Friday, December 22, 2006

Happy Holidays?

Holidays can be happy, or hopeless, for anyone. Are seniors more or less susceptible to depression during the holidays?

The website of New York Access to Health Online (NOAH) provides some links, updated on November 23, 2006, for articles generally relevant to "Depression and the Holidays", found here. There are many such articles posted year-end on this subject -- just search on the terms "holiday depression" to see.

One article specifically addresses seniors' reactions to the holidays. Coping with Depression and the Holidays, posted by the Geriatric Mental Health Foundation, affiliated with the American Association for Geriatric Psychiatry (AAGP), acknowledges the special situation of seniors during the holidays:
During the holidays, older adults may feel more acutely the passing of time, the absence of parents, siblings and friends who have died, and the distance of loved ones who have moved away. Traditional reunions and rituals that were observed in the past may not be possible and in their absence, the holidays may seem devoid of meaning.
Some major situational factors that contribute to "holiday depression" for the elderly include:
      • Financial limitations
      • Loss of independence
      • Being alone or separated from loved ones
      • Failing eyesight (and lessening of the ability to write or read holiday correspondence)
      • Loss of mobility and/or the inability to get to religious services
Depression may not be merely situational, but may be instead syptomatic of deeper problems that will continue after the holidays and must be addressed.

An article entitled "
Older Adults: Depression and Suicide Facts", last updated on December 1, 2003, considered the breath & depth of depression in seniors:
Of the nearly 35 million Americans age 65 and older, an estimated 2 million have a depressive illness (major depressive disorder, dysthymic disorder, or bipolar disorder) and another 5 million may have “subsyndromal depression,” or depressive symptoms that fall short of meeting full diagnostic criteria for a disorder.

Subsyndromal depression is especially common among older persons and is associated with an increased risk of developing major depression. In any of these forms, however, depressive symptoms are not a normal part of aging.

In contrast to the normal emotional experiences of sadness, grief, loss, or passing mood states, they tend to be persistent and to interfere significantly with an individual’s ability to function.

Depression often co-occurs with other serious illnesses such as heart disease, stroke, diabetes, cancer, and Parkinson’s disease.
The good news, according to AAGP, is: "Treatment for Depression Works". In its press release issued December 12, 2006, entitled "Treatment Available and Effective for Late-Life Depression", AAGP states:
Treatment for older adults with depression is available and effective, says the American Association for Geriatric Psychiatry (AAGP). With suicide rates disproportionately high in older persons and highest in older, white men, the AAGP encourages physicians and older patients to talk about the symptoms of depression and the full range of treatment options. * * *
“Treatment for late-life depression -- which can include anti-depressants, talk therapy, other behavioral therapy or some combination -- works,” said AAGP President Christopher C. Colenda, MD, MPH.

“Today, our challenge is getting older adults the help they need. Untreated depression is dangerous, greatly diminishes quality of life, adversely effects overall health, and can lead to suicide.
If, during this Holiday Season, you wish to help someone find their renewed spirit, free of depression, what can you do?

The BBC, on one of its "Health" webpages, in the excellent article "Depression at Christmas", by Dr. Trisha Macnair, suggests these tips:
  • Watch out for your friends and family. If you're worried about someone, give them plenty of appropriate opportunities to talk.
  • Invite those who seem isolated to join in social events and keep inviting them even if they refuse, which they may well do -- people with depression often don't feel like socialising, or feel their contribution won't be of value. * * *
  • Be as supportive as you can, learn about the condition, and don't expect them to snap back to their old self overnight.
  • Don't be afraid to talk about suicide or ask if they have thought about it. Focusing on suicide isn't likely to encourage someone to do it.
  • Encourage them to talk to someone in their family. A surprising number of suicides (especially among young men) come as a complete surprise to families, who had little idea what their loved one was going through and who spend the rest of their lives regretting they had no chance to help the person.
  • Encourage them to seek professional help, or at least to unburden themselves to an anonymous telephone helpline. Keep pointing out that depression can be treated.
Well-known actor Tom Bosley (hey, remember him? -- Richie Cunningham's dad in the TV Show "Happy Days") has spoken about depression. Here are three of his thoughts:
  • Many people think that depression is something you just have to live with when you get older, but it's not.
  • Just like other illnesses, depression can be treated so that people can live happy, active lives.
  • I want to help people with depression understand that there is hope, so that they can get the help they need to live rich, fulfilling lives.