As anyone who has experienced it knows, depression is far more than feeling sad. Depression colors your entire world: sleeping, eating, working, socializing, and more.  "Major depression," where everything seems essentially hopeless and meaningless, occurs commonly among seniors. Research suggests that untreated depression not only makes your life miserable, but it may shorten it too, by making you susceptible to illnesses, including cancer.

According to the American Psychiatric Association, 80 to 90 percent of all cases of major depression can be treated effectively. The best approach is usually a combination of psychotherapy (or counseling) to help you understand the underlying causes of your unhappiness, combined with drug therapy to help treat the symptoms.

Antidepressants don’t all work in the same way. It may take several months to find the right medication and dosage, but doctors today can choose from a wide array of drugs to maximize benefits and minimize side effects. A doctor can determine which drug is best for you, based on your symptoms. If insomnia is a problem, for example, you may need a medication that is more sedating. Depression accompanied by lethargy and fatigue may respond better to Prozac or Wellbutrin, because of their stimulatory properties.

Antidepressants can have side effects, especially in older persons who metabolize drugs more slowly. For example, certain tricyclic antidepressants, such as Elavil, can produce cardiovascular side effects and should probably be avoided if you have heart disease. Your doctor will probably try to minimize side effects by starting you on low doses and building up. If you still experience significant side effects, you should probably try another medication.

There are other nonpharmacologic things you can do to help lift your spirits:

• Be with other people. Spend time with others who make you laugh.
• Get physical. Exercise can actually increase positive feelings.
• Care for a pet. Pets provide companionship and help fulfill the desire to feel needed that is so important in the senior years. Medical literature supports the role of animal companions in maintaining health, and pet therapy is now a part of many hospital and nursing home routines.
• Express your feelings. Hiding your emotions can make you feel worse; tears can be healing.
• Give yourself a break. Don’t expect too much of yourself right now. It takes time to get over depression. It also takes time for antidepressants to start working.

The bottom line is to make a decision not to give in to depression but to climb out of it and reclaim your life. You can't always do it alone, but you can ask friends or family to make a phone call to your doctor, neighborhood mental health center, or senior citizens center. After this initial step, you will soon be walking out of the clouds and into the sunlight.

To evaluate your level of depression,  take this Depression Screening or call 1-888-640-CARE to have a free Depression Screening mailed to you.

For a list of out an inpatient Mental Health Services at the Health Alliance call the Senior Behavioral Medicine Services at (513) 585-1894.