Dear Savvy Senior,
Since retiring a few years ago, my husband has become increasingly irritable and apathetic. I'm concerned that he's depressed, even though he may not admit it. Where can we turn to get help with this, and what, if anything, does Medicare pay for?
Depression is unfortunately a widespread problem among older Americans, affecting approximately 15 percent of the 65-and-older population. Here's what you should know, along with some tips and resources for screening and treatments, and how Medicare covers it.
Everyone feels sad or gets the blues now and then, but when these feelings linger more than a few weeks, it may be depression. Depression is a real illness that affects mood, feelings, behavior and physical health, and contrary to what many people believe, it's not a normal part of aging or a personal weakness, but it is very treatable.
It's also important to know that depression is not just sadness. In many seniors it can manifest as apathy, irritability, or problems with memory or concentration without the depressed mood.
To help you get a handle on the seriousness of your husband's problem, a good first step is for him to take an online depression-screening test.
He can do this for free at Mental Health America, a national nonprofit organization that offers a variety of online mental health screening tools at MentalHealthAmerica.net - click on "Take a Screen" in the menu bar. Or at HelpYourselfHelpOthers.org, which is offered by Screening for Mental Health, Inc.
Both of these tests are anonymous and confidential, they take less that 10 minutes to complete, and they can help you determine the severity of your husband's problem.
If you find that he is suffering from depressive symptoms, he needs to see his doctor for a medical evaluation to rule out possible medical causes. Some medications, for example, can produce side effects that mimic depressive symptoms - pain and sleeping meds are common culprits. It's also important to distinguish between depression and dementia, which can share some of the same symptoms.
If he's diagnosed with depression, there are a variety of treatment options including talk therapy, antidepressant medications or a combination of both.
Cognitive behavioral therapy (CBT) is a particularly effective type of talk therapy, which helps patients recognize and change destructive thinking patterns that leads to negative feelings.
For help finding a therapist who's trained in CBT, ask your doctor for a referral, check your local yellow pages under "counseling" or "psychologists," or check with the Association for Behavioral and Cognitive Therapies (FindCBT.org), or the Academy of Cognitive Therapy (AcademyofCT.org).
And to search for therapists that accept Medicare, use Medicare's Physician Compare tool. Go to Medicare.gov/physiciancompare and type in your zip code, or city and state, then type in the type of profession you want locate, like "psychiatry" or "clinical psychologist" in the "What are you searching for?" box.
You'll be happy to know that original Medicare currently covers 100 percent for annual depression screenings that are done in a doctor's office or other primary care clinic. They also pay 80 percent of its approved amount for outpatient mental health services like counseling and therapy services, and will cover almost all medications used to treat depression under the Part D prescription drug benefit.
If you and your husband get your Medicare benefits through a private Medicare Advantage plan, they too must cover the same services as original Medicare but they will likely require him to see an in-network provider. You'll need to contact your plan directly for the details.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of "The Savvy Senior" book.