Depression in Middle Age
What about those people who have their
first depression later in life? Are they similar or different to those
who get depressed earlier in life?
What is interesting is
that there may be a type of depression in older adults that is
physically triggered. Let me tell you a story about how this was
Much of this research was
conducted by K. Ranga Ram Krishnan at Duke
University . In the 1980?s
they got their first MRI machines. These machines let you take detailed
pictures of the brain without using radiation (they use magnetic
resonance imagery instead.)
His group didn?t really
know what to do with these new machines. So they decided to take a look
at the brains of elderly depressed patients. What they found was
fascinating. In 70% of the patients who had suffered late in life
depressions, they found small white patches in various areas of the
brain. When they autopsied some of the these patients who later died,
they found that these were lesions in the brain that ranged from tiny
pinpoint lesions up to rather large (2 inches in diameter) lesions.
These were where silent strokes had occurred, killing the brain tissue.
Silent strokes are those
strokes that happen in a part of the brain that does not control
sensation or motion, so you often are unaware you even had the stroke.
This led to the
realization that these people were suffering from vascular depression,
that is, depression caused by damage to the brain from a silent stroke.
The main area of the brain
where Krishnan found these lesions was the prefrontal cortex, or more
specifically the orbitofrontal cortex, right behind the eyes.
These depressions were
very similar to regular depression, with the main difference being that
this group generally hadn?t suffered depression earlier in life.
The good news is that these depressions
respond well to antidepressant medications, and the patients tend to
get well just like regular depressions.
In summary, if you or a relative suffers
a sudden depression later in life, suspect the vascular depression.
And get treatment. (Also, if your elderly relative suffers
a vascular depression, they may also show pseudo-dementia, which is a
type of cognitive impairment which is caused by serious depression.
Treating the depression will resolve the pseudo-dementia.
Copyright © 2006 Andrew Gottlieb
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