Depression in older people
Many issues can cause depression as people age, such as retirement, the death of friends and loved ones, increased isolation, or medical problems
Left untreated, depression can impact physical health, impair memory and concentration, and prevent people from enjoying life
Depression is a common problem in older adults
The symptoms of depression can affect all aspects of life, including energy, appetite, sleep, and interest in work, hobbies, and relationships
Many depressed elderly people or their relatives fail to recognize the symptoms of depression and/or do not take the steps to get the help they need
There are many reasons depression in older adults and the elderly is so often overlooked:
- The assumption that they have good reason to be down or that depression, as it is just part of aging
- Isolation
- Physical issues
- They may be reluctant to talk about their feelings or ask for help
- People are frightened of admitting to depression
Remember: depression isn’t a sign of weakness, or a character flaw. It can happen to anyone, at any age, no matter your background or your previous accomplishments in life
Causes of depression in older adults and the elderly
As people grow older, they face significant life changes that can put them at risk for depression. Causes and risk factors that contribute to depression in older adults and the elderly include:
- Health problems – Illness and disability; chronic or severe pain; cognitive decline and damage to body image due to surgery, or disease
- Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges
- Reduced sense of purpose – Feelings of purposelessness, or loss of identity due to retirement or physical limitations on activities
- Fears – Fear of death or dying, or anxiety over financial problems or health issues.
- Recent bereavement – The death of friends, family members, and pets or the loss of a spouse, or partner.
Bereavement, loss, and depression in the elderly
As you age, you experience more loss and this is painful. Loss can be loss of independence, mobility, health, your long-time career, or someone you love.
Grieving over these losses is normal and healthy, even if the feelings of sadness last for a long time. Losing all hope and joy, however, is not normal.
Distinguishing between grief and clinical depression is not always easy, since they share many symptoms. However, there are ways to tell the difference.
Grief involves a wide variety of emotions and a mix of good and bad days.
Even in the middle of the grieving process, there will be moments of pleasure or happiness.
With depression, the feelings of emptiness and despair are constant and other signs include:
- Intense, pervasive sense of guilt
- Thoughts of suicide or a preoccupation with dying
- Feelings of hopelessness or worthlessness
- Slow speech and body movements
- Inability to function at work, home, and/or school
- Seeing or hearing things imaginary things
Depression and illness in older adults and the elderly
Chronic pain and physical disability can get people down
Symptoms of depression can also occur as part of medical problems such as dementia, or as a side effect of prescription drugs
- Medical conditions can cause depression in the elderly such as :
- Parkinson’s disease
- stroke
- heart disease
- cancer
- diabetes
- thyroid disorders
- Vitamin B12 deficiency
- dementia and Alzheimer’s disease
- lupus
- multiple sclerosis
Prescription medications and depression in the elderly
Symptoms of depression are a side effect of many commonly prescribed drugs and especially a combination of many drugs taken together
Older adults are more sensitive because, as we age, our bodies become less efficient at metabolizing and processing drugs
Medications that can cause or worsen depression include:
- Blood pressure medication
- Beta-blockers
- Sleeping pills
- Tranquilizers Calcium-channel blockers
- Medication for Parkinson’s disease
- Ulcer medication
- Heart drugs
- Steroids
- High-cholesterol
- Painkillers and arthritis drugs
Alcohol and depression in the elderly
Alcohol may make people feel better in the short term, but it can cause problems over time
Alcohol makes symptoms of depression, irritability, and anxiety worse and impairs brain function
Alcohol also interacts in negative ways with numerous medications, including antidepressants. It also affects quality of sleep
How to recognise depression in the elderly
Look out for the following symptoms:
- Sadness
- Fatigue
- Abandoning or losing interest in hobbies or other pleasurable pastimes
- Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home)
- Weight loss or loss of appetite
- Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness)
- Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing)
- Increased use of alcohol or other drugs
- Fixation on death; suicidal thoughts or attempts
- Unexplained or aggravated aches and pains
- Feelings of hopelessness or helplessness
- Anxiety and worries
- Memory problems
- Lack of motivation and energy
- Slowed movement and speech
- Irritability
Symptoms of Dementia rather than Depression
This is not always easy to diagnose, however with dementia:
- Mental decline is relatively rapid
- Do not know the correct time, date, and where he or she is
- Difficulty concentrating
- Memory problems
- Confused and disoriented; becomes lost in familiar locations
- Writing, speaking, and motor skills are impaired
- Doesn’t notice memory problems or seem to care
With symptoms of depression or dementia, see the GP as soon as you can for help.
Self-help
The more active people are—physically, mentally, and socially—the better they will feel.
- Exercise. Physical activity has powerful mood-boosting effects. In fact, research suggests it may be just as effective as antidepressants in relieving depression. The best part is that the benefits come without side effects. Encourage your parent to walk, take the stairs or if mobility is more difficult, try seated exercise
- Connect with others. Try to encourage your elderly parent to socialise with others or talk on the phone
- Get enough sleep. Lack of sleep can make depression worse
- Maintain a healthy diet. Try to get your parent to eat well and avoid eating too much sugar and junk food
- Volunteer . Helping others is one of the best ways to feel better about yourself and expand your social network.
- Take care of a pet. A pet can keep you company, and walking a dog, for example, can be good exercise and a great way to meet people.
- Learn a new skill by taking on a new hobby
Anti-depressant treatment for older adults and the elderly
Older adults are more sensitive to drug side effects and vulnerable to interactions with other medicines they’re taking. Recent studies have also found that drugs, such as Prozac, can cause rapid bone density and a higher risk for fractures and falls. Because of these safety concerns, elderly adults on antidepressants should be carefully monitored. In many cases, therapy and/or healthy lifestyle changes, such as exercise, can be as effective as antidepressants in relieving depression, but without the dangerous side effects.
Alternative medicine for depression in older adults and the elderly
- Herbal remedies, acupuncture and natural supplements can also be effective in treating depression, and in most cases, are much safer for older adults than antidepressants.
- Omega-3 fatty acids may boost the effectiveness of antidepressants or work as a standalone treatment for depression.
- St. John’s Wort can help with mild or moderate symptoms of depression but should not be taken with antidepressants.
- Folic acid can help relieve symptoms of depression when combined with other treatments.
Counselling and therapy for older adults and the elderly
Therapy work well on depression because it addresses the underlying causes of the depression, rather than just the symptoms
Supportive counselling includes religious and peer counselling. It can ease loneliness and the hopelessness of depression
Therapy helps people work through stressful life changes, heal from losses, and process difficult emotions and change negative thinking patterns and develop better coping skills
Support groups for depression, illness, or bereavement are a safe place to share experiences, advice, and encouragement
Cognitive behaviour therapy (CBT) is often used to treat depression and focusses very much on the symptoms, rather than the underlying causes of depression
What can you do to help?
If an elderly person you care about is depressed, you can make a difference by offering emotional support. Listen to your loved one with patience and compassion. Try not to criticise feelings expressed, but point out realities and offer hope. You can also help by making sure that your parent gets an accurate diagnosis and appropriate treatment. Go with them to appointments and offer moral support
Take your parent out. Depression is less likely when minds remain active. Suggest activities to do together: walks, an art class, a trip to the museum or the cinema—anything that provides mental or physical stimulation
Schedule regular social activities. Group outings, visits from friends and family members, or trips to the local senior or community centre can help combat isolation and loneliness. Be gently insistent if your plans are refused: depressed people often feel better when they’re around others
Plan and prepare healthy meals. A poor diet can make depression worse, so make sure your loved one is eating right, with plenty of fruit, vegetables, whole grains, and some protein at every meal.
Encourage your parent to follow through with treatment. Depression usually recurs when treatment is stopped too soon, so help your parent to keep up with his or her treatment plan
Make sure all medications are taken as instructed
Watch for suicidal tendencies
