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Depression and ageing

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Depressionisnotanormalpartofageing.Itsanillnessthatcanhaveseriousconsequencesifit
isntrecognisedandtreated.Depressionisoftennotwell-recognisedordetectedinolderpeople.
Symptomssuchassadness,sleepandappetiteproblemsormoodchangesmaybedismissedasa
normalpartofageing.Thesesymptomsmayalsobeconfusedwithotherconditionssuchas
dementia.
Depressioncandamageapersonsqualityoflifeandtheirrelationshipswithfriendsandfamily.
Severedepressioncanbelifethreateningasariskfactorforsuicidalthoughtsandsuicide.
Depression is often not recognised in older people
Symptomsofdepressionthatwouldcauseconcerninayoungerperson,suchasinsomniaorsocial
withdrawal,maybedisregardedinolderpeopleasjustoldage.Peoplealsosometimesassume
thatproblemswithmemoryorconcentrationareduetoage-relatedchangesinthinking,rather
thanbeingduetodepression.Olderpeoplemayalsofinditdifficulttotalkaboutfeelingsador
depressed.Depressioncanreversiblyimpairmemoryandconcentration,particularlyinelderly
people.
Depression is not a normal part of ageing
Olderpeopledonotnecessarilysufferhigherratesofdepression.Recentsurveyshavefoundolder
peopleingoodhealthandlivingintheirownhomehavesimilarratesofdepressiontopeopleof
youngeragegroups.However,theincidenceofdepressionwashigherinolderpeoplewhowerein
poorhealth,livinginacarefacilityornursinghome,orwhowereotherwiseisolated.
Situationssuchasillness,disability,lossandlonelinessaremorecommonforolderpeople.Itis
normaltogrievewhenfacedwithlossorillness,butdepressionisamoresevereandpersistent
sadness.Itisnotanormalreactiontotheseeventsandshouldalwaysbeinvestigatedandtreated
appropriately.
Symptoms of depression
Everyonecanfeelsad,particularlyifyouexperiencelossorgrief.Depression,however,ismore
thanfeelinglowandsaditisadisablingconditionthatrequirestreatment.Peoplewhoare
depressedcanexperiencesymptomsthataffecttheir:

Behaviour
Thoughts
Feelings
Physicalwellbeing.

Seek help if you experience symptoms of depression

Everyoneexperiencessomeorallofthesymptomsofdepressionfromtimetotime.However,if
youorsomeoneclosetoyouexperiencespersistentsymptomsinatleastthreeofthefollowing
categories,fortwoweeksorlongerandcausingthemsomeimpairment,thenhelpfromadoctoris
needed.Someexamplesofpossiblesymptomsofdepressionarelistedhere.
Behaviour

Neglectingyourresponsibilities
Notlookingafteryourselfforexample,noteatingwellorcaringabouthowyoulook
Withdrawingfromfamilyandfriends
Avoidingcertainsituations
Notenjoyinganyactivity
Doingthingsthatareoutofcharacterforexample,beingangryoraggressive.

Thoughts

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Regularlythinkingaboutsuicide(killingyourself)
Nolongerfeelinggoodaboutyourself.

Feelings

Irritability
Sadness
Anxiety
Worry
Emptiness
Guilt.

Physical symptoms

Sleepingmoreorlessthanusual
Feelingtiredallthetime
Unexplainedheadachesorotheraches
Digestiveupsets
Lossorchangeofappetite
Significantweightlossorweightgain
Memoryproblemsandconfusion.

People at risk of depression

Someriskfactorsmaytriggerdepression.However,notalldepressioncanbetracedtoariskor
cause.Riskfactorsfordepressioninolderpeoplemayinclude:

Isolationforexample,livinginaremotelocationorlivinginadifferentlocationtofamily
andfriends
Livinginanursinghomeorothercarefacility
DementiadepressioniscommoninpeoplewithdementiasuchasAlzheimersdisease.
Thereasonforthelinkisnotclear
Otherphysicalhealthconditionsincludingvitamindeficiencies,thyroidproblems,heart
disease,arthritis,Parkinsonsdiseaseandcancer
Somemedicationscanpromotedepressionforexample,benzodiazepines(suchas
diazepam)andpropranolol
Alcoholabuse.

Depression and stress

Stressisarecognisedriskfactorfordepressionforallagegroups.Stresscanariseinmany
situationsforolderpeople,whichmayinclude:

Retirement
Chronicpain
Beingtheprimarycarerforapartnerorotherrelative
Financialproblems
Loneliness
Deathorillnessofaspouse,partnerorothercloserelativeorfriend
Otherfamilyproblems.

Diagnosis
Adiagnosisofdepressioncanbemadeafteranumberofsteps.Theseareusedtobothconfirmthe
presenceofdepressionandtoexcludeotherphysicalcausesofthesymptoms:

Physical examinationtocheckforanyunderlyingphysicalillnessessuchasanaemiaor
thyroidproblemsthatmaycausedepression.
Medical historythedoctormayaskaboutyourprioruseofvariousdrugs(suchashigh
bloodpressuremedications,steroidsandalcohol),whichcancausedepressionasaside
effect.
Detailed questioningforexample,thedoctormayaskhowseverethesymptomsare,
howlongtheylastandifyouhaveexperiencedanymajorlifechangesrecently.

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Psychological testsmaybeusedtohelpidentifythetypeofdepression,your
performanceonmemoryandthinkingtasks,andanycontributingfactors.
Laboratory investigationsforexampletoexamineyourbloodcounts,electrolytesand
thyroidactivity.

Sometimesdepressionco-existswithdementia,whichcanmakeaspecificdiagnosisdifficult.Some
physicalsymptomsofdepression,suchasinsomniaorlackofappetite,mayalsohaveothercauses
theseneedtoberuledoutaspartofadiagnosisofdepression.
Treatment
Depressionisatreatableillness.Earlydetectionandtreatmentmayhelptokeepdepressionfrom
becomingsevere.Treatmentsmaybeacombinationof:

Medical
Psychological
Lifestylechanges.

Medical treatments
Medicaltreatmentsfordepressioncanbeveryeffectiveandmayinclude:

Antidepressantsthesemaytakeuptosixweekstoshowimprovements.Medicationfor
depressionshouldonlybetakenunderadoctorssupervisionandmustnotbestopped
suddenly.
Electroconvulsive therapyinseverecases.

Psychological treatments
Psychologicaltreatmentsfordepressioncanbeveryeffectiveandmayinclude:

Cognitive behaviour therapyhelpsthepersonchangetheirnegativethoughtpatterns.

Interpersonal therapyhelpstoimproverelationships.

Lifestyle changes
Aspartoftreatmentfordepression,adoctororotherpractitionermayrecommendchangestoa
personslifestyle.Thesechangesmayinclude:

Dietarychanges
Nutritionalsupplements
Exercise
Involvementinsocialactivities
Avoidingsituationsthattriggeranxiety.

Antidepressants can interact with other medications

Treatmentofdepressioninpeopleaged65andolderisgenerallythesameasforpeopleinother
agegroups.However,olderpeopletendtotakemoremedicationsforotherconditions.
Antidepressantsmustbeprescribedcarefullytoensuretheydonotcausedangerousinteractions
withotherdrugs.
Theriskofadverseinteractionalsoincludesherbalorothercomplementaryremediesfor
depression.TheherbStJohnsWortissometimestakentotreatdepression,butitcanhave
seriousinteractionswithotherdrugs.Consultyourdoctorbeforetakinganysupplementsorother
complementarytreatmentsfordepression.
Where to get help

Yourdoctor
Yourlocalcommunityhealthcentre
Psychologist
Occupationaltherapist
FindaGPnearyouwhospecialisesinmentalhealthissuesthroughthebeyondbluewebsite
beyondblueInfoLineTel.1300224636
SANEMentalHealthInformationLineTel.1800187263,MondaytoFriday,9amto5pm
MentalHealthAdviceLineTel.1300280737

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LifelineTel.131114
MentalHealthFoundationTel.(03)94270407,MondaytoFriday,9amto5pm

Things to remember

Depressionisnotanormalpartofageing.
Symptomsofdepressionmaybeconfusedwithotherillnessesorwithageing.
Depressioncanbesuccessfullytreatedwithpsychologicaltherapies,medicationand
lifestylechanges.

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