Depression is experienced by more than six million Americans over the age of 65. Quite often, disabilities and various illnesses can occur at the same time as the depression, and the depression itself may go untreated in all but 10% of all people. At that age, people will feel their world drastically changing as friends, siblings and spouses die, and their support systems appear to crumble around them. They no longer feel as productive as before, and any sense of joy in their lives, seem like a distant memory. The proper care of the elderly suffering from depression is delayed in many cases because family members, and even the elderly's doctor may not be aware that the slowing down the elderly is experiencing, may not be due to natural aging, but in fact to their suffering from depression. Depression is not normally an aspect of growing old, as many elderly people are able to enjoy their advancing years, even while managing the challenges of aging.
The Elderly and Depression
The loneliness, depression and sadness that the elderly feel, are often brought about by loss of someone close, or by the chronic changes of aging that include the loss of mobility and personal freedom, the need to depend more on others for daily personal necessities, the stiffness and pain in the joints and the need to take medication. These changes in the lives of the elderly may leave them feeling demoralized when once they were vibrant, healthy and independent individuals. This can produce a helpless, discouraging feeling that is not easily communicated to family members and even personal doctors. Doctors may not recognize the depression because they may be more focused on the physical symptoms of disease in the patient. Because the elderly may be alone, or even isolated because family and friends move away, they become even lonelier and it takes a longer period of time before the depression is spotted and treated. The depression may remain undetected for a long while because the elderly remain isolated, are reluctant to discuss their feelings, and because it is all too often assumed that the feelings and some of the symptoms seen are a natural consequence of the aging process. The cost of this oversight is quite high, as the untreated depression could result in prescription medication abuse, alcohol abuse, illness, high death rate and quite often suicide. But with the proper diagnosis of the condition, readily available treatment and support, the elderly will soon begin to feel much better about themselves and their lives.
Causes of Elderly Depression
Many circumstances in the lives of the elderly will cause onset of depression - such as illness, family history, lack of a support system and abuse of alcohol and drugs. Other factors include:
- Uncertainty and fear - Their inability to survive on Social Security benefits, the scare of increasing health issues, and also the fear of dying
- Debilitating health issues - Persistent chronic pain and physical disability and illness
- Losing a loved one - Losing a spouse and close friends or treasured household pets
- Loneliness - Lack of social interaction with others, and inability to be independently mobile because they can no longer drive themselves or are too ill to get out
- Medicines - Many medications cause depression the side effect
- Loss of drive - Loss of identity because of inability to be more active and participate socially, and the feelings of a lack of purpose in their lives
Elderly Depression Signs and Symptoms
The person suffering from depression is ill and this produces a bad effect on the quality of his life. The sign and the depression symptoms are as following:
- Fatigue - due to the inability to get well rested sleep
- Alcohol and Drug abuse
- Inability to sleep and sleeping too much - are due to mental fatigue brought on by great sadness and even though a person may sleep a lot, they are not well rested
- Persistent sadness - a common feeling in depression, and the affected person cannot cry
- Persistent thoughts of death and dying and even suicide
- Loss of self-esteem and self-worth
- Loss or gain in weight - appetite changes may occur and the depressed person may either lose or gain weight
- Lack of social interaction, and reluctance to leave the home
- Irritability and moodiness - the depressed person will distance themselves from those that are close to them, and may suffer from mood swings for no apparent reason
- Feeling hopeless - the depressed person may feel that nothing will get better and there is no point to living
How to Help Elderly People Suffering With Depression
Since the depressed person is unable to express their feelings adequately or even ask for assistance, it is critical that family and friends realize the suffering and seek medical treatment promptly, or the depression could develop into physical illness or may aggravate any illnesses the depressed person is currently suffering from. The following are ways anyone close to a depressed person can help.
- Seek medical attention for the depressed person - to rule out any other physical/medical conditions that may mask themselves as depression or cause a depression side effect
- Get your depressed loved one out of the home or his or her usual environment on a regular basis. You can take your loved one somewhere he or she previously enjoyed. Rent or borrow a wheel chair to make getting around easier
- Plan group activities with other individuals of the same age; they may be community members, friends or family
- Take an active interest in the person's eating habits. Help in the planning and preparation of healthy meals with them
- Be alert to the suicide warning signs, and if your loved one may be contemplating such a course of action, be sure to get immediate medical attention.
- Ensure that the depressed person is taking all medications as and how instructed often a depressed person can take steps to help themselves through their depression. Acknowledging the sad feelings, discouragement and depression is a good start and there is no shame in owning those feeling any more than there is in owning the feelings associated with any other illness.
Ways to Alleviate Depression
One of the key ways a depressed person can help themselves out of the depression, if they are able to, is to make a conscious effort to become and remain active on as many different levels as possibly, physically, socially and mentally. This will lift the spirits and will help ease the depression.
A Few Ways to Deal with Depression:
- Make plans to be among other people. Volunteering in hospitals or nursing facilities where you may read aloud to occupants, could be an avenue to pursue.
- Becoming involved in the daily activities of a senior center will foster social interaction and the development of various skills such as arts and crafts that may be taught there. It may even be possible to qualify for special free or reduced cost transportation to get to the center.
- Attend your favorite church on a weekly basis, especially if you can arrange to receive transportation. Some churches will have special activities for seniors and also support groups for assistance.
- Indulge in new hobbies and other activities you are physically able to manage. Look into different types of music that will lift you spirits.
- Visit the public library and get into the regular habit of reading, or listening to tapes or CDs. These activities will help you stay mentally active.
- Look for information regarding your circumstances from your local agency for aging issues, and read any good resources they provide.
- Keep open communication with your doctor, and inform him of any difficulty you are experiencing with the prescribed medication. Even difficulty with affording the medication, can be helped through you doctor and the patient assistant programs of many pharmaceutical companies. You may be able to receive medications either free or at a substantially reduced cost.
- Look after a pet if you are an animal lover. They will provide good company.
- Prepare healthy meals as directed by your doctor.
- Exercise regularly, and as appropriate for your physical condition - there are exercises available for everyone regardless of physical condition. You may even exercise from a wheelchair.
Profession Help for Depression
Professional medical help is also available for the treatment of depression in seniors in addition to self-help and the help of the support given by friends and family. A depressed senior's condition may be caused as a result of the his or her medication , by the medical condition he or she suffers from or even by the physiological changes he or she undergoes as a result of an aging body. Because of these factors, and before medical treatment can be administered to treat depression, the possible impact of these causes must first be ruled out. The doctor should know all the medications a patient is taking when he or she makes an appointment for a medical diagnosis of depression.
The effect of some medications to cause the side effect of depression, or aggravate the depression, is well documented for patients who are prescribed one or more medications to treat the following conditions:
- High bold pressure and heart disease medications
- Medication for arthritis
- Hormonal treatments
- Cancer medications
Additionally, because of the crippling, life-threatening and painful nature of some medical conditions, depression may often be suffered by those patients living with those illnesses.
These are a few that may lead elderly depression:
- Multiple sclerosis
- Parkinson's disease
- Alzheimer's disease
- Heart attack and heart disease
The emotional health and mood of a person can be affected by certain chemical imbalances in the body. These factors will need to be eliminated, prior to diagnosing a patient with depression. Included are:
- Nutritional deficiency of Vitamin B12 and nutritional deficiencies
- Thyroid irregularities
- Hormonal irregularities
- Electrolyte irregularities
After testing these possible causes for depression, and ruling out all as contributing to the depression, the choices left for treatment are counseling and therapy and the use of anti-depressant drugs. When treating a depressed senior, consideration has to be given to certain conditions that may be present at the same time as the depression, and may prevent effective treatment of the depression. These are usually health issues that are common among many elderly persons. One example of this is chronic pain. Chronic pain will contribute to depression and must be addressed as the patient is being treated for depression.
Treatment with Antidepressants
Antidepressant may take a long time to be an effective treatment of depression for the elderly, and there is concern that they may either refuse to take the antidepressant or forget to take it at all. There are serious side effects of taking antidepressants, such as fast bone loss caused by certain ingredients in some antidepressants, which then contributes to bone fractures and falls. Also antidepressants will not be an effective treatment of depression in those patients whose depression is caused by poor health and loneliness.
Treatment through Counseling and Therapy
Therapy has been found to be particularly effective in treating depression, has none of the adverse side effects of using antidepressants, and can be used to discover the true causes the patient's depression.
- The Cognitive-Behavioral approach helps patients look at their thinking patterns through exercises and discussions and it attempts to find out why they behave the way they do in different situations.
- Group Therapy-meetings are held with a trained therapist and a group in which the members all suffer with the same issues. Through the group discussions, solutions may be found and support is given to others as they grow together and share similar experiences.
- Support groups - these groups may provide social interaction for the depressed person, helping to reduce the loneliness and despair they feel because of the depression.
- Psychotherapy counseling works to help depressed people understand and come to terms with the losses and changes they are experiencing in their lives.
Elderly depression is a treatable condition, but its symptoms should be recognized early and promptly treated professionally, so that the quality of your loved one's live can be quickly restored to normal. There is a lot of help available; check with care providers like your medicare advantage. No one needs to suffer the pain and isolation of depression.
Elderly Depression Resources:
Guide to Elderly Depression - National Institute of Mental Health and the National Institute on Aging.
Understanding Geriatric Depression - ElderCare Online - Understanding signs and symptoms of depression in the elderly as well as a chart on distinguishing Depression from Dementia.
Overcoming Geriatric Depression -How You Can Help - Guide on how to talk to and meet the needs of an elderly person suffering from depression.
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