Depression and Aging – Potential Underlying Physical Health Issues

Depression and Aging – Potential Underlying Physical Health IssuesIt’s a rare individual who doesn’t at least secretly long for the fountain of youth.  After all, wouldn’t it be great to be 80 and still look and feel as if you were 25?  It’s not just that our physical appearance changes significantly over time (and sadly, not for the better) but we also become much more susceptible to various physical health issues.  When you don’t feel good physically, it’s hard to feel good emotionally.  Not only that, some health issues, like hypothyroidism, have depression as one of its potential symptoms.If you’re getting older and struggling with symptoms of depression, talk to your doctor.  Your symptoms may be due to an underlying health issue.  In some cases, such as a vitamin deficiency, these are easily treated.  Others, however, may require more serious measures in order to get both your physical health and your mood back on track. 

Following are some of the most common physical health issues that can trigger a depressive episode later in life:

Chronic Pain

Chronic pain becomes a constant, unwanted companion for many people as they get older.  Pain issues often trigger depression, as they significantly interfere with quality of life.  They disrupt your sleep (which is crucial to emotional well-being) and often make it difficult to do many activities that you once enjoyed.  The latter can also contribute to the increased social isolation – another potential depression trigger discussed above.

If you’re struggling with chronic pain issues, whether it’s achy joints, low back pain, or rheumatoid arthritis, don’t assume that there’s nothing that can be done (and don’t be quick to rely on potentially addictive potent pain medications either).  Talk to your doctor about all your options, including alternative treatments such as acupuncture.  Regular gentle exercise, yoga, stretching, meditation and dietary changes can all help reduce inflammation and help decrease your pain.

Sleep Problems

Sleep disturbances, particularly insomnia, tend to become much more frequent as we get older.  Chronic sleep deprivation due to any type of sleep disturbance can wreak havoc with your mood, making you much more vulnerable to depression. Besides insomnia, other frequent age-related sleep problems include restless leg syndrome and sleep apnea.

While sleep medication can help, it’s not the best remedy for insomnia. Benzodiazepines, which are commonly prescribed, can quickly induce a state of calm and drowsiness.  However, they also have a high risk for dependence and addiction.  Better options for insomnia include regular aerobic exercise (with your doctor’s OK, and never within three hours of bedtime), developing good “sleep hygiene” (e.g. getting up and going to bed at the same time every day, not watching TV or spending time on the computer just before lights out), avoiding foods and beverages (e.g. caffeine, alcohol or spicy foods) that can disrupt your sleep, and regularly practicing yoga or meditation – both of which help you feel more grounded and relaxed.

If you struggle with sleep apnea, restless leg syndrome, or another medical issue that is directly impacting your sleep, it’s important to talk to your doctor regarding the best treatment options.

Vitamin Deficiency

Two of the most common vitamin deficiencies that can impact your mood are vitamin B12 and vitamin D.

Vitamin B12 deficiency is particularly common in individuals who don’t eat animal products, as that is the only dietary source of B12.  However, some people also lack sufficient stomach acid and enzymes necessary to release the vitamin into their system even when it is present in their diet.  Certain prescription medications, excessive alcohol consumption and long-term antibiotic use can also cause B12 deficiencies.

Vitamin D deficiency is much more common than most people realize.  Sunshine helps our bodies produce vitamin D, but most of us don’t get enough regular exposure, especially during the winter months.

Both of these vitamins can be taken in supplement form.  Methylcobalamin is the preferred form of B12 and D3 (cholecalciferol) is the best form of vitamin D.   Many physicians don’t routinely test for these deficiencies, so it’s important to be proactive and ask your doctor for the appropriate tests. Knowing your levels will also safely determine whether you need supplementation. 

Low Libido and Other Sexual Problems

A healthy sex life not only makes life more enjoyable, it also has many physical health benefits.  Unfortunately, hormonal changes can cause your libido to dwindle.  For men, the primary sex hormone that decreases with age is testosterone.  This can lead to erectile problems as well as depression.

Women going through perimenopause and menopause also often experience a decrease in sex drive.  They may also experience other things that hamper their sex lives, such as vaginal dryness, which is also caused by hormonal changes.

Before jumping on the Viagra or hormone replacement therapy wagons, be sure to explore other, more natural, options to get your hormones back into balance.  For example, dietary changes can have a significant and positive impact on hormones, as Dr. Michael Aziz discusses in his book “The Perfect 10 Diet” (the “10” refers to 10 hormones that impact not only our weight, but every aspect of our health).  Regular exercise can also help with hormone balance -- not to mention energy and emotional well-being, which both play a role when it comes to a healthy sex drive.

Couples counseling and / or sex therapy may also be helpful, especially if relational or psychological issues are part of the problem.

Perimenopause and Menopause

Mood changes are not at all uncommon for women going through perimenopause or menopause.  Not only do these phases of life cause all sorts of hormonal fluctuations, they can also take a toll on a woman’s self-esteem.  The reality that you’re past or almost past your childbearing years can make you feel less than whole or desirable as a woman.  Not to mention, troubling symptoms such as hot flashes, anxiety, sleep disturbances and unwanted weight gain can also have a negative impact on your mood in and of themselves.

As mentioned above, dietary changes and regular exercise can both have a significant impact on your hormones -- especially during perimenopause and menopause.  Yoga and relaxation exercises can also be very beneficial.  Medication and hormone therapy may also be beneficial, but be sure to discuss all your options with your doctor first, as these remedies may also have undesirable side effects and other risks.

Type 2 Diabetes

Type 2 diabetes is becoming an increasing problem in our country, no doubt largely in part due to high sugar consumption and obesity.  The good news is that it can be prevented or, once developed, treated and managed with proper diet and other lifestyle changes.  The bad news is that many people don’t even realize they have it or how dangerously close they are to developing it.  For those who do have it, depression is a common co-occurring condition.

Diet plays a major role in how our bodies utilize insulin.  Many people find that by cutting out sugar, grains, and for some, dairy products as well (which can cause insulin spikes), they lose weight, feel better overall, and sleep more soundly -- all of which have a positive impact on mood.  This approach also helps stabilize blood sugar levels and increase insulin sensitivity.

As you get older, it’s important to have your blood sugar levels tested as part of your routine checkups. This is particularly vital if you are overweight or have a family history of diabetes.

Heart Attacks and Heart Disease

Heart problems become an increased risk as we get older.  The risk of depression is particularly high for individuals who suffer a heart attack or are diagnosed with heart disease.  This is often at least partially due to the requisite changes in lifestyle following a heart attack, heart surgery, or heart disease diagnosis, and the inevitable decreased quality of life that occurs with any chronic health condition. Not only that, coming face to face with one’s mortality can trigger feelings of depression for some individuals.

The scary Catch--22 is that depression can adversely impact your heart health, so it’s especially crucial to address your depression if you have any heart problems.  Talk therapy, antidepressant medication, regular exercise (only with your doctor’s OK), a good diet, getting sufficient sleep, and surrounding yourself with lots of support can all help decrease symptoms of depression.

Medication

As you age and are more prone to various health issues, you’re also more likely to be taking one or more prescription medications to treat them.  Unfortunately, many medications can cause symptoms of depression. These include (but aren’t limited to):

  • Beta-blockers (used primarily to treat hypertension and other heart-related problems)
  • Calcium-channel blockers (used for hypertension and other heart-related problems(
  • Anticonvulsants (used for seizures and also bipolar disorder)
  • Benzodiazepines (used to treat anxiety and insomnia)
  • Estrogens (used in hormone replacement therapy)
  • Bromocriptine (used for Parkinson’s)
  • Statins (used to lower cholesterol and prevent heart attacks)
  • Antibiotics (certain types)
  • Opioids (used to treat pain)
  • Zovirax (used for shingles)
  • Interferon alfa (used to treat hepatitis and some cancers)

If you’re experiencing symptoms of depression and taking any of these medications, talk to your doctor.  Switching to another medication, if possible, may help alleviate the depressive symptoms.  If a medication change isn’t possible, talk to your doctor about other options.

Chronic or Serious Health Issues

As mentioned above, any chronic health issue impacts your quality of life. This can increase your risk of depression.  A serious medical condition – even if acute – and especially a terminal condition, can also lead to depression.  In addition to diabetes and heart disease, serious medical problems such as cancer, Parkinson’s, and stroke all greatly increase your risk of depression.

While there may not be a cure for your illness, learning to manage your symptoms will enable you to enjoy life as much as possible.  A change in mindset is also vital to your well-being.  While it might sound trite or simplistic, you do have a choice -- stay positive and make the most of your life despite the challenges, or be a victim, feeling sorry for yourself and angry at the world.  Working with a therapist or joining a support group can be helpful in changing your perspective and finding hope and joy in spite of your circumstances.

Depression is a serious health condition, and when it accompanies other health issues, life can feel especially bleak.  It can also exacerbate existing health conditions.  When you feel depressed, it’s more difficult to find the energy and motivation to take care of yourself.  If you are struggling with feelings of sadness, low energy, hopelessness, suicidal thoughts, irritability, or any other symptoms that may suggest depression, talk to your doctor today.  You may have an underlying health issue that’s causing or contributing to your symptoms.  Treatment is available, so don’t hesitate to reach out for help.

Posted on December 26th, 2013
Posted in Depression

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