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Seven Things You Should Know About Depression

By Jodi Helmer

Consider: More than 6.5 million adults over age 65 struggle with depression, but fewer than 10 percent receive treatment.

Add that suicide rates among older adults are up to seven times higher than in other age groups, and you can understand why finding some relief in any way — be it antidepressants or talk therapy — could prove life-saving.

But there’s a problem. Doctors often miss the signs of depression in people 65-plus because the symptoms are different in younger patients. Instead of feeling sad or blue, seniors are apt to feel irritable or tired, have trouble sleeping, lose their appetite and be unable to concentrate, new research published in the Journal of Applied Gerontology finds.

In fact, Helen C. Kales, M.D., professor of psychiatry and researcher at the Veterans Affairs Ann Arbor Healthcare System, says research shows that up to 40 percent of older patients with depression — that’s 2.6 million people — may have such symptoms. No wonder it’s so much harder to diagnose depression in older adults.

Here are seven key things to keep in mind about this increasingly common condition:

1. You can get a free diagnosis
Depression screening is one of the free services offered under the Welcome to Medicare visit provided through the Affordable Care Act, and mental health experts say it’s helping more older patients get treatment. In 2000, research showed that fewer than 25 percent of patients over age 65 with probable depression received a diagnosis and treatment, but by 2007 that had jumped to nearly 52 percent.

2. Antidepressants aren’t always the answer
Antidepressant use has skyrocketed — jumping 400 percent between 1988 and 2008, according to the National Center for Health Statistics — but they’re far from a sure bet in beating depression.

To complicate matters, older adults are at higher risk for side effects from antidepressants, such as increased danger of falling and loss of bone density, as well as drug interactions with their other meds.

3. Depression is pain
Literally. Depression has a number of physical symptoms such as low energy level and appetite suppression. These signs can also indicate serious medical problems such as heart disease.

4. Hormones may play a role
Women are diagnosed with depression twice as often as men, possibly because they’re more at risk because of hormonal changes, including menopause. However, testosterone may also play a role in men’s depression.

5. Depression increases the risk of stroke
Depression was linked to a more than twofold increase in stroke risk for women between the ages of 47 and 52, according to a study published in Stroke, the journal of the American Heart Association.

6. Older white men are among those with the highest risk of suicide
In white adults over 65, the rate of male suicides is more than five times greater than female suicides. While suicide rates for women decline after age 60, for men, the odds of taking their own life increase with age. Men over 85 had a suicide rate more than twice that of their younger counterparts.

Part of the problem may be that no one realizes they’re so severely depressed. One of the leading causes of suicide in older adults is undiagnosed or untreated depression, according to the American Association of Suicidology.

7. There is hope
Depression is an illness characterized by feelings of hopelessness, but depression in older adults is generally highly treatable.
In fact, a study published in the Harvard Review of Psychiatry found a 48 percent reduction in symptom severity among people over age 55 who received antidepressant medications as treatment for depression. Research also found that 72 percent of patients over age 65 who participated in cognitive behavioral therapy sessions found it useful.

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