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Sometimes, we all feel melancholic or sad, in response to negative environmental elements. But these feelings, in general are temporary and disappear in few days, when the situation that gave rise to them or the emotions are settled.

When we talk about depressive disorder, we talk about a person who has problems with daily life for several weeks. Depression is a serious disease that needs treatment. However, if left untreated, depression can even lead to suicide.
 Though depression is a common problem among the elderly, it is not a normal stage of aging. It can be overlooked because in some older people who suffer from the condition, sadness is not the main characteristic.
 They may have other less obvious symptoms of depression or may not be willing to talk about their feelings. That is why, it is difficult for doctors to recognize if your patient is suffering from depression.

  • How can depression be identified?
  • Different people can suffer different types of symptoms, for example:
  • Feeling sad or empty
  • Feeling hopeless, irritable, anxious or guilty.
  • Loss of interest in favorite activities.
  • Feeling very tired.
  • Not being able to concentrate or remember details.
  • Not being able to sleep or sleep too much.
  • Eating too much or not inclined to eat at all.
  • Thoughts of suicide or even attempting suicide..
  • Pain or discomfort, headaches, cramps or digestive problems.

How is depression happening? What causes depression?
Several factors or a combination of factors can contribute to causing depression. Among them:
Genes – People with family history of depression may be more likely to develop it than those whose families do not have the disease.
Brain neurotransmitters – People who suffer from depressive illness have different brain chemistry than those who do not have the disease.
Stress – the loss of a loved one, a difficult relationship, or any stressful situation can trigger depression.
We find out that older people who suffered from depression when they were young are at a higher risk of developing it later in life than those who were not affected earlier. Then, for older people who experience depression for the first time at a later stage in life, this may be related to changes that occur in the brain and the body as the person gets older.. For example, older people may suffer from limited blood circulation, a condition called ischemia.
 With the passage of time, the blood vessels thicken, preventing blood from flowing normally to the body organs, including the brain. If this happens an older person without a family history of depression may develop what is called vascular depression.  Those suffering from vascular depression may be at risk of heart disease, stroke or other conditions linked to blood flow.
Depression can also coexist with other serious medical conditions such as diabetes, cancer, heart disease and Parkinson’s. Depression can worsen these conditions in the same way that they can be factors causing it.
 Some medications taken for these medical conditions can cause side effects leading to depression.
What  should we do in depressive conditions
 First, we need to visit the doctor who is in the best position to advise on medication and conditions that can cause symptoms similar to those of depression.
 If after the consultation, physical examination and laboratory tests, the doctor ascertains that you are in a state of depression, he/ she can refer you to a mental health professional such as a psychologist, counselor, social worker or psychiatrist.
 Some doctors are specially trained to treat depression and other mental illnesses in senior citizens.
  The doctor or mental health professional will interview you about the symptoms. He/she will be interested about when the symptoms began, how long they lasted, their severity, if they have occurred previously and if so, if they were treated and how.
 The professional will then diagnose depression and will decide on the most appropriate treatment.
  It is important to remember that a person with depression cannot simply recover “in a heartbeat.” The treatment options differ according to each person and sometimes different treatments are tried until  the most suitable one is found..
 Antidepressants may be effective in treating depression. It may take several weeks to take effect. Antidepressants can have side effect that include; headache, nausea, feeling of stomach break down, difficulty of sleeping or nervousness, agitations or restless, sexual problems and other less common ones.
 Most of side effects decrease with the passage of time. However, the doctor must be made aware of any side effect you think you have.
The antidepressants cannot work alone, especially for a long time. Together with the psychopharmacology, we need psychotherapy which is the most important stone in the treatment because it helps by teaching new ways of thinking as well as behavior.
 It is also important to change some habits that can contribute to depression. Therapy can help you understand and deal with difficult relationships or situations that may be causing or worsening depression.
If you know someone suffering from depression, advise him/her to see a doctor or mental health professional . Then continue assisting by”

  • Offering support, understanding, patience and encouragement.
  • Talk and listen carefully.
  • Invite this person to take on some activities in free spaces.
  • Remind her (him) that over the time with treatment, depression will heal.

Feeling depressed?
Remember that as you continue with the treatment, you will feel better gradually. If you are taking antidepressants, you can take several to take the effect. Sometimes the anti-depressants do not act immediately .The doctor will try different medications until he finds the one that works best .
 Very important Do not make important decisions or commitments until you are healed.!
Try to do things you used to enjoy before suffering from depression. Doing these things, even when you do not expect to enjoy them, can help improve your mood. Among other things that can help are:

  • Once you have a treatment plan, adhere to it, while taking time to work properly.
  • Divide the large task into small ones and do what you can.
  • Do not do many things at the same time.
  • Spend time with other people and talk with people you trust and share with them.

All these things may help with the correct treatment and the patient’s discipline.
Dr. Bienvenido Rodriguez Lezcano
Psychiatrist. Victoria Psychiatric Unit.