Will you have an uninvited and unwelcome guest at your family’s holiday gathering this season? Dr. Guido Nodal, board certified psychiatrist and neurologist at the Indian River Medical Center, says you might. Major depression, warns Nodal, can strike anyone, anywhere and it’s especially likely to show up over the holidays. Seniors, Nodal adds, can be particularly susceptible to this disease.
There are, in fact, many forms of depression. Major depression, persistent depressive disorder, psychotic depression, manic-depressive disorder, seasonal affective disorder and postpartum depression are all on that list but the most common form is major depression. No one knows for sure exactly what causes the chemical imbalance in the brain that brings on major depression yet the symptoms can be severe. They can interfere with a person’s ability to work, sleep, eat, join in conversations and generally enjoy life. Sometimes physical pain seems to increase as well. Major depression may occur only once in a person’s lifetime, but more than likely, it’s actually a recurring illness.
People suffering from major depression, as well as their families and friends, frequently mistake the symptoms as simply “a passing mood” and think the person affected will just simply snap out of it. Unfortunately, that’s just not possible. Depression is a medical illness that won’t go away on its own. It can be fairly easily treated but if ignored it can last for weeks, months or years. In worst-case scenarios, it can even lead to death.
Some researchers believe that older adults may be particularly susceptible to major depression this time of year. Why? Because they say seniors tend to feel the absence of deceased spouses, siblings and other loved ones more acutely over the holidays. One reason, according to the Geriatric Mental Health Foundation, is that seasonal advertising fills the airwaves this time of year with idyllic images of long ago holiday festivities and those images can trigger intense feelings of loss for many seniors.
“Most people,” explains Nodal, “have the blues at some time but that’s not what we define as depression.” The Johns Hopkins Medical Center in Baltimore, MD, agrees that depression is different from feeling sad or unhappy and they add, is it not a condition that can be willed or wished away. During any one-year period, according to the Maryland-based institution, nearly 21 million American adults suffer from depression and it’s something of a sexist disease. The National Institutes of Health reports that women are 70 percent more likely than men to experience depression during their lifetime.
Nonetheless, Dr. Nodal points out that for many seniors, “mental health issues still have a stigma attached to them.” The Geriatric Mental Health Foundation concurs. It is often difficult, the GHMF says, for a depressed seniors to describe their feelings let alone seek treatment because they grew up at a time when depression was not understood to be a biological illness and because many of them worry that they run the risk of being labeled as “difficult” or even worse, senile. Other seniors, says the GMCF, worry that their illness will be seen as a character weakness.
NIH tries to counter those misconceptions by stating unequivocally, “Depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging, have shown that the brains of people who have depression even look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite and behavior,” says NIH, are clearly different in those with depression. In other words, NIH says, the evidence is now clear that depression is an actual biological disease.
There are, however, some simple steps that people can take that may help ward off bouts of the holiday blues and possibly even depression itself.
Sunlight and exercise, according to the staff at Johns Hopkins, are good places to start. Compared to states in the north, Florida has more hours of daylight this time of year and that can be a big benefit. 20 minutes of direct sunlight each day, they say, can go a long way in helping to ward off depression. Adjusting holiday expectations is another good idea. Don’t get caught up, they warn, in the idea that everything has to be perfect. We’re human beings and none of us are perfect so don’t expect all your holiday plans to go off without a hitch. Getting enough sleep is another key in preventing depression from taking hold as is eating and drinking in moderation.
Still, since we don’t live in a perfect world and diseases like depression are not under our control, what should people watch for with friends or relatives over this holiday season?
Those with major depression tend not to experience pleasures from pleasurable stimuli such as spending time with friends and family. That’s one clue. Another might be noticing diminished concentration and memory in a friend or relative. More serious signs might include extended crying spells, a desire for isolation, feelings or statements of hopelessness or an unwillingness to sleep or eat and while it’s hardly a holiday-friendly thought, excessive comments or conversations about death and suicide should be taken extremely seriously.
Researchers aren’t sure if it’s a statistical anomaly or not, but while the overall number of suicide attempts tends to decrease during the holiday season, there are some notable exceptions. For those who feel socially isolated, for example, the suicide rate can skyrocket. After age 75, the rate of suicide is three times higher than national average and for white men over the age 80, that rate doubles again to six times the national average. In other words, if you suspect depression and hear a friend or relative making suicidal comments, seek professional help right away.
Dr. Nodal says that today the most common and successful treatments for depression “combine psychotherapy and anti-depressants” and there are scores of anti-depressants available. Antidepressants primarily work on brain chemicals called neurotransmitters, including serotonin, norepinephrine and dopamine. Some of the most popular antidepressants include well-known brand names such as Prozac, Zoloft, Lexapro, Paxil, Celexa, Effexor, Cymbalta and Wellbutrin.
According to Nodal, primary care physicians can either treat or quickly refer patients suffering from depression to an appropriate health care provider. Meanwhile, the Mental Health Association of Indian River County operates both a “walk-in” and a “drop-in” center here in Vero Beach so getting professional help, even over the holidays, need not be a problem for anyone dealing with depression.
Dr. Guido Nodal is with the Indian River Medical Center. The Mental Health Association of Indian River County’s Vero Beach walk-in center is at 820 37th Place and the phone is 772-569-9788. Their drop-in center is at 1031 18th Street, Suite B where the phone is 772-778-4444.
