Aging & Health A to Z

Depression

Basic Facts & Information

What is Depression?

Everyone feels sad from time to time. But depression is different. It’s more than just a case of the blues. Depression is a medical problem—it is a mood disorder that can interfere with all aspects of your daily life. It can cause long-term sadness, anger, frustration, interfere with sleep and cause feelings of hopelessness or loss. Depression can sap your energy and interfere with your ability to work and have healthy relationships and a satisfying social life. Depression can even lead to suicide. For all these reasons, you need to recognize and take your depression seriously, and get appropriate treatment right away.

How Common is Depression?

National surveys find that between one and two percent of the 35 million Americans older than 65 suffer from major depression, with more women than men reporting that they are depressed. However, the numbers are likely higher because older adults are less likely to admit or even realize that they are depressed. Another 5 million older Americans have milder forms of the illness. Of older adults who have committed suicide, an estimated 75% were probably clinically depressed when they did so.

Common Types of Depression

Depression comes in many forms. It ranges from mild, temporary bouts of sadness to severe, persistent depressed mood with poor functioning on a daily basis. The most common forms of depression are described below.

Major Depression
Major or “clinical” depression is the most severe, persistent type of depression. This depression occurs daily for at least 2 weeks but most older adults suffer much longer before they realize that something is wrong. As much as 15% of people with major depression commit suicide. If you have symptoms of major depression, consult your healthcare professional immediately.

The three forms of major depression listed below are relatively common in later life.

• Depression associated with dementia: Some symptoms of major depression resemble symptoms of dementia, which is another reason why anyone with signs of depression should see a healthcare professional. 
• Depression associated with physical illness: If you are suffering from a chronic disease such as diabetes, or have a serious health problem such as cancer or heart disease, you run an increased risk of depression. Medications that you may be taking to treat these illnesses may also cause side effects that contribute to depression.
• Depression associated with bereavement: As we get older, we are more likely to face the loss of family and friends. When you lose someone you care deeply about, you run an increased risk of becoming depressed.

Psychotic Depression
People with severe depression may experience hallucinations or delusions or may see or hear things that are not really there. Some may experience paranoia or feel very suspicious, such as feelings of worry that other people are trying to harm you. This type of psychotic depression is most common in severe types of  depression and towards the end of life.

Minor (sub-clinical) Depression
About 15% of older adults have milder symptoms of depression. Although this "minor" or subclinical depression is less severe than major depression, it can still cause problems. This form of depression has been linked to poor health, more visits to the doctor, difficulty functioning, decreased social activity, and early death.

Seasonal Depression
If you feel particularly depressed during the winter, you may have seasonal depression (also called Seasonal Affective Disorder or SAD). This type of depression usually occurs during the winter and lasts about two months. If the pattern repeats for 2 years or more, your healthcare professional may diagnose you with SAD.

Bipolar Disorder
Bipolar disorder (previously called “manic-depressive disorder”) involves periods of major depression that alternate with manic episodes. During the manic periods, patients are unusually high-spirited, talkative and hyperactive for a week or more.  They may have feelings of inflated self-esteem, grandiosity, increased sexual desire, and do not sleep as much as they normally do. They may spend money wildly and have racing thoughts. They may also have paranoid delusions. Older adults may be irritable or agitated rather than high-spirited and grandiose.

Updated: March 2012
Posted:  March 2012