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When It's More Than Just the Blues

Symptoms of Clinical Depression
(from the U.S. Department of Health and Human Services)

  1. Persistent sadness, anxiety, or empty mood
  2. Loss of interest or pleasure in ordinary activities, family, or friends
  3. Decreased energy, listlessness, fatigue, feeling "slowed down" especially in the morning
  4. Sleep problems and changes in sleep patterns (can't get to sleep, oversleeping, waking up too early)
  5. Eating problems and changes in eating patterns or foods consumed (weight loss or gain, gain or loss in appetite)
  6. Difficulty concentrating, remembering, or making decisions
  7. Feelings of hopelessness or pessimism
  8. Feelings of guilt, worthlessness, hopelessness or helplessness
  9. Thoughts of suicide or death
  10. Irritability
  11. Excessive crying, sometimes without reason
  12. Recurring aches and pains (headaches, backaches) that don't respond to treatment

It would be good if you can go to this doctor's appointment with your mom or at least talk to the doctor ahead of time. Don't, however, make this into some James Bond operation behind her back. You'll only be sending her the message that this is something shameful. Simply describe the symptoms as you would any other illness. Given her state of mind, however, she might need a little help in describing the symptoms and how they have affected her daily life. You also can be a good resource on how this is different from any past ways Mom has reacted to problems. Doctors often use standardized questionnaires and blood work to diagnose depression.

Can a Pill Fix It?

Now to make this even tougher, here's an adage to keep in mind, “The cure can be worse than the disease.” Antidepressant drugs can be great, but they should not be dispensed until a differential diagnosis (figuring out what's really wrong) has been made. Just giving out an antidepressant without knowing the underlying cause can mask a serious health problem that will only get worse. Studies have shown that far too many elderly are given a pill rather than offered psychotherapy or other mental health services.

These drugs are also very powerful and it takes time to get the dosing just right— especially among the elderly. Their body's drug absorption rate is different from the younger subjects that the drug companies tested before it was made available to the general public. A geriatric psychiatrist is the best prepared physician to figure out what is best for your mom. The right medication with the correct dosage can do wonders but be sure to monitor your parent's reaction to the drug very carefully!


Senior Alert

Going back and forth between different antidepressants can pose serious problems for your parent. Don't let insurance companies or pharmacists, who have been given an incentive by drug companies, switch your parent's medications without your parent, you, and the doctor knowing the full ramifications of what the change in medication can mean.


White males 85 years and over commit suicide at six times the national rate! Making up 13 percent of the U.S. population, individuals 65 years and over disproportionately account for 20 percent of all suicides.

Severe depression left unchecked can result in suicide. Your dad's age group (65 years plus) has the highest suicide rate of any age group in the country! White males over 85 years of age are at greatest risk. In the midst of writing this book, a dear friend's Dad took his life. He had never had a history of depression or mental illness. He was a hard worker, loved his family, and didn't have any money problems. But a complication during back surgery left him with even more physical problems, another surgery, and a tremendous amount of pain. His last comment from his doctor's appointment was “I just wish they could just give me some hope.” He ended his life days later with a loving note to his family assuring them it had nothing to do with them. He just couldn't live with the pain and despair one day longer. My friend's dad fit the pattern—a recent study has shown that 40 percent of elderly suicide victims saw their primary physician within one week of committing suicide, and 70 percent within the month! The bottom line? Even the doctors aren't picking up on our parents' suicidal state of mind.

If your mom or dad has symptoms of depression, don't simply look the other way thinking they'll get past it without any help. Urge them to seek help from their primary care physician or a mental health specialist.

Anxiety Disorders

Ever have your 17-year-old tell you to chill out or accuse you of worrying too much? It's pretty hard not to be an anxious parent as your teenager walks out the door with keys in hand. If you didn't worry, something would be wrong. But if your dad appears to be excessively worried about the future, feels nervous tension, or has become very fearful, he might be experiencing an anxiety disorder. About one in 10 adults over 55 years of age has this condition to a point where medical help is needed to get over it. You need a professional to figure out if this is related to a physical problem or is psychological. Anti-anxiety drugs must be prescribed very carefully and for a very short period of time. Be very cautious of the class of drugs known as benzodiazepines: They tend to become habit forming, and are known to cause respiratory problems, depression, and psychomotor impairment that can turn your dad into a terrible driver, make him confused, and impair his memory.

More on: Aging Parents


Excerpted from The Complete Idiot's Guide to Caring for Aging Parents © 2001 by Linda Colvin Rhodes, Ed.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

To order this book visit the Idiot's Guide web site or call 1-800-253-6476.


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