Depression without sadness:
alternative presentations of depression in late life
by
Gallo JJ, Rabins PV
Department of Family Practice and Community Medicine,
University of Pennsylvania School of Medicine,
Philadelphia, USA.
Am Fam Physician 1999 Sep 1; 60(3):820-6

ABSTRACT

Older adults often deny feeling sad while exhibiting other characteristics of depression. Elderly patients with depression who do not present with sadness often have unexplained somatic complaints and exhibit a sense of hopelessness. Anxiety and anhedonia (a general loss of ability to feel pleasure) are also encountered frequently. Other features that may indicate underlying depression include slowness of movement and lack of interest in personal care. A screening device, such as the Center for Epidemiologic Studies--Depression Scale, Revised (CES-D-R), may identify depression in suspicious cases. When this condition is identified, treatment should generally include the use of an antidepressant medication, usually a selective serotonin reuptake inhibitor.

TCAs
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Stress
Options
Bupropion
Amineptine
Reboxetine
Nefazodone
Mirtazapine
Venlafaxine
5-HT/dopamine
Antidepressants
Tranylcypromine
Chronic depression
Atypical depression
Retarded depression
New antidepressants
Personal inferiority and anxiety
The monoamine theory of depression
Noradrenergic plus serotonergic antidepressants

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