By BOB GRYLLS
Reporter
WESTMEATH — Throughout one’s life, there are times when it seems like it’s too much effort to do something, whether it be get out of bed and get dressed, or even leave the house.
Dr. Donald Brown, also like many of us, endured the ups and downs through life as well.
However, he knows the importance of social activities, sleep, physical exercise and exercise of the brain as a way of warning off these ups and downs, which can, if left to their own devices, lead to depression.
Dr. Brown was the guest speaker at the Riverview Seniors Social Club event last Friday at the Westmeath Hall. This is the first of two speaking events, which the club is able to host with funding from the federal government’s New Horizon for Seniors Program.
Gayle Stewart, co-ordinator of this Speaker Series event, welcomed Dr. Brown. The topic was Depression in Later Life and 31 seniors attended the event.
Reviewing Dr. Brown’s history, Ms. Stewart said Dr. Brown graduated in the mid-60s from Queen’s University Medical School, did his medical internship through the University of Alberta in Edmonton, followed by a Psychiatric Residency at Harvard, graduating in 1969 with a degree F.R.C.P. (Fellowship of the Royal College of Physicians), with the specialty of Psychiatry.
He set up his first Private Practice in Toronto. In 1975 he moved his Practice to Pembroke, where he became Chief of Psychiatry at the Civic Hospital, then the General.
He retired in 2007, but his wife Beverly says, “He is awful at it.”
Dr. Brown came out of retirement and went to work at the Appletree Clinic in Ottawa. However, he left that clinic and for the two years has been at Garrison Petawawa’s Mental Health Clinic with Post Traumatic Stress Disorder victims from the Canadian Forces.
Dr. Brown played hockey in our Westmeath Rink and rode the school bus with the other kids to Pembroke Collegiate Institute, where his piano skills made him popular among the students.
He began his talk with statistics. For people 65 and over who get treatment for depression, there is an 80 percent success rate. However, of those who are depressed only 10 percent seek help. Openness is good — stigma is bad.
“We have to start talking about mental health,” Dr. Brown said.
“Most people won’t admit they need help because they can’t accept the shame and disgrace of how others may feel about them, he said. These people consider depression too personal and would rather face it alone, he said, adding, they were likely raised to be stoic and self-reliant. For them there is no relief or quick-fix, whereas if a physical injury, then a pill or an injection could make things better, Dr. Brown said.
Adding to the difficulty of depression, is being unable to meet challenges, he said
One out of five seniors experience depression, whereas in nursing homes, etc. four of five face depression. Fifteen percent of seniors commit suicide, but in men over 80 years of age, it is six times as likely.
The causes of depression are genetics, stress, brain chemistry, physical health, medications taken, even attitude can contribute significantly, Dr. Brown said. The brain chemistry, or cognitive dysfunction, could be affected by one of the three transmitters – in this case, serotonin, norepinephrine and dopamine which play a role. An increase or decrease of norepinephrine along with a fall in serotonin causes depression, he explained. Fortunately, increasing serotonin levels by anti-depressant medication can raise the level of norepinephrine. Dopamine is the third substance that plays a part in moods, he said.
Medicines that can cause one to be too high: steroids, Ritalin, cyclosporine, antidepressants, and cancer medications.
Medications that provoke depression: alcohol, anticonvulsive, valium, opioids, statins, and zovirax (for shingles)
Dr. Brown, who met Anna Freud in early years, remarked, “She was like her father Sigmund Freud, by avoiding to mention much the father’s influence on their children.”
Physical changes such as appetite, sleep habits, aches and pains can influence depression, Dr. Brown said. Even thinking, not concentrating, not remembering or ruminating over self-failures contribute to this mental state, he said. A loss of interest in daily things along with a withdrawal from social activities are signs of depression, he added. Alcohol or drugs may dull the feelings but in time enhance the problem.
“Some of the same signs of depression are the similar to early signs of Alzheimer’s,” Dr. Brown said.
There are various types of depressions. A Major Depression could include thoughts of suicide. Therapy with a mental health specialist can help and/or antidepressants. Antidepressant drugs generally take three to six weeks to take effect. With the elderly, it could take as long as four to eight months.
A Depressive Disorder is one that lasts longer than two tears. Again, psychotherapy and/or antidepressants can help.
Bipolar disorder has mood episodes that range from extremes of high energy with an “up” mood to low “depressive” periods, often a 30-day cycle. The low phase shows symptoms of a major depression, while the up side, manic mood. Medication can help bring mood swings under control and one popular stabilizer is lithium, Dr. Brown said.
People with Psychotic Depression have the symptoms of major depression along with “psychotic” symptoms, such as hallucinations, allusions and paranoia, he said. A combination of antidepressant and antipsychotic drugs can treat psychotic depression. Electroconvulsive Therapy (ECT) may also be an option.
No talk is complete without a ‘shock’.
“This series of six to shock treatments work well the first time but less so for a second or third round,” Dr. Brown explained.
If someone needs help with a mental problem, “The first step is a Family Doctor who would ascertain if a psychiatrist is required,” said Dr. Brown. The psychiatrist, upon meeting with the new patient, would inquire details about the patient’s family history (both mother’s and father’s) and also review medications being taken. The psychiatrist would then recommend either a change of lifestyle or further therapy. The focus, if further therapy is decided, might be prescribing a medication to alter one or more of the serotonin, norepinephrine and dopamine transmitters.
Dr. Brown wound down his very informative talk on depression with some good old-fashioned advice, “Eat healthy, be active, get rest, manage stress levels, get involved and listen to your doctor.”
