Depression Archive

Act now to avoid potential dangers associated with solitary living, such as coronary artery disease, stroke, and thinking skills decline.

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One lovely picture of older age is of smiling seniors enjoying their golden years with partners, friends, and family. In reality, many seniors are isolated and lonely. The National Council on Aging reports that one in six adults ages 65 or older is isolated, either socially or geographically. And in a 2010 AARP survey, 25% of respondents ages 70 or older said they felt lonely.

Health risks

News Briefs

Don't be surprised if your doctor screens you for depression at your next visit. An update to the U.S. Preventive Services Task Force recommendations for screenings, published Jan. 26, 2016, in The Journal of the American Medical Association, suggests that all adults 18 or older, including older adults, should be screened for depression when there are systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. The previous recommendations encouraged selective screening based on professional judgment and patient preferences. The new recommendation also includes pregnant and postpartum women for the first time. "Older adults often struggle with chronic disease, or the loss of a loved one, which may lead to depression," says Dr. Michael Craig Miller, an assistant professor of psychiatry at Harvard Medical School. "Screening is just a way to open the door for people who might otherwise not get the help they need." Dr. Miller says screening can simply be asking if, over a two-week period, you have either had little interest or pleasure in doing things or felt depressed and hopeless.

They're cute, cuddly, and loving, but dogs and cats aren't always appropriate for older adults.

There's a reason dogs are dubbed man's best friend. Dogs—and cats, too—make wonderful companions and provide many emotional and physical benefits. "I'm a believer in the beneficial effects of having a pet, and I'm impressed with the ability of dogs in particular to form bonds with human beings. I think the science is starting to support their special ability to do that," says psychiatrist Dr. Greg Fricchione, director of the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine. However, there are a number of considerations to mull over before adding a pet to your household.

Benefits

The most obvious benefits of pet ownership are love and companionship. "We do best medically and emotionally when we feel securely attached to another, because we're mammals and that's the way we've evolved," says Dr. Fricchione. He points out that we feel especially secure with dogs and cats because of the unconditional love they provide. "No matter what you do or say, your dog or cat accepts you and is attached to you," says Dr. Fricchione. Taking care of a dog or a cat can provide a sense of purpose and a feeling of validation when you wake up or come home and there's someone who's happy to see you.

Learning to deal with stress can lower your risk for anxiety, depression, and cardiovascular disease.

The more we learn about women's hearts, the more we realize that they are different from men's. One of the most dramatic differences is a rare heart condition called takotsubo cardiomyopathy, or broken-heart syndrome, that is nine times more common in women than in men. It has been cited as evidence that sudden emotional stress can actually cause death in some women.

Like a heart attack, takotsubo cardiomyopathy strikes suddenly with symptoms such as chest pain and shortness of breath; however, it does not involve clogged arteries. Takotsubo cardiomyopathy is brought on by a surge of stress hormones that literally bend the heart out of shape. As a result, when the main pumping chamber of the heart (the left ventricle) contracts, it balloons out, so it can't eject blood into the arteries effectively.

Ask the doctor

Q. My daughter had a miscarriage a few months ago and since then she has been depressed and withdrawn. Do you know anything I can do to help?

A. Miscarriage can involve a difficult emotional recovery, and many women and their partners are surprised at the intensity of their feelings. Many women who have experienced a miscarriage feel that they have done something wrong. They may worry that the miscarriage resulted from stress or lifestyle choices they made during pregnancy. In fact, most miscarriages are the result of chromosomal abnormalities, structural abnormalities of the uterus, or maternal endocrine or autoimmune disorders.

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Research we're watching

Light therapy has been the treatment of choice for seasonal affective disorder (SAD)—the gloom that descends on some people as the days grow short. The therapy typically involves spending about 30 minutes a day—usually immediately after waking—in front of a box that emits bright fluorescent light. A study published online Nov. 18, 2015, by JAMA Psychiatry demonstrates that light therapy can also alleviate major depressive disorder.

Researchers randomly assigned 122 women and men with major depression to four groups—31 received fluoxetine (Prozac) and light therapy, 32 received light therapy and a placebo pill, 31 took fluoxetine and underwent a sham (placebo) treatment using an ion generator in place of the light box, and 30 took a placebo and underwent sham therapy. At the end of the eight-week treatment period, depression was alleviated in 17 of those who had both light therapy and fluoxetine, 14 of those who had light therapy and took placebo pills, six who took fluoxetene and had sham light therapy, and nine who had only placebo treatments.

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Plan now to help prevent overeating, trips to the hospital, and depression.

The winter holidays are supposed to be a joyous time, filled with celebration. But they come with health risks, such as loneliness and depression, overeating, weight gain, falls in icy weather, foodborne illness, and heart problems. Here are ways to protect yourself while enjoying the season.

Ask the doctor

Q. I've had some severe bouts of depression before my periods. I have done my own research and I am willing to try an antidepressant. What dosage of Sarafem or Prozac is usually given to treat this?

A. Selective serotonin reuptake inhibitors (SSRIs) are an excellent option for treating premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). In fact, most physicians now consider them first-line therapy. Many different SSRIs have been studied, including the one you asked about—fluoxetine (Prozac or Sarafem)—and they all appear to be equally effective.

Medical science is making good progress in unraveling the biological underpinnings of depression. Someday, these discoveries may lead to lab tests that can help identify or confirm depression and other mood disorders.

Right now, doctors and therapists rely on the symptoms reported by their patients, along with clinical expertise and experience, to diagnose depression and determine a course of treatment.

Sometimes, though, additional information can help distinguish depression from other problems. That's why your doctor might recommend any of the following tests:

Whether you get a recommendation for a therapist from your primary care doctor, a friend, or your insurance company, finding out about his or her background and training can help you feel comfortable with your choice. Here are some questions to ask before settling on a therapist:

1. What's your training (i.e., what certification or degrees do you hold)?
2. How long have you worked in this field?
3. What kinds of treatment or therapy do you think might help me?
4. What are the advantages and disadvantages of different approaches to treatment, including medications?
5. How does the type of treatment you offer work?
6. What are the chances that treatment will succeed?
7. How soon should I start feeling better?
8. How will we assess my progress?
9. What should I do if I don't feel better?
10. How much will treatment cost?

It's hard for a therapist to give precise answers to some of these questions, because no single therapist or type of treatment is best for everyone. But there are some general responses you should be looking for: The therapist should easily be able to describe his or her formal training and certification, for example. And while there's a tendency for mental health professionals to offer only the particular type of psychotherapy that they do best, it's a good sign if the person can describe the merits and drawbacks of different types of treatment, including ones he or she doesn't do.