What is depression?

Depression is more than an 'attack of the blues' or being 'in the doldrums' for a short while. Depression is a state of persistent and ongoing unhappiness. Many older people experience depression and it is often a factor in suicide in that age group. Yet most depression goes undetected and untreated.

What are some signs of depression?

• Feeling down, most of the day, nearly every day
• Change in sleeping patterns
• Loss of appetite or significant weight loss or gain
• Loss of interest and pleasure in life
• Loss of motivation
• Noticeable changes in behaviour such as irritability, withdrawing from others
• Mood fluctuations
• Feelings of hopelessness or worthlessness
• Loss of 'fighting spirit'
• Loss of self-esteem
• Pain, including headaches, abdominal pain and other body pain for which the doctor can find no cause
• Poor concentration, forgetfulness, finding it hard to make decisions
• A mood of apathy, irritability or anxiety, alone or in addition to being sad
• Being tearful for no reason
• Feeling guilty for no apparent reason
• Having suicidal thoughts/plans.

GPs and mental health professionals recognise these signs as possible indicators of depression, especially if you have experienced a number of them for two weeks or longer - or they may be the sign of a physical illness. Consulting a GP and having a check-up is really important.

Why is depression often not recognised in older people?

• Many people think depression is an inevitable part of ageing
• GPs themselves may stereotype old age as depressing
• Older people often don't like to bother the doctor about something other than a physical illness
• GPs often don't ask questions about feelings and emotions
• Most people don't complain of depression. They are more likely to tell the doctor about vague symptoms
• Those with memories of psychiatric patients being placed in 'asylums' may be scared to talk to a doctor about their mental health
• People born in the earlier part of the 20th century endured world wars and economic depression. Many have learnt to 'keep their chin up' or 'snap out of it'
• Some people don't like to ask for help
• Many fear losing their independence
• Older people don't like the idea of having to take more pills
• Depression can make people worry they are 'going mad' or that they have dementia
• There is widespread belief in the myth that people can just 'snap out' of depression or 'pull their socks up'
• People may accept they need help, but have difficulty putting troubled feelings into words.

What causes depression?

No one knows exactly what causes depression. Grief, loss, change, social isolation, poverty, illness, reaction to medication and many other factors may contribute to depression. Often it is due to a combination of factors. And sometimes it just seems to come 'out of the blue'.

What about grief?

The signs of depression and grief can be similar, although people who have experienced both, talk about the 'sadness' of grief compared with the 'numbness' or almost non-feeling state of major depression. Grieving is a natural process. After a period it usually lessens or resolves.  If you have persistent distressing signs, which continue for months after a bereavement or loss, you may need help from a doctor or counsellor.

Who's at risk?

Those more at risk of depression include people who've had previous episodes of depression; a family history of depression or suicide attempts; problem use of alcohol or other substances; childhood trauma; responsibilities for caring for others, and chronic or severe physical illness. 

What can I do?

Many older people have developed strategies for dealing with times when they feel down. These include gardening, walking on the beach, visiting grandchildren, reading a good book, phoning friends, treating yourself to a small luxury, having your hair done or even cleaning the oven! These things sometimes drive the blues away successfully. But a word of warning - lots of people also 'mask' or disguise depression by making themselves really busy and not getting the help they need.

It is said that 'friends are good medicine' and having meaningful contacts with others is of real value. You may find that hobbies or voluntary work contribute to a sense of worth and belonging in a community which often seems to forget its older citizens.

Use your voice and your vote to influence people's attitudes and change social factors like poverty that may contribute to depression. You may find comfort and meaning in spirituality or religious beliefs. These are all things that protect you from depression or help you make a successful recovery from it.

Where can I get help?

If those 'blues' turn to black despair, talk to your GP.  The earlier diagnosis is made and treatment begins, the better your chances of recovery and a return to your usual activities and enjoyment of life. 'The sooner the better' is the motto here. Sometimes, especially if you are feeling down, it is really hard to remember exactly what the doctor says. Consider having a supportive friend or family member accompany you.

Treatment for depression may include seeing a counsellor and/or taking medication, usually an antidepressant.  If you are prescribed medication remember that you are entitled to know its name, what symptoms it is treating, how long it will be before it takes effect, how long you have to take it for and what the side effects are.

Resources

The Mental Health Foundation has a number of pamphlets, books and videos on depression and older people for purchase or loan, and a relaxation CD is available to buy. The Foundation also runs workshops for caregivers, focusing on depression and older people.

For more information see also Depression

Support groups

See the support organisations (which include helplines) under Further information and support below.

Original material provided by the Mental Health Foundation of New Zealand. Edited by everybody, June 2005.