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Depression and Aging

by Dr. Lisa Campbell

Depression affects people at every stage of life, but tends to look differently at different ages. In later life, people tend to experience either an extension or worsening of an existing mood disorder, or an all-together new experience of depression. Depressive symptoms may accompany serious medical conditions such as diabetes, heart disease, dementia, or chronic pain; or may be related to loss or social isolation following the death of a spouse or other loved one. For many, particularly men, depression can be masked for years by the use of alcohol or prescription medications-and only really show up in a medical crisis where substances are restricted.

Depression in older adults tends to appear less as overt sadness and more as fatigue, focus on physical pain/discomfort, change in appetite, anxiety, irritability, insomnia, isolation, hopelessness/ helplessness, and thoughts of death. As a result, people may not identify what they are experiencing as "depression," but perhaps "the blues" or "nerves" or simply "not feeling like myself." Many of today's elders grew up in a time when depression was stigmatized and not recognized as worthy of attention, learning instead to remain silent and suffer.

More good news: depression after 50 is treatable, just as in earlier years. Research has shown that people at all levels of depression improve with certain forms of psychotherapy, medication, electro-convulsive therapy (ECT, much different today than in the past), and/or some combination of these treatments.