When depression strikes, however, it can affect not only mental but also physical health. Being diagnosed with any serious illness can lead to depression, says Lehmann. “One-third of people who have had a stroke go on to develop depression, for example. Forty percent of people with Parkinson’s develop depression.”
Depression, in turn, can make these diseases worse. “Studies show that depression slows recovery from a heart attack or hip or knee replacement surgery,” says Lehmann. “When people with diabetes are depressed, their blood sugar is less well controlled.”
Depression also can aggravate symptoms of memory loss and dementia. “So depression is really a double or a triple whammy for older people who are dealing with serious medical conditions,” says Lehmann.
Finding a way out
Of course, when patients are mired in severe depression, all they want is some relief.
The first step is seeking help. The symptoms of severe depression are usually obvious. Overwhelmed by feelings of hopelessness, sufferers find themselves unable to manage even the simplest daily activities.
The distinction between moderate depression and garden-variety sadness over the loss of a job or a troubled marriage is less clear-cut. One clue, says Lehmann, is how persistent the sadness or hopelessness is. “Even if something really tough has happened, most people can be distracted or cheered up for a short period of time. That’s often not true when people are suffering depression.”
Perhaps the best indication that it’s time to seek help is when persistent changes in mood get in the way of everyday life. “Anytime someone begins to have problems carrying out the basic activities of daily life—managing money, putting meals together, going to church—it’s worth talking to a doctor,” says Lehmann.
A variety of psychotherapeutic approaches have also been shown to help. Indeed, a combination of drug treatment and counseling may offer the best chance of banishing the shadows of depression for good. Psychotherapy takes many forms, from addressing relationship problems that may be causing distress to practicing ways to counter negative thoughts. Research suggests that techniques such as these may have long-lasting results, reducing the risk that depression will return.
“The important message to get out there is that people do get better,” says Small. “Depression may feel hopeless, but it isn’t.”
Also of interest: Are doctors overprescribing antidepressants?
Peter Jaret is a freelance health writer in Petaluma, Calif., and the author of Nurse: A World of Care.