Guest Commentary: The holidaze, older adults and depression

So, the “holidaze” are here and you’re not feeling really “with it.”

The holidays are supposed to be a time full of joy, presents, special foods, parties, and family gatherings. But perhaps your family lives across the country or you’re not on the best of terms with your only sister, or this is the first holiday you’re celebrating without your longtime spouse. Maybe everyone around you is spending lots of money (or you think they are) and you’re struggling to make ends meet on a small fixed income.

Do you find yourself being unusually introspective, feeling lonely, reflecting on past regrets and experiencing anxiety about the future? Unrealistic expectations of what the holidays should bring, fatigue from shopping and frustration with over-commercialization may lead to excessive drinking and over-eating, problems sleeping and headaches. Even after Jan.1, people can experience a post-holiday let-down - a combination of unrealized expectations, exhaustion and getting hit with credit card bills.

Social isolation, unresolved grief and loss, substance abuse and financial concerns can all contribute to feeling depressed at any time of the year.

With the onset of enforced “cheer,” you may be more keenly aware of the contrast between how you really feel and what you are expected to be feeling.

In spite of what the media tells us are supposed to be “normal” holiday emotions, it really is OK to feel sad and lonely if that’s what’s going on. Where the problem arises is if you are persistently feeling “down” to the point where your daily functioning is impaired for a period of at least two weeks. Changes in sleep, appetite, lack of pleasure in activities, difficulty concentrating and thoughts of suicide are some of the symptoms of depression.

Isn’t depression just part of aging?

Let’s start by exploding a prevailing myth- depression is not a normal part of the aging process. Depression is a true medical condition. More than 6 million Americans 65 and older suffer from depression - but only 10 percent are treated for it.

Symptoms of depression in older adults are often confused with the effects of multiple illnesses and the medicines used to treat them. Also, health professionals, as well as older adults themselves, may accept depression as a response to illness, events such as the “holidaze” and social and financial hardships. (National Institute of Health).

According to the American Psychiatric Association, women are twice as likely as men to suffer depression. 50 percent of all families in this country are affected by depression.

In one survey, lesbian and gay adults ranked depression as their No. 1 mental health concern after HIV/AIDS.

What if I don’t do anything about my depression?

Untreated depression can delay recovery or worsen the outcome of other illnesses. Depression can be a precursor to suicide. In studies of nursing home patients with physical illnesses, depression was shown to substantially increase their likelihood of death from those illnesses. Depression also has been associated with increased risk of death following a heart attack.

Depression in the elderly is more likely to lead to suicide. Elderly white men are at greatest risk, with suicide rates in people ages 80 to 84 being more than twice that of the general population.

The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem.

How can I get help?

The best prevention is early detection; most cases of depression are treated on an outpatient basis. Even if the depression is mild, make sure that you (or the person you are concerned about) are evaluated and treated, if necessary. Ask for an evaluation to rule out any physical reasons for symptoms of depression. Your doctor may treat your depression with antidepressant medications or recommend psychotherapy, or prescribe a combination of both. For some, electroconvulsive therapy (ECT) may work. Doctors may discontinue or switch other medications you may be taking that have a tendency to intensify depressed conditions.

How can I prevent depression?

People with broad social networks enjoy better physical and mental health. Isolation increases vulnerability to depression. Maintain as high a quality of life as you can. Avoid self-medicating with alcohol and drugs, get enough sleep, eat a healthy diet and stay busy through activities like volunteering and exercise. Taking a class (like “Conscious Aging”) or having lunch with friends (both available at the Casa Community Center) can help you feel connected. A sense of connection to the community can help mitigate unrealized expectations of the holiday season.

Call 625-2273 to access the 24 hour Care Line and to find out about various programs at Casa de Esperanza, such as the Community Center, Adult Day Health Care, Caregiver Support groups and Behavioral Health services. Alcoholics Anonymous (624-4183) has meetings in Green Valley and Tucson.

Sage Bergstrom MSW, LCSW has been the Clinical Director of Casa de Esperanza since 1999. She is a licensed clinical social worker with 27 years’ post-Master’s degree experience having worked in a wide variety of setting.