By Sandy Goldberg, RN, Senior Care Manager, Ft. Lauderdale

The holidays bring to most of us feelings, of joy and togetherness with family and friends. However, some seniors have lost many of their friends and their families are separated by geographical distance. The senior is left with feelings of loss and abandonment. These feelings can lead to depression. The question then arises, how do we know when our loved one has the "blues" clinical depression?

Most of us have a day when we feel blue or "out of sorts." A sad mood is the normal response to loss or disappointment. Depression however does not simply last for a day or two but persists for more than two or three weeks. Clinical depression also interferes with normal functioning and routine.

Depression that occurs after the loss of a loved one may be a normal part of the grief process and usually does not interfere with normal functioning. Grief usually dissipates with time and needs evaluation only if it persists longer than 3 months and impairs daily functioning, along with other symptoms of a clinical depression.

Symptoms of clinical depression include:

• Difficulty falling asleep, staying asleep, or sleeping too much
• Reduced appetite and weight loss or increased appetite and weight gain
• Loss of interest in activities once enjoyed
• Feelings of anxiety, restlessness, or irritability that interfere with functioning
• Persistent physical symptoms that don't respond to treatment (headache, chronic pain, digestive disturbances, dizziness). Somatic complaints
• Difficulty concentration, remembering, or making decisions
• Fatigue or loss of energy
• Feelings of guilt, hopelessness, or worthlessness
• Thoughts of death or suicide
• Crying spells, sadness, low mood, loneliness

Older people may not present as feeling sad or depressed and often deny that their mood is depressed. Nevertheless, they may have a clinical depression if they have 5 of the symptoms listed above. Many times the senior presents with agitation or severe anxiety and/ or numerous somatic (physical) complaints.

Often the senior does not wish to see a psychiatrist and is treated by their medical doctor. There are many new medications which can now be prescribed by the family physician. If the depression continues despite the medications it may be necessary to have the elder evaluated by a mental health professional.