Get professional help, says a woman coping with depression

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Bobbie Ferguson, 71, has a message for older people who are feeling depressed and for their families.

"Get to professionals who will provide help," said the Pittsburgh resident, who is struggling through her third round of depression. "A lot of older folks are overwhelmed — they drink, they self-medicate — but they don't want to go see anyone about it," she said.

Ferguson is being treated with antidepressants, which help about 50 percent of older patients the first time they try these medications. Subsequent adjustments to medication regimens can help another 20 percent. Other recommended interventions include problem-solving therapy, cognitive behavioral therapy and interpersonal therapy.

Getting help is important because depression in later life tends to be recurrent, with a shorter interval between relapses and an average three-year recovery period for about two-thirds of patients.

Symptoms may not resemble those in younger adults. Older people with depression are less likely to report intense feelings of sadness and more inclined to say things such as "my food doesn't taste right, I'm not sleeping well, I'm having trouble concentrating," said Barry Lebowitz, a professor of psychiatry at the University of California at San Diego School of Medicine.

Minor depression in older adults — feelings of helplessness or a loss of pleasure in life that doesn't rise to the threshold of major depression — is also a significant concern and should not be overlooked, Lebowitz said. Up to 20 percent of older adults are thought to have "sub-threshold" depression; this substantially raises their chance of developing major depression, according to a 2006 study in the American Journal of Psychiatry.