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Coping with depression

Coping with depression

Here is some advice about depression that older people may experience, including the signs, and support available.

All of us feel sad sometimes. But getting older can give you more reasons to feel low. Stopping work, having less money, health difficulties and dealing with the death of a loved one can all contribute to a sense of sadness.

While many cope with this feeling there that sadness can become more severe, leading to depression. This can affect 1 in 5 older people living in the community, and 2 in 5 living in care homes. But help is available.

What does it feel like to have depression?
Feeling down is not the only sign of depression. You may lose interest in life. You may feel tired, and find doing simple things a real effort. You may lose your appetite, and weight, feel restless, anxious, and find it hard to relax. You may feel irritable with others. Sleep can be a problem, and you may find it hard to sleep or wake up earlier than usual and find it hard to get back to sleep. If you have severe depression, you may even have contemplated suicide. 

Particular difficulties older people experience
Physical symptoms and depression
Some physical illnesses can give you symptoms that are similar to those in depression, such as, loss of appetite or poor sleep. This can be caused by thyroid problems, heart disease or arthritis.

Long-term illness
If you are experiencing depression you may start to get more upset by your health, even though it hasn’t really changed for the worse.  Treating the depression can’t take away physical health problems, but it can make them more easy to cope with.

Memory  problems
Depression, worry and anxiety can affect your memory. You may feel confused and even worry that you are suffering from dementia – which is a permanent loss of memory –  when you are actually experiencing is depression.

Feeling isolated
Being on your own does not automatically make you depressed. But you may feel lonely for no obvious reason. This also may be a sign of depression.

Where to get help
If you have strong feelings of depression, this is not a sign of being weak. Many people experience depression, and you shouldn’t feel afraid to seek help.

How do you know when you need to seek help?
If your feelings are getting worse, have gone on for some time, are affecting your life, making you feel life is not worth living and causing concern to loved ones, then you should consider getting help. If you are having suicidal thoughts or considering harming yourself then it is important to seek support. 

What to do if you are feeling depressed
Make an appointment with your GP. Your doctor will be used to helping people with depression and they will know what to do. Remember, you are not wasting your GP’s time by asking for support and advice. If you unable to visit your GP ask them to visit you at home. You may find it helpful to take relative or friend with you when you visit your doctor.

Depression is a real illness
Depression can be treated like any other illness so it is important not to feel you are bothering your doctor, or that you should only see your doctor if you have a physical complaint. 

Reasons why people experience depression
When people feel depressed, they tend to blame ourselves. This is because depression makes people view things in a very negative way. They may even start to blame themselves for things that are not their responsibility.

Past depression 
You are more likely to get depression if you have experienced it before.

Painful events
Depression can come out of nowhere. It is often triggered by something, such as the death of a loved one. Some of people are just more likely to get depressed when faced by a difficult or painful situation – it’s their temperament.

Physical illness
Some physical illnesses can make you feel depressed, such as a problem with the thyroid gland. Having a stroke, or experiencing a long condition, such as Parkinson’s disease, can also take its toll. Some medicines can also lead to feeling depressed. You should visit your doctor for support.

Self-help steps you can take
Seek help from your doctor: It doesn’t matter how old you are. You shouldn’t have to put up with feeling depressed. Talk to your GP.

Try and stay active: It can be difficult to do physical activities if you have physical problems, but we know some kind of activity tends to make us feel better.

Keep in touch: You can boost your mood by, say, staying in touch with your family and friends, keeping up with hobbies, or joining a local lunch club.

Try to eat well: If you lose your appetite, you will probably lose weight. That means you could be lacking vital vitamins and minerals. When you are older this can really affect your health. Try to eat lots of fruit and vegetables rather than snacking on chocolate and biscuits, which lack vitamins.

Remember depression is an illness and not a sign that you are weak. You are not letting other people down or feeling sorry for yourself. Try not to feel guilty.

Tell someone if you feel so low that you have thoughts of taking your own life. Don’t keep your feelings to yourself. I can really help to talk to someone.

Be careful about alcohol consumption. Consuming too much alcohol can make depression worse and could potentially react with any tablets you are taking.

If you are not sleeping properly try not to panic. When depression lifts sleeping will get easier.

Treatments available for depression

Talking treatments
It can help to talk to someone who really listens, such as a friend, a relative, a volunteer or a professional. If this is not enough, professionals can offer talking treatments. This include:

Cognitive Behavioural Therapy: which helps you to see how some of the ways you think or behave may be making you depressed. It then helps you to think in more realistic ways that make you feel better. 

Psychotherapy: this helps you to see how your depression may be connected with past experiences.

If your depression has been triggered by bereavement or problems in a relationship, then bereavement counselling can be helpful.

Antidepressant medications
If you are depressed and have poor sleep, poor appetite and loss of weight (or over-eating and weight gain), or the depression has gone on for a long time, your doctor will often suggest an antidepressant. Many people who take these tablets will find they help. There are several types of antidepressant now available, and you can talk to your GP who will look at a medication best suited to your needs.

Do antidepressants have side-effects?
You may feel sick or more anxious over the first few days, but these effects usually wear off. Some may make you sleepy or give you a dry mouth. They can sometimes interfere with other medicines, but your doctor will be aware of this.

In older people, antidepressants can lower the amount of salt (sodium) in the blood – this can make you feel weak and unsteady.

About 1 in 3 people can get withdrawal symptoms if they stop these medicines suddenly. So it’s best to come off them slowly. To find out more, the Royal College of Psychiatrists has a leaflet on antidepressants.

Antidepressants take 1 or 2 weeks to start working. You may find that it takes 6 to 8 weeks for them to really make a difference. Don’t drive if they make you sleepy or if they slow down your reactions – if this happens, mention it to your GP.

Many older people are already taking medication. If you add an antidepressant, you may find it hard to keep track of which tablet you should take, and when you should take it. To help with this, your doctor or chemist can give you a special box, or blister pack. This has all the tablets set out in separate compartments for each time and day of the week.

St John’s Wort
This is a herbal antidepressant that you can buy from a chemist without a prescription. It has fewer side-effects than prescribed antidepressants, but is not effective in more severe depression. It can be harmful if taken with some other medications – so, if you are taking other medication, ask your GP about this.

Specialist support
Most people get better at home with these treatments, but some people might need help from a specialist. Your GP may need a second opinion or advice about the best treatment for you.

They may refer you to a psychiatrist who specialises in helping older people with depression. These doctors usually work as part of a specialist mental health team, so you will usually see a nurse or a social worker first.

If you are referred to a psychiatrist, you can ask a friend, neighbour or  relative to be there with you. It can also help to write down your thoughts and concerns before the interview.

Going into hospital
If you are very unwell – perhaps unable to eat or drink, or have tried to kill yourself – you may need the safety of a hospital. Only a small number of people with depression become this unwell. 

Keeping well
To stay well if you are experiencing depression, it is best not to stop the antidepressants until your doctor advises you to – even if you have been feeling well for some time. There’s the possibility that your depression may return if you stop taking your tablets too soon.

If your overall health is good and this is the first time you have experienced depression, you will probably need to keep taking medication for 6 to 12 months. If you have already had depression several times, your doctor may suggest that you stay on an antidepressant for longer.

Talking treatments, such as Cognitive Behavioural Therapy (CBT) may also help prevent you experiencing depression again.

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