Some people think sadness is a natural part of aging. After all, as people get older, they are more likely to have health issues or lose loved ones. The holiday season can sometimes make this grief even more acute. In these instances, sadness can be normal. But it’s more than the holiday blues when it persists to the point that it regularly interferes with daily life. Then it might be depression, which is a problem. The Centers for Disease Control and Prevention (CDC) defines depression as “a persistent sad, anxious, or empty feeling, or a feeling of hopelessness and pessimism.” 1 According to a 2007 report, about seven million adults 65 and older (roughly 15 to 20 percent of that population) are affected by depression. 2 Despite its prevalence, depression is often not recognized or treated because people are ashamed to discuss it. They may view depression as a personal weakness or character flaw. That’s unfortunate. Left untreated, depression can delay recovery or worsen the outcome of certain illnesses and even lead to suicide. Although many people assume that the highest rates of suicide are among young people, white males age 85 and older actually have the highest suicide rate in the United States, according to the National Institute of Mental Health. 3 “It should never to get to that point,” said Dr. Mary McCluskey, chief medical officer of WellPoint’s Government Business Division. “Depression can be successfully treated. There are many programs available at no or low cost as part of a Medicare or Medicare Advantage (MA) plan to help.” McCluskey offers the following tips and resources for Medicare members who have, or think they may have, depression. Get Screened. Routine screening can successfully identify people who are depressed and direct them to appropriate treatment. 4 Medicare covers the cost of depression screening in a primary care physician’s office, as long as the provider has resources to follow up with appropriate treatment and referrals. Additionally, depression screening is typically covered in a “Welcome to Medicare” visit or an “Annual Wellness Visit.” Depression is evaluated with a screening tool, such as the Patient Health Questionnaire, or PHQ-9, which includes questions about the patient’s mood, energy, appetite and sleep habits. Consider Treatment. When someone has been diagnosed with depression, their doctor may prescribe antidepressant medication for them. Medicare Part D and Medicare Advantage Prescription Drug plans, like those administered by WellPoint’s affiliates, cover most anti-depressant medications. This includes selective serotonin reuptake inhibitors, which affect the brain’s neurotransmitters. Since different medications affect different neurotransmitters, it may take time to find the one that works best so it is important to be patient. Take the medication as prescribed and watch for any side effects, such as trouble with balance. To be safe, remove all fall hazards from the home. Drug copays may apply. Low-income members may qualify for extra help with payment for their drugs. Some people may prefer talk therapy to medication. Talk therapy can be effective in treating mild to moderate depression. 5 Therapy also can be effective when combined with medication. Medicare typically covers visits with mental health experts, including a psychiatrist, a clinical psychologist or a clinical social worker. Copayments or coinsurance may apply. Talk to your doctor about a referral for therapy. Be Active. Exercising three times a week can be effective in relieving major depression among seniors and decreasing the chances of depression returning, according to a study by Duke University Medical Center. 6 Walking, gardening, dancing and swimming are all good forms of exercise. Many MA plans include a free gym membership as well as classes with other seniors. Avoid Alcohol. It’s not uncommon for seniors to self-medicate with alcohol as a way of coping with loneliness or chronic pain. However, alcohol is actually a depressant that can compound depression. Medicare provides outpatient substance abuse counseling for people who need help to quit drinking. Some Medicare members have access to a behavioral health service through their plan. In other instances, this benefit can be purchased for a small premium. Community mental health centers and social workers also may be able to provide services. Anyone in crisis should call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). TTY users should call 1-800-799-4TTY (1-800-799-4889). The service is free and confidential. Counselors are available 24 hours a day, 7 days a week.
This information is intended for educational purposes only and should not be interpreted as medical advice. Please consult your health care provider for advice about treatments that may affect your health.WellPoint affiliates are PPO plans, HMO plans and PDP plans with a Medicare contract. Enrollment in WellPoint affiliated plans depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on Jan. 1 of each year. You must continue to pay your Medicare Part B premium. The SilverSneakers Fitness Program is provided by Healthways, Inc., an independent company. SilverSneakers® is a registered mark of Healthways, Inc. Please check with your doctor before you start a physical activity program. 1 http://www.cdc.gov/aging/pdf/CIB_mental_health.pdf, accessed November 21, 2013 2 Steinman, 2007: Steinman LE, Frederick JT, et al. Recommendations for treating depression in community-based older adults. Am J Prev Med 2007;33(3):175–81. Available at www.ajpm-online.net/article/S0749-3797%2807%2900330-3/abstract. 3 http://www.nimh.nih.gov/health/topics/depression/index.shtml 4 http://www.cdc.gov/aging/pdf/CIB_mental_health.pdf, accessed Nov. 21, 2013 5 http://www.nimh.nih.gov/health/publications/men-and-depression/diagnostic-evaluation-and-treatment.shtml , accessed Nov. 21, 2013 6 http://abcnews.go.com/Health/Depression/story?id=117946&page=1, accessed Nov. 21, 2013