Why does depression at 51 cause emotional numbness?

Question

Hello doctor,

I am 51 years old and have had depression for many years. Lately, something feels different. Why does depression at 51 cause someone to stop caring about things they once loved?

It is not that I am crying all the time anymore. I just do not seem to care about anything. Hobbies I used to enjoy no longer interest me. I avoid friends, and even spending time with family feels like too much effort. I am taking Escitalopram, but this numb feeling has not gone away.

Is this still depression?
Does it mean the medicine is no longer working?

I keep wondering if I will ever feel excited about life again.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Depression is the same regardless of age and gender. It is similar to diabetes, which presents with similar kinds of symptoms in all groups of people.

What you have described are the core symptoms of depression:

Hopelessness.
Loss of motivation.
Loss of interest.

These are all core symptoms of depression.

It is true that because of constant stressors, the intensity of depressive disorder (a mood disorder) can change, but medicines do not stop working. There is no tolerance to antidepressants. However, due to the worsening symptoms, you may need to increase the dose or even augment it with other medications.

Escitalopram or other SSRIs (selective serotonin reuptake inhibitors) may cause emotional blunting, but the symptoms you are experiencing are probably due to depressive disorder.

Psychotherapy (a treatment for mental health issues) is also an option that you can choose along with medicines. For instance, cognitive behavioral therapy (CBT, a talk therapy) is very helpful and evidence-based. Instead of adding more burden with medicines, you can opt for psychotherapy as well.

You can also do regular exercise, such as cycling, which is evidence-based and helps improve mood. If you are using any kind of substance, such as smoking, you should quit, as it can worsen your symptoms. Maintain a regular sleep schedule.

If you can share more details about the duration of your symptoms, their severity, any comorbidities, the number of episodes, physical symptoms, sleep, appetite, any suicidal or homicidal thoughts, the previous dose and name of your medicines, and your thyroid hormone and vitamin D levels, you can share them with me, and I will give you more specific advice.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.