Recognizing and coping
When you’re ready to move forward
The difficult changes that many adults face, such as the loss of a relationship, a job, divorce, death of a spouse or medical problems, can lead to depression, especially in those without a strong support system. Left alone, depression not only prevents people from enjoying life, it also takes a heavy toll on health. If you learn how to spot the signs of depression, you can find effective ways to help yourself or your loved one.
Is it grief or depression?
Loss is painful—whether it’s a loss of independence, mobility, health, your long-time career, or someone you love. Grieving over these losses is normal, even if the feelings of sadness last for weeks or months. Losing all hope and joy, however, is not normal; it is depression.
Although a grieving person may experience a number of depressive symptoms such as frequent crying and profound sadness, grief is a natural and healthy response to bereavement and other major losses. There is a difference, however, between a normal grief reaction and one that is disabling or unrelenting. While there’s no set timetable for grieving, if it doesn’t let up over time or extinguishes all signs of joy — laughing at a good joke, brightening in response to a hug, appreciating a beautiful sunset — it may be depression.
Depression without sadness
Adults don’t always fit the typical picture of depression. Many depressed individuals don’t claim to feel sad at all. They may complain instead, of low motivation, a lack of energy, or physical problems. In fact, physical complaints, such as pain or headaches that have gotten worse, are often the predominant symptom of depression in adults.
Adults with depression are also more likely to show symptoms of anxiety or irritability. They may constantly wring their hands, pace around the room, or fret obsessively about money, their health, or the state of the world.
Although depression in seniors is a common problem, only a small percentage get the help they need. There are many reasons depression in seniors is so often overlooked. Some assume seniors have good reason to be down or that depression is just part of aging. Seniors are often isolated, with few around to notice their distress. Finally, many depressed seniors are reluctant to talk about their feelings or ask for help.
Feeling Depressed in Reaction to Your Problems with Anxiety
It’s also common for people who are having a difficult time with an anxiety disorder to feel depressed as a result of the way anxiety is interfering with their lives. It’s my experience that most patients who go through this will find that their depression lifts naturally as a result of doing better with anxiety, and no special treatment for the depression is necessary.
There are two circumstances under which anxiety patients may need specific help for depression. One, is if they have become so depressed in response to anxiety that they no longer have the energy and motivation to overcome the anxiety disorder. In this case, either medication or cognitive behavioral methods can be used to help overcome the depression. The second is the case of individuals who experienced a severe depression before the anxiety disorder appeared, a depression which was not just a reaction to the troubles imposed by the anxiety disorder. This depression, called a primary depression, is likely to require medication treatment.
If you find yourself confused about your symptoms of anxiety and depression, and what kind of trouble they may indicate, don’t struggle in silence with the confusion. Ask your doctor or therapist directly about your diagnosis.
Thoughts About Death
People with chronic anxiety disorders may find they are having lots of thoughts about death, and may then worry that this means they are suicidal, or even homicidal. People with Panic Disorder often have lots of worrisome thoughts about dying, particularly of heart attacks and terrible diseases. People with OCD may have thoughts in which they wonder what stops them from committing some terrible crime, like killing people they love. People with Generalized Anxiety Disorder may have “what if” thoughts in which they worry about becoming so anxious and hopeless that they become suicidal.
If you have such thoughts, and find them disturbing, it’s a good idea to discuss them with a qualified psychologist. People often want to keep these thoughts to themselves because they feel ashamed of them and worry that a therapist will over-react and want to hospitalize them. However, these thoughts are a common part of anxiety disorders, and a therapist who is well versed in the treatment of anxiety disorders will probably be able to evaluate the thoughts and come to a realistic understanding of what they mean and don’t mean. So review these with a therapist, in the same way you would review all the other symptoms you experience.
Bring any Doubts to Your Psychologist
It’s often difficult to come to grips with the confusion and uncertainty that characterize the problems of anxiety and depression, when you keep them to yourself and try to figure it out on your own. It is helpful to come in to talk to a psychologist who can help you over the bumps on the pathway of life.
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