Does depression in middle age feel different than young age?

Question

Hello doctor,

I am 43, and I have had depression on and off since my 20s. Lately, it does not even feel like sadness anymore. Does depression in middle age feel different than when I was younger, at 43?

Now it is more like I have no energy, no interest in anything, and everything feels like hard work. I am taking sertraline, but it does not seem to help as much as before.

Is this just depression changing over time, or is something else going on? I keep blaming myself for not getting better. I miss feeling like the old me.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for reaching out.

The physical symptoms you are describing are known as the neurovegetative symptoms of depression.

These symptoms are part of major depressive disorder itself. With increasing age, they may feel more intense because ageing can also cause some degree of body pain, mental slowing, and generalised weakness.

The presentation of depression varies from one individual to another and can also differ between episodes. Therefore, some people with major depressive disorder may experience predominantly physical symptoms during one episode but not another, such as fatigue, generalised body aches, headaches, or other physical complaints.

Blaming yourself for your condition is not going to help because depression is a medical condition and is not under your control.

Sometimes, people with major depressive disorder also have low vitamin D levels, hypothyroidism, or low vitamin B12 levels. Therefore, it is advisable to have these blood tests done as well.

Rest assured. There are antidepressants like Fluoxetine and Sertraline that can boost your energy and lift your mood. If you are only responding partially to Sertraline, then sometimes it can be helpful to add combination drug therapy.

But prior to switching or adding therapy, it is generally recommended to optimise the dose of Sertraline by gradually increasing the dose to an effective therapeutic level under the supervision of your doctor.

I hope this helps.

Please revert in case of further queries.

Thank you.