Depressed Parent

Dear Dr. LeCrone:

My siblings and I are very concerned about our 71 year old father. Until about 6 months ago he was a very active and vibrant person but he has become increasingly withdrawn and sullen. His appetite has vanished and he has lost 25 pounds, stopped shaving and is not interested in any of his old hobbies. Dad rarely drank but he is now consuming 6-8 cans of beer a day on a regular basis. We think he is depressed but he says that he is just unhappy. He refuses to go to his doctor. Please discuss the difference between unhappiness and depression.

-A reader in Texas

Dear reader:

This brief column allows me to cover only some of the high points of your question. Everyone experiences unhappiness, disappointment, sadness, and “normal” or reactive depression at times. Relatively small losses such as not getting a promotion, to major losses like the death of a family member, can all produce reactive depression which may last for days, weeks, or even months in some cases. This type of depression is certainly characterized by unhappiness but usually can be more or less resolved with time, support, love and understanding from someone who cares, and, perhaps professional counseling. The duration and depth of despondency along with certain persistent psychological and physical symptoms often separate unhappiness from more severe and medically significant types of clinical depression.
The problems that your father is currently experiencing may also include sleep problems, mood swings, feelings of helplessness and hopelessness, exaggerated or unwarranted feelings of guilt, difficulty in concentration and memory, feelings of fatigue and lack of energy, frequent tearfulness, and possible thoughts of suicide. These symptoms all point to clinical depression rather than simply experiencing unhappiness.

Untreated clinical depression can lead to other major medical problems, can become life threatening and can include a real possibility of suicide.

Six months is a long time for your father to have experienced his “unhappiness” and he needs professional evaluation beginning with his family physician.

If he resists this suggestion to see a family physician, you may want to help him reconsider his decision by gathering his children, your mother, a close friend whose opinion he values, and, perhaps, his clergyperson. The purpose of the meeting would be to express your united love and concern for him, encourage him to see his physician, and let him know that you want to be supportive in helping him through this difficult period of his life.