Understanding depression

Depression has been aptly referred to as the ‘common cold’ of mental health. In fact, depression will touch the lives of virtually every Canadian, through a family member, a friend, or a colleague. And, depression is a great equalizer, as it can affect anyone regardless of age, income, education, or culture.

What is really alarming is that the Canadian Mental Health Association (CMHA) states that, “Almost one half (49%) of those who feel they have suffered from depression or anxiety have never gone to see a doctor about this problem.” This highlights just how much mental health problems continue to carry a stigma, which in turn becomes a serious barrier to seeking help.

We all have our “down” days or feel “blue” at times, but that doesn’t equal depression. It is just part of the human experience to sometimes feel low or “down in the dumps.” And there are times when these feelings make perfect sense – for example when we have a financial setback, or a relationship ends or experience a loss.

Depression is much more than having a down day and is better described as feeling like you have sunk into a deep dark hole with no way out and no hope that it will ever change.

Symptoms of major depression

Below are the criteria for identifying the most commonly diagnosed form of depression- major depression (major depressive disorder) also known as clinical or unipolar depression.

The point of this list is not so you can diagnose someone (leave that up to the professionals), but simply to help you be aware of flags or signals that suggest a person may have clinical depression. Also, changes in a person’s mood and behaviours are often quite evident to caregivers, friends and family, so you are in an excellent position to recognize if there is a problem.

For there to be a diagnosis of clinical depression, the person would need to experience 5 or more of the following symptoms:

Depressed mood most of the day, nearly every day, or a loss of interest or pleasure in activities consistently for at least a 2 week period
Social, occupational, educational or other important functioning is negatively impacted (for example, missing work or school)
Feeling hopeless, pessimistic
Decreased energy and increased fatigue
Difficulty thinking or concentrating
Changes in sleep patterns (insomnia or oversleeping)
Appetite change (increased or decreased)
Inappropriate feelings of guilt
Psychomotor agitation or retardation (for example, restlessness, inability to sit still, or slowed speech and movements)
Suicidal ideation or recurrent thoughts of death (suicidal ideas without a specific plan for suicide)
- If someone tells you they are going to kill themselves, take it seriously

Negative effects of depression

What likely jumps out at you is how invasive depression is, with a negative impact on all facets of a person’s life. At its worst or most severe, depression is like a thief that robs you of your life and the joy of living.

And you can see why it can be difficult to seek help or treatment—if my mood is depressed and I have little energy, and I can’t imagine that I can feel better or that I can be helped then most likely I will not reach out to others. This is where the importance of caregivers, family and friends, and co-workers comes in.

Older adults and depression: why it often gets missed

It is extremely important to know that depression is NOT a normal part of aging. Symptoms such as sadness, sleep and appetite problems or mood changes may be dismissed as a ‘normal’ part of getting older. Other symptoms such as poor concentration and memory difficulties may also be confused with age-related changes in thinking or other conditions such as dementia.

Older people may find it hard to recognise or talk about feeling sad or depressed and may not reach out for help. Also, symptoms of depression that would be a concern for a younger person, such as insomnia or social withdrawal, may be dismissed in older people as ‘just getting older’.

If you are wondering, it is best to raise the issue and encourage your mom or dad to be assessed and treated if there is a diagnosis.

When you suspect your mom or dad is depressed

Raise the issue.

Gently and sensitively, let them know that you have noticed a change in their mood and behaviour. You can tell them that you notice that they do not seem to be themselves. You can then suggest that they see a doctor or mental health professional. What we do know is that depression (and anxiety) can be effectively treated, a fact that makes the silent suffering even more unsettling and distressing.

Breaking the silence by raising the issue also chips away at the stigma. And, not least important, you are bringing the knowledge that depression can be overcome. A person who is depressed often feels hopeless. You can be a surrogate for hope until the person regains it for themselves.

Offer to make and/or go to medical appointment with them.

This is not to be confused with taking over and becoming controlling – it’s simply being aware that the depression symptoms themselves can stop your mom or dad from seeking help. You are offering a rope to help them crawl out of that deep dark hole.

Be mindful that you don’t fall down that deep dark hole yourself.

Caring for someone who has symptoms of depression or a formal diagnosis of depression can be, well, depressing.

Depression can cast a dark shadow for the people caring for and living with someone who has depression. So, you need to be aware of this and take steps to take care of yourself as well.

Bookmark this page should you become concerned that your mom or dad is depressed in the future. If you are concerned now, act now!