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Holidays Without Cheer

It's not unusual for elderly women and men to suffer from sadness, loneliness and mood swings — especially during the holiday season.

However, relatives and loved ones risk mistaking the signs of a serious illness — clinical depression — for the holiday blues. Dr. Steven P. Roose, professor of clinical psychiatry at Columbia University, gave tips on The Early Show to recognize the signs of depression for loved ones in their golden years.

At this time of year, many elderly people have memories of past holidays with loved ones who have since died. For some this festive time can trigger a mourning period for spouses, siblings and friends who are no longer here. On top of medical, financial, legal and housing problems they may face at this time in their lives, the loneliness and sadness they experience during the holidays can be the proverbial straw that breaks the camel's back.

Sadness is a response to an event, and is temporary. But if a person is very sad for more than a month and starts having problems with sleep, normal activities, appetite, maintaining their weight and so forth, then they are clinically depressed.

During the holiday season, Roose encourages family and friends to give elderly loved ones as much support as possible. There are many treatment options, including new medications with fewer side effects. Most elderly sufferers will accept psychiatric care, because they realize they need help.

Assuming an elderly loved one will get better once the holidays end is misguided thinking. Ignoring the problem now will only result in a further downward slide in the months ahead.

Roose says depression is an illness often associated with women and during the course of a lifetime, women have a greater risk of it. But late in life, the gap closes and depression becomes almost as common in men.

For white men over 60, there is an astronomical increase in suicide rates. In the United States, 80 percent of suicides are male, and 90 percent of suicides are Caucasian. Suicide cases are strongly associated with depression.

Roose says depression also hurts men with a cardiovascular disease — post stroke, post heart attack. Men have high rates of cardiovascular disease and men who are depressed after a heart attack or heart disease are more likely to die of that disease. Depressed women with cardiovascular disease are also at much higher risk of mortality from that disease. However, women tend to get the disease later than men.

People with depression die at a higher rate of heart disease, because depression increases your risk for having another heart attack or fatal arrythmia. Why? Because there are significant changes in the brain that effect the nervous system and hormones.

About 20 percent of all people who had a heart attack will experience depression afterward. Depressed individuals are at a greater risk of having a heart attack or stroke. It is known that depressed people are more likely to die after a heart attack or stroke compared with non-depressed patients. The bottom line is that if you're worried about the life of a man over 50, you should check his mood before his heart, Roose says. Men need to be made aware of the risks they face as they hit 50 because effective treatments are available.

Depression is usually treatable with a combination of medications and therapy.

Signs of Depression

  • Loss of interest in activities and people (tired, fatigues, loss of interest in work, sex, family and people) difficulty concentrating and often worry — mistakenly — that they're getting Alzheimers's disease.
  • The depressed may experience decreased energy. Family members may notice constant fatigue and irritability.
  • The elderly may complain of aches and pains. A study found that 20 percent of people who commit suicide have seen a physician on that very day, 40 percent made a physician visit within one week and 70 percent made a physician visit within one month.

Finally, Roose warns that medications for depression can conflict with heart medications. He says people have to take responsibility for their own care. Don't let a doctor prescribe a medication unless they've reviewed a list of medication you're taking and assure you there are no drug interactions. Drug interactions account for 13 percent of hospitalizations of people over the age of 65. Only doctors can make sure there are no interactions.