DEPRESSION: Out of the Shadows
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Ask an Expert: Depression in Elders
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Read Dr. William McDonald's bio >

Learn more about depression in elders:

Depression in Older Adults: English version (PDF, 736k) Spanish version (PDF, 748k)
American Association for Geriatric Psychiatry:


Why is depression hard to diagnose in the elderly?

DR. WILLIAM MCDONALD: There's probably about a third of people who have some significant depressive symptoms. And really it's not just depression. It's anxiety. And anxiety's often the presenting symptom, particularly in older people. So you can have cognitive problems where they get confused and disoriented, but also anxiety. Somebody comes in, and they've got this sort of agitated hand-wringing depression. That's really the most common presentation for older people.

I think it's more common in older people. And I think depression isn't a word that they recognize. But a problem with your nerves, particularly in the South, that's-- that's a phrase they can recognize and understand. And there's also something somewhere in the culture that it's easier to be depressed, or it's more acceptable to be depressed and anxious than to just be depressed, that depression carries with it this-- It's synonymous with being lazy or having a fault in your personality or your character.

Whereas anxiety somehow is more accepted. You can have an older person come to you and say, "I've got a problem with my nerves," and readily admit it. And you say, "Well, you seem depressed. You're talking about feeling worthless. You feel guilty about things." And they say, "I'm not depressed. I'm just-- have a nerve problem."

More Topics

Causes of Depression | Suicide | Depression in Youth | Depression in the World | Depression Treatment

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