The world is round and the place which may seem like the end, may also be only the beginning.— Ivy Baker Priest, (1905-1975) U. S. Secretary of the Treasury

It’s very nice to think of getting older in pleasant ways: as a time of rest, reflection, and opportunities to do things that were put off while we were busily raising our families and pursuing our careers.

Unfortunately, the aging process is not always so peaceful and pleasant. Late-life events such as chronic and debilitating medical disorders, loss of friends and loved ones, and the inability to take part in once-cherished activities can take a heavy toll on an aging person’s emotional well-being.

The older adult also faces the loss of control over his or her life due to failing eyesight, hearing loss, and other physical changes, as well as external pressures such as limited financial resources. These and other issues often cause negative emotions such as sadness, anxiety, loneliness, and lowered self-esteem, which in turn lead to social withdrawal and apathy.

NAMI (The National Alliance on Mental Illness) says that depression affects more than 6.5 million of the 35 million Americans aged 65 or older.  Most people in this stage of life with depression have been experiencing episodes of the illness during much of their lives.  For others, depression has its first beginning in late life —even in persons in their 80s and 90s.  Depression in older persons is closely associated with dependency and disability, and causes great suffering and pain for the individual and their family and caregivers.

Actually, it is a mystery for me.  I have clients who are just full of happy-go-lucky, thankful attitudes no matter their age and condition.  I have clients who look and sound like they cannot take another step because of their sadness over circumstances.  Certainly I’m not one to lecture on this topic.  Several things about my own aging frustrate me unbelievably.  As my dad used to say, “old age is not for sissies.”

However, I’m writing about it this week because depression in older people so often goes undiagnosed and untreated.  The reason most often given for that is that so many think that depression is a normal part of aging, and a natural reaction to chronic illness, loss and social transition.  In addition, many older persons think that depression, or any emotional illness, is a character flaw.  They are worried about being ridiculed or humiliated.  They may blame themselves for their illness, or fear that any treatment would be too costly.    Elderly persons are much more likely to seek treatment for any other physical ailment than they are to seek treatment for depression.

Of course, it’s natural to feel grief in the face of major life changes that we face as we grow older.  Sometimes we have to leave our home of many years.  Often, we watch friends and loved ones pass away.  We find ourselves unable to do simple things – like get the top off a little container of creamer or balance our checking account.

Unlike normal sadness and a blue day here and there, clinical depression does not go away by itself.  It requires professional treatment to reduce duration and intensity of symptoms.  Unresolved depression can actually affect the physical body, too.  If left untreated, it is a risk factor for heart disease.  Depression can also suppress the immune system raising the risk of infection.

NAMI reports that older women are at a great risk for depression because women in general are twice as likely as men to become seriously depressed.  Biological factors like hormonal changes may make older women more vulnerable.  The stresses of maintaining relationships or caring for an ill loved one and children also typically fall more heavily on women.

Fortunately, the treatment prognosis for depression, even in the elderly, is good.  Once diagnosed, 80 percent of clinically depressed individuals can be effectively treated by medication, psychotherapy or a combination of both.  Medication is effective for a majority of people with depression.  Research has shown that some depressed individuals may need to try more than one medication to get optimal results.

Psychosocial treatment plays an essential role in the care of older patients who have significant life crises, lack social support or lack coping skills to deal with life’s situations.

As always, Senior Moments recommends social support groups such as church or bridge friends.  In Bowie we have our marvelous Senior Center, and you should look for a column soon about a local senior exercise class at the gym.  It’s been shown that people who socialize with others as they age, actually live longer and have less trouble with depression.

Late-life depression increases risk for medical illness and cognitive decline.  Unrecognized and untreated depression can have fatal consequences in terms of length of life.  Actually, the highest rate of suicide in the U.S. is among older white men.  Depression is the single most significant risk factor for suicide in the elderly population.

If you are taking care of an elderly loved one, and they have unexplained behaviors and don’t seem like themselves, please have them checked out for depression.

Thank you for reading.  Stay well.  See you next week.