 Welcome to the topic, Understanding Depression and Suicide Risk in Later Life. This is Sean Brotherson, Family Life Specialist within the Issue Extension. I am also joined on this topic by Jane Strowman, 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 four 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 and suicide risk 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 five million Americans age 65 and older each year. Depression is not a natural part of aging. However, if it is 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. If a person experiences chronic or severe depression, one of the symptoms may be the occurrence of suicidal thoughts or feelings. A person may feel that he or she is trapped, feel helpless or hopeless emotionally, and think about wanting to disappear or even die. These symptoms of suicidal thinking often reflect serious depression and require prompt diagnosis and treatment. An accurate understanding of depression as well as suicide risk associated with serious depression can assist a person to recognize these conditions and the importance of getting assistance for diagnosis and treatment. Let's explore some of what we know about depression and suicide risk in later life, and then share information on how to get help if it 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. The experience of depression also is associated with suicide. Research consistently has shown that there is a strong linkage between depression and the likelihood of suicidal feelings or suicide itself. Older adults have the highest rates of suicide of any age group in the United States. Therefore, we suggest it is important to be aware of this topic and to consider what to watch for and how to get help if it is needed. In fact, suicide rates are particularly pronounced among older men. White men age 85 and older are more likely to die by suicide than Americans in any other age group. Suicidal behavior in older men can be a reaction to perceived loss of social status among other factors. For example, a person may feel discouraged due to the loss of physical mobility, diminishing involvement with others in retirement or other changes in status. This group's high rate of suicide may be linked to loss of the ability to control impulses, which can be a feature of cognitive changes in aging or even dementia. If a person loses much control of their emotions or mood, then it becomes more difficult to resist impulses associated with severe depression. That can include suicidal feelings. Identifying a person at risk of suicide can be difficult, even for a trained professional. However, here are a few common events or situations that may place an older adult at higher risk for suicide. Withdrawal from activities they used to enjoy, such as getting together with friends for breakfast or walking with a neighbor. Negative thoughts, including frequent talk about death, such as statements like, I just want to disappear or it's time for me to move on. Strong feelings of guilt or self-doubt, a decline in one's appearance or hygiene, such as not washing clothes, brushing teeth or bathing, or stockpiling of medication rather than taking a prescription as prescribed by a physician. Be attentive to these warning signs in yourself or among others that you know or care about. If you are unsure whether a person is immediately at risk for suicide, seek help and take him or her to the nearest emergency room for an evaluation by healthcare professionals. You may also contact www.suicidepreventionlifeline.org or call 1-800-273-TALK or 8255, which is a 24-hour suicide prevention lifeline, which is connected to a national network of crisis response services. By calling this number, you can reach call specialists who focus on helping those who are having thoughts of suicide or individuals who have a concern about someone and their possibility of suicide. An important consideration for any individual with concerns about emotional health is seeking treatment and support for depression. Understanding the steps associated with getting treatment and support for depression is helpful. Many people do not seek help because of the stigma associated with mental health concerns. A key first step for many people is to focus on getting help and then getting better, not on being embarrassed or isolating oneself if there are concerns about depression or anxiety. In general, the beginning point for many people in seeking help is to discuss concerns with their personal doctor, usually a primary care physician or general health practitioner. A medical professional can assist you or another in seeking an opportunity for medical screening that will help to assess emotional and mental well-being and any potential diagnosis regarding depression or anxiety. To emphasize this point, a visit with one's personal doctor or a trusted counselor, pastor or friend can be an important step in the journey of getting help and increasing hope. Let's sum up a few key points about depression and suicide risk in later life. Depression is an important condition to understand because it affects a significant number of people and it 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, thoughts or feelings of suicide may occur with chronic or severe depression in later life and suicide rates tend to be higher among older adults. It is important to be attentive to warning signs in yourself or those you care about that reflect depression or suicide risk. Although depression and suicidal thoughts or feelings can feel overwhelming, both depression and suicide risk can be managed with prompt diagnosis and treatment along with attentive care. It is everyone's responsibility to understand depression and suicide risk 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 four in this series, Understanding Depression and Later Life. Thank you for viewing this resource. We encourage you to seek out further understanding on key issues relating 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 NDSU Extension YouTube channel or at the web link on your screen. This educational resource has been brought to you by NDSU Extension. Extending knowledge, changing lives.