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It’s the time of the winter blues, the darkest days of the year, which many of us can find so jarring and difficult to manage. But when is this “normal,” and when is this something to be concerned about?

What makes depression an issue that needs attention? The word “depression” is now a part of our everyday language, and we might ask who hasn’t felt down at times, after all? In the mental health field, we look for some specific indicators.

Depression is a physical, cognitive, emotional state that affects all aspects of a person’s life. Physical symptoms, including pain, can be notably worse in a person experiencing depression, and even more so in older adults. One of my first jobs in the field was working nights in a psychiatric hospital in Chicago, and my last task of my shift was to get some of the patients ready for their early morning treatments. I would come in, and it might take a half an hour to assist someone to the bathroom, who seemed unable to move or speak, and could hardly interact with me at all. A few weeks later, I would be back on the unit, and some of the same patients would wake up and not need my assistance at all, and would greet me robustly. In other words, what I had naively ascribed to aging were actually symptoms of depression.

This physicality of acute depressive episodes has, at times, led people to believe incorrectly that depression is an expected part of aging. That idea, that it makes perfect sense for a person who is older to experience more depressive symptoms, has worked its way into our cultural narrative about aging, and this can cause treatable, serious problems to be overlooked.

Cognitive symptoms of depression can also be significant, and can also be overlooked in older adult populations. A person’s ability to concentrate and attend to something (a book, a movie, etc.) can be one of the first symptoms to appear in a major depressive episode. People describe trying to think through molasses, as a person’s whole system slows — body, speech and mind. While there can be many causes for such a slowing, depression is often a culprit. Changes in a person’s ability to think and concentrate should be evaluated by a medical professional, especially if they are persistent, and should not be overlooked.

The World Health Organization and the CDC have both emphasized that depression is not a normal part of growing older, and express concerns that many who are suffering are not properly diagnosed and offered treatment.

In the mental health field, we work to be on the side of hope and life, and we cannot give up caring about, and working to help, people with even the most intractable forms of depressive illness. Depression is an affliction of thoughts, feelings, and even physical states that can cause hopelessness, despair, disconnection and withdrawal.

If you or someone you know may be suffering from depression, I want you to know that help is available, and can take many forms — from psychotherapy to medications and other treatments. Talk to your medical provider, seek help from specialists (psychotherapists, psychiatrists), and don’t hesitate to use the suicide and crisis lifeline by calling or texting 988 from any phone.

Kurt L. White is the vice president of outpatient services at the Brattleboro Retreat, and is a licensed social worker and drug and alcohol counselor.


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