Depression in the Elderly

There are many things about growing older—friends or a spouse passing away, loneliness, job loss, illness—that make it seem as if feeling blue and sad is normal. But, it is important to realize that depression is not a natural part of the aging process.

It is a real issue in the senior population, and if someone you care about, like a parent or grandparent, is showing signs of depression it is crucial to reach out and offer help. Depression can be treated and successfully managed at any age.

If your older loved one occasionally feels sad or gets depressed for short periods after stressful life events, this is normal. Depression, on the other hand, is a serious mental illness and goes well beyond normal episodes of feeling down or blue. Major depression is diagnosed when a person feels sad and hopeless most days for two weeks or longer. The downswing in mood is severe and long-lasting enough to cause significant impairment in daily life.

Depression is a bigger problem in the elderly population than many people realize. If you have older loved ones, family members or friends, it is important to be aware of the statistics and the risks.

• Approximately 18 percent of adults over the age of 65 in the U.S. struggle with depression.
• Many older adults have had depression throughout their lives, but some experience first-time, late-life depression.
• Disability and being dependent on others are major triggers for depression in seniors.
• Many older adults fail to get treated for depression because they assume the low mood is normal and a part of aging.
• The second highest rate of suicides by age group is in adults 85 and older.
• By age and gender, men over 65 have the highest suicide rates.

Many of the risk factors for depression at any age also affect the elderly. Genetics and family history, having had another mental illness or previous bouts of depression, brain chemistry and structure, and a lot of stress can all predispose a senior or anyone of any age to experiencing depression.

It’s also important for you to understand the unique risk factors that older adults may face. If your loved one has any of these, be on the lookout for warning signs of depression. For instance, having a chronic illness can trigger depression, and seniors are more likely to be battling one or more diseases, like cancer, diabetes, or heart disease. Having a physical disability can also increase the risk of depression, as can being socially isolated or lonely. If your older family member has few social contacts, depression can be a real risk.

Other factors that may increase the risk of a depressive episode in older adults include taking certain medications that trigger depression, losing loved ones, having a brain disease like Alzheimer’s, lacking a sense of purpose with no job and no one to take care of, and financial stress.

You should be aware of the signs of depression in general, but also the specific symptoms that are more common in older adults. Whether the senior in your life has risk factors for depression or not, knowing these signs can help you intervene more quickly. The general diagnostic criteria for depression include a low mood, fatigue, loss of interest in activities, changes in eating and sleeping habits, feelings of worthlessness and guilt, difficulty thinking and concentrating, and suicidal thoughts.

The elderly may not show all of these signs, and they may exhibit different symptoms, which is one reason that diagnosis and treatment rates are low. Older adults with depression often don’t describe themselves as being sad, but their behaviors indicate depressed mood. Among the elderly, additional signs of depression may include:

• Memory problems
• Social withdrawal or isolation
• Weight loss
• Irritable mood
• Insomnia
• Confusion
• General complaints of pain, not related to a known condition
• Slowed movements and activity
• Neglecting hygiene and other types of personal care

The first and most important thing to do if you suspect your parent or older friend is depressed is to reach out and offer help. He or she needs to be screened by a mental health professional and then treated if depression is diagnosed. You may find a lot of resistance to this, because of denial or embarrassment, but being persistent and getting your loved one help is the only way that he or she will get better.

There are other things you can do to support a loved one struggling with depression and to help an older friend reduce the risk of developing depression:

• Spend time with your older loved ones. Isolation and loneliness are not uncommon in seniors, and spending time with them can make a big difference.
• Encourage more social connections. Help your loved one develop a better social network, through senior groups and community centers or family gatherings.
• Take your loved one to the doctor or to therapy. He or she may need extra encouragement to stick with treatment.
• Encourage hobbies and activities. Get your loved one involved in a new hobby or something they already enjoy, like ballroom dancing, painting, or a book club.
• Spend time with animals. Pets can do wonders for mood. If owning a pet is not reasonable for your loved one, look into animal therapy visits at senior centers or get him or her involved in the care of your pet.
• Do a volunteer job together. Having a purpose and feeling needed and useful can help someone with depression feel better.

Most importantly, your older loved one needs professional treatment if he or she has been diagnosed with major depression. This is not an illness that will simply go away; it requires ongoing, professional care. Typical treatment plans for depression include antidepressant medications and therapy. Antidepressants can be risky for older adults, so these should be tried with strict supervision.

Therapy, especially cognitive behavioral therapy, can be very useful for anyone living with depression. Ongoing therapy helps the patient learn to recognize triggers for depressed mood, use healthy coping mechanisms for stress, change negative thoughts and behaviors, set and achieve goals, and make positive, action-oriented lifestyle changes to relieve depression symptoms.

If you are worried about an older loved one in your life, it is essential to do something about it. Many seniors will not reach out for help and will never get diagnosed and treated. The consequences can be serious, ranging from poor quality of life to suicide. You can be a big part of helping your loved one feel better, by encouraging getting screened and treated and by getting involved in his or her life, taking steps to minimize depression risk and manage moods.

Depression Treatment at Bridges