Depression: A Lifelong Problem That Can Be Treated

DANBURY — “Depression is a story one tells about one’s life,” said Charles Herrick, MD, medical director of the Inpatient Psychiatric Unit at Danbury Hospital. Often a lifelong problem, affecting both children and the elderly, depression is treatable. The first step to treatment, however, is recognition.

Dr Herrick spoke with Orestes Arcuni, MD, chairman of the Department of Psychiatry and Behavioral Health, at a recent Medical Town Meeting, “Depression Across the Life Cycle: How You Can Get Better,” sponsored by Danbury Hospital.

Dr Herrick focused on depression in children and adolescents, while Dr Arcuni addressed the problem in the elderly.

Depression in children can show itself as early as infants and preschoolers. Babies can withdraw from caregivers and have eating and sleeping problems, according to Dr Herrick. In school-age children, the signs may be more overt, such as stomach aches, headaches, and school phobias. By adolescence, depressed children may be eating and sleeping more or less than previously, as well as acting reckless, depending more on peers, and struggling with autonomy.

 “Privacy and confidentiality are important issues,” said Dr Herrick.                If depression in children is not treated, it can lead to low self-esteem, chronic dysfunction, educational deficiencies, injurious behavior, alcohol and drug use, criminal activity or violence, and suicide. Therapies usually include both medications and counseling, including play, group, and cognitive behavioral therapy.

Depression is a widespread problem among the elderly, according to Dr Arcuni, with about 15 percent of the population over age 65 having at least one episode. At any given time, 20 percent of the adult population is depressed.

Depression in the elderly is often linked to the loss associated with aging. “There’s a loss of friends, family, and physical health,” said Dr Arcuni, “and it’s hard to maintain who you are through this all.” The suicide rate in depressed persons over age 65 is five times greater than the general population, he said.

In addition to having some of the classical symptoms of depression, sometimes the elderly can exhibit a slowdown of body symptoms, too. People who are depressed move and think slowly, said Dr Arcuni. “They have no energy.” There can also be a slowing down of body chemistry and body symptoms that can result in symptoms such as constipation. Pain is also exacerbated for the elderly, because their bodies are not making a lot of endorphins, or natural painkillers.

Thyroid problems, stroke, and blood pressure medications can also put one at a higher risk of depression. Problem relationships and issues with children are also risk factors.

Dr Arcuni suggests that the elderly maintain strong family relationships and friendships, as well as multigenerational relationships. Focusing on what you have, and not what you don’t have, also helps, he said. “Don’t focus on the glass being half full, but rather, on what is there.”

If you or a loved one is struggling with depression, contact your primary care doctor. Other help may be suggested, but starting with your family doctor is the first step, the specialists said. Anyone who needs a physician referral can call the Danbury Hospital Medical Staff office at 797-7322.