Depression without sadness: Alternative presentations of depression in late life

Older adults often deny feeling sad while exhibiting other characteristics of depression. Elderly patients with depression who do not present with sad ness often have unexplained somatic complaints and exhibit a sense of hopel essness. Anxiety and anhedonia (a general loss of ability to feel pleasure) are also encountered frequently. Other features that may indicate underlyi ng depression include slowness of movement and lack of interest in personal care. A screening device, such as the Center for Epidemiologic Studies-Dep ression Scale, Revised (CES-D-R), may identify depression in suspicious cas es. When this condition is identified, treatment should generally include t he use of an antidepressant medication, usually a selective serotonin reupt ake inhibitor.