| The key understanding about depression | | | | Some people have the mistaken idea that |
| causes "and, in fact, causes for any | | | | it is normal for the elderly to feel |
| mental disorder" is that we still do not | | | | depressed. On the contrary, most older |
| know what causes these mental disorders. | | | | people feel satisfied with their lives. |
| It is generally believed that all mental | | | | Sometimes, though, when depression |
| disorders are caused by a complex | | | | develops, it may be dismissed as a |
| interaction and combination of | | | | normal part of aging. Depression in the |
| biological, psychological and social | | | | elderly, undiagnosed and untreated, |
| factors. This theory is called the | | | | causes needless suffering for the family |
| bio-psycho-social model of causation and | | | | and for the individual who could |
| is the most generally accepted theory of | | | | otherwise live a fruitful life. When he |
| the cause of disorders such as | | | | or she does go to the doctor, the |
| depression by professionals. | | | | symptoms described are usually physical, |
| Some types of depression run in | | | | for the older person is often reluctant |
| families, suggesting that a biological | | | | to discuss feelings of hopelessness, |
| vulnerability can be inherited. This | | | | sadness, loss of interest in normally |
| seems to be the case with bipolar | | | | pleasurable activities, or extremely |
| disorder. Studies of families in which | | | | prolonged grief after a loss. |
| members of each generation develop | | | | Recognizing how depressive symptoms in |
| bipolar disorder found that those with | | | | older people are often missed, many |
| the illness have a somewhat different | | | | health care professionals are learning |
| genetic makeup than those who do not get | | | | to identify and treat the underlying |
| ill. However, the reverse is not true: | | | | depression. They recognize that some |
| Not everybody with the genetic makeup | | | | symptoms may be side effects of |
| that causes vulnerability to bipolar | | | | medication the older person is taking |
| disorder will have the illness. | | | | for a physical problem, or they may be |
| Apparently additional factors, possibly | | | | caused by a co-occurring illness. If a |
| stresses at home, work, or school, are | | | | diagnosis of depression is made, |
| involved in its onset. | | | | treatment with medication and/or |
| In some families, major depression also | | | | psychotherapy will help the depressed |
| seems to occur generation after | | | | person return to a happier, more |
| generation. However, it can also occur | | | | fulfilling life. Recent research |
| in people who have no family history of | | | | suggests that brief psychotherapy (talk |
| depression. Whether inherited or not, | | | | therapies that help a person in |
| major depressive disorder is often | | | | day-to-day relationships or in learning |
| associated with changes in brain | | | | to solve problems of everyday life) is |
| structures or brain function. | | | | effective in reducing symptoms in |
| People who have low self-esteem, who | | | | short-term depression in older persons |
| consistently view themselves and the | | | | who are medically ill. Psychotherapy is |
| world with pessimism or who are readily | | | | also useful in older patients who cannot |
| overwhelmed by stress, are prone to | | | | or will not take medication. Efficacy |
| depression. Whether this represents a | | | | studies show that late-life depression |
| psychological predisposition or an early | | | | can be treated with psychotherapy. |
| form of the illness is not clear. | | | | Improved recognition and treatment of |
| In recent years, researchers have shown | | | | depression in late life will make those |
| that physical changes in the body can be | | | | years more enjoyable and fulfilling for |
| accompanied by mental changes as well. | | | | the depressed elderly person, the |
| Medical illnesses such as stroke, a | | | | family, and caretakers. |
| heart attack, cancer, Parkinson's | | | | Depression in Children |
| disease, and hormonal disorders can | | | | Only in the past two decades has |
| cause depressive illness, making the | | | | depression in children been taken very |
| sick person apathetic and unwilling to | | | | seriously. The depressed child may |
| care for his or her physical needs, thus | | | | pretend to be sick, refuse to go to |
| prolonging the recovery period. Also, a | | | | school, cling to a parent, or worry that |
| serious loss, difficult relationship, | | | | the parent may die. Older children may |
| financial problem, or any stressful | | | | sulk, get into trouble at school, be |
| (unwelcome or even desired) change in | | | | negative, grouchy, and feel |
| life patterns can trigger a depressive | | | | misunderstood. Because normal behaviors |
| episode. Very often, a combination of | | | | vary from one childhood stage to |
| genetic, psychological, and | | | | another, it can be difficult to tell |
| environmental factors is involved in the | | | | whether a child is just going through a |
| onset of a depressive disorder. | | | | temporary "phase" or is suffering from |
| Women experience depression about twice | | | | depression. Sometimes the parents become |
| as often as men. Many factors may | | | | worried about how the child's behavior |
| contribute to depression in women | | | | has changed, or a teacher mentions that |
| particularly such factors as | | | | Johnny doesn't seem to be himself. In |
| menstruation, pregnancy, miscarriage, | | | | such a case, if a visit to the child's |
| postpartum period, and menopause. Many | | | | pediatrician rules out physical |
| women also face additional stresses such | | | | symptoms, the doctor will probably |
| as responsibilities both at work and | | | | suggest that the child be evaluated, |
| home, single parenthood, and caring for | | | | preferably by a psychiatrist who |
| children and for aging parents. | | | | specializes in the treatment of |
| Recent studies show that in the case of | | | | children. If treatment is needed, the |
| premenstrual syndrome (PMS), women with | | | | doctor may suggest that another |
| a preexisting vulnerability to PMS | | | | therapist, a social worker or a |
| experienced relief from mood and | | | | psychologist, provide therapy while the |
| physical symptoms when their sex | | | | psychiatrist will oversee medication if |
| hormones were suppressed. Shortly after | | | | it is needed. Parents should not be |
| the hormones were re-introduced, they | | | | afraid to ask questions: What are the |
| again developed symptoms of PMS. Women | | | | therapist's qualifications? What kind of |
| without a history of PMS reported no | | | | therapy will the child have? Will the |
| effects of the hormonal manipulation. | | | | family as a whole participate in |
| Many women are also particularly | | | | therapy? Will my child's therapy include |
| vulnerable after the birth of a baby. | | | | an antidepressant? If so, what might the |
| The hormonal and physical changes, as | | | | side effects be? |
| well as the added responsibility of a | | | | The National Institute of Mental Health |
| new life, can be factors that lead to | | | | (NIMH) has identified the use of |
| postpartum depression in some women. | | | | medications for depression in children |
| Treatment by a sympathetic physician and | | | | as an important area to learn more |
| the family's emotional support for the | | | | about. Among the medications being |
| new mother are prime considerations in | | | | studied are antidepressants which can be |
| aiding her to recover her physical and | | | | effective in treating children with |
| mental well-being and her ability to | | | | depression, if properly monitored by the |
| care for and enjoy the infant. | | | | child's physician |
| Depression in Seniors | | | | |