What to do about Midlife Depression

A few days ago we wrote about female midlife depression and its confusing relationship with female menopause. This posting covers common sense methods for addressing midlife depression for both men and women suggested by the University of Michigan Depression Center.

1. Make a commitment to address your problem--whatever the root cause. Of course setting goals can be tough if you are suffering depression but a strong commitment to get better is an important first step.

2. See a medical doctor and get a thorough physical examination to rule out any physical illnesses that may cause depressive symptoms--some of which are associated with aging but mimic depression. In addition to diagnosing your situation seeing a doctor is important because depression can cause physical complications. Discuss medical treatment options with your doctor, which can include:

a. Medications. There are many effective, well-tolerated antidepressant medications.

b. Hormone Replacement Therapy (women). While not normally considered with depression, women with depression around the time of menopause should discuss it with their doctor. From the University of Michigan, "Some clinical studies indicate that estrogen may help with depression in the early stages of menopause. Although the usefulness of as an antidepressant has not been well established, it may be an important adjunct to other treatments for depression. Be sure to discuss the benefits and risks of hormone replacement therapy with your health care provider, including the potential benefits to your mood."

c. Alternative medicine, herbal remedies and dietary supplements. There has been a great deal of discussion about so-called "alternate medicines" for the treatment of depression. St John's Wort (hypericum perforatum) has been the most common of these but it must be noted that scientific studies of these alternative forms of treatment have so far been short-term and not well controlled. There is no uniformity of dose or amounts and types of ingredients because the Food and Drug Administration does not regulate them.

3. Therapy. Talking with a trained professional (psychologist, psychiatrist, clinical nurse or social worker) on a short term (12-20 weeks) or a long-term basis is often an effective tool for addressing depression either alone or in conjunction with other methods.

4. Stress management. Middle age can be a time of seemingly overwhelming tasks. One of the simplest ways to reduce this form of stress is to eliminate non-critical activities and ask for help on your priorities.

5. Exercise. The benefits of exercise for dealing with depression are well-documented. You don't have to run a marathon. Research has shown that 20-30 minutes of cardio activity 3-4 times a week will produce significant benefits. Exercise helps treat depression by releasing the body's mood-elevating compounds, reducing the depression hormone cortisol, providing perspective on life, providing a feeling of accomplishment, enhancing self-esteem, and increasing levels of serotonin. Walking is a great way to start.

6. Dietary changes. Failing to eat a well-balanced diet and regularly scheduled meals can cause problems and exacerbate symptoms. Medical experts often recommend reducing the intake of refined sugar, caffeine, and alcohol.

7. Don't be alone. Humans are by their nature social beings. During periods of depression individuals have a tendency to withdraw from others making the depression even worse. Fight this tendency and if appropriate join support groups so that you are with people with whom you already have a shared experience.

8. Do what you enjoy. If you don't have time to do what you want then you meed to make time to do so. Depression can eliminate the ability to step out and enjoy oneself. Even if it is just for a short period make an attempt to do what you like, yes even if you don't feel like it.