The Mean Disease
Emory’s Fuqua Center helps combat depression in the elderly

“I was practicing surgery, working very hard day and night, and was under tremendous amounts of stress with no outlets,” he says.

King (left) underwent psychoanalysis and within six months his depression was gone. But, like an unwelcome acquaintance, it returned almost fifty years later when King was eighty-three, sapping his energy, taking away his appetite, and stealing his enthusiasm.

“Everything was an effort, even walking or thinking,” he says. “Depression is a mean disease.”

When Virginia Allen, of Atlanta, started withdrawing from her usual activities and going into seclusion over a period of several months, she couldn’t figure out what was wrong. “I spent all day sitting in a recliner,” she says.

“I thought, well, a seventy-six-year-old woman ought to walk with a cane and sit in a chair.”

As many as two million of the country’s thirty-five million seniors, age sixty-five and above, suffer from major depression, and five million have depressive symptoms such as lethargy, lack of interest in normal activities, or sleeplessness, according to the National Institute of Mental Health.

Unfortunately, depression often goes underdiagnosed in the elderly, says Eve Byrd, associate director of the Fuqua Center for Late-Life Depression at Emory’s Wesley Woods. Only a small percentage receive treatment from mental health professionals.

“People think, ‘Oh, I’m just getting old.’ Or, ‘I’m not sad, I just don’t have any energy.’ Or, ‘I just have too much to do and I can’t concentrate.’ Depression can be numbing,” says Byrd. “Also, people of this generation believe you should be able to ‘pull yourself up by your bootstraps.’ They aren’t used to relying on anyone but themselves. But you can’t just snap yourself out of depression.”

The Fuqua Center seeks to improve this inequity. Working with health professionals, clergy, and caregivers, the center provides a full spectrum of services, from in-patient to day treatment programs to group therapy. The center emphasizes community outreach, conducting educational programs at assisted living facilities, nursing homes, and senior communities.

Atlanta businessman J.B. Fuqua, whose donations established the Fuqua Center in 1999 as well as an academic chair in late-life depression in 2003, suffered from the illness for much of his life.

“Mr. Fuqua has made a huge difference in our ability to reach out to–and help–a large group of elderly persons who have traditionally suffered in silence,” says William McDonald, associate professor of psychiatry and director of the Fuqua Center (at left with Eve Byrd, associate director of the Fuqua Center). McDonald holds the J.B. Fuqua Chair in Late-Life Depression.

More than fourteen thousand seniors have been served since the center started, including King and Allen, whose depressions lifted almost immediately with proper treatment.

Now seventy-nine, Allen golfs regularly and walks three miles a day. “Life is once again really and truly a joy,” she says. She attributes the difference to the Electro-Convulsive Therapy (ECT) treatments she received at Wesley Woods.

“ECT is not our first-line treatment, but it is a very effective treatment for depression,” Byrd says. “There are a lot of preconceived notions about ECT, but it’s very safe.”

ECT, which involves passing an electric current through the brain, has been used for decades on patients with severe depression or mania. The treatment appears to trigger the release of neurotransmitters, which leads to an antidepressant effect. With sedation, muscle relaxants, and IV fluids, the procedure is far less intense than in the past, and has minimal side effects, although it can result in short-term memory loss.

King, now eighty-seven, was treated with counseling and medication. He has resumed playing golf twice a week, walking two miles a day, and tending to Robbin Hills, his seven-hundred acre farm just outside of Griffin, Georgia. He has returned to leading roles in his church, community, and charities like the Salvation Army and the Boys and Girls clubs. He and his wife, Mariella, have traveled to Norway, South Africa, Australia, and France.

“I have a busy, happy life. I’m happy within my skin,” he says. “The more I give to life, the more it gives to me.”–M.J.L.

For more information, call the Fuqua Center at 877.498.0096, or visit the Web site at http://fuqua.emoryhealthcare.org. The Eldercare Locator, a nationwide toll-free service, is also available to help older adults and caregivers find local services, at 800.677.1116.