How can you tell if a bad mood is true depression or a temporary case of the blues? Depression is usually characterized by a sustained worsening of mood, disturbed sleep or appetite, and difficulty meeting obligations or finding pleasure in daily activities. Thus, depression is a “whole-body” illness that involves the behavior, thoughts and feelings.  In the elderly, physical complaints often predominate.

Some depressions resolve on their own, while others linger and produce behaviors which worsen the very life stresses that affects mood.  Fatigue, irritability and negativity are as often the cause of bad fortune as its consequence.

According to the National Institute of Mental Health, depression affects about 19 million Americans each year. Some people are more prone to depression than others.  Factors which increase risk include family history of depression, loss of a loved one, a serious medical condition or other stressful life event, alcohol or drug addiction, and season of the year, especially winter.

Diagnosis and treatment of depression often begins in consultation with a primary care physician, who can usually identify the symptoms. An honest discussion with your doctor can be liberating and is the only way to diagnose depression. There are no blood tests or imaging studies that are useful in this diagnosis, except to rule out other medical conditions which can look like depression.

Contact your primary care physician if you experience any of the following signs or symptoms for a prolonged length of time:

• Feelings of sadness and hopelessness

• Crying spells

• Increased drug/ alcohol use

• Loss of interest in activities you used to enjoy

• Inability to concentrate

• Changes in weight - significant increase or decrease in appetite

• Inability to sleep or excessive sleeping

• Loss of energy

• Persistent agitation/ irritability

• Increased isolation

• Persistently low self-esteem

• Less interest in sex or sexual promiscuity

Primary care physicians can prescribe medications to relieve insomnia and restore mood to normal.  Such medications are generally easy to tolerate but may take several weeks and some minor dose adjustments to produce their best effect.  Psychotherapy or counseling is also available and is usually helpful, but is not always necessary.

David Schlager is a board certified psychiatrist on the Medical Staff at Eastern Long Island Hospital.