Doing your Crossword puzzles yet?

From Christine Scheller, on geriatric depression and warning signs:

When The High Calling interviewed Dr. Blazer last fall, he talked about a patient who is close to 90 years old. The man had called Blazer a few weeks earlier to say he was feeling “terrible,” that he wasn’t sleeping and was losing weight, all of which are symptoms of depression.

The patient also said, “I’m not doing my crossword puzzles.”

“He had been doing crossword puzzles for 80 years,” said Blazer. “All of a sudden he wasn’t doing them. That signals loss of interest, which is another symptom of depression.”

Blazer prescribed medication. When he talked to the patient a few weeks later, he said he was feeling much better.

Blazer asked, “Are you doing your crossword puzzles yet?”

“No,” he replied.

The doctor knew then that the man wasn’t well yet and increased his medication dosage.

“He was sleeping better and his had appetite has returned, but, I’ll know he’s well when he starts doing his crossword puzzles again,” Blazer explained.

“If I were a family member and I had seen him doing crossword puzzles every day for 70 years, and then he stopped doing them and was just sitting in a chair, even though he might say he feels fine, I would be concerned about him,” he added….

This narrow perspective contributes to the suffering of the elderly, many of whom don’t seek out mental health services, even when they perceive a need for them.

In Depression in Late Life, Blazer said that “if they are seen by a primary care physician or social agencies, the depressive symptoms may be overlooked or may not be diagnosed as a depressive disorder and therefore are not counted.”

For those who do manage to have their symptoms counted, “multiple interventions, if orchestrated effectively” are likely to be effective.

“Recognize the symptoms early and try to get help as early as you can. That, to me, is absolutely critical,” Blazer told us.