A Help the Aged information sheet 11 Beating the Blues Many of the changes we go through as we get older can be stressful and upsetting. However, being sad or depressed is not an inevitable part of getting older and you do not have to put up with it or manage alone. Looking after your emotional and physical health can help you get through some of the difficult things that may happen to you. This information sheet looks at some of the things that might make you feel sad and ways of coming to terms with them. It also tells you how to recognise the difference between feeling down and being depressed and how to get help. ------------------------------------------------------------------------------ Contents Section 1. Physical health worries Section 2. Financial worries Section 3. Bereavement Section 4. Feeling lonely Section 5. Feeling isolated Section 6. Feeling unsafe Section 7. Depression Section 8. Getting help Section 9. Tips for staying well Section 10. Advice for relatives and friends Section 11. Useful contacts Everyone knows what it is like to feel down or sad. For some people this low mood becomes difficult to shake off and they become depressed. As you get older you may find that there are more reasons to feel sad. But this does not mean that depression is a normal part of getting older or that you have to accept it. The first half of this information sheet looks at some of the worries or situations that can make you feel low or sad; it gives you ideas for helping you to cope with them. If not dealt with properly, some of these may contribute to depression. In the second half of the information sheet (from section 7) we focus on depression itself, how to recognise it and how to get help. ------------------------------------------------------------------------------- Section 1. Physical health worries Problems with your physical health can often affect your state of mind. Developing a new illness such as arthritis or heart problems can be very distressing. As well as having to deal with pain or other symptoms, you may have to change your diet, take more medication or get help around the house – things which may be difficult to come to terms with. Sometimes just a combination of different illnesses can get you down. Or you may be finding it harder to cope with a condition that you’ve had for some time. There is a lot of help available for your physical health needs. Don’t feel that your problems are not important enough for you to seek help with them and don’t be disheartened if the first person you ask for help isn’t the most supportive – there are lots of alternatives. * Your GP practice or local hospital may run clinics for particular conditions which can monitor your illness and give you advice on dealing with it. * Advice and information is also available from specialist charities that focus on particular medical conditions: for example, the British Heart Foundation or Cancerbackup. * Locally, there may be self-help or support groups run by people who have the same condition as you. You can find out about these groups from your local library; the information desk at your local council; or by calling NHS Direct on 0845 46 47 (in Scotland, call NHS24 on 08454 24 24 24; in Northern Ireland, contact your regional health and social services board. Their contact details are listed in the Useful contacts section, starting on section 11). ----------------------------------------------------------------------------- Section 2. Financial worries After you or your partner retire, you may find that your income is less than it used to be and it is more difficult to make ends meet. Or the death of a loved one may mean that you have to manage your finances on your own for the first time. This can all be very stressful and upsetting but you may be able to get extra help. Benefits You should check that you are getting all the benefits that you are entitled to. * If your weekly income is low, you may be entitled to Pension Credit – extra money which brings your income up to a certain level. You may be able to get help with your Council Tax and rent through Council Tax Benefit and Housing Benefit. If you have tried to claim benefits in the past but did not qualify, it is still worth trying again. Benefits rates change every year and Pension Credit is more generous than past benefits such as Income Support. * Not all benefits depend on the amount of income you have. If you need help with personal care you may be able to claim other benefits such as Disability Living Allowance or Attendance Allowance. Our free advice leaflets Can You Claim It? and Claiming Disability Benefits will help you to work out what benefits you are entitled to. You can also contact our free advice service, SeniorLine, on 0808 800 6565 (0808 808 7575 if you are in Northern Ireland). Home repairs and adaptations If you need to make improvements or carry out repairs to your home you may qualify for help. See our free information sheet no. 4, Home Repairs and Improvements. There are also measures to help keep your home warm through insulation and draughtproofing. For more information see our free advice leaflet Keep Out the Cold. This leaflet also gives advice on other ways of keeping your fuel bills down. Budgeting and debt advice Help the Aged produces a free advice leaflet called Thinking About Money. This leaflet shows you how to prepare a balanced budget sheet and how to use this to help manage your money. If you have debt problems you can use your budget sheet to help negotiate repayments. Thinking About Money also refers to other organisations which can advise you on budgeting and help you deal with debt. Benevolent societies If you can’t get other types of financial help you could try applying to a benevolent society. These are organisations that are set up to help particular groups of people. They are associated with things such as a trade, religion, particular illness or the area where you live. For more information see our information sheet no. 6, Financial Help from Benevolent Societies. -------------------------------------------------------------------------------- Section 3. Bereavement Everyone experiences grief or loss at some point in their lives. However, as you get older, it is more likely that you will experience the loss of people who are close to you. Although bereavement is a unique experience, you may find that you go through a range of recognisable reactions and emotions. Some common feelings include shock, disbelief, anger, guilt and depression. You might feel shocked and upset by your changing emotions but these feelings are quite normal. Help the Aged produces a free advice leaflet called Bereavement which gives more advice on coping with the loss of someone close to you and lists other organisations which can also help. It also gives advice on the practical aspects of dealing with a bereavement. ------------------------------------------------------------------------------- Section 4. Feeling lonely Most of us like company, and enjoy having our friends and family around us. Sometimes, when you retire and get older, it becomes harder to keep in touch with people, and there are fewer opportunities to meet new people. When we’re younger, we can make friends at work, or through our children but, if you have problems getting out, or you find yourself living in a new place, making new friends can feel like an impossible task. Loneliness is not the same thing as being alone. Some people really enjoy living by themselves, and prefer their own company. Relationships shouldn’t be the only thing in your life and it’s important to have your own interests and hobbies. Loneliness is not simple – it can have many causes. It may be that your situation in life has changed. Maybe you’ve recently retired, or divorced, or lost someone you love. Or perhaps your health is making it difficult for you to leave your home? You may have chosen to move to a new area, and are now feeling like a bit of an outsider. Perhaps you came to the UK when you were younger, not intending to retire here. Now, you may find it difficult to come to terms with the idea of growing old in this country. Older people may not have the same role and status your grandparents had and this can make you feel undervalued and isolated. There are organisations which can offer you support if you are from a minority ethnic community. Contact MindinfoLine on 0845 766 0163, web: www.mind.org.uk, for details of local groups, or try your local library. Change itself can also be a cause of loneliness; at various times in our lives, we reach a point where things change. Getting older can bring on many changes – your situation can change, maybe for the reasons mentioned above, and your body and physical appearance may change too. Change of any kind can make us feel vulnerable and insecure, but it’s important to remember that these feelings eventually go away and we become accustomed to our new way of life. Loneliness may be something you have lived with for a long time, and may not be related to something new that’s happened in your life. It can be very difficult to understand why you feel like this: perhaps you lack confidence or feel very uncomfortable around other people. If this is how you feel, you must remember that many other people feel as you do, and there are people you can talk to who will try to help you deal with these feelings of loneliness. Coping with loneliness One of the first steps to overcoming your loneliness is to think about why you’re feeling lonely. Is it because you miss working, or have been unable to make friends in your new neighbourhood? Or have you lost a dear companion or friend? Once you have decided what the main cause of your loneliness is, you can try to think of a way to improve your situation. If you are lonely because you find it hard to meet new people and make friends, you could try some of the following ideas: * Make the most of every chance you get to talk to people: for example, when you are in your local shop or when you are taking part in an activity Ask them about themselves, and make an effort to show an interest. * Join a club or start an evening class – it’s sometimes easier to make friends with people who share the same interests as you. Our information sheet no. 25, Leisure Ideas, contains advice on how to go about doing this. * Think about volunteering – it can be a good way to meet new people and keep yourself busy. Doing something for other people can also make you feel better about yourself. Our information sheet no. 25, Leisure Ideas, also has a section on volunteering that lists useful organisations to contact. * Get in touch with your local Age Concern group and find out what activities or groups there are where you live. Check your phone book for details of your local group or visit its website at www.ageconcern.org.uk ------------------------------------------------------------------------------ Section 5. Feeling isolated Isolation generally means that you have very little contact with other people. It can be different from loneliness in that it is often caused by practical or physical problems. For example, you might be unable to leave your home without lots of help, or be too unwell. Or you might be living in the countryside and far away from friends and shops, where public transport is infrequent or unreliable. This section takes you through some of the practical difficulties that you might have, and gives you some suggestions to improve your situation. Help for people who are frail or unable to leave the house If you can’t leave your home at all it can be extremely difficult to keep in touch with people, other than people who come in to help you. Or, while you might be able to get out of your house, it takes so much effort and trouble that it seems a lot easier to stay indoors. If you are in this situation, there are quite a few organisations which may be able to help. They might be able to organise transport for you, or arrange for someone to come and visit you and spend time with you. * A good place to contact to find out about local services is your nearest Age Concern group. It may run its own activities, such as day centres and lunch clubs, and will probably also have a good knowledge of other organisations in the area. Your local group should be listed in your phone book. * You can also get in touch with your local social services department to see how it can help you either to get out, or to arrange for someone to come and visit you. It may know about any befriending organisations in the area which may be able to help you find activities and meet other people. Social services will also be able to help you at home with practical tasks. To get this help you will need to ask your local social services department for a care assessment. For more information see our free advice leaflet, Help in Your Home. * Contact the Elderly is an organisation which helps lonely, older people who cannot leave their home, by organising monthly tea parties. You can find its address in the Useful contacts section on section 11. * You might also want to think about starting a hobby, club or some kind of further education that you can do from your own home. Our information sheet no. 25, Leisure Ideas, has some suggestions on how to go about doing this. * Some magazines, such as Yours and Saga, have pages for people who are looking for penfriends and friendship. * If you have access to the internet, there are many email groups online for people who are looking for penfriends worldwide. There are also many email groups for people with particular hobbies, so you may find some new friends with similar interests to you. For information and advice on getting online and staying safe online, order a free copy of our leaflet, Computers and the Internet. * Help the Aged runs a service, called SeniorLink, which you can ring in emergencies, if you are worried about a stranger at your door, or if you would just like a chat with someone. To find out more call SeniorLink on 0845 603 4576 (or call CareLine on 0808 100 2435 if you live in Northern Ireland). You could also think about getting a community alarm. See section 6 for more details. ------------------------------------------------------------------------------ Section 6. Feeling unsafe There are lots of reasons why you might feel unsafe. You may be worried about being robbed or having your house broken into. You could be worried by rowdy neighbours who make you feel threatened. Or you might be concerned about having a fall or being ill in the night, or at any time while you are on your own. All of these fears can make you upset and anxious. However, there are some measures you can take to help you feel more protected. * You don’t have to be a prisoner in your own home or be afraid to go out because of the fear of crime. The fact is that as an older person you are less likely to be attacked or robbed than someone in any other age group. Our free advice leaflet, Your Security, explains some simple steps that you can take to make you feel more safe and secure. * To avoid falling prey to bogus callers see our information sheet no. 19, Buying Goods and Services at Home. This information sheet explains some of the techniques con artists can use to trick their way into people’s homes, in order to steal or to sell them goods they don’t want or need. * If your life is being made a misery by nuisance neighbours who try to intimidate you or repeatedly commit crimes in your neighbourhood, help is available. Our information sheet no. 7, Neighbours, gives advice on how you can get help to deal with anti-social behaviour in your neighbourhood. Your local council, the police or the courts should be able to advise you on how to deal with anti-social behaviour. * If you are worried about being alone in an emergency you could think about getting a community alarm. These are phones that are linked to a response unit. You can wear a pendant around your neck or wrist and press it if you need help in an emergency. To find out more call SeniorLink on 0845 603 4576 (or call CareLine on 0808 100 2435 if you live in Northern Ireland). As you get older there are likely to be more things which happen to you that can make you feel low and sad. But it is important to remember that this is a natural reaction to some of the changes which may happen in your life and that there is help available should you need it. -------------------------------------------------------------------------------- Section 7. Depression You may find that you can’t shake off a feeling of sadness, that your situation seems hopeless and that you don’t have the energy or motivation to try to find a solution. This could be a sign that you are experiencing depression. What are the symptoms of depression? * a lasting feeling of being down or sad which is more severe than normal sadness; * losing your interest in life, not enjoying things in the way that you used to; * wanting to avoid your usual social activities and avoid other people; * finding even simple tasks a major effort and generally feeling tired and exhausted; * losing your confidence and self-esteem; thinking that you are useless and people would be better off without you; * not eating properly and losing or putting on weight; * finding that your sleep is disturbed; * finding it hard to concentrate, feeling restless and agitated and having memory problems; * crying a lot; * dwelling on things that have happened in the past and feeling guilty; * feelings of hopelessness; * self harming (for example, cutting yourself); * thoughts of suicide. Getting help When symptoms of depression start to interfere with your life, or are much worse than you expect, it is time to stop struggling on your own and get help. You should make an appointment to see your doctor. If you are not well enough to go to the surgery you can ask your doctor to visit you at home. If you don’t feel comfortable talking to the doctor you normally see, ask to see another doctor in the practice. It may help if you have a friend or relative with you during the appointment. Don’t feel you are wasting your doctor’s time. In the long run it is better for you and your doctor if you get help sooner rather than later. Untreated depression can also make it harder for you to cope with any physical illnesses. Depression can affect anyone at any time in their life. In the past some people felt that it wasn’t the done thing to talk about mental health problems. Nowadays people are much more open. If you have a physical illness that doesn’t heal on its own you should go to your doctor and the same applies for a mental health problem such as depression. Sometimes when people are depressed they experience symptoms such as a lack of concentration and loss of memory. Some older people worry that these are signs of dementia or that others will mistake them for dementia. However, depression and dementia are separate conditions. Most doctors have had training in helping people with depression and will be used to seeing people with both conditions in their surgeries. Depression can be treated and older people respond to treatment as well as anyone else. You don’t have to put up with feeling depressed and you don’t have to fight it on your own. Seasonal affective disorder (SAD) SAD is a type of depression which particularly affects people in the winter months, between September and March (sometimes until April). It is caused by a biochemical imbalance due to the fact that the days are shorter and there is a lack of sunlight. For some people SAD can be very disabling and can prevent them from functioning properly in the winter. For other people SAD is milder but can be just as disabling. Mild SAD can cause discomfort but not severe suffering; it is sometimes known as ‘winter blues’. If you think you may be affected by SAD, go to your doctor. Several effective treatments are available. For more information about SAD contact the Seasonal Affective Disorder Association (SADA). Its contact details can be found in the Useful contacts section, starting in section 11. Treatments There are different ways of treating depression. Talking treatments You might think that talking to a stranger won’t help you. But counselling proves to be a very effective treatment for most people. Rather than it being embarrassing and unhelpful, most people find the opportunity to talk about their problems, in confidence, a great relief. Counsellors are trained to listen carefully and won’t judge you. A counsellor can help you to examine your thinking and the things that make you depressed. You can then go on to look at practical ways to change negative thoughts, relax and worry less. Your doctor may refer you to a counsellor or you could contact the British Association for Counselling and Psychotherapy for a list of counsellors in your area. See the Useful contacts section, starting in section 11 for its contact details. Anti-depressant drugs If you have severe depression, your doctor may prescribe you anti-depressant drugs. (It is possible that anti-depressant drugs may be offered as a first treatment choice. If this is the case, don’t be afraid to ask your doctor what other treatments there are.) There are different types of anti-depressant drugs, so there should be one to help your particular symptoms. All anti-depressant drugs have side effects which are worse to begin with; your doctor will be able to tell you what these are. It may take between two to four weeks for the anti-depressant drugs to take effect. Remember that they don’t always work for everyone. If you are already taking medication for other conditions, make sure the anti-depressant drugs will not react with the drugs you are already taking. Ask your doctor for advice. It can be difficult to remember what to take and when, especially if you are a bit absent-minded because of your depression. For good advice on the safe use of medicines see our free advice leaflet, Managing Your Medicines. Alternative treatments There are various complementary and alternative therapies which some people have found useful in the treatment of depression. These include herbal medicine, acupuncture, and homeopathy. For more information contact MindinfoLine on 0845 766 0163, web: www.mind.org.uk MindinfoLine can also provide information and support on all aspects of mental health. Going into hospital In rare cases some people have to have their depression treated in hospital. This is usually because they are so depressed that they cannot look after themselves properly or have thoughts of suicide. -------------------------------------------------------------------------------- Section 9. Tips for staying well There are things you can do to help yourself stay well and keep your mood lifted. * Try to get out and about. This will help you to stay physically fit as well as being good for your mood. For more information on staying active and mobile see our free advice leaflet, Keeping Mobile. * If you find it difficult to leave the house, there are still things you can do to stay active and occupied. See our information sheet no. 25, Leisure Ideas. * Try to eat a balanced diet. Sometimes as we get older we lose our appetite, but having a varied diet helps us to stay physically and mentally well. Our free advice leaflet, Healthy Eating, gives more information. * Think about ways to help you relax, such as deep breathing exercises, calming music, baking, gardening or anything you find relaxing, and make sure you allow yourself time to do it. * Don’t stop taking any medication or change your dose without speaking to your doctor first. * Don’t struggle on your own. See your doctor or tell someone else you trust how you feel. * Be kind to yourself and remember that depression is an illness. You need time to get better, as you would with any illness. ------------------------------------------------------------------------------ Section 10. Advice for relatives and friends It can be very upsetting to see someone you care about feeling low or depressed. Sometimes people who are feeling sad and miserable might be coming to terms with some of the changes they are experiencing. You can support them by being there to listen to them. If they talk to you about any practical concerns they have, perhaps you can help with those. For example, if they have money worries, help them to find out if they may be entitled to benefits. If they don’t get out much, you could find out about local clubs and classes. Sometimes people can become depressed. Some older people might not say outright that they are depressed but complain more of a variety of physical illnesses. If your relative or friend shows any of the symptoms mentioned in section 7 and you are worried that they might be depressed, perhaps you could gently suggest that they get a check-up from their doctor. You could also offer to go with them if they would like some moral support. Reassure them that there is no stigma in having depression, and that it is not a sign of going senile but a separate illness which can be treated. Some people with severe depression may have thoughts of suicide. Try to encourage your friend or relative to get some emotional support from someone they trust: friends, family or their doctor. You can also suggest that your friend or relative calls Samaritans on 08457 90 90 90, or you could call yourself. Samaritans provide confidential emotional support to anyone experiencing feelings of despair and distress. If you are caring for someone with depression, don’t forget your own needs. If you can, talk things over with a friend and have some time to yourself. This will probably help you to be more supportive to your friend or relative. For more information on caring for someone with depression contact MindinfoLine on 0845 766 0163. ------------------------------------------------------------------------------- Section 12. Useful contacts British Association for Counselling and Psychotherapy BACP House 15 St John’s Business Park Lutterworth LE17 4HB Tel: 0870 443 5252 Web: www.bacp.co.uk Contact BACP if you would like a list of counsellors in your area. Chinese Mental Health Association 2nd Floor, Zenith House 155 Curtain Road London EC2A 3QY Tel: 020 7613 1008 Adviceline: 0845 122 8660 Web: www.cmha.org.uk Provides support to Chinese people in the UK who are affected by mental health issues. Contact the Elderly 15 Henrietta Street London WC2E 8QG Tel: 0800 716543 Web: www.contact-the-elderly.org.uk Contact the Elderly groups organise tea parties for older people who live alone. Groups of between 7 and 12 people visit a different home every month. Depression Alliance 212 Spitfire Studios 63–71 Collier Street London N1 9BE Tel: 0845 123 2320 Web: www.depressionalliance.org Depression Alliance produces publications on various aspects of depression, runs a written advisory service offering support and understanding and co-ordinates self-help groups across the UK. MIND PO Box 277 Manchester M60 3XN MindinfoLine: 0845 766 0163 Web: www.mind.org.uk Mind provides a mental health information service by letter, phone or email and offers information, support and understanding. Nafsiyat (Inter-Cultural Therapy Centre) 262 Holloway Road London N7 6NE Tel: 020 7686 8666 Web: www.nafsiyat.org.uk Nafsiyat offers psychotherapy to people from ethnic and cultural minorities. Seasonal Affective Disorder Association (SADA) SAD Association PO Box 989 Steyning West Sussex BN44 3HR Tel: 01903 814942 Web: www.sada.org.uk The SAD Association is a charity which offers help, support and advice to people affected by SAD, their friends and families. Samaritans PO Box 90 90 Stirling FK8 2SA Tel: 08457 90 90 90 Web: www.samaritans.org.uk You can contact Samaritans any hour of the day or night if you are experiencing emotional distress or suicidal thoughts and want to talk to someone. NHS information and advice England: NHS Direct Tel: 0845 46 47 Textphone: 0845 606 4647 Web: www.nhsdirect.nhs.uk Wales: NHS Direct Wales Tel: 0845 46 47 Textphone: 0845 606 4647 Web: www.nhsdirect.wales.nhs.uk Scotland: NHS 24 Tel: 08454 24 24 24 Textphone: 18001 08454 242424 Web: www.nhs24.com NHS Direct and NHS 24 are 24-hour advice and health information services run by nurses. They provide confidential information on what to do if you or your family are feeling ill, including feeling depressed. They also have information on local healthcare services, self-help and support organisations. Northern Ireland: Local health and social services boards: Eastern Health and Social Services Board 12–22 Linenhall Street Belfast BT2 8BS Tel: 028 9032 1313 Textphone: 028 9032 4980 Web: www.ehssb.n-i.nhs.uk Northern Health and Social Services Board County Hall, 182 Galgorm Road Ballymena BT42 1QB Tel: 028 2531 1000 Helpline: 08457 626428 Textphone: 028 2531 1001 Web: www.nhssb.n-i.nhs.uk Southern Health and Social Services Board Tower Hill Armagh BT61 9DR Tel: 028 3741 0041 Textphone: 028 3741 4530 Web: www.shssb.org Western Health and Social Services Board 15 Gransha Park Clooney Road Londonderry BT47 6FN Tel: 028 7186 0086 Textphone: 028 7186 5281 Web: www.whssb.n-i.nhs.uk For further information contact: Information Resources Team Help the Aged 207–221 Pentonville Road London N1 9UZ Tel: 020 7278 1114 If you have access to the internet you can download our advice leaflets and information sheets by logging on to www.helptheaged.org.uk SeniorLine is the free welfare rights advice and information service run by Help the Aged for older people and their carers. Trained advice workers offer free, confidential and impartial advice about: * welfare and disability benefits * care at home * residential care * housing options and adaptations * access to health and community services. Freephone: 0808 800 6565 Textphone: 0800 26 96 26 9am to 4pm, Monday to Friday If you are in Northern Ireland, contact SeniorLine on 0808 808 7575. Last updated: January 2008 (GP) Next update due: January 2009 Help the Aged is a registered charity No. 272786, registered in England at the above address.