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Depression and the Aging Man

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June 27, 2001 (New York) -- Two years ago, Mark Helmke almost became a suicide statistic. At the time, he was a successful business consultant with few complaints.

Then, it hit, just like that: Depression.

"Depression sucks the life blood out of you," he says. "You feel as though you would be better off dead."

Like many men, he had trouble admitting he was depressed. But after receiving treatment, he came "out" and now spends time helping take the cloak of shame off men and depression. Today, Helmke is the senior director of public affairs at the National Mental Health Association.

Depression is a plague among men aged 50 and older, and suicide in this age group is an epidemic, says Steven P. Roose, MD, professor of clinical psychiatry at Columbia University in New York and the co-director of the Neuropsychiatry Research Clinic at the New York State Psychiatric Institute. Roose and Helmke spoke about aging men and depression at a media briefing recently held here.

"Depression is in the background as a causative factor or a co-existing condition in most of the diseases facing men over age 50" such as heart attack and stroke, he says.

But as Helmke can attest, depression is generally treatable with a combination of medications and talk therapy.

In the next few months, several studies slated to be published will shed more light on depression in the aging.

One study, dubbed the 'old-old' study looks at 178 depressed individuals older than 75 who took the selective serotonin reuptake inhibitor, or SSRI, antidepressant Celexa or a placebo for eight weeks at 10 centers across the U.S.

The results, slated for August publication, will offer "a tremendous advance in understanding the effectiveness of treating depression in the old-old," says Roose. "Unfortunately older people with depression have been neglected by research studies until recently," he says. This is especially crucial given the rapidly expanding numbers of elderly people in the population. In the next 20 years, the number of people over age 85 is expected to double.

What happens to men as they age that puts them at risk for depression?

Meet ADAM, a.k.a Androgen Deficiency of the Aging Male. As men age, they experience a decline in male sex hormones, especially testosterone. As testosterone drops, they lose muscle, gain weight -- especially around their stomach -- and they lose hair. They also experience a decrease in sexual desire and function, an increase in depression, anxiety and memory problems.

"Unfortunately, treatment is not as simple as just replacing testosterone," Roose says. "Although the literature is filled with very enthusiastic proponents of testosterone, there are few studies using rigorous clinical trials methodology."

When it comes to illness and depression, it's a chicken or egg situation.

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