How common is depression among senior citizens?

Depression is more than feeling sad or “Down”. Depression affects our thinking, our emotions, our behavior and our physical health. You might feel down, or empty. Some people have difficulty remembering, or can’t make decisions like they once did. Many leisure activities just don’t interest you any more. You have aches and pains that keep coming back, and your physician can’t explain it. A depressed mood, with many of these symptoms, that goes on and on and on for weeks and months is called clinical depression.

Depression is also more than the feeling of grief you experience after losing someone you love. Following such a loss, for many people, a depressed mood is a normal reaction to grief. Some people find it helpful to join a mutual support group, such as a widowed persons group, to talk with others experiencing similar feelings. But, if the grief does not go away within a few months, it may be depression.

Clinical depression is a whole body disorder. It affects the way you think and the way you feel, both physically and emotionally. It isn’t “Normal” to feel depressed all the time when you get older. In fact, most older people feel satisfied with their lives. Nonetheless, among people of 65 and over, as many as 3 out of 100 experience clinical depression. This is a serious problem, and can even lead to suicide.

But there is good news. Nearly 80 per cent of people with clinical depression can be treated successfully with psychotherapy. Sometimes, a combination of psychotherapy and medication works better, especially if you have very disturbed sleep, or can’t get yourself out of bed to do anything. Even the most serious forms of depression usually respond rapidly to the right treatment. But first, depression has to be recognized.

My spouse has been very ill for a long time, and lately, I have become very irritable. What can I do?

Caring for someone who is chronically ill can be very stressful. We have a tendency to put off doing things for our self when we are caretakers, because our (spouse, child, parent) needs our attention and assistance. We forget that professional caretakers work in shifts, and are relieved by others after they complete a shift. Caring for a chronically ill relative at home rarely leaves time for breaks or days off. Unless you allow time for yourself, you will eventually suffer the effects of chronic stress.

Tension, or anxiety, is the most common symptom of a caretaker. This eventually leads to anger and desperation. If you are a caretaker, you need to take care of yourself as well. You need an emotional outlet, but don’t feel you deserve one. Caretakers should talk to psychologists to help relieve their stress, and to dissipate their anger before they give vent to their emotions on their chronically ill relative. Supportive counseling can help you cope with the stress of this responsibility, and allow you to maintain a positive relationship with the person you are helping.

How long does psychological treatment usually take?

A national research study found that 50 per cent of psychotherapy clients had made some improvement within eight sessions of therapy, and 75 per cent showed an improvement after six months of therapy. Of course, showing improvement is not the same as successfully completing treatment. Most psychologists will tell you that the length of treatment depends upon the nature of the problem, the severity of the problem, and the treatment goals selected. Most individuals complete psychological treatment within three to six months. The severity of the problem also affects treatment length and intensity. (Intensity refers to whether sessions are scheduled twice weekly, weekly, or less frequently. The norm is once per week).

More serious problems, including recurring chronic depression, serious post-traumatic stress responses, substance abuse, personality problems, and ongoing stress responses such as those related to caring for a chronically ill family member, often require treatment for one year or longer, depending upon the severity of the symptoms.

We’ve been having problems in our marriage. We seem to argue all the time. Do psychologists provide marriage counseling?

Absolutely. Most psychologists are trained to help couples work out problems in their relationship. No one ever taught us how to interact in a relationship. If your parents had a good marriage, you might have learned to resolve problems using the same methods they used, but even that doesn’t work for everyone. If you don’t think your parents did a good job at resolving conflicts, then your own attempts to make relationships work have been “Trial and error”.

Psychologists can help troubled marriages in at least two ways. First, psychologists can function as mediators, not taking sides, but helping both sides express themselves, to clarify issues and discuss problems in the relationship. Couples often do not do this at home because of interruptions, the children, or fear of starting an argument. Second, psychologists can teach you specific skills that can help you interact in a relationship better. These skills include basic communication skills, assertiveness skills, problem solving skills, anger management skills and listening skills. These two methods can help most couples resolve their conflicts, improve their communication and feel more satisfied with their marriage.

What are the symptoms of a serious clinical depression?

A major depression is marked by a combination of symptoms that occur together, and last for at least two weeks without significant improvement. Symptoms from at least five of the following categories must be present for a major depression, although even a few of the symptom clusters are indicators of a depression, but perhaps not a major depression.

Persistent depression, sad, anxious, or empty mood, feeling worthless, helpless, or experiencing excessive or inappropriate guilt. Hopeless about the future, excessive pessimistic feelings, loss of interest and pleasure in your usual activities, decreased energy and chronic fatigue. Loss of memory, difficulty in making decisions or concentrating. Irritability or restlessness or agitation. Sleep disturbances, either difficulty in sleeping, or sleeping too much. Loss of appetite and interest in food, or overeating, with weight gain. Recurring thoughts of death, or suicidal thoughts or actions.

This list is a guide to help you understand depression. It is not offered for you to diagnose yourself. If you have some of these symptoms, don’t focus on how many symptoms you have. Instead, talk to a psychologist about how you have been feeling, to see if he/she can help.