By ROB LAMBERTS, MD
He came in for his regular blood pressure and cholesterol check. On the review of systems sheet he circled “depression.”
“I see you circled depression,” I said after dealing with his routine problems. ”What’s up?”
“I don’t think I am actually clinically depressed, but I’ve just been finding it harder to get going recently,” he responded. ”I can force myself to do things, but I’ve never have had to force myself.”
“I noticed that you retired recently. Do you think that has something to do with your depression?” I asked.
“I’m not really sure. I don’t feel like it makes me depressed. I was definitely happy to stop going to work.”
I have taken care of him for many years, and know him to be a solid guy. “I have seen this a lot in men who retire. They think it’s going to be good to rest, and it is for the first few months. But after a while, the novelty wears off and they feel directionless. They don’t want to spend the rest of their lives entertaining themselves or completing the ‘honey do’ list, but they don’t want to go back to work either.”
He looked up and me, “Yeah, I guess that sounds like me.”
“What I have seen work in people, especially men, in your situation is to get involved in something that is focused on other people. Volunteer work at the food pantry, work for Habitat for Humanity, or anything else that lets you help other people. I think the reason people get depressed is that they turn their focus completely on themselves, which is not what they are used to when they are working.” (I knew that this man had a job that helped disadvantaged people).
“That’s great advice, doc.” he said, with a brighter expression on his face.
“It’s from experience,” I responded. ”I’ve seen a lot of retirees start to feel like they are on a hamster wheel, just entertaining themselves until they die. I know I wouldn’t want to retire that way. Knowing you, I wouldn’t imagine you would either.”
We talked for about 15 minutes about the various groups around town that would need someone of his skills. I told him about how my parents went to Africa for a year after Dad retired. He actually taught physics over there, but that is what they needed. Of all the time I spent with him, over half of it was regarding his post-retirement “blues.” He wasn’t clinically depressed, so I couldn’t charge for depression as a diagnosis. The code I used? 99214 for Hypertension and Hyperlipidemia.