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A stiff upper lip won't cure depression

By definition, depression is a treatable mental disorder, and suicide, which is intentional self-harm, is also preventable. As glum as these topics may be, about 10 percent of the adult population suffers from depressive illness, and each year nearly 30,000 people commit suicide. If these numbers still don't register, perhaps this will: People over 65 have the highest rate of suicide reported.

In some ways, depression is the "Everyman's Disorder." It can happen to anyone at any time. It causes people to feel down in the dumps, blue, out of it and sad. There are several kinds of depression, but the most debilitating and unrelentingly painful kind is severe, or clinical depression.

The cover stories in this issue are the tip of a very large berg of information and resources available. This is important for seniors because someone you know (or perhaps it's you), could be suffering in silence. One point to remember is that it is not okay to feel bad for the rest of your life. Depression is not a normal part of aging (a message that will be repeated frequently).

The process of aging can include such factors as declining health, financial problems, grief and the loss of loved ones, all of which can increase a person's vulnerabilities, but it is not a given that you will become depressed simply because you are old.

It may be difficult for the average person to understand what life is like for someone who suffers from severe or clinical depression. No amount of shaking one's soul can rid the person of feeling hopeless. In testimony before the U.S. Senate Special Committee on Aging in September 1996, 60 Minutes correspondent Mike Wallace described depression as "Endless darkness. . . . Sunshine means nothing to you. The seasons, friends or good food mean nothing. All you focus on is yourself and how badly you feel."

I spoke with a woman who was diagnosed with clinical depression and who twice attempted suicide. To understand depression, she said to picture someone carrying a 5-pound weight on their back and each day another 5 pounds is added; the weight continues to build up until there's a breaking point and the person becomes immobile. Depression, she said, is the invisible, silent destroyer.

When someone is severely depressed, no task is simple, not even eating or bathing _ everything becomes overwhelming. If the person does not get help, suicide becomes an option because the pain of living becomes unbearable and all hope is lost.

These descriptions should loom large for anyone who has watched a loved one or friend "act differently" or no longer "seem like themself."

Many seniors simply do not like talking about what ails them, either physically or mentally. This is a pitfall for anyone who needs help or treatment.

"There has always been some shame associated with mental illness, but lately psychiatric disorders are nothing to be ashamed of," said Michael Bernstein, president and CEO of Gulf Coast Jewish Family Services.

"Older people have more shame and the attitude of keeping a stiff upper lip and dealing with it. They isolate themselves and are less likely to come out for help."

Bernstein said the Gulf Coast Community Care's Geriatric Crisis Response Team, in association with State Adult Protective Services, provides in-home assessment and crisis intervention for those at risk. Loneliness, lack of mobility and embarrassment are just a few of the issues that can prevent a senior from seeking help.

Clinical depression that is untreated can have disastrous effects on the victim, family and friends. Research shows that suicide immediately affects at least six other people.

"We need to eliminate the shame of going to the doctor for mental health problems," said Donna Cacciatore, director of Suicide Prevention and Volunteer Services at Crisis Center Tampa Bay.

"Some people are embarrassed and think mental health problems are a weakness. If you have suicidal thoughts, you're not weak or crazy. It just means that you are going through something that has overwhelmed your coping skills."

One misconception associated with suicide is that talking about it will put the idea in a person's head.

"Talking about suicide does not put the idea in someone's head. Experts agree that talking about it opens up the communication process," Cacciatore said.

Gender plays a role in who is at risk for suicide. According to the latest data, from 2000, older white men have the highest suicide rate, comprising 80 percent of all elderly suicides. White men 80 and older have a suicide rate 6 times (59 per 100,000 deaths) the national average (10.6 per 100,000 deaths).

"White men who are elderly are not used to being caregivers or used to reaching out for help. They are used to sustaining themselves emotionally. Elderly black women have the lowest suicide rate," said Bernstein. "Men are not as good dealing with isolation, depression and caregiving. Women are more resilient and are much better dealing with losses. It is particularly important for men to take the first step."

No matter a person's age or race, depression IS treatable and suicide IS preventable. Men don't need to muscle up and go it alone, and women don't need to bear up and forge on. Family, friends, neighbors, co-workers _ anyone can be a life saver.

"People can make a great difference," Cacciatore said. "Learn the warning signs and don't be afraid to ask the person if they are okay. You will not put the idea in their head. Ask about the health of the person. Ask if they need to talk about something."

For adult children who have parents in other cities or states, it's crucial to know what resources are available where a parent or grandparent lives.

"Lots of referrals come from third parties, concerned neighbors," Bernstein said. "Rarely do I get a client who takes offense if the intervention is done in a loving manner. Seniors don't complain, and they don't do gestures (for suicide). A child, for instance, will announce that they don't want to live and go tell 10 people; or they might slash their wrists, but it won't be deep. Seniors are less likely to cry out for help. When they make up their mind to do it, they do it. So it's important to get intervention."

Fear. Isolation. Pain. Shame. Hopelessness. Failure. These are just a few of the words associated with depression and suicide. But words alone need not seal your fate or mar your existence. Help is available. Use the information in this section as a place to gather your courage as you take the first step toward the light.

Sources: National Institute of Mental Health Research and Geriatric Depression and Suicide, Violence & Injury Prevention Program Homicide/Suicide Prevention & Intervention Resources, and the Journal of Mental Health And Aging.

_ Sheila Reed, Seniority editor, can be reached at (727) 893-8452 or toll-free 1-800-333-7505, ext. 8452. Write to her in care of the St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731; or send e-mail to