Can Seniors Have Depression, But Not Sadness?

Depression without sadness sounds like a mental-health oxymoron, but it’s a very real condition that’s especially common in older adults. But because other symptoms of depression are present — trouble concentrating, fatigue, rumination — it too often gets dismissed as "just getting old."

Overlooking the signs of depression in seniors can be a dangerous mistake. The highest rates of suicide occur in men over the age of 85, and studies show that many of these men had visited their doctors in the month before their suicide — but their depression was not recognized.
"Older people don't always say 'I'm depressed.' They tend to focus on physical symptoms instead of on sadness," says Vineeth John, MD, associate professor of psychiatry at the University of Texas Health Science Center in Houston. “The diagnosis is frequently missed.”
10 Signs of Depression Sans Sadness

Depression is not a normal part of aging, even though the symptoms are often mistaken as so.
"Although elderly people with depression may have classic depression symptoms such as hopelessness, they may also express their sadness as headache or nonspecific aches and pains,” explains Dr. John. “This may result in them being given pain medications instead of being treated for their depression."

Signs of depression without sadness include:
· Personality changes
· Isolation and loss of motivation
· Fatigue
· Loss of appetite and loss of weight
· Agitation and combativeness
· Changes in sleep patterns
· Poor concentration
· Forgetfulness
· Rumination
· Deterioration in home and self-care

Who’s at Risk for Depression in Old Age?

"Changes in the brain and illnesses that occur in aging may make it harder for the elderly to cope with stress and adapt to change, but depression is not a normal part of aging," says John. Still, certain risk factors increase the risk of depression in the elderly — and knowing these risk factors may help doctors and loved ones spot depression (and start treatment).

Risk factors include:
· Loss of a spouse
· Loss of mobility and independence
· Change in living arrangements
· Chronic illness
· Recent heart attack or stroke
· Use of alcohol or drugs

How Depression Is Diagnosed and Treated

"Sometimes the best person to recognize signs of depression in the elderly is a friend or family member who knows the elderly person’s level of functioning very well and notices a significant change," explains John.

Mental health professionals may use a diagnostic tool called the Geriatric Depression Scale to help diagnose depression in the elderly. Some of the questions asked on the scale include:
· Have you dropped many of your interests and activities?
· Would you rather stay at home than go out and do new things?
· Do you fear that something bad is going to happen to you?
· Do you feel you have more difficulty with memory than most people?
· Do you feel that you are full of energy?

Doctors must also factor in the effects of all medications being taken and search for medical conditions such as Parkinson's disease, thyroid disorders, or Alzheimer's disease that increase the risk of depression.

"The good news is that depression in the elderly is very treatable, just as it is in younger adults," notes John. “And treating depression may also improve the symptoms of other co-existing conditions.”

Depression and aging don’t always go hand in hand, but it is a common problem that often gets missed. Knowing the risk factors and signs of depression (even when sadness isn’t one of them), however, can help prevent a misdiagnosis.

-- from EveryDayHealth.com,
http://www.everydayhealth.com/depression/can-you-have-depression-without-sadness.aspx?xid=aol_eh-emo_14-_20110627&aolcat=AJA&ncid=webmail6