lessens or resolves. If you have persistent distressing signs, which continue for months after a bereavement or loss, you may need help from a doctor or counsellor.
Who is at risk?
Those more at risk of depression include people who have:
- had a previous episodes of depression
- a family history of depression or suicide attempts
- a problem use of alcohol or other substances
- had childhood trauma
- responsibilities for caring for others
- chronic or severe physical illness.
Signs of depression can include:
- feeling down, most of the day, nearly every day and for weeks on end
- change in sleeping patterns
- loss of appetite or significant weight loss or gain
- loss of interest and pleasure in life
- loss of motivation
- noticeable changes in behaviour such as irritability or withdrawing from others
- feelings of hopelessness or worthlessness
- pain, including headaches, abdominal pain and other body pain for which the doctor can find no cause
- poor concentration, forgetfulness, finding it hard to make decisions.
Doctors and mental health professionals recognise these signs as possible indicators of depression. They may be also be a sign of a physical illness. See your doctor for a check up if have experienced a number of these signs for 2 weeks or longer.
How is depression treated?
Depression can usually be effectively treated with a combination of psychological therapy, lifestyle changes and antidepressant medication. For some people, alternative approaches have been useful, such as mindfulness meditation, St John's wort and online tools and courses. Find out more about treatment for depression.
Why is depression often not recognised in older people?
Possible factors include:
- Many older people don't like to bother their GP about something other than a physical illness. They seldom mention depression and are more likely to talk about vague symptoms
- Although they know they need help, some people have difficulty putting troubled feelings into words.
- People born in the early part of the 20th century endured world wars and economic depression and learnt to 'keep their chin up' and carry on without complaining.
- Those with memories of people being placed in 'asylums' and being subjected to treatment without their consent may be frightened of talking to a doctor about their mental health.
- Some older people don't like the idea of taking more pills and do not easily accept that counselling can help when they are depressed.
- Many people, including some GPs, seem to think depression is an inevitable part of ageing.
Many older people have developed strategies for dealing with times when they feel down. These include gardening, walking on the beach, visiting grandchildren, reading a good book, phoning friends, treating yourself to a small luxury, having your hair done or even cleaning the oven!
These things sometimes drive the blues away successfully. But a word of warning – people can also mask or disguise depression by making themselves really busy and not getting the help they need.
It is said that friends and family are good medicine and having meaningful contacts with others is of real value. You may find that hobbies or voluntary work contribute to a sense of worth and belonging in a community which often seems to forget its older citizens.
Use your voice and your vote to influence people's attitudes and change social factors like poverty that may contribute to depression. You may find comfort and meaning in spirituality or religious beliefs. These are all things that protect you from depression or help you make a successful recovery from it.
If those 'blues' are persistent, talk to your GP. The earlier diagnosis is made and treatment begins, the better your chances of recovery and a return to your usual activities and enjoyment of life. The sooner the better.
Sometimes, especially if you are feeling down, it is really hard to remember exactly what the doctor says. Consider having a supportive friend or family member accompany you. If you do not exercise regularly, ask your GP about a green prescription.
Treatment for depression may include seeing a counsellor and/or taking medication, usually an antidepressant. If you are prescribed medication remember that you are entitled to know the following:
- the medication name
- what symptoms it is treating
- how long it will be before it takes effect
- how long you have to take it for
- what the side effects are.
If you feel the medication is not working after 2 to 3 weeks, you should go back to see your GP as something else may suit you better.
The Mental Health Foundation has a comprehensive range of information on mental health and wellbeing.
The Journal Free personalised online programme to help you to stay positive, create lifestyle changes, and learn steps for problem solving.