LITTLE ROCK — December is here and Christmas is around the corner. It’s the best time of the year, a time for family, togetherness, friendship and good will. We should all be so happy - yet this is the time of the year that depression is most common. Instead of joy, many feel sadness, loneliness and a yearning for a time when things were better.
This particularly applies to older people. Instead of everyone gathering at their home, the family is scattered, a loved one has gone and the children have their own lives to lead. Older people feel particularly lonely and vulnerable and, worst of all, many feel no longer needed or valued.
Winter aggravates the problem. Days are shorter and cooler, we are exposed to less sunlight, and a condition called seasonal affective disorder (SAD) becomes very common. So this time of joy and love is often accompanied by a high prevalence of depression.
Unfortunately, the reaction to this feeling of glumness is often not appropriate. Depressed people are frequently scolded. “Stop being such a slug!” “Snap out of it.” “What do you have to be upset about?” or “You are no fun to be around and you’re spoiling ours!” are common, but inappropriate, responses.
Most depressed people can’t help themselves, and most importantly, the depression is not their fault.
For those of you reading this who feel depressed, the important message is: These feelings frequently cannot be helped, you are not worthless, it is not your fault, and yes, there is help out there.
While depression is often precipitated by an external event, it persists because of reversible but abnormal changes in the brain. Specifically, the concentrations of the chemicals noradrenaline and serotonin become depleted, and for various reasons the brain is unable to correct the deficiency, leading to symptoms of depression. These include becoming fatigued, sleeping excessively during the day, insomnia, weight loss or gain, tearfulness, becoming very quiet, not participating in daily activities, staying in your room and even experiencing memory loss.
If you are experiencing any of these symptoms, seek help, and if you know someone who has them, please make sure they seek help. There is much that can be done. Persuade the affected person to see a physician. A careful evaluation may identify conditions that aggravate or even cause depression.
Many chronic illnesses can precipitate or aggravate depression, and so can drugs used in treatment. These include beta blockers used to treat hypertension; other heart medications; tranquilizers and sleeping pills; and most importantly, excessive use of alcohol.
Treatment of depression includes psychotherapy, education and often medications. The most common are drugs called selective serotonin re-uptake inhibitors (SSRIs), and every week a new medication is released with the hope that it will better treat depression. Currently one in four adult women are on one of these medications. Paradoxically many people just refuse to take them: “I will not take anything that messes with my mind!” or “Those drugs will make me crazy!”
While they do have side effects, for those who need them, the results can be very beneficial. What works for one person might not for another. Generally, a primary care physician adequately treats depression. If initial treatment is not successful or if symptoms are severe and suicide is a concern, referral to a specialist is essential.
And understand the importance of sunlight in treating seasonal affective disorder at this time of the year. There are many Internet sites that sell light boxes. Sitting close to them for a minimumof four hours daily can help relieve depression in many patients.
Please become aware of the signs of depression and remember to be there for your loved ones and attuned to their needs. Paying attention to physical, mental and spiritual health is particularly important whether the time is joyful or sad. Remember to be considerate, do what you can to include everyone in holiday plans and, for parents and grandparents, make them feel important and involved. Look on the bright side, be as considerate and understanding as possible, and see the inner and outer beauty in you and those around you.
Dr. David Lipschitz is the director of The Longevity Center at St. Vincent Infirmary Medical Center. More information is available at:
drdavidhealth.com
High Profile, Pages 39 on 12/04/2011