Reprinted from the Health District's quarterly publication mailed to district residents (Winter 2002)

Joan’s 70s have been a time of loss.

“I lost my husband, my home, my health and my independence – one right after the other,” said the Fort Collins resident who asked that her last name not be used. “After awhile, I just thought I was just going to spend the rest of my life grieving.

“I didn’t realize that my feelings had become a medical problem.”

The most likely to dismiss depression are those who suffer from it. About 58 percent of people age 65 and older believe that it is “normal” for people to get depressed as they grow older, according to a study by the National Mental Health Association. Even when depression is recognized, it often goes untreated because older adults are more likely than any other group to try to “handle it themselves.” In addition, only 38 percent of Americans older than 65 believe that depression is a “health” problem.

“We had a man come in diagnosed as having Alzheimer’s, but as it turns out he was depressed,” says Al Heath, a licensed therapist and clinical social worker at the Larimer Center for Mental Health. “But he wouldn’t tolerate hearing the word ‘depression,’ instead he described himself as being frustrated.”

Depression in the elderly may not express itself in the typical fashion. Elderly people suffering depression may be more anxious and agitated, complain about disorientation, memory loss, or difficulty concentrating. This may look like dementia, making a careful diagnosis important because depression and dementia have different treatment programs.

Heath said the most visible sign of depression in the elderly is often anger.

“Men especially think of having depression as being weak,” he says. “And it’s much more acceptable for them to be mad than be weak.”

Bonnie Shetler, a Fort Collins psychologist whose practice is focused on mid-life and aging issues, says she hasn’t seen an increase in depression in the elderly as much as she has an increased awareness of the disease and a slow eroding of the stigma surrounding it.
“When I started out, people were dragged into counseling by their kids, friends or social services,” she says. “Now there’s an increased awareness that this isn’t the way that life is supposed to be.

“Now people are starting to come in on their own.”

In the Health District’s 2001 Community Health Survey of northern Larimer County residents, 12 percent of people 65 and older reported struggling currently with depression, anxiety or other mental health problems. That’s up from 10 percent in 1998. Nationally, more than 2 million of the 34 million Americans age 65 and older suffer from some form of depression.

It is evident from studies that episodes of depression appear to become more frequent and severe, with a longer duration as a person ages. One theory to explain this is that the neurotransmitters norepinephrine and serotonin, which regulate emotions, become less efficient with age and therefore may be responsible for the increase in severity and duration of depression in the elderly.

Because symptoms of clinical depression can be triggered by other chronic illnesses common in later life, such as Alzheimer’s disease, Parkinson’s disease, heart disease, cancer and arthritis, it is important to seek the opinion of a medical professional for a differential diagnosis.

While grieving is normal for those experiencing a loss, be it of a loved one, one’s health or even the ability to drive, family members should be attentive to make sure grief isn’t slipping into depression.

“Grief should last a finite amount of time,” says Nancy Driskil, a therapist with Consultants for Aging Families in Fort Collins. “If you think it might be something more than grief, it deserves some looking into.

“There should be happiness at every stage of life.”