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Depression isn't part of growing older

Depression has many forms, from brief feelings of sadness to a serious medical condition. Most people feel sad and worried at some time in their life. These feelings are normal reactions to disappointments, illness or death. It is also normal to be moody, lose interest in people or favorite activities, have sleep problems and feel tired. These are all common expressions of what is known as normal reactive depression.

The circumstances that cause reactive depression may or may not go away, but you find ways to deal with your problems. In other words, you bounce back and feel better in a short time.

But when sadness persists and habits, such as eating, sleeping, working and enjoying life, continue to be difficult, you are dealing with something more serious than just "feeling down." You are facing a clinical depression, an illness that requires treatment. Many people believe that depression is normal in older adults. It is not. Most people also believe that depression in adults with chronic illness is normal. It is not. Clinical depression is a medical disorder, and it is caused by biological and psychosocial factors.

Fortunately, most depressive disorders are treatable with psychotherapy, drugs and other interventions. But if undetected and untreated, clinical depression can destroy quality of life and exacerbate health problems. It can lead to personal suffering, withdrawal from others, family disruption and sometimes suicide. Because it brings the potential for suicide, depression is a life-threatening illness.

Signs of depression

Clinical depression affects the body and the mind, causing changes in thinking, mood, behavior and body functions. If you recognize the following changes in yourself or someone you know, seek help from a physician or mental health professional.

Thinking: Depressed individuals often feel inadequate or overwhelmed. Even easy tasks seem impossible. Concentration is difficult and decisionmaking is burdensome. The world appears bleak, and pessimism colors perceptions of self-worth. Even successes are interpreted as failures. Thoughts of suicide may occur when the depression is severe.

Mood: Depressed individuals feel empty, helpless, hopeless and worthless, and they may report feeling pain and despair. Individuals may cry a great deal, often for little or no reason. Many, especially older men, become agitated and worry about everything. It is common to feel anger or even rage, as well as irritation, frustration and anxiety. Depressed moods are pervasive and persistent and do not lift even when good things happen.

Behavior: Depressed individuals often show such behavior as restlessness, hand-wringing, pacing, the inability to meet deadlines, withdrawal from friends, staying in bed most of the day, and decreased interest in sex. Many drink alcohol excessively or take sedatives to try to make the depression go away.

Body functions: Depression is a disease that affects the entire body. Individuals report physical pains such as headaches, backaches, joint pain, stomach problems, chest pain and gastrointestinal distress.

Getting help

It is not a sign of weakness to see a doctor when you are depressed. Unfortunately, the very nature of depression drains the desire and energy to talk with family members or seek professional help. Because depressed people often believe they are failures, many feel they are not worthy of help. The most courageous thing you can do is to get help.

Both men and women get depression. There is a widespread myth that depression is a woman's disease. It is not unmanly or wimpy to admit feeling depressed. Unfortunately, men are reluctant to seek treatment and instead become irritable, angry, drink or use drugs, and withdraw from loved ones.

It is not unusual to resist getting help, but telling someone how bad you feel is the first step to feeling better. A physician is the best person to contact; they need to know your medical history.

To be clinically depressed is to have a medical illness. Treatment is needed. Depressive disorders are diseases of the brain, just as cardiovascular diseases are diseases of the heart and circulatory system. Depressive disorders are not the result of character flaws, bad parenting, divine punishment, or personal weaknesses. They are not anything to be ashamed of.

Learning to spot the signs of depression is like learning to spot signs of cancer. It can save your life. Learning to detect the signs of depression and then getting help are essential steps to good health.

Donna Cohen, Ph.D, is a professor in the Department of Aging and Mental Health at the University of South Florida and also head of the Violence and Injury Prevention Project.

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