Mood Swings and Mood Disorders
Are you isolating yourself from others because you never know how you will feel from moment to moment? A depressive disorder is an illness that involves the whole person; mind, body, spirit and emotions. Between doctors and elderly patients in primary care depression is generally the place of initial diagnosis and treatment. It is not acceptable for depression to be dismissed as a natural consequence of ageing. As explained by the President of care Homes in Wiltshire, specialists, psychiatrists and hospitals will normally enter at a later stage, especially in countries where the GP acts as ‘gatekeeper’ to secondary and tertiary care. Doctors who have already diagnosed elderly depression or accepted the patients’ self-diagnosis, but regard the condition as ‘natural at your age’.
Yet there is little evidence to suggest that elderly depression is interactive with hypertension, whereas its interaction with chronic pain/arthritis is well recognised. Individual co-morbidities interact with depression in different ways, and the number of comorbid conditions tends to increase with advancing age.
Depression in bipolar disorder is a mood disorder characterized by mood swings from mania (exaggerated feeling of well-being, energy, and confidence in which a person can lose touch with reality) to depression. Late-life depression can have different causes, symptoms and treatment needs than that observed in younger persons. It is less likely to be grounded in family history, and more frequently associated with the medical and psychosocial problems of ageing or with cognitive deficit.
It is important to understand that depression and sadness are different. The death of a loved one, loss of a relationship, termination of a job, including retirement, will cause us to feel sad. Grief is a normal response to these situations. Individuals experiencing challenging times will often remark that he or she feels depressed. However, sadness, grief and depression are not the same. Feelings of sadness and grief will lessen with time while depression can continue for months and years, if untreated.
Bipolar disorder is a mood disorder in which feelings, thoughts, behaviors, and perceptions are altered in the context of episodes of mania and depression. Previously known as manic depression, bipolar disorder was once thought to occur rarely in youth. Depression is much more common in women than in men, but the reason for this female predominance is unclear.
A fictional case study (Bruce & Pearson) of a 78-year-old widower who has lost interest in life and eventually commits suicide illustrates what can go wrong when “depression remains unrecognized by the patient and the primary care physician”. It results that detection of depression is motre difficult and take priority in the doctor’s limited time with the patient; and the fear of stigma induces the patient to deny depression.
