Depressive symptoms are part of many physical illnesses that are associated with aging. In yet other physical illnesses, the depression results from the limitations and discomfort the illness causes. If you and your family are told to expect some depression with these illnesses, you may feel less alarmed when it happens.
Just as a heart attack is a loss of blood and oxygen to heart cells, a stroke is a loss of blood and oxygen to brain cells. Frequently, a stroke cuts off the blood supply to the left frontal lobe of the brain (the centre for mood regulation), which can result in depression. This is because the damage to the cells of the frontal lobe impairs the smooth operation of functions needed to regulate moods. If you develop depression early in the period after a stroke, antidepressants can alleviate these effects and help speed your recovery. Even if the depression is not directly caused by the stroke, it may develop later if you have decreased ability to move, or difficulty making yourself understood.
Parkinson’s disease is a hereditary illness that usually begins in people sixty or older. It is characterized by tremors, a shuffling gait and a flat facial expression. The hands perform rapid ‘pill rolling’ movements at rest. Damage to the part of the brain that makes muscle movements smooth and coordinated causes this illness, but the illness doesn’t only involve movement. In 50 per cent of cases there is also depression, which is thought to be directly due to the underlying brain damage. Often, though, the person with Parkinson’s – and perhaps the family, too – misunderstands the irritability. They don’t realize that it’s due to depression, but see it as a personality problem. Treating the depression can help.
As it ages, the human body begins to have difficulty absorbing certain nutrients. Decreased supplies of these nutrients going to the brain can cause depression. A doctor who suspects vitamin B12 deficiency or folic acid deficiency generally checks for anaemia, but in 33 per cent of cases the depression begins before the anaemia, so the deficiency may not be recognized for a while. Other blood tests can pick up these specific deficiencies so that supplementary treatment can begin earlier.