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By Cara Brady
*Check out discussion questions after article
Recognizing the Signs
Life was good for Paula (not her real name) the year she turned 50. She was happily married, proud of her son, and loved her work as a teacher. She enjoyed spending time with family members and her many friends. She had a variety of interests, including art, music, and travel.
Then, with no warning, life wasn’t good.
“I would wake up early in the morning and think that I had another whole day ahead of me and that I had to get through it somehow,” she said. “I was shaking all the time, feeling like I was on the edge of a roller coaster about to plunge down into something unknown. The anxiety was overwhelming. Nothing like this had ever happened to me before. I had always been a reasonably positive person.”
Paula, now 66, never even considered the possibility that what was happening to her could be the signs of depression.
“I had had some friends who had experienced depression, but I didn’t know much about it. People didn’t talk about it much. I thought depression was something that happened to other people.”
“I thought depression was something that people went through after the death of someone close or some other traumatic life-changing experience. Nothing had changed in my life at that time.”
She thought back to her grief and despair after losing a pregnancy at seven-and-a-half months many years before.
“I think what I felt then was normal grief, what anyone would feel, but what was happening to me didn’t feel like grief.” Paula had a lot to learn about depression.
“I didn’t know then that mental illness can have physical causes, often a chemical imbalance in the brain, and that it can be triggered by external factors. Sometimes the cause or trigger is not known, as in my case.”
She resisted the thought that she should get medical help for the unprecedented changes she was going through and downplayed it to herself and others.
“There was a stigma about mental illness at the time, some stereotypes, in society in general. I think that there was a sense that people who had signs of mental illness weren’t experiencing what they said they were or that they somehow brought it on themselves and could get better if they wanted to.”
“My mother was like that, always a strong person who insisted that people could overcome a perceived weakness and pull themselves together and not complain. Maybe I felt I had to be strong enough to deal with things myself. I think many people feel that way at first.”
She did not get over it by some kind of magical thinking.
Reaching Out for Help
“I was stubborn for several weeks. When I did ask what was happening to me, my doctor recognized that it was depression and explained to me that it was real. I was able to start taking medication immediately. My family continued to be supportive.”
Paula said starting with a general practitioner is important, to check for other health issues that could cause symptoms. She is concerned that people may put off asking for help for mental health, or worse, give up and never ask for help.
“There can be a lack of access to care when it is critically needed, or delays. How tragic for someone to say they are suicidal and be told they have to wait months to see a psychiatrist. There needs to be much more funding for this.”
She was able to start medication that took away the anxiety quickly.
“It took longer to find the right combination of medications and dosages to get back in balance. You have to try things out and it has to be carefully supervised.”
Realizing That Treatments May Vary
Paula took medical leave while she continued her treatments.
“I didn’t want to because mental health or stress leave wasn’t common at the time. I needed it to recover but I didn’t want many people to know.”
Paula’s treatment plan included talk therapy with a psychiatrist, a counsellor, and her priest. She also tried light therapy; sitting in front of a light that mimics sunlight and is used for people with SAD − Seasonal Affective Disorder. This is beneficial for some people, but she did not find it helpful.
“I was advised to walk but didn’t like walking inside. It was good when I could get outside in the spring.”
Group therapy was a series of day-long sessions that included sharing stories, writing, art, and other activities.
“That helped me a lot. The group was pretty normal people like me, all ages but mostly older. They were nice people who were struggling, but willing to do what it took to get better. We developed a lot of trust and helped each other along the way.
“After I was feeling better, I wanted to share what I had learned. We had been encouraged to speak out openly, so I did. After I went back to work, I told my students, who were secondary school age, some of the things that had happened to me. This is a time of many changes in their lives, and I wanted them to know about mental illness for themselves and others and that help is available.”
Paula also stressed the importance of the use of medication in treatment for depression and that continuing it long term can be beneficial.
“People think you feel drugged all the time if you are on medication long term. But you don’t. You feel normal.”
Returning to Normal
Life was good for Paula for about five years. Then she did something she would never want her students to do once they have found what is right for them at the time, at any point, in any area of their lives.
“I made a mistake. I thought I was okay, that I was able to cope. I slowly weaned myself off the medication without telling my doctors. I didn’t see what was happening to me because of that.”
“Not long after, I was anxious, irritable, and shaking again. I had a breakdown at work and found myself crying in the principal’s office.”
The way back to normal didn’t take as long this time. It was still difficult, but she knew what had to be done. She worked with her doctors to find effective medications and spent some time with a counsellor.
“I was fortunate to have another teacher who had experienced depression to help me. And in that short time since I had first had depression, attitudes about mental illness had changed and there was more openness.”
“I only realized later how much I had let myself change. There is a little incident that shows that. One of the teachers who had only met me the second time I was depressed met me again after I was better. She said to me, ‘You’re really nice. I didn’t realize what a nice person you are when I met you before.’”
Paula felt good to be a nice person again and that her family and friends were happy to see her back to her normal self. She is doing everything she can to keep it that way.
She emphasized the importance of people being aware of changes in their own mental health and that of those around them, including senior family members. Seniors may not always be aware of changes in themselves or think any changes are part of normal aging. Seniors can be reluctant to talk about their concerns.
“My mother had signs of depression when she was in her mid-80s,” Paula said. “She was not eating well and was crying often. She had always had that get-a-hold-of-yourself attitude, and didn’t say anything. With a doctor’s care and moving to assisted living where she had better nutrition and interesting activities, she got back to her normal self.”
“Different care is needed in different situations. If you do need mental health care, take it. Don’t be afraid of medication. It doesn’t alter who you are. It helps make you your normal self again.”
Paula is now enjoying retirement, does volunteer work with seniors and is perfecting her painting. She and her husband are looking forward to their upcoming trip to Europe.
Resources
- If you or someone you know is affected by depression, start by contacting your family doctor.
- There are also numerous resources available by phone or online, including 8-1-1, the free health information and advice phone line operated by HealthLink BC through the Ministry of Health.
- Here to Help B.C.
- Mood Disorders Society of Canada
- Canadian Mental Health Association
- Canadian Coalition for Seniors’ Mental Health
Cara Brady has been a professional writer for newspapers and magazines for more than 30 years. She has always enjoyed helping people tell their stories.
Discussion Questions
The questions below will help stimulate discussion among family members, friends, groups of seniors, and with health care providers.
- Many famous people have had depression. The British Second World War leader Winston Churchill used the expression “black dog” to describe his depression. How would you describe ‘depression’ based on personal experience or what you’ve seen?
- Do you think that depression is common in seniors? Why or why not?
- Was depression discussed in your family, among your friends, or in your community? Why not? And why is it important to have these conversations?
- Eventually, Paula did ask her doctor about what was happening to her and was diagnosed with clinical depression (chemical imbalance in the brain). Would you feel comfortable talking to your doctor or mental health care professional about your concerns?
- In the story, Paula did not initially recognize the change from what was normal for her to a state of depression. Why do you think she didn’t? And what might be warning signs for you?
- Could you recognize the difference between depression and feeling low for a short time?
- What would you do if you or someone close to you had significant changes to normal feelings and behaviours? How could you support him/her?
- Do you think there is a difference between grief and depression? Could a person feel grief and depression at the same time?
- Are there any lifestyle changes you might try before asking for professional help for depression?
- Paula thinks there is more openness and less stigma about mental illness now than there was when she was younger. What do you think?
- Do you think there should be more research about mental illness with more information and resources easily available?
- Do you think that people can get treatment for and recover from depression and other mental illness at any age?
- Do you know of, personally or by other means, seniors getting back to their normal selves after medical treatment or other changes in their lives?
- What do you think was the most important thing Paula learned from her experience with depression?
- What is the most important thing you learned from her story?