Take Antidepressants? Who, me?

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Dearie,

My doctor wants me to take an antidepressant to help me sleep and improve my appetite. What questions should I ask?

— Almost Happy

 

Dearie: I know a lot of people on antidepressants. What’s going on in the world? Maybe it’s just life as you get old.  I think doctors are too quick to prescribe medicines.

Barbara: I see a lot of people who get overwhelmed with one sadness after another – losing friends and spouses, having to move, losing your physical abilities and not being able to do all the things you used to do. That’s a lot to feel sad about and get depressed. And doctors don’t always know what to do. It’s easy to prescribe a pill rather than sit and talk about sadness and loneliness. But this lady is saying something about sleep and appetite. You know, Mama, you have a terrible sleep problem!

Dearie: Yes, but I get by. I don’t want to take medicine for that. Though you know, I’m constantly being told to practice “sleep hygiene.” What do you think of that new-fangled word?

Barbara: I know, it’s a little weird—it sounds more like dental hygiene than anything to do with going to sleep.   But it’s just a new way to talk about having good routines and getting in the practice of doing some relaxing things before you go to bed.

Dearie: My problem is that I get started reading and I can’t put my book down. I just get so excited! But then I sleep too late in the morning. Or sometimes I worry too much about one thing or another.

Barbara: You’ve said that often and then the rest of the day gets a little bollixed up. Wouldn’t it be worth trying some relaxation techniques? It might help with the worry too!

Dearie: Yes, I suppose. Much better than any medications. But what about this question of eating? You know, I’m lucky. I still can prepare my own meals, and I really like that. I love to tell you about my shopping expeditions and you always ask what I cooked for dinner. But it’s just me, so sometimes I feel like it’s not worth the bother. The building I live in, though, it’s pretty wonderful—we have several meals a week when I can be with other people.

Barbara: Almost Happy may be living alone and it may be hard to get motivated to prepare meals for herself. But you’re right, Mama. It is good to spend time with other people around meals. That’s why so many senior centers have lunchtime meal programs. Getting involved in one of those could be a good solution. So what are we going to tell this lady?

 

 

Takeaways

Dearie’s Takeaway:
I’m glad this woman feels comfortable enough with her doctor to ask questions! From the medicines I’ve been on. I’d say she should ask about possible side effects of taking anti-depressants, and maybe how long it takes to work. And I like your point about finding ways to manage sleep and appetite without medications.

Barbara’s Takeaway:
Before agreeing to medication, try some home management and self-care. Establish good sleep routines; minimize caffeine and alcohol through the day and find calming and restful activities before bedtime. A little exercise during the day or right after dinner is also a good way to ensure that you’ve used all your muscles and now need a good rest.
Don’t be afraid to admit you’re sad or lonely. Depression is a real thing and loss of sleep and appetite are signs and symptoms of a true depression, not just a passing sad moment. If you do agree to take medication, I would recommend you also seek professional help from a therapist. One-on-one counseling is often helpful and these days you can often find therapists who will come to your home. There may also be group programs that can be very successful in helping to find ways to get past the hurt of loss and loneliness.
For ways to find therapists in your area check with local senior centers who often have social workers on staff and offer short-term counseling. Your doctor may also have a social worker or psychologist on staff. Some healthcare systems have clinics in a specialty field called Geropsychiatry. Most areas have community mental health centers or searching the web for a therapist with a special interest in aging will be your best bet. Mama, what do you think?
Dearie: Sounds good to me!

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Ask Dearie is a service of Barbara Green, LICSW and Sound Aging. Barbara’s mother is now 95 years old, and wishes for privacy. Though “Dearie” is fictive, she speaks much as Barbara’s own mother has over the years. Their conversations reflect an intimate mother-daughter shared history as well as the many conversations Barbara has had with other older women. Some of your questions may require more attention than Barbara can provide in this advice column. For a more in-depth response, Barbara may contact you about referral for a consultation.
 

©2019 Barbara Green, LICSW and Sound Aging | 206.799.7108 | barbara@soundaging.org Providing Advice to Seniors and Their Loved Ones in Seattle, Washington and Beyond