The death of a loved one, retirement, physical illnesses and disabilities can all contribute to an increased sense of anxiety and a loss of independence. For many people, changes such as these tend to occur in older age. While most people find that they can come to terms with big lifestyle changes, for some it can spark a depressive episode they find difficult to come out of. For people who suffer from depression, prolonged feelings of sadness can dominate their thoughts to the point where life seems to lose meaning.

It is important to remember that depression is not “normal”. Neither is it an inevitable part of ageing. Clinical depression is a serious disease and successful treatment demands a holistic approach, according to Aware, a voluntary organisation that supports people suffering from depression. “A truly holistic approach in the assessment of depression is necessary, focussing on both psychological and any physical symptoms. Most elderly people with a depressive disorder will require some combination of physical, psychological and social interventions to achieve the best recovery and, just as important, to maintain that recovery and prevent relapse.”

Although the stigma associated with mental illness in the past has, thankfully, been largely rejected by today’s society, some people still feel ashamed about being depressed. Older people tend to be particularly reluctant to address the issue. “Depression is the most common psychiatric disorder in later life; 10-15 per cent of the population aged 65 or over suffer from significant depressive symptoms,” according to the Samaritans, which helps those suffering from depression. Despite this, older people are still the most likely group to “mask” their depression, often going to the doctor with complaints of headaches or tiredness, rather than speaking candidly about their feelings.

The misplaced shame that some people feel about their illness can result in clinical depression continuing undiagnosed for long periods, causing unnecessary suffering and considerably increasing the risk of the depression worsening. For some, this can place them in danger of suicide.

Fortunately, depression is a treatable illness and speaking with your doctor will help you to decide what treatment is right for you. Approaches to defeating depression can range from calming activities designed to change the sufferer’s perspective, such as yoga or gentle exercise; to counselling sessions, where a sufferer can openly express their fears and anxieties; to the use of anti-depressant medications that help to break the cycle of depression on a chemical level. It is important to remember that, because depression is brought about by a combination of factors, it needs to be treated with a combination of approaches.

If you are feeling depressed, remember that you are not alone. According to Aware, more than 400,000 people in Ireland suffer from a depressive illness. If you are reluctant to speak with your doctor, calling a helpline such as the Samaritans might help you to find the strength to do so.

Some common signs of depression
• Change in sleeping pattern: sleeping too little or too much are both common signs of depression
• Change in weight: a loss of appetite can lead to weight loss; conversely, weight gain can occur if a person “comfort eats”
• Loss of interest in things that used to bring joy
• Irritability
• Fatigue
• Thoughts of suicide or self-harm
• Continuing feelings of hopelessness and despair; seeing no point to life
• A combination of these factors that continues almost constantly over a period of two weeks or more

As with all illnesses, depression can affect each individual differently. Some people may cope with depression throughout their lives, while others can become unexpectedly depressed for the first time when they are much older. Levels and varieties of depression also exist, which makes it even more important to speak to a doctor about how you are feeling: conditions such as dementia and Alzheimer’s disease can cause depression, and bipolar and psychotic disorders require specialised medical treatment.

Bereavement counselling can be a tremendous help in dealing with the shock, anger and grief of losing someone you love. Social support systems, such as Friends of the Elderly, also exist for older people experiencing feelings of isolation. Whatever has led to depression, for either you or a loved one, the message is loud and clear – help is out there, do not be afraid to ask for it.