Have you been feeling blue lately? Sleepless? Irritable? The questions sound like any of the TV commercials for anti-depressants—ads that have more Americans than ever inquiring about such prescriptions. Some doctors say the influx of queries is a good thing: It signals a welcome shift in the way our culture views mental health issues.
We still have a distance to go, however. Only about one-third of the 19 million Americans who are depressed actually seek treatment, in part because they fear their negative emotions are a personal failing. If that sounds like you, Brent Lovett wants you to know your fear is misplaced. The medical director of the David Lawrence Center in Fort Myers says depression is often a medical condition that won’t get better on its own. "In fact, if you don’t seek help it can get worse, and may even lead to thoughts of suicide," Lovett says.
Depression takes many forms, has many triggers and can be treated with several approaches. Here’s what you need to know to take charge of your mental health, before it takes charge of you.
Depression or the blues?
You’re at the grocery store when the memory of a lost loved one takes over; next thing you know, you’re crying in front of the Cheerios.
Your tennis buddies want to set up a game, but you keep turning them down because you haven’t felt like playing for a while.
Your back hurts, and you think you’ve been in a foul mood as a result of it.
Maybe you’ve got a case of the blues—or even the blahs. But keep tabs on how long it lasts. Symptoms of depression include trouble sleeping or excessive sleeping, a dramatic change in appetite, fatigue and loss of interest in activities you normally enjoy. If you experience some of these for a period of more than two weeks, it’s time to call your doctor, though not necessarily a psychiatrist or psychologist. Internists and general practitioners are trained to recognize these signs and, if necessary, can refer you to a mental health professional.
Two of the most common types of depression are known as major depression and minor depression. The former is generally characterized by five or more depressive symptoms that are present for at least two weeks and generally last several months. The latter is characterized by less than five symptoms for longer than two weeks.
Dysthymia is another common type, characterized by a mild depression that lasts for an extended period, sometimes years.
These guidelines are fine for a patient’s general knowledge, but you’ll need a doctor to let you know if you have something more serious—or less. Among baby boomers and the generation before them, depression commonly appears with other illnesses, such as cancer or diabetes.
Then again, you may not have depression at all. Hypothyroidism, in which the thyroid gland operates deficiently, results in a lowered metabolic rate that can cause a perpetually sluggish feeling, Lovett explains.
Besides a loss of vigor, patients over 50 commonly struggle from extreme anxiety, often rooted in concerns about their physical health or their seemingly deteriorating memories. A professional evaluation can help get to the root of what’s really ailing you. "We have wonderful psychological tests that would determine [a patient’s] level of depression or of dementia," says Larry Kubiak, former president of the Florida Psychological Association. "It’s nice to be able to say, ‘Look, you don’t have that. Maybe the reason you don’t remember as well is because you’re worrying so much that you’re only getting four hours of sleep at night.’ "
Beat the blues
With so many treatment options, from medicines to lifestyles, why carry the burden of even minor depression? Among those over 50, and especially over 60, dealing with loss becomes more common. To help keep the natural process of grieving from developing into a mental health condition, Kubiak offers the same practical advice for those who have experienced a loss and those who haven’t. "The brain is like any other muscle: The more we exercise it, the more we keep it [strong]," he says. As for physical activity, Kubiak adds, "The more we exercise, the more we learn to manage our stress, the better we’ll be able to combat these stressors that come up along the way."
Other home remedies include ample sleep, socializing and adding omega-3 fatty acids to your diet (found in cold-water fish such as tuna and salmon) as well as folate, or vitamin B9.
Of course, if you’re experiencing depressive symptoms as a result of a loss—whether it’s loss of a loved one, loss of a career, even loss of vision or motor skills—a healthy lifestyle may not be enough to stave off serious mental challenges. That’s when talk therapy and medications come in.
Many antidepressants are believed to make neurotransmitters more available to the brain, which relies on them for healthy functioning. You won’t feel better after just one dose; it can take several weeks, and you may be on antidepressants for four to six months or longer. Though there are a myriad of options available, selective serotonin reuptake inhibitors (SSRIs) are some of the most frequently prescribed, and include Celexa, Lexapro, Prozac, Paxil and Zoloft.
Kubiak understands that not all patients, particularly seniors, feel comfortable discussing their personal problems with a psychiatrist or a psychologist—especially if they’re feeling better on antidepressants. "But they should talk about their issues with someone. If not a professional, then someone close to them," he says. "Grieving and fears are natural, and talking about them can help you come to terms with your situation."