Crawford Care Management


More than 40 million people in the United States suffer from depression each year. Depression can affect anyone regardless of their state of physical health. In fact, depression very often accompanies almost any chronic disease or condition. Depression is characterized by feelings of sadness, worthlessness, loss of energy and desire for two weeks or more.

It is important to understand that depression is more than just feeling sad. Indeed, some events in our lives, like retirement from a productive career, losing friends or loved ones, loneliness, health problems, or loss of independence may cause feelings of sadness or grief. These feelings are considered a normal reaction to life situations. But when symptoms continue for weeks or months after such events, it's time to seek professional help.

Depression is often the underlying condition for which individuals seek medical care. Today, 15 percent to 20 percent of the general population is being treated for depression by their primary care physicians. And many more people suffer from the disorder but do not seek treatment. Older adults may be less likely to talk to their doctors about sadness or anxiety because of embarrassment. As a result, older Americans with psychological symptoms don't always get the care they need. It is very important that patients feel totally free to discuss any physical or psychological issues with their doctors. And you, your friends and/or family members may ultimately be in the best position to recognize signs of depression.

How do you know if you or someone you care about is depressed? There are a myriad of symptoms and generally, the more symptoms that are present, the more depressed someone may be. Any of the following symptoms, that persist longer than two weeks may indicate the presence of depression.

  • Loss of interest in work, hobbies, or activities one used to enjoy.
  • Extended feeling of sadness, emptiness, or pessimism.
  • Crying easily or over something that normally would be insignificant.
  • Feelings of guilt or worthlessness.
  • Unintended change in weight or poor appetite.
  • Difficulty recalling things, concentrating, or making decisions.
  • Problems sleeping, or wanting to sleep at all times of the day.
  • Feeling tired, sluggish, or fatigued.
  • Thoughts about death or suicide or pre-occupation with death or dying.

If these symptoms persist, get help! Depression is not something to be ashamed to talk about and it is not a weakness in one's character. It is an illness that affects the entire body, not just the mind. And, without treatment, it can continue for months - and get worse. Depression sufferers cannot simply will themselves to feel better. No matter how strong one's character, you can't "fix it" yourself. It is an illness, much like arthritis, heart disease, and diabetes.

Causes of depression are not well known, however hereditary or environmental factors may both contribute to changes in chemicals in the brain, which lead to the disorder. Other factors may also contribute. Some illnesses themselves, like heart disease, stroke, Parkinson's disease, and Alzheimer's disease may cause depression. Multiple medications may cause or worsen depression. Alcohol and drug abuse can also lead to depression.

While depression is common in older adults, it is not a normal part of aging and therefore should never be considered as something to simply tolerate. Safe and effective treatment is available for most types of depression. Medications, called antidepressants, can help us regain the proper balance of chemicals in the brain. In addition, several types of therapy are available to help identify and change negative thinking, and help to resolve issues or better manage problems. See your doctor for more information about which treatment may be right for you.

What Can You Do?

  • Everyone suffering from depression can gain some benefit by just learning more about the illness. There is ample material available from numerous sources.
  • Understand that depression rarely resolves on its own. Understand that the illness is treatable and that you are starting the healing process. Untreated, depression can last for months, even years.
  • Get help. See a physician for evaluation and treatment. Report all physical ailments to your doctor as these may be contributing to your depression. Sometimes it can help if a trusted family member accompanies the patient to the doctor's office.
  • Follow doctor's instructions carefully, an important step toward getting better. Some positive effects of treatment may be felt relatively soon; others will take more time. Don't stop taking medication without talking to your doctor.
  • Document your progress and let your doctor know how you are doing and any side effects you may be experiencing from medication.
  • Stick to an exercise schedule, get enough sleep, and maintain good nutrition and personal hygiene. Depression affects your whole body. Keeping healthy is a solid defense.
  • Stay involved. Spend time with people rather than be alone. Accept invitations to participate in activities. Find time to do the things you enjoy.
  • Associate with people who will offer emotional support and encouragement for following through with treatment.
  • If you have thoughts about hurting yourself, these thoughts may be part of your depression. Tell a doctor, family or friends, or contact the suicide hot line. Treatment will help.

Non-Medication Depression "Busters"
Many elderly people suffer from depression. Some naturally have chemical imbalances and other medical causes of the illness, but others suffer from depression for other reasons. Isolation, loss of function, loneliness, chronic illness, and death of friends and family are examples of contributing factors. In those situations, there are non-medication interventions that are often very powerful in lifting feelings of helplessness and hopelessness. These tasks and activities can be accomplished by family, friends, and caregivers with significant success.

  • Visit as frequently as possible. Loneliness heightens feelings of inadequacy and unimportance. If family and friends are not geographically close, a home health aide whose personality is compatible with the client can be equally as effective.
  • During visits be attentive and supportive. Holding hands, applying hand lotion, and hugs are all examples of caring behaviors that work wonders.
  • The elderly typically need three times the lighting to see well and avoid falls and other accidents. Bright, non-glaring light is much more uplifting than a dimly lit room. Lack of sunlight is tied to an increase in depression in winter months. Adding a pretty lamp in the corner of a favorite seating area will help.
  • Fresh flowers are cheerful for both women and men. Carnations are inexpensive and last longer than many other flowers and they come in bright colors.
  • Bringing a warm scone or apple muffin to a morning visit is thoughtful and a nice way to introduce having a cup of tea together as "friends" do from time to time.
  • There are some charming videotapes available that were originally made for children. They are non-animated animal baby films that show animals playing. Older people often find themselves laughing at the antics of a 20 minute show of fun. Laughter is a powerful antidote for depression.
  • Participate in hobbies. If the older person likes cooking, ask for recipes. If they enjoy gardening, ask for instruction for planting bulbs. If they played cards or checkers, suggest a game. Reminders of enjoyable times are good conversation starters and lighten the mood.
  • Ask questions. Getting an elderly person to talk about the past can be rewarding for them and for the audience. Find out about grade school in their day. Get them to describe their first date or their wedding day. Trigger good memories about pleasant times.
  • Look through family albums. Ask about children, pets, or homes. Offer to bring pictures of your own, and then make a note to yourself to really do it!
  • Always smile when you're visiting. It's contagious.