Sadness and hopelessness are to be investigated in the context of co-morbidities (other illnesses), like hypertension and prescription medication and their side effects.
Many times lack of physical activity in particular walking contributes to depression. Emotional well-being is tied to walking. Walking improves emotional well-being by releasing endorphins. Opiates and tranquilizers and the side effects of other medications interfere with the release of endorphins.
But many times, it is personal loss and recent changes of life style which have taken a toll. In this case, they can cause waning joy of life, but even there, life-style changes can improve overall health.