 Welcome to the topic, Understanding Depression, Loss, and Grief in Later Life. This is Sean Brotherson, Family Life Specialist with NDSU Extension. I am also joined on this topic by Jane Strohman, Extension Aging Specialist. Thank you for your interest in this topic and how it might be of relevance in your life and work. This is video number three in a series of short educational videos on the topic of understanding depression in later life. In this short video, we are exploring the topic of depression, loss, and grief in later life. Depression is an important condition to understand because it affects a significant number of people and can have severe consequences. Research indicates that depression is quite common in later life, affecting over 5 million Americans aged 65 and older each year. Depression is not a natural part of aging. However, if left unaddressed, depression may result in serious challenges, including difficulties in physical, mental, or social functioning, decreased quality of life, and delayed recovery from illness or other health conditions. As a person ages, it is common to experience a variety of losses in one's life. These losses can bring pain and sadness, whether it is a loss of independence, quality health, or a loved family member or friend. Grief is a natural part of loss and includes mourning the loss. However, if not managed well, grief can become challenging and a person can slide into depression. An accurate understanding of depression, as well as the loss and grief experience, can assist a person to recognize these conditions and the importance of managing them well. Let's explore some of what we know about depression, loss, and grief in later life, and then share information on how to get help that is needed. There are many factors that may raise the risk of depression for aging community members, such as living alone, having no relatives or friends nearby, or experiencing recent losses. Being aware of these risk factors can enable greater awareness of this condition. So what is depression? Depression is a mental health condition characterized by an inability to concentrate, insomnia, loss of appetite, physical tiredness or fatigue, feelings of extreme sadness, guilt, hopelessness, and helplessness, and thoughts of despair, discouragement, and death. It's also called clinical depression. Almost 4% of people age 55 and over living independently in the community suffer from major depression in any given year. Depression usually is marked by a variety of symptoms occurring together during a period of more than two weeks. Occasional episodes of fatigue, discouragement, or anxiety are common for all individuals. However, when a wider array of symptoms develops and lasts longer than two weeks, then clinical depression may occur. Some individuals may experience symptoms that are substantial risk factors for depression, such as social isolation, personal history including chronic medical illness or prior depressive episodes, and family history of mental health issues or alcohol abuse. It's important to assess a person's experiences to consider the risk for depression in his or her life. Next, we're going to focus on great loss and depression. Following is a short video from the National Institute on Aging that tells the story of an older woman who dealt with depression for years, but is now in recovery. My symptoms included loss of appetite, inability to sleep. I guess for a while I was irritable. I would begin to shun people because I knew something was wrong and I didn't want them to know. Peggy Templeman is 78 years old and has experienced depression throughout her adult life. It would come and then it would go for maybe over 40 years. About 2 million older adults in the United States suffer from full-blown depression. Another 5 million suffer from less severe forms of illness. Depression and later life can be caused by a variety of factors. The triggers for depression are changes in health, traumatic events, major changes in one's life circumstances, loss of people who are dear to you, loss of the ability to do the kinds of things that you are used to doing and give you pleasure. The triggers for Peggy's bouts of depression included high levels of stress, an inner ear disease, and losing a valued psychotherapist. And so I began to get sicker and sicker. My husband had to go to work. No one was at home. I was sick and so I did not take the medication. And so finally I did make an attempt to harm myself. I was seeking help. Peggy did get help and the combination of talk therapy and medications made a significant difference. With the medication initially and with talk therapy, psychotherapy, then I really began to get back on my feet. I had a marvelous psychotherapist who I continue to see periodically now. Peggy's experience with depression involved a spiritual side which she says was key to her improvement. She even wrote a book about it. The medications, all of that, and the talk therapy led to the spirituality, the meditation, the sitting in silence, the communing with the Almighty. Although depression is treatable, people should realize that it may take time to find the right treatments and for those treatments to work. Treatments for it typically need to be approached as something that's going to take a considerable period of time in order to have a beneficial effect. Peggy's journey out of depression was long and difficult, but she is now in recovery. And she has a message for those who may be suffering with this disease. Talk. Tell it to the family. Tell it to the friend. Tell it to the family doctor. Help is here. Help is there. As one ages, many older adults experience losses in their lives. These losses can be very painful. Examples of losses that older adults may experience include moving from your long time home to be closer to family or going to an assisted living facility or nursing home. Spouses, family and friends passing away. Loss of a long time career that provided a professional identity or status. Loss of health. The inability to perform daily activities resulting in the loss of independence or the loss of ability to get around or drive. Grieving over these losses is normal and healthy. Even if the feelings of sadness last for a long time, you can see in the stages of grief listed that depression is a normal stage of grief, manifesting itself with the same signs and symptoms as clinical depression. Sometimes telling the difference between grief and depression is difficult. Grief is a roller coaster involving a variety of emotions and a mix of good and bad days. Even in the middle of the grieving process, you will have moments of pleasure and happiness. With depression, on the other hand, the feelings of emptiness and despair are more constant. Grief after a significant loss, such as losing a loved one, is a normal reaction that generally does not require professional mental health treatment. However, when grief is complicated and lasts a very long time following a loss, treatment may be required. Let's sum up a few key points about depression, loss and grief in later life. Depression is an important condition to understand because it affects a significant number of people and can have severe consequences. For example, it can disturb a person's thoughts and feelings, alter a person's behavior and cause physical difficulty and emotional distress. In addition, loss is a common experience for individuals in their later years and may involve a change in job or status, losses associated with health or mobility, or the passing of a loved family member or friend. Grief is a typical part of the loss experience and includes a period of mourning and sadness. At times, depression and grief can overlap with each other, and the symptoms linked with each can be the same or similar, but both depression and grief can be managed with attentiveness and care. It is everyone's responsibility to understand depression, loss and grief and help individuals find effective solutions. A critical question is where can I get help? If you think you or someone you care about might be experiencing depression, you may want to visit your doctor first to determine if this is a problem for you. If so, your doctor may find a medication to help you or could refer you to counseling. In North Dakota, you can call 211 for confidential listening and support as well as information and referral. This concludes video number three in this series, Understanding Depression in Later Life. Thank you for viewing this resource. We encourage you to seek out further understanding on key issues related to depression, anxiety, grief, suicide and helping resources in later life by viewing the other short educational videos in this series. These and other educational resources can be accessed on the Andiesu Extension YouTube channel or at the web link on your screen. This educational resource has been brought to you by Andiesu Extension. Extending knowledge, changing lives.