Depression

Depression

British statesman Winston Churchill called his bouts of gloom “the Black Dog.” When President Abraham Lincoln developed melancholia, friends thought he had the gloomiest face on Earth. Novelist Nathaniel Hawthorne compared the feeling to being held captive in a dungeon. Even Sigmund Freud got the blues.

Virtually everyone slinks through an occasional period of the blues. It is as pervasive as the common cold and often no more than an annoyance, a vague feeling of self-doubt or hopelessness that quickly passes within a few days, says David Casey, M.D., geriatric psychiatrist at the University of Louisville School of Medicine in Kentucky.

Chronic illness, loss of family members and friends, social isolation, and financial worries all contribute to late-life depression. Though depression is one of the most common psychological disorders among those over 65—affecting up to 15 percent of the population over 65 years of age—it is not a normal part of aging, says Nathan Billig, M.D., geriatric psychiatrist in Washington, D.C., and author of Growing Older and Wiser.

To bolster your resilience, try these blues busters.

Try This First

Be a busy body. If you can keep yourself absorbed in gardening, woodworking, traveling, and other projects, it will prevent you from dwelling on whatever is making you feel unhappy. So whenever you’re feeling low, ask yourself, “What am I going to do next?” suggests Isaac Tylim, Psy.D., assistant professor of psychiatry at Downstate Medical Center in Brooklyn, New York. Write down a list of goals you want to accomplish in the next week or month and dive into them. Always have something to look forward to, suggests Dr. Tylim, and you’ll be less susceptible to the blues. “Staying active gives you a sense of purpose for the future. It really is the elixir of youthfulness and hope,” he says.

Other Wise Ways

Close ranks. Share your feelings with one or two close friends or relatives, suggests Richard Zweig, Ph.D., geriatric psychologist and assistant professor of psychiatry at the Albert Einstein College of Medicine in New York City. More than likely, you’ve helped them through many upheavals in the past and, if you allow it, they’ll let you lean on them for emotional support for a while now. This doesn’t mean you’re asking them to solve the problem for you. It simply means you’re asking them to listen, allow you to get things off your chest, and be supportive.

Plus, regular social contacts may also help keep depression away, adds Dr. Casey.

Wield the pen to trump the slump. If you’re uncomfortable talking about your depression with others or have no one whom you can share your thoughts with, write down your feelings in a journal, suggests Daniel L. Segal, Ph.D., assistant professor of psychology at the University of Colorado at Colorado Springs. Writing will help you organize your thoughts and provide an outlet for your feelings that can help dissolve unpleasant emotions. Set aside 20 to 30 minutes daily to jot down your thoughts, feelings, and observations about life, Dr. Segal recommends.

Try déjà vu all over again. One terrific antidote for the blues is doing an activity you used to enjoy but haven’t participated in for many years, Dr. Segal says. Bowling, camping, fly-fishing, and other long-dormant hobbies can spark fond memories that will actually uplift your spirits.

“It gets you out of a rut,” notes Dr. Segal. “Let’s say that you haven’t been bowling for months or years because you think you’re too old to do it well anymore. But don’t forget, some positive things could happen, too. If you go, you might bump into an acquaintance you haven’t seen in a long time and renew your friendship,” Dr. Segal points out. “Or maybe you bowl better than you thought you would, and you end up feeling better about yourself. But if you just sit at home, none of those positive things are going to occur.”

Step out. Regular aerobic exercise like walking, swimming, and dancing increases the production of mood-enhancing chemicals in the brain, such as serotonin, that can help pull you out of a funk, Dr. Casey says. Try exercising for at least 20 minutes a day three times a week. If you’re wobbly on your feet, try this: Put a favorite piece of music on your stereo, sit in a chair, and swing your arms as if you were conducting an orchestra, Dr. Casey suggests. Doing that will give you a modest but mood-lifting aerobic workout.

Let flapjacks flip your mood. Pancakes, oatmeal, pasta, potatoes, and other foods loaded with complex carbohydrates can help a person who is 60-plus keep depressed moods under wraps, says Judith Wurtman, Ph.D., research scientist at the Massachusetts Institute of Technology and author of The Serotonin Solution. Complex carbohydrates elevate brain levels of serotonin. Try eating at least one meal a day that includes pasta primavera or a hearty potato soup that is very high in complex carbohydrates without lots of protein, Dr. Wurtman suggests.

Seek out seafood. Eating tuna, salmon, and other fish loaded with omega-3’s, a type of polyunsaturated fat, may help bolster your mood, says Joseph Hibbeln, M.D., chief of the outpatient clinic at the National Institute on Alcohol Abuse and Alcoholism in Bethesda, Maryland. Although the research is still preliminary, Dr. Hibbeln suspects that low levels of omega-3’s in your nervous system may increase your vulnerability to depression. So regular consumption of fish once or twice a week may prevent the blues, he says. Lobster, crab, shrimp, and other shellfish also contain some omega-3’s.

Brew up herbal relief. For centuries, herbalists used St.-John’s-wort to treat snakebites, soothe nerves, and relieve melancholy. As late as the nineteenth century, doctors studied, wrote about, and even prescribed St.-John’s-wort to their patients.

But in the late 1990s, a flurry of clinical studies began re-examining the effectiveness of this lush green plant with yellow star-shaped flowers. These studies confirmed what herbalists have known all along: St.-John’s-wort works, according to James Duke, Ph.D., botanical consultant, author of The Green Pharmacy, and a former ethnobotanist with the U.S. Department of Agriculture who specializes in medicinal plants. In fact, some research suggests that the herb rivals the effectiveness of some antidepressant pharmaceutical drugs such as fluoxetine (Prozac), sertraline (Zoloft), amitriptyline (Elavil), and imipramine (Tofranil), Dr. Duke says.

In Germany, Commission E (the panel of scientific experts that reviews the safety and effectiveness of herbs) heaps praise on St.-John’s-wort as a treatment for depression, notes Dr. Duke.

Researchers are still investigating how St.-John’s-wort conquers the blues, but at least one active ingredient in the herb, hypericin, has been found to cause significant reduction in symptoms of depression and anxiety, Dr. Duke says. Several of its constituents all contribute, perhaps, synergistically to the increase in compounds that relieve depression, he says.

To try it, Dr. Duke recommends tinctures, or evening primrose infusions, in which the flowering tops have been steeped. Or use just plain old teas. He suggests steeping one to two teaspoons of the dried herb in a cup of boiling water for 10 minutes. For best results, herbalists recommend drinking one to two cups of the tea daily for four to six weeks, according to Dr. Duke.

The herb, in extremely large doses, can make the skin more prone to sunburn, so be wary of intense sun exposure, Dr. Duke warns.

Also, don’t use St.-John’s-wort with antidepressants without medical approval. It may affect the effective dose of prescription medication.

Keep the faith. There are no lifeguards that will keep you from getting caught in depression’s undertow. But a little faith might help.

“Spirituality offers comfort in times of suffering and provides a message of hope that gives those who rely on it an extraordinary buffer against depression and other emotional upheavals,” says Harold G. Koenig, M.D., author of Is Religion Good for Your Health? and associate professor of psychiatry and behavioral sciences at Duke University Medical Center in Durham, North Carolina.

In a study of 4,000 older Americans ages 65 to 102, Dr. Koenig found that those who attended church at least once a week were half as likely to be depressed as those who attended religious services less frequently. Other studies have shown that religiously inclined people over 60 are healthier and live longer than those who are less spiritual, Dr. Koenig says.

In particular, the Christian and Jewish faiths are therapeutic, he says, because these religions offer stellar examples of overcoming adversity and emotional suffering. “The Bible is an excellent mental health guide because it doesn’t cover these issues up,” explains Dr. Koenig. “It shows you lots of people, like King David, Elijah, and Jeremiah, who were extremely depressed and yet persevered.”

So how do you make the most of your spirituality after age 60? “Reach up to God, reach out to others, and reach inside yourself,” Dr. Koenig says. “If you actively participate in your chosen faith, help others within your community, and develop your own religious faith, it will result in personal growth and mental well-being.”